Testing the Q-DIO as an instrument to measure the documented quality of nursing diagnoses, interventions, and outcomes.

PURPOSE: To describe pilot testing of Quality of Diagnoses, Interventions and Outcomes (Q-DIO), an instrument to measure quality of nursing documentation. DESIGN: Instrument testing was performed using a random, stratified sample of 60 nursing documentations representing hospital nursing with and without implementation of standardized nursing language (30 for both strata) in a Swiss General Acute Hospital. METHODS: Internal consistency and intrarater and interrater reliabilities were tested. Through item analyses, the grades of difficulty and the discrimination validity of items were evaluated. FINDINGS: Internal consistency of nursing diagnoses as process produced Cronbach's alpha .83; nursing diagnoses as product .98; nursing interventions .90; and nursing-sensitive patient outcomes .99. With Kappas of .95, the intrarater and interrater reliabilities were good. Criteria for the grades of difficulty of items and discrimination validity were well met. The results of this study suggest that Q-DIO is a reliable instrument to measure the documentation quality of nursing diagnoses, interventions, and outcomes. Further testing of Q-DIO in other settings is recommended