Operationalising a modified Delphi study to progress quality care process nursing metrics for acute care

Area of Science:

• Nursing Quality Improvement
• Healthcare Metrics
• Patient Safety

Background:

• Nursing practice complexity often renders nurses' contributions 'invisible' within healthcare.
• Quality Care Metrics can quantify nursing care processes in complex clinical settings.

Purpose of the Study:

• To develop an evidence-based metric system for measuring nursing care quality and clinical safety in Irish acute care settings.
• To classify, agree upon, and prepare for the implementation of nursing care process metrics and indicators.

Main Methods:

• A modified four-round Delphi study involving 422 nurses, patient representatives, stakeholders, and 26 expert nurse clinicians.
• Surveys and consensus meetings were used to identify and refine metrics and indicators.

Main Results:

• Consensus was reached on 11 quality care process nursing metrics and 53 corresponding indicators for acute care.
• Concerns were raised regarding the subjective nature of metrics like 'patient experience' and 'patient engagement' due to a lack of objective measurement tools.

Conclusions:

• The study operationalized a Delphi technique to establish key nursing quality care process metrics and indicators.
• Implementation of these metrics is crucial to making nurses' contributions to patient-centered care tangible in acute care.