Page 460 - Encyclopedia of Nursing Research

QuAlITy OF lIFE n 427

standardized nursing languages as content measurement programs that provide infor-
areas for nursing. The Nursing Outcomes mation to consumers.
classification (NOc; Moorhead, Johnson, The public health imperative and chal- Q
& Maas, 2004) was developed to mea- lenges to measure quality and improve
sure the effectiveness of nursing interven- patient outcomes are not new issues in the
tions. used with the Nursing Interventions health care system. There is evidence that the
classification and diagnoses from the North genesis of a paradigm shift in the health care
American Nursing Diagnosis Association quality and safety movement is underway.
international, the outcomes are designed What can be viewed as a fourth component
to measure the effectiveness of the nursing has recently been added to Donabedian’s
process. linkage of these three classifica- three-component quality evaluation model:
tions through a recent publication assists The fourth component is an economic incen-
nurses and students to use these languages tive to improve patient outcomes, that is, hos-
more effectively (Johnson et al., 2001). The pitals will no longer be paid for additional
NOc has 330 outcomes that measure along costs associated with certain preventable hos-
a continuum an individual, family, or com- pital medical errors, HAcs. Attention must
munity state, behavior, or perception in remain on these key four factors as nurses
response to a nursing intervention. Each and other health care providers develop bet-
outcome has an associated set of indicators ter structures, processes, outcome measures,
that are measured to determine the patient, and awareness of HAcs to evaluate and
family, or community status in relation to improve the effectiveness of the care we pro-
the outcome. Examples of some of the out- vide. This desire and support for providing
comes relevant to a discussion of quality are safe, high quality of care is central to nursing
pain control, symptom control, quality of practice.
life, participation in health care decisions,
asthma self-management, cardiac disease Patti Hart O’Regan
self-management, risk control, and knowl-
edge disease process. use of this classifica-
tion in practice settings with an evaluation
of the outcomes achieved provides needed Quality of life
knowledge to nurses related to the effec-
tiveness of the interventions provided and
the care planning process. This evaluation Although quality of life (QOl) holds
of real patient data on outcomes allows for inherent meaning to most people and has
a continual review of the structure, process, been studied extensively in a broad range
and outcomes of nursing care. of contexts and from various research
The current environment also is chal- perspectives, the precise definition and
lenged to meet patient expectations. Because measurement of QOl remains elusive.
of this, NOc has added 14 client satisfaction Differences in how QOl is operationalized
outcomes to measure patient perceptions of have made comparisons between studies
their care. Private nonprofit organizations difficult (Garratt, Schmidt, McIntosh, &
such as the National committee for Quality Fitzpatrick, 2002). QOl is composed of
Assurance have been created to improve broad concepts of life satisfaction and
health care. This organization evaluates welfare, including adequate social, educa-
health plans in the areas of patient safety, tional, environmental, political, and eco-
confidentiality, consumer protection, nomic conditions, including accessibility;
access, and continuous improvements. They family safety and well-being; leisure pur-
have both accreditation and performance suits; and physical, emotional, and spiritual