Publication Details

J. Sim, P. A. Crookes & K. Walsh (2010). Nursing care - moving beyond being a commodity and measuring the actual contribution that nurses make to patient outcomes. presented at The National Convention Centre, Canberra, 26 october 2010.


There is a new imperative on nursing as a profession to identify and measure the contribution that nurses make to patient outcomes. This is not an easy task. All nurses know that nursing is complex. Largely because of the complexity of the nursing task there has been no collective agreement in the literature or in practice of what constitutes good nursing care and no consensus or universal measure of quality nursing practice. This lack of consensus and inability to define a set of nursing indicators that quantify the impact that nursing care has on patient outcomes has left the nursing profession vulnerable to those wishing to undermine its relevance and importance within the health care system. This is evident in discussions about and planning for the future healthcare workforce of Australia. As a result of a worldwide focus on professional and financial accountability within nursing, nursing sensitive outcomes are being developed and measured in many facilities across the world. Nursing sensitive outcomes are also the subject of a growing body of research. Most nursing sensitive outcomes that are being used look at adverse event data and are negative in orientation. This approach does not recognise or measure the true impact of nursing care on patient outcomes. This presentation will provide an overview on nursing sensitive outcomes and describe the first phase of research being conducted to develop a set of indicators that provides a balanced view of nursing care and its contribution to patient outcomes. The research described will broaden the debate on nursing sensitive outcomes so that the contribution that nursing care makes to patient outcomes is able to be identified and measured. A conceptual framework that describes patient outcomes that can be attributed to nursing care from a balanced and person-centred focus will be presented. The next phase of research will be described. The overall aim of the research is to develop and validate a set of nursing sensitive outcomes that provides a balanced view of nursing care. This set of indicators could then be used to provide a snapshot of the quality of nursing care as is reflected in the impact that nursing care has on patient outcomes. This set of indicators could also be used to evaluate the impact of changes in nursing hours, staffing and ratios within a health care setting. The availability of empirical data on nursing care and patient outcomes should be used to make decisions about the future healthcare workforce in Australia. The absence of this data treats nursing as a commodity. In the modern healthcare workforce this leaves more than just nursing compromised. Decisions about nursing care should be made based upon the impact that those changes may have on patient outcomes.