Developing and Testing Nursing Quality Measures with Consumers and Patients

Research briefs from the Robert Wood Johnson Foundation (RWJF) Nursing Research Network identify specific ways nurses affect patient care quality and outcomes. Since 2005, the Interdisciplinary Nursing Quality Research Initiative (INQRI) program has supported interdisciplinary teams that involved nursing scholars and scholars from other disciplines in research projects—from the conceptual study design to the adoption in practice of new measures of standards of care.

This research brief assesses how well patients understand and value the fifteen nursing sensitive quality measures endorsed by the National Quality Forum (NQF). The research by Sofaer and Johnson develops and assesses the components of care coordination in hospitals that patients believe are likely to be significantly affected by nursing quality.

Key Findings

  • Patients identified several NQF measures as very important and understandable: failure to rescue; bed sores; urinary tract infections among catheterized patients; central line infections; pneumonia among patients on ventilators; and positive nursing work environment.

  • Patients identified three smoking cessation measures as inadequate. Measures of falls and restraints got a mixed response among consumers, although all were considered important by a majority of participants. Patients reported finding measures related to nursing staffing, nurse retention, and nursing mix confusing

  • Nurses see themselves as primarily responsible for hospital care coordination, especially at the point of discharge, but have difficulty articulating clearly what they actually do to coordinate care.

  • Nurses take more responsibility for care coordination in community hospitals where physicians are not routinely available on units, and less in academic medical centers, when interns, residents, fellows, and sometimes attending physicians are more often present.

  • Highly experienced nurses take a prominent role in coordinating care and supporting less experienced nurses in handling difficult situations. In some settings nurses’ sole responsibility is to coordinate care.

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To support interdisciplinary studies that address critical knowledge gaps regarding causal linkages between nursing and health care quality and to synthesize, translate, and disseminate major findings to key stakeholders.

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