A new measure of parent satisfaction with medical care provided in the neonatal intensive care unit.

The objective of this study was to develop a valid and reliable discriminative index that measures parent satisfaction with the medical care of their infant in the NICU. We developed an initial questionnaire (Item Reduction Questionnaire) by reviewing the literature, surveying 63 NICU clinicians, and interviewing 125 parents of infants in 2 tertiary level NICUs regarding what they liked and disliked about the medical care of their infants. We administered the Item Reduction Questionnaire, which included 154 items, to 60 parents, who rated the frequency and importance of these items. We included the items identified most frequently as sources of dissatisfaction and rated most important in a second, briefer instrument, the Neonatal Index of Parent Satisfaction (NIPS). To measure reliability we administered the NIPS to 47 parents twice, separated by a 1-week interval. We assessed validity by comparing actual to predicted correlations between NIPS scores and other measures: parent's global rating of satisfaction, medical caregiver ratings of mother's satisfaction, medical caregiver ratings of father's satisfaction, and parents' perception of their infant's health status. We also compared mean NIPS scores for parents who did and who did not report incidents when errors occurred in the medical care of the infant. Of 154 items generated, we included 27 in the NIPS. The intraclass correlation between two administrations of the NIPS to the same 47 parents was 0.71. As predicted, there was a high correlation (0.61) between the NIPS score and parent global rating of satisfaction, and much lower correlations with other variables. Mean NIPS scores for parents who did and who did not report errors differed significantly (difference, 14.6; 95% CI around difference, 5.8-23.5; p < 0.001). The NIPS is likely to be a useful measure for discriminating between parents who differ in terms of their satisfaction with the medical care of their infant in the NICU.

Community as client: a challenge for nursing education.

The mandate of public health departments has been, and continues to be, to provide and deliver a variety of health programs and services pertinent to local circumstances and needs. Public health nurses are the largest group of health care professionals who deliver these services. The objectives of this paper are to identify what policy makers expect of public health nurses related to community development for health, and to describe the educational components necessary for baccalaureate nursing curricula if these expectations are to be met.

Validation of a survey instrument to measure the extent to which physician and dentist office environments discourage smoking.

The health professional's office environment has been identified as one of the potential influences on smoking behaviour of patients. This study compared characteristics of office smoking policies and environments of 30 physicians and 30 dentists using both telephone survey and site visit. The site visit was considered the 'gold standard'. The sequence of interview presentation was randomly reversed for half the physicians and half the dentists to control for order effects. Kappa estimates and two-way Analysis of Variance were used on categorical and continuous variables, respectively. The results show there was a high agreement between the two modes of surveying. Physicians and dentists do not differ in level of agreement and in the consistency of responses obtained by telephone and site visit. We conclude that a telephone survey is a valid method to obtain smoking-related information from health professional offices.

Student nurse computer experience and preferences for learning.

Seventy-three third and fourth year generic baccalaureate and post-RN university nursing students aged 20-50 years responded to a survey designed to assess their experience with and interest in use of computers for nursing. The survey included questions about use of computers for educational purposes, nursing practice, and nursing administration. There was much variation between student actual and preferred experience. In general, students showed the strongest preference for learning applications for clinical practice, and less interest in learning about those for education and administration. The results of the survey show that these students would like more knowledge and skills to prepare them for careers in our increasingly computerized health care environment.

Experiences of nursing joint appointments in a teaching health unit.

This article describes the experiences of five community health nursing faculty who are jointly appointed between McMaster University School of Nursing and the Hamilton-Wentworth Department of Public Health Services in Hamilton, Ontario, Canada. The appointees are actively involved in service, education, and research activities within the teaching health unit, a specially funded project of the Ontario Ministry of Health. Various kinds of consultation and expertise are offered by joint appointees to staff and management within the Department of Public Health Services. The amount of time and effort invested in a particular activity or project varies as staff, students, and joint appointees each make their contributions. Several lessons are learned in acting out our diverse roles in this exciting and challenging service environment.