Expertvalidering av Oulu Patient Classification — En fas i utvecklingen av ett nytt system för vårdtyngds-klassificering, RAFAELA

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Abstract
During the 1990s patient classification has once more become a topical theme for nurse managers in the Nordic countries. At the Vasa Central Hospital in Finland a research project concerned with patient classification has been going on since 1994. This article has two aims: to present on the one hand a new system of patient classification, RAFAELA, developed at the Vasa Central Hopsital and on the other hand research results from a study on the content validity of a relatively new instrument for patient classification, the Oulu Patient Classification (OPC). The RAFAELA system is based on the OPC instrument and on the method of «Professional Assessment of Optimal Nursing Care Intensity Level» (PAONCIL). On the basis of earlier research on patient classification it can be noted that economic and administrative motives have dominated and that caring science has not consituted a clear theoretical point of departure. In this article the caring science basis for the development of the RAFAELA system and its structure as well as topical research results concerning the PAONCIL method are presented. The sample for the study of content validity consisted of 68 nurses, who by the aid of a validation instrument evaluated the content validity of the OPC basic manual. According to this panel of experts, patient classification by means of the OPC can be regarded as valid; the method is considered to give a realistic picture of the patient's nursing care intensity. But there are certain weaknesses that the expert panel think should be attended to, above all the content of subareas of needs 1 and 6 in the basic manual. The psychic and spiritual needs as well as the nursing care acitivities connected with these need to be clarified. The RAFAELA system constitutes an efficient instrument for managing nursing care and is at the same time a method by means of which the content of nursing care can be developed.

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