Measuring nurses' impact on health care quality: progress, challenges, and future directions.

Susan L Beck, Marianne E Weiss, Nancy Ryan-Wenger, Nancy E Donaldson, Carolyn Aydin, Gail L Towsley, William Gardner
Author Information
  1. Susan L Beck: University of Utah College of Nursing, Salt Lake City, UT 84112, USA. susan.beck@nurs.utah.edu

Abstract

BACKGROUND: Quality measurement is central in efforts to improve health care delivery and financing. The Interdisciplinary Nursing Quality Research Initiative supported interdisciplinary research teams to address gaps in measuring the contributions of nursing to quality care.
OBJECTIVE: To summarize the research of 4 interdisciplinary teams funded by The Interdisciplinary Nursing Quality Research Initiative and reflect on challenges and future directions to improving quality measurement.
METHODS: Each team summarized their work including the targeted gap in measurement, the methods used, key results, and next steps. The authors discussed key challenges and recommended future directions.
RESULTS: These exemplar projects addressed cross-cutting issues related to quality; developed measures of patient experience; tested new ways to model the important relationships between structure, process, and outcome; measured care across the continuum; focused on positive aspects of care; examined the relationship of nursing care with outcomes; and measured both nursing and interdisciplinary care.
DISCUSSION: Challenges include: measuring care delivery from multiple perspectives; determining the dose of care delivered; and measuring the entire care process. Meaningful measures that are simple, feasible, affordable, and integrated into the care delivery system and electronic health record are needed. Advances in health information systems create opportunities to advance quality measurement in innovative ways.
CONCLUSIONS: These findings and products add to the robust set of measures needed to measure nurses' contributions to the care of hospitalized patients. The implementation of these projects has been rich with lessons about the ongoing challenges related to quality measurement.

MeSH Term

Adolescent
Adult
Child
Child, Hospitalized
Clinical Competence
Costs and Cost Analysis
Cross-Sectional Studies
Foundations
Humans
Nurse's Role
Nursing Staff, Hospital
Organizational Case Studies
Outcome and Process Assessment, Health Care
Pain Management
Pain Measurement
Patient Care Team
Patient Discharge
Patient Education as Topic
Patient Satisfaction
Pediatric Nursing
Personnel Staffing and Scheduling
Quality Indicators, Health Care
Quality of Health Care
Research Support as Topic
Surveys and Questionnaires
United States
Young Adult

Word Cloud

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