Linking Nursing Care to ANA Quality Indicators

Increased health care costs within the Department of Defense (DoD) have mirrored the increases in the civilian sector. As DoD expenditures for health care have increased, the total budget has decreased. This, in combination with national pressure to limit the cost of military health care, has resulted in drastic changes in the manner in which health care is delivered within the DoD. Military health care institutions, when faced with an imperative to cut costs, have targeted labor costs and, in particular, nursing staff. In the absence of any meaningful data relating nursing care with positive patient outcomes, the likelihood is that military health care institutions will translate additional reductions in budgets into additional nursing staff cuts.

Because nurses are an integral part of the health care delivery system, both in terms of patient contact and hospital spending, the American Nurses' Association (ANA) has initiated an endeavor to formulate a nursing report card which will include patient-focused outcome indicators chosen for their ability to link nursing care quality to patient-focused outcomes. The links between patient outcomes and the nursing care quality identified by the ANA Nursing Quality Indicators are not well-understood. However, before these relationships can be tested, more information about the feasibility of collecting nursing care data and patient outcomes data is necessary.

This feasibility pilot study will use existing data to demonstrate the following: 1) nursing care quality data and ANA Nursing Quality Indicator data can be collected; and 2) using the known groups approach, ANA Nursing Quality Indicators will demonstrate sensitivity and specificity toward known differences in nursing care quality.

Using a variety of methods including expert panels, chart review and questionnaires, information related to the ANA Nursing Quality Indicators and nursing care quality will be gathered and evaluated. The final goal is to statistically determine whether the ANA Nursing Quality Indicators are sensitive to documented differences in the quality of nursing care patients receive using ANOVA.

Further research on indicators sensitive to changes in nursing care quality will potentially improve the quality of patient care by promoting both the science of outcomes research and the practice of nursing. In addition, identifying quality indicators will provide valuable input for balancing administrative and clinical decision making.

Final report is available on NTRL: https://ntrl.ntis.gov/NTRL/dashboard/searchResults/titleDetail/PB2007107...