Tuesday, November 3, 2009: 1:55 PM
Karole Mourek, PhD
Consulo Inc, Chicago, IL
Katia Grillo Padilha, PhD
School of Nursing, University of São Paulo, São Paulo, Brazil
Kenneth W. Colbert, MS
Research, QuadraMed Corporation, Chicago, IL
Ana Maria Tranquitelli, PhD
School of Nursing, United Metropolitan Faculties, São Paulo, Brazil
Learning Objective 1: identify all aspects of a crosscultural workload instrumentation validation process.
Learning Objective 2: identify the process for comparing resource allocation and patient outcomes incorporating workload controls, temporal dimmensions and multiple levels of analysis.
Although patient care needs are independent of where nursing care is delivered, there exists little documentation of cross-cultural studies in workload measurement instrument translation, validation and reliability. Further, there are almost no published cross-cultural studies comparing resource allocation to nurse sensitive patient outcomes using shared instruments and methodologies.
This project began in 2000 as a collaborative effort between Brazilian and United States researchers. In the initial phase of collaborative work the research goal was to add to the body of research on patient-centered nursing care workload measurement by establishing the validity and reliability of instruments which could be used to generate global databases for future use in patient-centered workload analysis research. The study design included selection of an instrument, language translation, reliability testing, application and evaluation.
The resource management instrument selected was one which has been used in over one hundred United States hospitals and generates a large research database which has been used over the past decade to analyze relationships between resource allocation and patient outcomes. Several of the larger studies have been published and presented at both national and international conferences. The selected methodology provides data on daily patient care nursing workload including separate measures of acuity and care complexity. The transportable instrument allows the researcher to compare at the hospital, service, unit level both required and actual staffing allocation. It also provides a powerful model for comparing nursing resource allocation to nurse-sensitive patient outcomes.
Once translation and cross cultural validity and reliability factors were tested and the team was assured of the instrument’s cross cultural value, the study population was expanded to include medical surgical patients in multiple Brazilian hospitals. Results of these studies were also compared with the larger established United States database.
The next step was to examine cross culturally patterns of relationships between resource allocation and patient outcomes. The team has built and tested a model which adds refined “temporal dimensions” that allowed the researchers to compare resource allocation measures and nurse-sensitive outcome data within the most relevant timeframes.
This cross-cultural research team’s goal is to improve research models and build international databases that promote a platform for global nursing research in the field of resource allocation. Such databases would support evidence-based decision making in practice and policy.
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