McEvoy Natalie L, Kalvas Laura Beth, Walsh Killian, Curley Martha A Q
Department of Anesthesia and Critical Care, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Education and Research Centre, Beaumont Hospital, Dublin, Ireland.
Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA.
Nurs Outlook. 2025 Mar-Apr;73(2):102379. doi: 10.1016/j.outlook.2025.102379. Epub 2025 Feb 24.
Few nurse-sensitive patient and family outcome measures are included in hospital core metrics used for accreditation, credentialing, or recognition.
Identify and characterize patient and family outcome measures that are sensitive to the work of acute and critical nursing.
Systematic literature review that included all age groups and excluded measures commonly reported for hospital accreditation, credentialing, or recognition (i.e., patient falls, pressure injuries/pressure ulcers, and hospital-acquired infections).
In total, 16 studies met review criteria. Eight (50%) studies were conducted in acute care, five (31.3%) in critical care, and three (18.8%) in surgical settings. Eight (50%) were conducted in adults, four (25%) in pediatrics, and one (6.3%) in neonates. Three (18.8%) studies did not specify the population of interest. Overall, 55 nurse-sensitive outcomes were identified and 47 (85.5%) were operationally defined. These included patient/family satisfaction (n=7, 12.7%), patient complications (n=6, 10.9%), ventilator-related outcomes (n=6, 10.9%), unplanned extubation (n=5, 9.1%), and symptom-related outcomes (n=6, 10.9%). Outcomes differed by patient population and setting.
It is important to broaden nurse-sensitive outcome measurement in acute/critical care settings to recognize the full spectrum of nursing's work in hospitals. When core hospital outcome measures reflect the true work of nursing, its value to patients, families, and organizations can be made visible.
用于医院认证、资质认定或表彰的核心指标中，很少纳入对护士敏感的患者及家属结局指标。
识别并描述对急性和危重症护理工作敏感的患者及家属结局指标。
进行系统文献综述，纳入所有年龄组，并排除通常用于医院认证、资质认定或表彰的指标（即患者跌倒、压力性损伤/压疮和医院获得性感染）。
共有16项研究符合综述标准。8项（50%）研究在急性护理环境中进行，5项（31.3%）在重症护理环境中进行，3项（18.8%）在手术环境中进行。8项（50%）研究针对成人，4项（25%）针对儿科患者，1项（6.3%）针对新生儿。3项（18.8%）研究未明确感兴趣的人群。总体而言，共识别出55项对护士敏感的结局指标，其中47项（85.5%）有操作性定义。这些指标包括患者/家属满意度（n = 7，12.7%）、患者并发症（n = 6，10.9%）、呼吸机相关结局（n = 6，10.9%）、非计划拔管（n = 5，9.1%）和症状相关结局（n = 6，10.9%）。结局指标因患者人群和环境而异。
在急性/重症护理环境中扩大对护士敏感的结局指标测量范围很重要，以便全面认识护理工作在医院中的作用。当医院核心结局指标反映护理工作的实际情况时，其对患者、家属和组织的价值才能显现出来。
