New commentary calls for shift to nurse-sensitive outcome measures

Current health care metrics fail to capture the true value of acute and critical care nursing, evaluating the profession primarily by the absence of patient harm rather than positive clinical outcomes, according to a commentary in JAMA Internal Medicine.

Martha A.Q. Curley, Ph.D., RN, FAAN, professor in the Department of Family and Community Health and the Ruth M. Colket Endowed Chair in Pediatric Nursing at Children’s Hospital of Philadelphia, served as senior author of the commentary, which urges health systems, payers and credentialing bodies to adopt metrics that reflect the full scope of nursing practice—including surveillance, symptom management and care coordination.

Her co-authors include Lori Kennedy, Ph.D., RN, ACNP-BC, from the Center for Nursing Science at UC Davis Health and the Betty Irene Moore School of Nursing at UC Davis in Sacramento, California; and Laura Beth Kalvas, Ph.D., RN, from the Center for Nursing Excellence and the Center for Biobehavioral Health at the Abigail Wexner Research Institute at Nationwide Children’s Hospital in Columbus, Ohio.

“At a time when health care professional burnout and turnover are high, our solution is to concentrate on what makes nursing the most trusted health care profession,” the authors write. “Data drive accountability. We ask our physician colleagues to join in our call for change in how nursing quality is measured in hospital environments. The value of nursing care is not in the sum of harms prevented. It is in the sum of what nurses do.”

The commentary highlights that traditional metrics—such as hospital-acquired infections or pressure injuries—force a defensive economic case for nursing investments, overlooking the critical role nurses play in early intervention and preventing clinical deterioration.

Drawing on nine core practice domains established by the American Academy of Nursing’s Expert Panel on Acute and Critical Care, the authors call for a shift toward nurse-sensitive patient outcomes and invite physician colleagues to partner in reforming health care quality evaluation.

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