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Ambulatory Care Nurse-Sensitive Indicators: A Scoping Review of the Literature 2006-2021
Leilani A Siaki1, Patricia A Patrician, Lori A Loan
1Tripler Army Medical Center, Honolulu, Hawaii (Dr Siaki); School of Nursing, University of Alabama at Birmingham, Birmingham (Drs Patrician and Loan); National Institutes of Health Clinical Center, Bethesda, Maryland (Dr Matlock); Rush University Medical Center, Chicago, Illinois (Ms Start); Daniel K. Inouye Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Dr Gardner); and Madigan Army Medical Center, Tacoma, Washington (Dr McCarthy).
Background/Purpose:
Meeting recommendations that nurses should partner in leading health care change is hampered by the lack of ambulatory care nurse-sensitive indicators (ACNSIs). This scoping review was conducted to identify evidence regarding ACNSI identification, development, implementation, and benchmarking.
Methods:
Following the PRISMA-ScR reporting guide, we performed PubMed/MEDLINE, CINAHL, and Cochrane Library searches for the period January 2006 to March 2021.
Results:
Twelve of the 1984 articles from 6 countries met inclusion criteria. All focused on identifying, developing/pilot testing indicators, and included structure, process, and outcome indicators. Seven articles were level II and all were at least grade B quality. Leverage points involved leadership support, automated data extraction infrastructure, and validating links between nurses' roles/actions and patient outcomes.
Conclusions:
While high-quality work is ongoing to identify clinically meaningful and feasible ACNSIs, knowledge in this field remains underdeveloped. Prioritizing this work is imperative to address gaps and facilitate national strategic health care goals.
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