The contribution of nursing to high-value inpatient care

Reports of suboptimal health care quality and rising expenditures have led payers to institute policies intended to improve outcomes and lower costs. Referred to as value--driven health care, these policies have multiplied in recent years. Despite their appeal, nursing--the nation's single largest provider of health care-has largely been excluded from these policy directions. This article describes the nature of the evidence substantiating nursing's contribution to quality and cost and explores the reasons--scientific, economic, societal, and political--that these contributions have been largely ignored in the formulation of federal policy. Recommendations are made to strengthen the nurse-value case and convince health care stakeholders, including policy makers, that the relationship is established, enduring, and sufficient for national action.