Nurse reported quality of care: a measure of hospital quality

Abstract

As the primary providers of round-the-clock bedside care, nurses are well positioned to report on hospital quality of care. Researchers have not examined how nurses' reports of quality correspond with standard process or outcomes measures of quality. We assess the validity of evaluating hospital quality by aggregating hospital nurses' responses to a single item that asks them to report on quality of care. We found that a 10% increment in the proportion of nurses reporting excellent quality of care was associated with lower odds of mortality and failure to rescue; greater patient satisfaction; and higher composite process of care scores for acute myocardial infarction, pneumonia, and surgical patients. Nurse reported quality of care is a useful indicator of hospital performance.

FIGURE 1

Percentage of nurses reporting quality of care as excellent in hospital with poor, mixed, and good nurse practice environments. Note: If the notches of two plots do not overlap this is strong evidence that the two medians differ significantly at the 0.05 level.

FIGURE 2

Percentage of nurses reporting quality of care as excellent in magnet recognized hospitals and non-magnet hospitals. Note: If the notches of two plots do not overlap this is strong evidence that the two medians differ significantly at the 0.05 level.