Measuring Nurses' Impact on Health Care Quality

Four Interdisciplinary Nursing Quality Research Initiative (INQRI) teams summarize their work to close the gaps in measuring quality of nursing care.

The Robert Wood Johnson Foundation's Interdisciplinary Nursing Quality Research Initiative (INQRI) supported interdisciplinary teams to address gaps related to measuring the contributions of nursing to quality of care. This article summarizes previously published research of four such INQRI-funded teams:

  • Measuring the Quality of Nursing Care Related to Pain Management developed and tested a tool (PainCQ) to measure quality of care related to pain management in the acute care setting.
  • 6th Vital Sign: Hospitalized Children’s Evaluation of the Quality of their Daily Nursing Care asked pediatric patients (ages 6 to 21), rather than their parents, to evaluate their daily hospital experience.
  • Nurse Staffing, Discharge Preparation, and Post-Discharge Utilization investigated gaps in knowledge related to staff, discharge teaching, and readmission or use of emergency department within 30 days of discharge.
  • Development of a Composite Measure of Direct Care Staff Expertise found that patient outcomes were predicted by different combinations of multiple elements.

Among the challenges in measurement:

  • Whether to measure processes from a nurse-centric perspective or patient-centric one.
  • How to conceptualize and measure “doses” of care.
  • How to account for the interdisciplinary aspect of patient care.

Looking to the future, the authors believe that advances in the use of electronic health records “create enormous opportunities for measuring nursing’s contribution to quality.”