Measuring the intensity of nursing care: Making use of the Belgian Nursing Minimum Data Set

• Published in: International journal of nursing studies Vol. 45; no. 7; pp. 1011 - 1021
• Main Authors: Sermeus, Walter, Delesie, Luc, Van den Heede, Koen, Diya, Luwis, Lesaffre, Emmanuel
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.07.2008; Elsevier Limited
• Subjects: Belgium; Classification; Health care policy; Intensity of nursing care; Intensive care; Measurement; Nursing; Nursing Care; Nursing minimum data set; Nursing Staff, Hospital; Patient classification system; Quality of care; Retrospective Studies; Staffing; Belgium; Nursing minimum data set; Intensity of nursing care; Patient classification system
• ISSN: 0020-7489; 1873-491X
• DOI: 10.1016/j.ijnurstu.2007.05.006

The Belgian Nursing Minimum Data Set (B-NMDS) is a nationwide registration of 23 nursing activities. It was developed for the measurement of nursing care in acute hospitals. It is used to support healthcare management & policy decision making such as hospital financing and nurse staffing decisions. To develop a measure of the intensity of nursing care based on information that is available in the B-NMDS. Retrospective analysis of the B-NMDS from all Belgian acute hospitals ( n=115) for the year 2003. The sample included 690,258 inpatient days for 298,691 patients that were recorded from 1637 acute care nursing units. The 23 nursing activities were synthesized into one new latent variable by PRINQUAL analysis. This variable was evaluated as a measure of nursing care intensity using key characteristics of the San Joaquin patient classification system, which was designed to measure the intensity of nursing care. The main NMDS component from the PRINQUAL analysis accounted for 26.8% of the variance. The distribution of inpatient days over all four San Joaquin categories is: 11.1% (self-care); 40.4% (average care); 30.8% (above average care); 17.7% (intensive care). In 97.5% of the nursing units the intensity of nursing care score of the B-NMDS (main NMDS component) followed the ordinality of the San Joaquin classification system. Furthermore, the San Joaquin categories alone explained more variability—70.2% in the intensity of nursing care measure (main NMDS component) than did other determinants, such as department type, age, diagnostic-related groups (DRG) and severity of illness, hospital type and hospital size together. The B-NMDS is an instrument that produces a measure of the intensity of nursing care in acute hospitals.