A blueprint for change in acute and critical care nursing

A novel article published in the latest issue of Nursing Outlook proposes a significant shift in how nursing care is measured within acute and critical care settings. This “blueprint for action” seeks to revolutionize current methods by recognizing the full scope of a nurse’s work and its profound impact on patient outcomes.

“The current measurement systems fail to capture the essence of what nurses truly do,” explains lead-author Martha A.Q. Curley, Ph.D., RN, FAAN, Professor of Nursing in Penn Nursing’s Department of Family and Community Health, and the Ruth M. Colket Endowed Chair in Pediatric Nursing at Children’s Hospital of Philadelphia. “This blueprint outlines a new framework that acknowledges the diverse skillsets and contributions of nurses, ultimately leading to improved patient care delivery and outcomes.”

Key components of the proposed blueprint

• Nine domains of practice: The framework outlines nine core areas where nurses provide essential care, encompassing not just clinical expertise but also patient education, advocacy, and emotional support.
• Supportive hospital environment: The blueprint highlights the importance of fostering a supportive hospital environment that empowers nurses to provide optimal patient care.
• Precision-based outcomes: Moving beyond a simple focus on preventing negative events, the proposal advocates for measuring positive outcomes directly linked to nursing interventions.
• Collaborative partnerships: The article emphasizes the need for collaboration between stakeholders—nurses, researchers, policymakers, and health care systems—to develop and implement new outcome measures.

Benefits for patients and the profession

By highlighting the work of bedside nurses, this blueprint has the potential to:

• Enhance patient outcomes: Making nurses’ contributions visible can lead to better recognition of their impact on patient well-being.
• Empower nursing practice: Highlighting the full scope of nursing practice can lead to a more rewarding and fulfilling career path for nurses.

A call to action for stakeholders

The article outlines specific actions for individuals within the health care system:

• Nurses: Engage in discussions about impactful nursing practices and participate in data collection efforts.
• Nurse leaders: Utilize data and analytics to focus on patient outcomes derived from the full spectrum of nursing care.
• Nurse researchers: Partner with data scientists to develop new outcome metrics.
• Hospital systems: Implement information systems that capture data encompassing all nine domains of nursing practice.
• Policymakers and accreditors: Hold the profession accountable for developing metrics that reflect nursing excellence.

Moving forward

“This blueprint marks a pivotal step towards a future where the value of acute and critical care nurses is fully recognized,” said Curley. “By working together, we can ensure that the impact of nurses’ work is clearly visible, leading to better patient outcomes and a more rewarding profession for nurses.”