Diane K. Boyle, PhD, RN; Peggy A. Miller, PhD, RN; & Nancy Dunton, PhD University of Kansas School of Nursing Kansas City, KS. Consensus standards for Nursing-sensitive care and implications for certification. ABNS Spring Conference March 5, 2010 Costa Mesa, CA. Objectives.
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Peggy A. Miller, PhD, RN; & Nancy Dunton, PhD
University of Kansas School of Nursing
Kansas City, KSConsensus standards for Nursing-sensitive care and implications for certification
ABNS Spring Conference
March 5, 2010
Costa Mesa, CA
(Dawn of Nursing-Sensitive Indicators)
*TNHPPD = total nursing hours per patient day
Quality Measurement and Consensus Standards for Nursing-Sensitive Care
“…nursing-sensitive performance measures are processes and outcomes— and structural proxies for these processes and outcomes (e.g., skill mix, nurse staffing hours)—that are affected, provided, and/or influenced by nursing personnel, but for which nursing is not exclusively responsible. Nursing-sensitive measures must be quantifiably influenced by nursing personnel, but the relationship is not necessarily causal
National Quality Forum: National Voluntary Consensus Standards for Nursing-Sensitive Care: An Initial Performance Measure Set. Washington, DC: 2004
Donabedian’s Structure – Process - Outcome
Antecedents Structure Process Outcome
healthcare practitioner & patient
Changes (desirable or undesirable) in individuals & populations
Patient-Centered Outcome Measures
Nursing-Centered Intervention Measures
Smoking cessation*** counseling for
Acute myocardial infarction
* Death among surgical inpatients with treatable serious complications
**Also an NQF-endorsed voluntary consensus standard for hospital care
*** The smoking cessation standards were not re-endorsed
Issues to Ponder Nursing-Sensitive Care
What model can be used for linking specialty certification with processes and outcomes?
Structure Process Outcome
What research exists linking specialty certification with improved processes and outcomes?
Snapshot of Specialty Certified Nurses from the improved processes and outcomes?
2009 NDNQI RN Survey
270,423 US total survey respondents