Nursing Surveillance in the Acute Care Setting: Latent Variable Development and Analysis

Abstract

The nursing profession has utilized a variety of terms to describe the work that nurses do, such as observing, monitoring, and critical thinking. Nursing surveillance is a term emerging in the research and clinical environment to describe the care, both seen and unseen, by professional registered nurses. It has been described as a complex, multi-dimensional concept that influences patient outcomes, yet little research has been done to examine the concept, how it is measured, and its role in outcomes.The surveillance process includes ongoing data collection, interpretation, and synthesis for decision making. This research proposes that nursing surveillance is comprised of five dimensions: actions, expertise, early recognition, intuition, and decision making. The purpose of this study is to examine the dimensions of nursing surveillance in the acute care setting.This study used a descriptive design to survey nurses on the dimensions of nursing surveillance. The survey consisted of four existing instruments measuring expertise, early recognition, intuition, and decision making, and one new instrument measuring activities associated with nursing surveillance. A content review panel was used to develop the new Nursing Surveillance Activities Scale. A sample of 158 medical-surgical nurses participated in completing the full Nursing Surveillance Survey.The goal of the analysis was to determine how well the dimensions represented the surveillance variable; however, based on sample size, revisions to the methods were made. Factor analysis was used to analyze each instrument's items and total representation of the variable. The instruments performed adequately in psychometric testing, and modifications were made so composite development could be achieved. The dimensions were factored as a composite variable and four of the five dimensions loaded onto a single variable, while the activities dimensions loaded separately. These results can be explained through a theoretical difference between the dimensions or limitations with the newly created Nursing Surveillance Activities Scale.This study identified a relationship between the four cognitive dimensions of nursing surveillance and their representation of the variable. Future research in nursing surveillance should analyze the role of the nursing surveillance variable, including the relationship to nursing outcomes.