Call to action: Blueprint for change in acute and critical care nursing

• Published in: Nursing outlook 2024-11, Vol.72 (6), p.102271, Article 102271
• Main Authors: Curley, Martha A.Q., Zalon, Margarete L., Seckel, Maureen A., Alexandrov, Anne W., Sorce, Lauren R., Kalvas, Laura Beth, Hooper, Vallire D., Balas, Michele C., Vollman, Kathleen M., Carr, Devin S., Good, Vicki S., Latham, Christine L., Carrington, Jane M., Hardin, Sonya R., Odom-Forren, Jan
• Format: Article
• Language: English
• Subjects: Critical Care; Critical Care Nursing - standards; Health policy; Hospitals; Humans; Incentive; Nurse's Role; Nursing Staff, Hospital; Organizational Innovation; Outcome assessment; Reimbursement; United States; Workforce
• ISSN: 0029-6554; 1528-3968; 1528-3968
• DOI: 10.1016/j.outlook.2024.102271

Herein, we propose a blueprint for action to completely measure and recognize the care provided by acute and critical care nurses to be incorporated into policy that shapes and supports practice. We address the nature of nurses’ work by identifying nine practice domains, hospital practice environment assumptions, and expected outcomes. Nurses’ work, as a cross-system process, needs to be included in hospital-based core measures to fully reflect nurses’ impact on patient care. We call for a balanced measurement portfolio focused on patient/family-, unit-, and systems-level outcomes. We focus on what nurses do and what patients and their families can expect rather than only on the elimination of select adverse events. We provide a way forward to allow measure development and implementation with incentives for their use. This approach to making nurses’ contributions and impact on outcomes visible will enhance acute and critical care nursing practice and benefit patients and their families. •We call for a major change in how nursing is measured in acute and critical care hospitals.•We articulate nine domains of practice and core elements of hospital environments that support nurses’ capacity to provide optimal care.•We propose precision-based outcomes that call attention to the presence, not the absence, of nursing care.•Novel partnerships are needed to develop and incorporate new measures into hospital accreditation and reimbursement structures.•Highlighting outcomes of stellar bedside practice, making them visible to all, will benefit patients and families.