There is an increasing interest in Nurse Sensitive Outcomes, which can be used to examine and demonstrate the impact of high quality nursing care. This presentation will describe the development of a set of outcome based measures that are intended to be sensitive to the work of nurses in ambulatory cancer chemotherapy settings. This setting is, in many countries, often nurse led but the role and value using specialist nurses in these settings is often contested. Nurse sensitive outcome measures give the possibility of monitoring and demonstrating how variation in nursing service quality impacts upon patients.
Methods: Systematic literature review to identify nurse sensitive outcomes and piloting and feasibility testing of indicators in 10 chemotherapy centres in England
Results: The literature review identified three broad areas where evidence for sensitivity to nursing was strongest – symptom management, safe medication administration and patient experience. The outcome measure developed primarily relied on patient self-report via a specially designed tool which was completed on 2466 occasions during the study period. Analysis revealed variability both in terms of patient’s experience of subjective symptoms and the support nurses provide to patients which remained even after case mix adjustment.
Conclusions: Monitoring outcomes provides a stimulus to develop services to improve the experience and health of patients. Validated nurse sensitive measures open the possibility of demonstrating the ‘added value’ of specialist nursing services and of using registered nurses in settings where they might be replaced by other, less qualified, staff. Without such measures and such evidence it may become hard to defend these posts in periods of financial constraint.