Which priority indicators to use to evaluate nursing care performance? A discussion paper

Abstract

Aims: A discussion of an optimal set of indicators that can be used on a priority basis to assess the performance of nursing care.

Background: Recent advances in conceptualization of nursing care performance, exemplified by the Nursing Care Performance Framework, have revealed a broad universe of potentially nursing-sensitive indicators. Organizations now face the challenge of selecting, from this universe, a realistic subset of indicators that can form a balanced and common scorecard.

Design: Discussion paper drawing on a systematic assessment of selected performance indicators.

Data sources: Previous works, based on systematic reviews of the literature published between 1990 - 2014, have contributed to the development of the Nursing Care Performance Framework. These works confirmed a robust set of indicators that capture the universe of content currently supported by the scientific literature and cover all major areas of nursing care performance. Building on these previous works, this study consisted in gathering the specific evidence supporting 25 selected indicators, focusing on systematic syntheses, meta-analyses and integrative reviews.

Implications for nursing: This study has identified a set of 12 indicators that have sufficient breadth and depth to capture the whole spectrum of nursing care and that could be implemented on a priority basis.

Conclusions: This study sets the stage for new initiatives aiming at filling current gaps in operationalization of nursing care performance. The next milestone is to set up the infrastructure required to collect data on these indicators and make effective use of them.

Keywords: healthcare improvement; nursing care performance; nursing care quality; nursing sensitive indicators; patient safety; performance management; performance measurement.