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Development of a Core Set of Nursing-Sensitive Patient Outcomes in Intensive Care Units: A Delphi Consensus Study
Luciano Cellura1, Anna Maria Grugnetti2, Stefano Gabriele Scaglia3
1Emergency and Urgency Department, Foundation Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Policlinico San Matteo, 27100 Pavia, Italy.
Clinics and Practice
|May 26, 2026
Summary
This study developed a core set of 15 nursing-sensitive patient outcomes (NSPOs) for intensive care units (ICUs). This provides a standardized framework for evaluating and improving critical care nursing quality.
Area of Science:
- Critical Care Nursing
- Patient Outcomes Research
- Healthcare Quality Improvement
Background:
- Nursing care significantly impacts patient outcomes in intensive care units (ICUs).
- Lack of standardized nursing-sensitive indicators hinders objective evaluation of ICU care quality.
- There is a need for an evidence-based core set of nursing-sensitive patient outcomes (NSPOs) specific to intensive care.
Purpose of the Study:
- To develop an evidence-informed core set of nursing-sensitive patient outcomes (NSPOs) tailored for intensive care nursing.
- To establish a standardized framework for measuring and improving the quality of critical care nursing.
Main Methods:
- A Delphi consensus study involving 38 ICU nurses was conducted.
- The study included a scoping review, two Delphi rounds, and a consensus meeting.
- Fifteen evidence-based NSPOs were evaluated using a five-point Likert scale, with consensus defined as ≥75% agreement.
Main Results:
- Fifteen NSPOs met the consensus threshold, demonstrating moderate-to-excellent reliability (ICC = 0.65-0.85).
- The validated core set is organized into four domains: safety, clinical, functional, and perceptual.
- These domains encompass both preventive-technical and holistic aspects of ICU nursing care.
Conclusions:
- The study established the first ICU-specific, evidence-based NSPO core set in Italy.
- This core set offers a measurable and reproducible framework for systematic outcome monitoring.
- The findings support quality improvement initiatives in critical care nursing practice.
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