Many different patient surveys are used to ascertain patient “satisfaction”. None of them allow patients to actually evaluate their nursing care. There is a discrepancy between measurement of “patient satisfaction” and a genuine evaluation of nursing care received.

But… what exactly constitutes “quality nursing care” from the patient’s point of view? No real criteria have been defined.

Until now.

This new assessment tool is called the “Patient’s Assessment of Quality Scale - Acute Care Version (PAQS-ACV). Through interviews with patients from medical, surgical and OB units in two different hospitals, researchers were able to produce initial questions/items for a tool that would allow a patient to evaluate their nurses.

Testing subjects were recruited over three years from 43 med/surg units at two rural hospitals, three urban hospitals, one university medical center and one Federal hospital. The initial survey was taken by 1, 470 patients.

The questions/items were grouped into five categories of factors:

• Individualization: nursing behavior toward the patient as an individual, using touch as reassurance, making the patient feel important, spending actual time with the patient and tending to minor needs without being asked to do so

• Nurse Characteristics: attitude and presentation (sensitivity, patience and efficiency)

• Caring: caring, trust, courtesy and competence

• Environment: noise in hall or room

• Responsiveness: how well the nurse anticipated the patient’s needs, how much self-care was encouraged, the promptness of the nurse and the perception that the nurse was there when needed

Two weeks later, ten percent of the research participants took a second survey, the PAQS-ACV 2. In this section, the patients were asked:

• What they said to friends and relatives about their hospital stay and their nursing care

• Would they want the same nurses caring for them should they be hospitalized again

• To compare the status of their health at the time of the PAQS-ACV2 to just before their hospitalization

The PAQS-ACV increases the ability to evaluate actual nursing care because the tool uses questions based on what the patient thinks is important. Patients view nurses as helping them cope and understanding how they feel in the environment. Patients believed that the competence of their nurses was a “given”, showing that patients value personal care over technical know-how.

Trying to measure nursing care or a specific nursing unit using a standard tool results in an inaccurate measurement. The researchers found that the most commonly used surveys include many items patients never even mentioned in the interviews (how hot the food was, for example).

The study on the PAQS-ACV continues.

Our hospitals have no idea what our patients value in us, the nursing staff. An evaluation tool such as the PAQS-ACV in the hands of our patients could remedy this situation.

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Lynn, M. R., McMillen, B. J., & Sidani, S. (2007). Understanding and measuring patient’s assessment of the quality of nursing care. Nursing Research, 56(3), 159-166.