An exploratory analysis of the nurse dependency of patients with burn injuries using data collected in a national burn injury database

Leaver, Jane (2021) An exploratory analysis of the nurse dependency of patients with burn injuries using data collected in a national burn injury database. Doctoral thesis, Birmingham City University.

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Abstract

It has long been recognized that poor nurse staffing levels can have a detrimental effect on patient care and outcomes. Yet there is a lack of validated UK nurse dependency tools available to predict or support staffing levels and none specifically related to burn care. The international Burn Injury Database (iBID) has been collecting data on the nurse dependency of patients with a burn injury alongside information on their burn injury from specialised burn services in England and Wales.

The aim of this research was to “explore the nurse dependency data contained within iBID; to gain an increased understanding of nurse dependency in relation to burn injuries and to assess if iBID contained information that could be used to predict nurse dependency of acute burn inpatients and help with nursing staff planning”.

An observational exploratory study approach was undertaken. First, to ascertain whether the iBID nurse dependency tool measured nurse dependency it was compared to the Safer Nursing Care Tool (SNCT) tool, the most commonly used nurse dependency tool in the UK. Nurses in three burn services scored the nurse dependency of their burn-injured patients daily using both nurse dependency tools as well as fictional case studies to assess inter-rater reliability. The results were analysed using Spearman correlation and Krippendorff alpha. Secondly, the nurse dependency data from iBID was analysed. Multiple regression was used to build a predictive nurse dependency model and the nurse dependency trajectories were plotted to understand how staffing levels are influenced by the recovery pathway a patient may be on.

This research has shown a correlation between the iBID nurse dependency tool and the SNCT scores suggesting that the iBID nurse dependency tool does indeed measure aspects of nurse dependency. There is a positive relationship between nursing dependency and burn severity. In particular, the size of the burn has been shown to have an influence on the nursing dependency trajectory over a patients’ stay. Moving forward this may be used to help predict nursing workload for a group of patients in advance and whether the individual patient’s stay is likely to be longer than 1 day/percentage burn. The regression modelling has highlighted several variables that have predictive properties. The variables that had some clinical judgement associated with them appear to be better predictors than pure objective variables, thus giving weight to the argument that ND tools should be used alongside professional judgement.

Item Type: Thesis (Doctoral)
Dates:
DateEvent
August 2021Submitted
Uncontrolled Keywords: Nurse Dependency, Burn, Burn-injury, International Burn Injury Database (iBID), Safer nursing Care tool, iBID nurse Dependency tool
Subjects: CAH02 - subjects allied to medicine > CAH02-04 - nursing and midwifery > CAH02-04-01 - nursing (non-specific)
CAH02 - subjects allied to medicine > CAH02-04 - nursing and midwifery > CAH02-04-02 - adult nursing
CAH02 - subjects allied to medicine > CAH02-04 - nursing and midwifery > CAH02-04-09 - others in nursing
Divisions: Doctoral Research College > Doctoral Theses Collection
Faculty of Health, Education and Life Sciences > School of Nursing and Midwifery
Depositing User: Richard Birley
Date Deposited: 25 May 2022 12:28
Last Modified: 25 May 2022 12:28
URI: http://www.open-access.bcu.ac.uk/id/eprint/13254

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