Assessing variation in quality of care in ambulatory chemotherapy units: a feasibility study to develop and implement nurse-sensitive outcome indicators in the Kingdom of Saudi Arabia

Abstract

Background: The quality of patient care is a universal concern among healthcare managers, policymakers and consumers. In order to benchmark and improve patient outcomes and demonstrate the impact of high-quality care provided by ambulatory chemotherapy services (ACSs), it is important to develop patient-reported nurse-sensitive indicators, specific to chemotherapy-related symptoms and experiences of supportive care. This study builds on previous work by Armes et al. (2014) who developed the Patient-Reported Chemotherapy Indicators of Symptoms and Experience (PR-CISE).

Aims: This study aims to explore a range of methodological and feasibility issues that relate to the development and implementation of Nurse-Sensitive Outcome indicators (NSOIs) and associated tools in the Kingdom of Saudi Arabia (KSA). It also aims to establish whether variability exists in Nurse-sensitive Outcomes (NSOs) amongst ambulatory chemotherapy units in the KSA.

Methods: This study employed a descriptive, cross-sectional survey with two preparation stages. In Stage I, instrument items were developed. Two rounds of cognitive interviews were conducted with 10 patients to ensure the clarity, comprehensiveness and appropriateness of the proposed questionnaire (a translated Arabic version of the PR-CISE tool). In Stage II, the feasibility of delivering the protocol was evaluated and the questionnaire piloted with 30 cancer patients undergoing chemotherapy in a single centre. Moreover, a data collection tool that describes the characteristics of chemotherapy units and provides contextual data (on unit size, staffing, etc.) were tested. Finally, a small-scale survey was implemented. Survey data were collected from five ACSs located in the two largest regions in the KSA, using the last version of the questionnaire and the aforementioned tool developed for this study.

Results: The cross-sectional survey confirmed that survey processes were efficient. The Arabic PR-SICE questionnaire was acceptable and may be used to generate evidence about NSOs in ACSs in the KSA and inform future policy and practice. A total of 748 completed questionnaires were returned and the response rate was 93%. Significant differences were observed in the distribution of the severity of symptoms between ACSs in six out of seven studied symptoms. A large-scale survey of NSOs is feasible, acceptable and recommended, and can be largely implemented as planned.

More information

Identifiers

ORCID for Alison Richardson: orcid.org/0000-0003-3127-5755

Catalogue record

Export record