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Medical Care Research and Review
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Performance Measurement of Nursing Care

State of the Science and the Current Consensus

Jack Needleman

UCLA School of Public Health

Ellen T. Kurtzman

National Quality Forum

Kenneth W. Kizer

Medsphere Systems Corporation

Concerns about nurse staffing in hospitals, nursing's influence on patient safety and health care outcomes, and nurses' work environment (e.g., equipment failures, documentation burden) have led to increased interest in measuring and reporting nursing's performance. This article reviews recent efforts and issues involved in identifying a set of nursing-sensitive performance measures. Sustaining and strengthening current efforts requires developing measures that address all the domains of nursing, addressing technical issues needed to analyze the impact of nursing on patient safety and health care outcomes, developing data systems that provide the information needed to implement the model system, regularly improving the set of endorsed standards to reflect the most current science and empirical evidence, and persuading all health care stakeholders that measurement and reporting nursing-sensitive standards make a difference in the care and quality that are delivered. Each of these tasks requires substantial development work and construction and maintenance of the infrastructure to sustain the performance measurement efforts.

Key Words: nursing care • quality indicators • measurement • nurse staffing • performance improvement

Medical Care Research and Review, Vol. 64, No. 2 suppl, 10S-43S (2007)
DOI: 10.1177/1077558707299260


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