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Kim, Kim, and Kim: Development of Patient Classification System based on Nursing Intensity in Stroke Unit
Original Article

Journal of Korean Academy of Nursing Administration 2014; 20(5): 545-557.

Published online: 31 December 2014

DOI: https://doi.org/10.11111/jkana.2014.20.5.545

Development of Patient Classification System based on Nursing Intensity in Stroke Unit

Eunjung Kim1, Heejung Kim1, Miyoung Kim2

1Graduate School, Ewha Womans University, Korea.

2Ewha Womans University, College of Health Sciences, Division of Nursing Science, Korea.

Corresponding author: Kim, Miyoung. Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 120-750, Korea. Tel: +82-2-3277-6694, Fax: +82-2-3277-2850, mykim0808@ewha.ac.kr

Received 29 July 2014       Revised 2 September 2014       Accepted 29 September 2014

Copyright © 2014 Korean Academy of Nursing Administration

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to develop a patient classification system based on nursing care intensity for patients with acute stroke-related symptoms and verify its validity and reliability.

Methods

Data were collected between November, 2013 and February, 2014. The verification for content validity of the patient classification system was conducted by a group of seven professionals. Both interrater reliability and concurrent validity were verified at stroke units in tertiary hospitals.

Results

The intensive nursing care for acute stroke patients consisted of 14 classified domains and 56 classified contents by adding 'neurological assessment and observation' and 'respiratory care': 'hygiene', 'nutrition', 'elimination', 'mobility and exercise', 'education or counselling', 'emotional support', 'communication', 'treatment and examination', 'medication', 'assessment and observation', 'neurological assessment and observation', 'respiratory care', 'coordination between departments', and 'discharge or transfer care'. Each domain was classified into four levels such as Class I, Class II, Class III, and ClassIV.

Conclusion

The results show that this patient classification system has satisfactory validity for content and concurrent and verified reliability and can be used to accurately estimate the demand for nursing care for patients in stroke units.

Keywords: Nursing care, Stroke, Classification, Patients

Figures and Tables

Table 1
General and Clinical Characteristics of the Patients (N=23)
jkana-20-545-i001

NIHSS=National Institute of Health Stroke Scale.

Table 2
Direct and Indirect Nursing Care Time and Frequency per Day
jkana-20-545-i002

NIHSS=National Institute of Health Stroke Scale; LOC=Level of consciousness; BP=Blood pressure; PR=Pulse rate; RR=Respiration rate; SpO2=Saturation of peripheral oxygen; EKG=Electro cardiogram.

Table 3
Final Patient Classification System in Stroke Unit
jkana-20-545-i003

NIHSS=National institute of health stroke scale; NPO=Nothing per oral; ECG=Electro cardiogram; ICU=Intensive care unit; CT=Computed tomography; ERCP=Endoscopic retrograde cholangiopancreatography; IV=Intravenous; V/S=Vital sign; BP=Blood pressure; I/O=Input/output; U/O=Urinary output.

ClassI: 14~20, ClassII: 21~34, ClassIII: 35~48, ClassIV: 49~56 point.

Table 4
Inter-rater Reliability and Concurrent Validity
jkana-20-545-i004

PCS=Patient classification system; ICC=Interclass correlation.

Notes

The work was supported by the 2013 research grant fund in Korean Academy of Nursing Administration.

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