Creating and analyzing a statewide nursing quality measurement database.
OBJECTIVE
To explicate a replicable methodology for designing and analyzing a large ongoing reliable and valid quality database to examine nurse staffing and patient care outcomes in acute care hospitals.


METHODS
Prospective nurse staffing, process of care, and patient outcomes data based on the American Nurses Association's (ANA) nursing quality indicators collected from a voluntary convenience sample at acute care hospitals in California with rolling-site accrual.


METHODS
The ongoing CalNOC database development and repository project, the largest statewide effort of its kind in the United States (US), currently includes data on hospital nurse staffing, patient days, patient falls, pressure ulcer and restraint prevalence, registered nurse (RN) education, and patients' perceptions of satisfaction with care.


RESULTS
As of May 2003, the CalNOC database contained staffing data from 842 units in 134 acute care hospitals over 20 quarters from April 1998 to March 2003. The repository also included clinical outcome information on 34,262 reported patient falls, pressure ulcer prevalence data on 41,982 patient observations, and service outcome data on patient satisfaction from 26,461 patients. Participating hospitals receive quarterly reports allowing them to benchmark their own performance against other participating hospitals. CalNOC methods have been adapted and replicated by both the Military Nursing Outcomes Database and VA Nursing Outcomes Database projects, and CalNOC nursing-sensitive measures have been endorsed by the National Quality Forum.


CONCLUSIONS
This working model for collecting reliable and valid data was derived from multiple hospitals across California. The data are the basis for studies to contribute to the development of evidence-based public policy, and for ongoing study of the effects of nurse staffing on clinical and service outcomes.
Aydin
Carolyn E
CE
Nursing Research and Development, Room 2021, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA 90048, USA. aydin@cshs.org
Bolton
Linda Burnes
LB
Donaldson
Nancy
N
Brown
Diane Storer
DS
Buffum
Martha
M
Elashoff
Janet D
JD
Sandhu
Meenu
M
D000058:Accidental Falls / Q000706:statistics & numerical data; D019985:Benchmarking / Q000458:organization & administration; D015982:Bias; D002140:California / Q000453:epidemiology; D003625:Data Collection; D003627:Data Interpretation, Statistical; D016208:Databases, Factual; D019317:Evidence-Based Medicine; D006801:Humans; D017146:Models, Organizational; D015401:Nursing Administration Research; D009732:Nursing Care / Q000592:standards*; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration*; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration*; D017060:Patient Satisfaction; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D003668:Pressure Ulcer / Q000453:epidemiology; D015995:Prevalence; D019984:Quality Indicators, Health Care / Q000458:organization & administration*; D015203:Reproducibility of Results; D012149:Restraint, Physical; D018570:Risk Assessment; D012680:Sensitivity and Specificity