National Voluntary Consensus Standards for Nursing-Sensitive Care: An Initial Performance Measure Set
Final Report: National Voluntary Consensus Standards for Nursing-Sensitive Care: An Initial Performance Measure Set.
The Opportunity
Nursing is the largest healthcare profession in the United States, with nurses serving as the principal caregivers in hospitals and other institutional care settings and nursing time constituting the single largest operational expense in any healthcare delivery system. However, considering that nursing as an organized service and nurses as individual caregivers are critical to optimal healthcare system performance, it is surprising how little attention has been directed to date toward developing nursing care performance measures.
There is a need for national standardized performance measures to assess the extent to which nurses in acute care hospitals contribute to patient safety, healthcare quality, and a professional work environment.
Statistics
The extent to which nursing contributes to the quality of U.S. healthcare and the degree to which the work environment contributes to a culture of safety have been the recent focus of significant professional, research, and policy attention.1,2
A growing body of evidence demonstrates the influence of nursing personnel—and the stability of that personnel—on patient outcomes, healthcare costs, and the professional atmosphere in which care is provided. Yet, although interest in nursing-sensitive performance measurement3 is increasing, a lack of scientific research has hindered the development of knowledge in this area.
About the Project
The final report was completed in August 2004.
Results
This report details 15 voluntary consensus standards for nursing-sensitive care, including evidence-based nursing-sensitive performance measures, a framework for measuring nursing-sensitive care, and related research recommendations. While the project emphasized nursing care in acute care hospitals, the framework for general measurement recognized the need for measures to be compatible across settings of care.
Process
Candidate measures were considered for NQF endorsement as national voluntary consensus standards. Agreement was developed through NQF's Consensus Development Process (CDP). This project involved the active participation of representatives from across the spectrum of healthcare stakeholders. It was guided by a steering committee and advised by a technical advisory panel .
Funding
This project is supported by a grant from the Robert Wood Johnson Foundation.
Related NQF Work
Tracking NQF-Endorsed® Consensus Standards for Nursing-Sensitive Care
Contact Information
For more information, please call 202-783-1300, or email at info@qualityforum.org.
Notes
1 Needleman J, Buerhaus PI, Mattke S, Stewart M, Zelevinsky K. Nurse Staffing and PatientOutcomes in Hospitals.Health Resources and Services Administration (HRSA) Report
2 Committee on the Work Environment for Nurses and Patient Safety. Keeping Patients Safe:Transforming the Work Environment of Nurses. Washington DC: National Academies Press; 2004.Endorsed in May 2006, as part of phase 3, cycle 1 of NQF's ambulatory care project.
3 For this report, nursing-sensitive performance measures are processes and outcomes-and structural proxies for these processes and outcomes (e.g., skill mix, nurse staffing hours)-that are affected, provided, and/or influenced by nursing personnel, but for which nursing is not exclusively responsible. Nursing-sensitive measures must be quantifiably influenced by nursing personnel, but the relationship is not necessarily causal.
This report details 15 voluntary, NQF-endorsed consensus standards for nursing-sensitive care, including evidence-based nursing-sensitive performance measures, a framework for measuring nursing-sensitive care, and related research recommendations. This is the first-ever set of national standardized performance measures to assess the extent to which nurses in acute care hospitals contribute to patient safety, healthcare quality, and a professional work environment.
