Benchmarking in nursing care by the RAFAELA patient classification system – a possibility for nurse managers

Purpose: This study was done to develop and validate a scale for assessing nursing needs on comprehensive nursing care units and to derive a patient classification system based on nursing needs.Methods: In this methodological study, the initial items were identified through a review of the literature and surveys from nursing staff regarding the nursing needs on comprehensive nursing care units. Content validity was evaluated by nine nursing staff members from comprehensive nursing care units. To evaluate the concurrent validity and derive a patient classification system, nursing needs scores, perceived nursing needs and perceived patient severity for 216 patient cases were evaluated by five nurses. These data were analyzed using Pearson‘s correlation coefficients, one-way ANOVA with Scheffépost hoc tests and K-means clustering.Results: After evaluating content validity, the developed scale contained 64 activities in two domains: nursing intervention and assistance of daily living. Concurrent validity was verified by analyzing the differences in the nursing needs scores according to each group of perceived nursing needs and severity (p<.001) and by analyzing the correlation between the score of the developed scale and the National Health Insurance Service nursing need assessment scale (r=.68, p<.001). Based on the score of the developed scale, a patient classification system that classified nursing needs into four stages was derived.Conclusion: The developed scale represented nursing activities in comprehensive nursing care units. It also provided specific data regarding the time spent on nursing activities. Therefore, it is expected to contribute toward establishing appropriate nurse staffing strategies to provide quality patient care.

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Patient classification system: a proposal to complement the instrument by Fugulin et al.

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692007000500015 ◽

2007 ◽

Vol 15 (5) ◽

pp. 980-985 ◽

Cited By ~ 12

Author(s):

Fernanda dos Santos ◽

Noemi Marisa Brunet Rogenski ◽

Cleide Maria Caetano Baptista ◽

Fernanda Maria Togeiro Fugulin

Keyword(s):

Classification System ◽

Patient Classification ◽

System A ◽

Bibliographic Search ◽

Wound Classification ◽

Operational Models ◽

Patient Classification System

Analysis of patient classification instruments available in the literature shows that many significant aspects related to the assistance to patients with wounds are not approached, evidencing the importance to elaborate criteria to assess these patients. This study proposes the development of new of areas of care to complement the Fugulin et al. instrument, validated by the Federal Nursing Council (COFEN). The construction of new areas to evaluate wounds was based on a bibliographic search on the operational models of the Patient Classification System (PCS), as well as on several instruments of wound classification. New areas of care were established, as follows: tissue impairment, number of dressing changes and time taken to their preparation. Values were also redefined indicating the patient's assistance category. The complementation of the Fugulin et al. instrument, proposed here, favors the application of this instrument in a more diversified group of patients since it adds a relevant assistance aspect, as the dressing issue.

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Gehaltesorg en koste-effektiewe dienslewering deur middel van ’n geoutomatiseerde pasientklassifikasiestelsel.

Curationis ◽

10.4102/curationis.v8i1.515 ◽

1985 ◽

Vol 8 (1) ◽

Author(s):

Mirinda Coetsee

Keyword(s):

Nursing Staff ◽

Classification System ◽

Quality Care ◽

Computer Software ◽

Cost Effective ◽

Patient Classification ◽

Patient Acuity ◽

Staffing Requirements ◽

Staffing Needs ◽

Patient Classification System

A patient classification system is used to classify patients according to the acuity of their condition and the amount of care which they need in order to determine staffing needs. Such a system enables optimal provision of nursing staff thus ensuring cost-effective quality care. A patient classification system must be tailored to the needs of each hospital to ensure reliability. There is an adaptable computer software program which is able to do all the calculations for a patient classification system. It provides valuable daily, weekly and monthly print-outs — such as summaries of patient acuity and staffing requirements for each unit and for the hospital as a whole.

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