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46 Musculoskeletal & Neurological Rehabilitation KCE reports 57
analysis of the scales, obstacles are seen to the development of a standardized approach to
post-acute care quality assessment related to the potentially different characteristics in
patient populations served by different types of providers. Bryant et al conclude that it
may not be possible to construct a single dataset that by itself meets all needs in each
setting. However, a single core set of measures applicable to all settings is considered to
be useful for assessing quality, facilitating transfers between providers, and minimizing any
data collection burden for healthcare professionals.
4.3 THE BELGIAN NURSING MINIMUM DATA SETS
4.3.1 Background
The Belgian Nursing Minimum Data Set (BNMDS) is a registration of nursing activities
implemented nationally in 1988. Four times per year, during a two-week period, patients
in hospitals are scored on the level of nursing activities. The results of these scores are
presented as so called “fingerprints” of hospital departments, projected on a national map.
The reference for this national comparison is the “average” Belgian nursing unit.
4.3.2 Fingerprints of rehabilitation departments
The fingerprints identify the nursing care on a nursing department organised around 23
activities (see Appendix to chapter 4) The fingerprint is presented as horizontal
histogrammes for each of the 23 dimensions. Each variable is scored between -0,5 and
+0,5. A score 0 implies that the department scores identical to the average Belgian nursing
department. The calculations of the scores are based on a Ridit-analysis.
• Example: The reference value 0 for the dimension “hygiëne”, is based on
the observation that 35% of the patients in general hospitals is not
getting help in hygienic care, 30% is receiving supportive help, 20% partial
help, 15% full help. Each nursing unit is then compared to this reference
point. A higher percentage patients needing a higher level of care, will
lead to a positive score on the fingerprint. A lower percentage of
patients needing more care will lead to a negative score
Figure 4.1 is an example of a 1998 fingerprint of an average Belgian “locomotor”
rehabilitation department, and Figure 4.2 of an average Belgian “neurological”
rehabilitation department. These average departments are characterized by a large (always
compared to the average nursing unit) amount of basic nursing care (hygiene, mobility,
excretion and nourishment), a lot of day clothing tasks, comfort care (special mouth care
and pressure ulcer care), and training for independency (programme). The units have little
technical nursing care. Figure 4.2 shows a similar fingerprint of an average Belgian
neurological rehabilitation department.