Aptitude-based assignment of nurses to depressed patients

The study investigated the relationships between psychiatric nurse aptitudes and outcomes of depressive patients in residential psychiatric care. Upon admission, it is common practise for one nurse to be assigned to a patient for the entire hospital stay. Nurses differ individually. Depending on their professional rank (novice, proficient, master), nurses rely on other components of aptitude to care for their patients. Depending on a nurse's professional rank, other relationships exists between specific nurse aptitudes and certain changes in a patient's depressive feelings. Novice nurses should be assigned to patients that suffer more from performance impairment than negative attitudes towards self, whereas master nurses should be assigned to patients that suffer more from negative attitudes towards self than performance impairment. As a patient recovers, depressive feelings can change (e.g. switching from performance impairment to negative attitudes towards self). Our results suggest that nursing assignments should change in line with the dominant type of dysfunction displayed by the patient. This recommendation differs with current practises of assigning the same nurse to a patient for the entire hospital stay. Abstract In psychiatric units, head nurses face the daily challenge of assigning nurses to patients. The match between a patient and a nurse is not always optimal. This can hinder the therapeutic relationship. Aptitude is an important component of competence, especially for psychiatric nurses involved in therapeutic relationships. In this study, we undertook explorative research to investigate possible relationships between nurse aptitudes and outcomes in depressed patients. We found statistically significant relationships between specific nurse aptitudes, along professional rank, and particular patient outcomes. During the hospital stay, patients' depressive feelings change as they recover. Our results indicate that, as a patient's depressive feelings change, another type of nurse, one with an aptitude that supports the patient's current needs, should be assigned to care for that patient. This suggestion is at odds with current practises of assigning a patient to one nurse for the entire hospital stay

Validation of a new concept: aptitudes of psychiatric nurses caring for depressed patients

Validation is vital for operationalising a new concept into a measurement instrument. The measurement of human attributes is usually done with questionnaire items in ordered categories. Our objective was to validate a questionnaire capable of measuring, at the ordinal level, the aptitude of psychiatric nurses caring for depressed patients. We used expert panels, experimentation, categorical principal component analysis, and parametric and non-parametric item response theory to develop such a questionnaire and assess its validity. Expert panels delineated five aspects and 29 components of aptitude and formulated 32 items. Four consecutive exploratory experiments were performed to gauge and calibrate the items and their response categories into a semantic frame of reference and a socio-cultural and job context of nurses. This resulted in a questionnaire comprising three aspects of aptitude. Fourteen questionnaire items with a different number of response categories assessed aptitude. Appropriate techniques shed light onto how nurses understand and respond to items in the questionnaire. Before it can be reliably used in a different context, the questionnaire needs to be re-evaluated for validity. Moreover, validity needs to be re-established for translated versions. In conclusion, validation is a process. Understanding that the scope and limitations of a questionnaire develop as it is being used requires validity to be re-established at each step of development

Revision of the Belgian Nursing Minimum Dataset: from data to information

The Ministry of Public Health commissioned a research project to the Catholic University of Leuven and the University Hospital of Liege to revise the Belgian Nursing Minimum Dataset (B-NMDS). The study started in 2000 and will end with the implementation of the revised B-NMDS in January 2007. The study entailed four major phases. The first phase involved the development of a conceptual framework based on a literature review and secondary data analysis. The second phase focused on language development and development of a data collection tool. The third phase focused on data collection and validation of the new tool. In the fourth phase the validity and reliability of the dataset was tested. The new dataset is without avail if it is not leading to new information. Four applications of the dataset has been defined from the beginning: evaluation of the appropriateness of stay (AEP) in the hospital, nurse staffing, hospital financing and quality management. The aim of this paper is to describe how the B-NMDS can contribute to each of these applications

A nation-wide project for the revision of the Belgian Nursing Minimum Data Set : from concept to implementation

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