Over 150 nurses rated 5,460 patient visits using the PINAC during the study period.
These two diverse settings were used since it is important to determine whether PINAC can be used reliably across a variety of patient populations and types of nursing practice.
Nurses were trained and tested in their use of the PINAC following a general strategy developed for use with PINI (Castorr et al.
Training consisted of two didactic group sessions of about 2 hours in length to explain the PINAC and its proper use.
In its original form, PINAC contained seven items which reflect the conceptual components of the measure -- patient needs for care and complexity of the care and services delivered to the patient.
Based on rater training and a set of decision rules, the nurse selects one of the five ordered levels of nursing intensity as the basis for scoring the PINAC items.
The PINAC and PINI from which it is derived, can be used for all of the purposes previously identified in Figure 1.
In addition to determining outcomes of care for an individual patient as a guide to the clinician providing care, outcomes for groups of patients can be examined using PINAC item level scores.
Another potential use of PINAC data involves using subscores associated with conceptual components of the measure.
Finally total PINAC scores can be related to hours of care through work sampling studies to yield the traditional algorithms for projecting staffing.
The PINAC is one effort to create a multiple use PCS that is short and easy to use as well as conceptually based.
Nurse managers and nurse executives can use data from PINAC and PINI for a variety of research, quality assurance, and administrative purposes as illustrated in Figure 1.