title: Three population-patient care outcome indicators for public health nursing: results of a consensus project.
abstract: OBJECTIVE
  Difficulties in recruiting nurses into public health settings threaten the public's health. Gaps in existing data make determining the health impact of workforce changes numbers difficult to perform. Public health practice leaders are left to make difficult staffing and program decisions without knowing how the health of their vulnerable populations will be affected. The objective of this study was to identify indicators that could be used to document the effect of the shortage of public health nurses (PHNs) on the health of a population.
  
  
  METHODS
  A consensus-building process was used. Nursing directors from 6 local health departments (LHDs) in 2 states participated along with 3 public health system researchers.
  
  
  RESULTS
  The findings from this collaborative process suggest that it is possible to identify outcome indicators across states and multiple LHDs that may be sensitive to PHN staffing levels and interventions. Possible connections between PHN staffing and each population-patient care indicator (rates of Chlamydia, first trimester prenatal care, early childhood immunization) are presented.
  
  
  CONCLUSIONS
  The process used here in identifying these indicators and the proposed nursing-sensitive population outcome indicators themselves provide a template for the development and analysis of additional outcome indicators sensitive to the quality of nursing and other health care.
authors.affiliation: School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA. issel@uic.edu
authors.forename: L Michele
authors.initials: LM
authors.lastname: Issel
authors.forename: Betty
authors.initials: B
authors.lastname: Bekemeier
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Baldwin
mesh_terms: D002689:Chlamydia; D003152:Community Health Nursing / Q000592:standards*; D003299:Cooperative Behavior; D003657:Decision Making; D003697:Delphi Technique; D006801:Humans; D015397:Program Evaluation; D011637:Public Health Nursing / Q000592:standards*; D011787:Quality of Health Care / Q000592:standards*; D014481:United States