New blueprint calls for radical overhaul of acute and critical care nursing metrics
Researchers propose a comprehensive framework to better measure and recognise the full scope of nurses’ contributions to patient care and outcomes.
A groundbreaking article published recently in the journal Nursing Outlook [1] has put forth a bold new vision for measuring and valuing the work of acute and critical care nurses. The proposed “Blueprint for Action” aims to revolutionise current assessment methods by capturing the full breadth of nursing practice and its profound impact on patient outcomes.
Reimagining nursing metrics
The blueprint, developed by a team led by Professor Martha A.Q. Curley of the University of Pennsylvania School of Nursing, outlines nine core domains of nursing practice that span the entirety of what nurses do in acute and critical care settings. These domains encompass not just clinical expertise, but also crucial aspects like patient education, advocacy, and emotional support.
“The current measurement systems fail to capture the essence of what nurses truly do,” explains Professor Curley. “This blueprint outlines a new framework that acknowledges the diverse skillsets and contributions of nurses, ultimately leading to improved patient care delivery and outcomes.”
A key criticism levelled by the researchers is that existing metrics predominantly focus on negative outcomes or harm prevention, such as rates of patient falls or hospital-acquired infections. While important, these measures fail to capture the myriad ways in which nurses actively contribute to positive patient outcomes.
The authors argue for a shift towards “precision-based outcomes” that directly link nursing interventions to measurable improvements in patient health and wellbeing. This could include metrics around symptom management, patient knowledge acquisition, or achievement of care goals.
Supportive environments and collaborative partnerships
Beyond individual nurse performance, the blueprint emphasises the critical importance of fostering supportive hospital environments that empower nurses to provide optimal patient care. This includes ensuring appropriate staffing levels, providing ongoing professional development opportunities, and involving nurses in decision-making processes that impact patient care.
The researchers also highlight the need for collaborative partnerships between stakeholders – nurses, researchers, policymakers, and healthcare systems – to develop and implement new outcome measures. They envision a future where nursing contributions are fully integrated into hospital-wide performance metrics and used to drive continuous quality improvement.
Potential benefits for patients and the profession
By making nurses’ contributions more visible and measurable, the authors believe this new approach has the potential to significantly enhance patient outcomes. When the full scope of nursing practice is recognised and optimised, patients stand to benefit from more comprehensive, personalised care.
For the nursing profession itself, the blueprint could lead to a more rewarding and fulfilling career path. By highlighting the complexity and impact of nursing work, it may help address issues of burnout and retention that have plagued the field, particularly in the wake of the COVID-19 pandemic.
A call to action across the healthcare system
The article outlines specific actions for various stakeholders within the healthcare system to bring this vision to fruition:
- Nurses are encouraged to engage in discussions about impactful nursing practices and participate in data collection efforts.
- Nurse leaders are called upon to utilise data and analytics to focus on patient outcomes derived from the full spectrum of nursing care.
- Nurse researchers are urged to partner with data scientists to develop new outcome metrics that capture the nuances of nursing practice.
- Hospital systems are advised to implement information systems that can capture data encompassing all nine domains of nursing practice identified in the blueprint.
- Policymakers and accreditors are challenged to hold the profession accountable for developing metrics that reflect nursing excellence.
Benefits outweigh obstacles to implementation
The authors acknowledge that implementing such a radical overhaul of nursing metrics will face significant challenges. Developing new, validated outcome measures is a time-consuming and resource-intensive process. Additionally, there may be resistance from established systems and stakeholders comfortable with current practices.
However, they argue that the potential benefits far outweigh these obstacles. By providing a comprehensive framework and roadmap for change, this blueprint aims to catalyse a shift in how nursing care is measured, valued, and optimised within acute and critical care settings.
“This blueprint marks a pivotal step towards a future where the value of acute and critical care nurses is fully recognized,” says Prof. Curley. “By working together, we can ensure that the impact of nurses’ work is clearly visible, leading to better patient outcomes and a more rewarding profession for nurses.”
Reference:
- Curley, M. A. Q., Zalon, M. L., Seckel, M. A., al. (2024). Call to action: Blueprint for change in acute and critical care nursing. Nursing Outlook, 72(5), 102271. https://doi.org/10.1016/j.outlook.2024.102271
