Nurse-Sensitive Quality Metrics to Benchmark in Pediatric Cardiovascular Care

Abstract

Background Associations between the quality of nursing care and patient outcomes have been demonstrated globally. However, translation and application of this evidence to robust measurement in pediatric specialty nursing care has been limited. Objectives To test the feasibility and performance of nurse-sensitive measures in pediatric cardiovascular programs. Methods Ten nurse-sensitive measures targeting nursing workforce, care process, and patient outcomes were implemented, and measurement data were collected for 6 months across 9 children’s hospitals in the Consortium of Congenital Cardiac Care–Measurement of Nursing Practice (C4-MNP). Participating sites evaluated the feasibility of collecting data and the usability of the data. Results Variations in nursing workforce characteristics were reported across sites, including proportion of registered nurses with 0 to 2 years of experience, nursing education, and nursing certification. Clinical measurement data on weight gain in infants who have undergone cardiac surgery, unplanned transfer to the cardiac intensive care unit, and pain management highlighted opportunities for improvement in care processes. Overall, each measure received a score of 75% or greater in feasibility and usability. Conclusions Collaborative evaluation of measurement performance, feasibility, and usability provided important information for continued refinement of the measures, development of systems to support data collection, and selection of benchmarks across C4-MNP. Results supported the development of target benchmarks for C4-MNP sites to compare performance, share best practices for improving the quality of pediatric cardiovascular nursing care, and inform nurse staffing models.

Measuring Acuity and Pediatric Critical Care Nursing Workload by Using ICU CAMEO III

“…[1][2][3][4] This information has been used to support the development of ways to measure and benchmark staffing models across pediatric cardiovascular programs. [5][6][7] An evidence-based pediatric acuity measure that could be used to guide staffing assignments in hospitals or benchmarking across programs is lacking. 8,9 Pediatric patient acuity has been measured by using physiological indicators to predict patient outcomes, length of stay, and resource utilization.…”