The identification and characterization of nurse-sensitive outcomes in acute and critical care: A systematic review.

BACKGROUND

Few nurse-sensitive patient and family outcome measures are included in hospital core metrics used for accreditation, credentialing, or recognition.

PURPOSE

Identify and characterize patient and family outcome measures that are sensitive to the work of acute and critical nursing.

METHODS

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).

DISCUSSION

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.

CONCLUSION

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.