Abstract
Objective: In this era of patient safety, quality indicators associated with the
nursing profession have evolved from nursing-sensitive to adverse eventsensitive.
This paper aims to compare and contrast available quality indicator
tools associated with nurse staffing outcomes. Methods: We conducted a
systematic review of literature from the past 6 years, identifying research and/or
monitoring efforts reporting structure, process, and/or outcomes measures
associated with nursing care. Twenty-four articles were selected, and identified
indicators from the National Quality Forum were compared/contrasted with
relevant AHRQ Patient Safety Indicators. Results: The results of this study
provide an important comparative assessment of the types, content, and intended
purpose of available nursing indicators. We found little overlap and direction in
the types of indicators available to examine the influence of nurse staffing on the
outcomes of care. Further, there are no process measures available. The need for
consistent indicator definitions and process measures is addressed. Conclusions:
The central role nurses play in patient safety suggests a need for consensus on a
set of measures that will enable us to examine the impact of staffing changes on
the quality of care received. To support institutionalization of this set, research
examining the sensitivity of available, evidence-based indicators (outcomes)
sensitive to nurse staffing is needed. Such indicators could be used to evaluate the
outcomes of nursing practice when changes are made in care processes or the
delivery of nursing care.