Tracking NQF-Endorsed™ Consensus Standards for Nursing-Sensitive Care: A 15-Month Study
Access the final report: Tracking NQF-Endorsed® Consensus Standards for Nursing-Sensitive Care: A 15-Month Study.
The Opportunity
Nursing care is integral to inpatient care and is uniquely delivered in hospital settings. The sheer number of nurses and their primacy in caregiving are compelling reasons for measuring their contribution to patients' experiences and the outcomes that are attained. This report and its specific recommendations for future measure development, research, policy setting, and practice outline specific steps that will ensure this achievement.
This 15-month study, funded by the Robert Wood Johnson Foundation:
- generated a comprehensive understanding of the use of the NQF-endorsedTM consensus standards by hospitals and other healthcare stakeholders;
- identified the successes and challenges experienced by users of the consensus standards, including factors that influence their voluntary collection and reporting; and
- identified technical and other issues that were barriers to uniform implementation.
Statistics
Nurses, as the single largest healthcare profession, provide more direct care than any other caregivers in this nation. Yet, until recently, no single method was available for quantifying the influence of nursing personnel and their care-related behaviors on the quality of healthcare and patient safety. To address this, in 2004, NQF endorsed a set of 15 nursing-sensitive consensus standards.1, 2
About the Project
This project was completed in 2007.
Results
This report and its 10 specific recommendations for future measure development, research, policy setting, and practice outline specific steps that will ensure this achievement.
Process
This project, like all NQF activities, involved the active participation of representatives from across the spectrum of healthcare stakeholders. The project was guided by a Planning Advisory Committee.
Funding
This work was supported by a grant from the Robert Wood Johnson Foundation.
Related NQF Work
National Voluntary Consensus Standards for Nursing Sensitive Care Performance Measure Set MaintenanceNational Voluntary Consensus Standards for Nursing-Sensitive Care: An Initial Performance Measure SetContact Information
For more information, contact Ellen Kurtzman, RN, MPH at 202.783.1300, or by email at info@qualityforum.org.
Notes
1 National Quality Forum. National Voluntary Consensus Standards for Nursing-Sensitive Care: An Initial Performance Measure Set. Washington, DC. 2004.
2 Project was funded by a grant provided by the Robert Wood Johnson Foundation (RWJF) with additional funding from the Department of Veterans Affairs.
This project formalized efforts to monitor the experiences of adopting
and implementing national voluntary consensus standards for
nursing-sensitive care endorsed by the National Quality Forum (NQF).
NQF established a tracking database of hospitals implementing these
consensus standards, identified implementation successes, challenges,
barriers to uniform adoption, and other technical considerations, and
offered feedback to relevant measure developers for future enhancement
of these standards.
A Planning Advisory Committee was appointed to provide counsel to project staff. The Committee was composed of individuals representing early adopters, measure developers, national hospital corporations, and researchers. It included liaison members whose research and/or affiliations would help inform the project plan and its findings (i.e., principal investigators [PIs] of the RWJF-funded Interdisciplinary Nursing Quality Research Initiative and Transforming Care at the Bedside initiative).
The Planning Advisory Committee held its first meeting on April 17.
Planning Advisory Committee Roster
In response to the objectives, the Committee collectively recommended a mixed methodology for data collection that incorporated both telephone interviews and a web-based survey. This approach effectively shifted the project deliverables from a database and tracking system to semi-structured interview sets and a close-ended web-based survey that provided complementary information about penetration, diffusion, and implementation experience.
This short, web-based survey (N=31) was constructed with two primary aims:
- to solicit responses to basic items regarding awareness, penetration, and ease of implementation of the NQF-endorsed consensus standards for nursing-sensitive care; and
- to discern basic information that could be used for assigning potential interviewees to the categories within the 14 characteristics.
Once final, the survey was posted to the NQF website.
The Planning Advisory Committee identified 14 institutional and implementation characteristics important to be included among people who would be surveyed by telephone. Ultimately, a sample was selected for the semi-structured telephone interviews to ensure that each category of the 14 characteristics included interviewees.
Interviews were ultimately completed with 30 respondents
Two senior NQF staff members, both nurses, conducted all of the interviews between November 2006 and January 2007.
Only 60 responses to the web survey were received, but once the survey period closed, simple descriptive analyses were conducted on the survey data that were submitted electronically. Once all the telephone interviews were conducted, NQF project staff used qualitative techniques derived from a modified content analysis to assess the data.
The Planning Advisory Committee, together with NQF staff, drafted a report that included the analyses and recommended 10 strategies to improve adoption of the NQF-endorsedTM nursing-sensitive care measures.
