Early Career RNs' Perceptions of Quality Care in the Hospital Setting

Measures and indicators of quality care—such as the Healthcare Effectiveness Data and Information Set, and those developed by the Agency for Healthcare Research and Quality—inform consumers, practitioners and policy-makers about the quality of patient care. Other measures, such as those developed by the National Quality Forum, define quality by using nurse-sensitive patient outcomes. But even these measures do not capture some important aspects of quality nursing care in hospitals.

In order to inform more nursing-specific indicators of quality, researchers asked early-career (less than four years experience) registered nurses (RNs) what they thought constituted high-quality nursing. Three themes emerged as integral to quality nursing care:

1. RN presence—being present with the patient at the bedside; having the time and flexibility to spend time with patients; and having a workload that facilitates both.
2. Developing relationships—trust between RNs and their patients; focusing on the patient; treating the patient as if he or she were family; and being an advocate for the patient.
3. Facilitating the flow of knowledge and information—informed by an evidence base; RN education and competence; and teamwork and communication.

Quality indicators need to include process measures in order to reflect the complexity of bedside nursing care.