A tool, Patient Indicators of Nursing Care, was designed to measure quality of nursing care, defined in this study as prevention of nursing care complications. Nursing—accountable complications are seen as the presence of negative patient care outcomes as evidenced by observable physiologic indicators. A negative outcome results when either an observed indicator which was present at admission remains evident up to seven days postadmission or an absent indicator becomes evident during this time period. PINC is a 24-item list. The list is first administered up to 48 hours postadmission; the second administration lakes place between five and seven days postadmission. Scoring of PINC is based on the idea that four important presence-absence conditions exist and that each represents a value of quality of nursing care. Split-half reliability was computed for PINC, based on a sample of 124 patients from four hospital settings. The Spearman-Brown reliability coefficient was .871. An item analysis was accomplished by computing the correlation of each item with the total score. The computed correlation of .797 was a measure of interrater agreement. Face validity was established early in the test development by having the investigators judge the items in terms of observability, availability, and credibility. Predictive validity was not explicitly examined although a major difference in PINC scores was found between critical care patients and other groups.
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