Determining older people’s needs for care by Registered Nurses: the Nursing NeedsAssessment Tool

Aims. This paper reports a study to determine an appropriate framework for assessingolder people’s needs for nursing within the policy of ‘free nursing’, and to attempt toidentify valid, reliable and usable assessment tool for determining this eligibility.Background. In 2001, the United Kingdom government introduced ‘free nursing care’legislation, eligibility for which was subject to a nursing needs assessment. This paperoutlines the search for and subsequent development of an appropriate tool for assessingolder people’s eligibility for free nursing care in Northern Ireland.Methods. Following a systematic search of the literature, existing tools used inascertaining older people’s nursing needs were identified. Each tool was systematicallyassessed in accordance with criteria of validity, reliability, usability, comprehensivenessof assessment and ability to quantify nursing care needs. From the findings, anassessment instrument, Nursing Needs Assessment Tool was subsequently developedand tested. Paired assessments of older people were undertaken independently byassessor dyads and evaluated statistically. Assessors’ opinions on the usability of theinstrument were sought through a focus group.Results. One hundred and ten paired assessments were returned (63%). Overall therewas 65% agreement between assessors. Kappa scores indicated good levels of interraterreliability. Correlation co-efficient measures reinforced these results. Findingsfrom the focus group confirmed the validity, usability and comprehensiveness of thetool.Conclusions. The Nursing Needs Assessment Tool is a reliable, valid and usableinstrument. This has major implications for the standardization of assessment forolder people.