How the reliability and validity of the patient classification system can be ensured in daily nursing work? A follow-up study

Jaana K. Junttila, Kaisa Haatainen, Aija Koivu, Pirkko Nykänen

Research output: Contribution to journalArticleScientificpeer-review

3 Citations (Scopus)
49 Downloads (Pure)

Abstract

Abstract Aims and Objectives This study aimed to determine the reliability and validity of the RAFAELA patient classification system (PCS) for qualified and efficient nurses. Background The number of patients per nurse or diagnosis-based determination of nursing workload are imprecise measures that do not consider the variation in patients' care needs. Ensuring the reliability and validity of the RAFAELA is important for the efficient allocation of nursing resources. Methods In this study, we investigated how the maintenance (parallel classification measurement and professional assessment of optimal nursing care intensity level measurement) of the RAFAELA was done with 9?years of follow-up data. The results were analysed using quantitative methods supplemented with qualitative audit descriptions. The STROBE checklist was used. Results The RAFAELA was used continuously in 44?units (40%). The length of use of the RAFAELA influenced the success of parallel classification measurements. Six per cent of units passed parallel classification measurement over 75% after 1?3?years' use, 42% after 4?6?years and 83% after 7?9?years. Among the units that used the RAFAELA PCS continuously, only four (9%) passed the professional assessment of optimal nursing care intensity level measurement. Conclusions This study shows that ensuring the reliability and validity of the use of the RAFAELA is laborious, requires several years of use and continuous investments in nurses' skills and motivation. Relevance to Clinical Practice Qualified use of PCS is challenging, and organisations should invest to maintenance, training, support and user motivation. Each patient should be classified comprehensively, and nursing resources should be calculated correctly. In addition, utilisation of the nursing intensity level should be maximised. Clinical Trial Registration Number Kuopio University Hospital organisation permit number 73/2014. Patient or Public Contribution Information regarding individual patients or nurses was not available to the researchers. All materials are in the form of summary tables.
Original languageEnglish
Pages (from-to)3720-3729
Number of pages10
JournalJOURNAL OF CLINICAL NURSING
Volume32
Issue number13-14
Early online date2022
DOIs
Publication statusPublished - 2023
Publication typeA1 Journal article-refereed

Keywords

  • HIS, HRIS, maintenance, patient classification system, PCS, RAFAELA, reliability, validity

Publication forum classification

  • Publication forum level 2

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