Outcomes Measurement as Evidence of Quality Nursing

The contribution that nursing makes to healthcare is well known, but, has not been clearly demonstrated. Little objective evidence presently exists establishing linkages between nursing and health outcomes. Most of present day nursing care is still based on intuition or trial and error practices. Although it presents challenges, and sometimes confusion and chaos, the profession of nursing must join its medical colleagues in the routine investigation of its practices for the purpose of generating EVIDENCE (Figure 2).

This EVIDENCE can then be used to improve care, justify staffing levels and other structural variables, and revise institutional, state, and national policy.

The ANA Safety and Quality Indicator Project has provided the impetus for these linkages through the assessment of structural, process, and outcomes indicators. This national database enjoys a growing pool of participating acute care institutions and is beginning to show evidence that nursing does indeed impact health outcomes (15).

The Nursing Care Report Card for Acute Care (4) as this project is known provides acute care institutions with the framework for collecting, analyzing, and comparing specific nurse-sensitive indicators. The ANA views these data as "a tool for protecting our patients" (p. E-3), part of our professional accountability, and an agenda for future research. Overcoming the challenges of measurement, data collection, and analysis will provide the missing EVIDENCE that demonstrates nursing as a strong link to patient safety and healthcare quality.