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Abstract
Introduction: Quality indicators are important for service management. However, in primary care, there is a shortage of indicators specifically regarding the elderly population. Objective: To build and validate process indicators of the quality of nursing care for the elderly. Methods: This is a methodological research, and the steps are based on proposals from the National Database of Nursing Quality Indicators and the Agency for Healthcare Research and Quality. The indicators were evaluated according to the criteria of face validity, terminology, necessity, content validity, reliability, viability, utility, and usability. Nine nurses participated in the expert panel, including professionals who provided primary care assistance, researchers in the area of health care for the elderly, and members of Brazilian health-related organizations. The Adequacy Method developed by Research and Development at the University of California Los Angeles was used. Data were analyzed using the median, Content Validity Index, and Kappa. Results: Twenty-two indicators were validated. All measures were considered appropriate, with content validity, and reached an agreement on terminology and necessity. Of the 22 indicators, only four were considered unavailable and impractical to collect. Thirteen indicators were not considered useful for determining the reception of financial incentives. In the assessment of usability to compare public reports, six indicators had relatively low scores. Conclusion: Indicators can contribute to monitoring the quality of care for the elderly, identifying opportunities for improvement in actions performed by nurses in primary care.
Highlights
Quality indicators are important for service management
To build and validate process indicators of the quality of nursing care for the elderly. This is a methodological research, and the steps are based on proposals from the National Database of Nursing Quality Indicators and the Agency for Healthcare Research and Quality
The steps for the construction of nursing care quality indicators were based on the development process proposed by the National Database of Nursing Quality Indicators (NDNQI)[10] and by the Agency for Healthcare Research and Quality (AHRQ)[11] (Figure 1)
Summary
Quality indicators are important for service management. in primary care, there is a shortage of indicators regarding the elderly population. Objective: To build and validate process indicators of the quality of nursing care for the elderly. The health system loses its effect as a social determinant of health, preventing its benefits for the health of the population[2] In this context, investment in primary health care is considered a fundamental principle for success in this subject[1]. The quality of care can be monitored or assessed through three dimensions related to the structure, the process, and the result. According to Donabedian[4], the process is the only direct way to assess quality This is because the good structure may not be used to implement good practices, and the good or bad results do not always occur due to health care[4]. The process denotes what is done in the assistance/care to the individual, as well as the professional’s activities related to the diagnosis, recommendation, or implementation of the treatment[4]
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