title: Measurement of Quality of Nursing Practice in Congenital Cardiac Care.
abstract: BACKGROUND
  The impact of nursing care on patients' outcomes has been demonstrated in adult and pediatric settings. However, limited attention has been given to standardized measurement of pediatric nursing care. A collaborative group, the Consortium for Congenital Cardiac Care Measurement of Nursing Practice, was formed to address this gap. The purpose of this study was to assess the current state of measurement of the quality of pediatric cardiovascular nursing in freestanding children's hospitals across the United States.
  
  
  METHODS
  A qualitative descriptive design was used to assess the state of measurement of nursing care from the perspective of experts in pediatric cardiovascular nursing. Nurse leaders from 20 sites participated in audiotaped phone interviews. The data were analyzed by using conventional content analysis.
  
  
  RESULTS
  Each level of data coding was increasingly comprehensive. Guided by Donabedian's quality framework of structure, process, and outcome, 2 encompassing patterns emerged: (1) structure and process of health care delivery and (2) structure and process of evaluation of care. Similarities in the structure of health care delivery included program expansion and subsequent hiring of nurses with a bachelor of science in nursing and experienced nurses to provide safety and optimal outcomes for patients. Programs varied in how they evaluated care in terms of structure, measurement, collection and dissemination of data.
  
  
  CONCLUSIONS
  External factors and response to internal processes of health care delivery were similar in different programs; evaluation was more varied. Seven opportunities for measurement that address both structure and process of nursing care were identified to be developed as benchmarks.
authors.affiliation: Jean Anne Connor is director of nursing research, Cardiovascular and Critical Care Services, Department of Nursing Patient Services, Boston Children's Hospital, Boston, Massachusetts, and clinical instructor of pediatrics, Harvard Medical School, Boston, Massachusetts. Sandra Mott is a nurse scientist research consultant, Boston Children's Hospital. Angela Green is vice president of performance improvement, Arkansas Children's Hospital, Little Rock, Arkansas. Carol Larson is a quality improvement consultant, Department of Cardiology, Boston Children's Hospital. Patricia Hickey is vice president, Cardiovascular and Critical Care Services, associate chief nursing officer, Department of Nursing Patient Services, Boston Children's Hospital, and assistant professor of pediatrics, Harvard Medical School. jean.connor@cardio.chboston.org.
authors.forename: Jean Anne
authors.initials: JA
authors.lastname: Connor
authors.affiliation: Jean Anne Connor is director of nursing research, Cardiovascular and Critical Care Services, Department of Nursing Patient Services, Boston Children's Hospital, Boston, Massachusetts, and clinical instructor of pediatrics, Harvard Medical School, Boston, Massachusetts. Sandra Mott is a nurse scientist research consultant, Boston Children's Hospital. Angela Green is vice president of performance improvement, Arkansas Children's Hospital, Little Rock, Arkansas. Carol Larson is a quality improvement consultant, Department of Cardiology, Boston Children's Hospital. Patricia Hickey is vice president, Cardiovascular and Critical Care Services, associate chief nursing officer, Department of Nursing Patient Services, Boston Children's Hospital, and assistant professor of pediatrics, Harvard Medical School.
authors.forename: Sandra
authors.initials: S
authors.lastname: Mott
authors.affiliation: Jean Anne Connor is director of nursing research, Cardiovascular and Critical Care Services, Department of Nursing Patient Services, Boston Children's Hospital, Boston, Massachusetts, and clinical instructor of pediatrics, Harvard Medical School, Boston, Massachusetts. Sandra Mott is a nurse scientist research consultant, Boston Children's Hospital. Angela Green is vice president of performance improvement, Arkansas Children's Hospital, Little Rock, Arkansas. Carol Larson is a quality improvement consultant, Department of Cardiology, Boston Children's Hospital. Patricia Hickey is vice president, Cardiovascular and Critical Care Services, associate chief nursing officer, Department of Nursing Patient Services, Boston Children's Hospital, and assistant professor of pediatrics, Harvard Medical School.
authors.forename: Angela
authors.initials: A
authors.lastname: Green
authors.affiliation: Jean Anne Connor is director of nursing research, Cardiovascular and Critical Care Services, Department of Nursing Patient Services, Boston Children's Hospital, Boston, Massachusetts, and clinical instructor of pediatrics, Harvard Medical School, Boston, Massachusetts. Sandra Mott is a nurse scientist research consultant, Boston Children's Hospital. Angela Green is vice president of performance improvement, Arkansas Children's Hospital, Little Rock, Arkansas. Carol Larson is a quality improvement consultant, Department of Cardiology, Boston Children's Hospital. Patricia Hickey is vice president, Cardiovascular and Critical Care Services, associate chief nursing officer, Department of Nursing Patient Services, Boston Children's Hospital, and assistant professor of pediatrics, Harvard Medical School.
authors.forename: Carol
authors.initials: C
authors.lastname: Larson
authors.affiliation: Jean Anne Connor is director of nursing research, Cardiovascular and Critical Care Services, Department of Nursing Patient Services, Boston Children's Hospital, Boston, Massachusetts, and clinical instructor of pediatrics, Harvard Medical School, Boston, Massachusetts. Sandra Mott is a nurse scientist research consultant, Boston Children's Hospital. Angela Green is vice president of performance improvement, Arkansas Children's Hospital, Little Rock, Arkansas. Carol Larson is a quality improvement consultant, Department of Cardiology, Boston Children's Hospital. Patricia Hickey is vice president, Cardiovascular and Critical Care Services, associate chief nursing officer, Department of Nursing Patient Services, Boston Children's Hospital, and assistant professor of pediatrics, Harvard Medical School.
authors.forename: Patricia
authors.initials: P
authors.lastname: Hickey
mesh_terms: D002983:Clinical Competence / Q000706:statistics & numerical data*; D064648:Critical Care Nursing / Q000592:standards* / Q000706:statistics & numerical data; D006330:Heart Defects, Congenital / Q000451:nursing*; D006801:Humans; D007407:Interviews as Topic; D009741:Nursing Staff, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D010371:Pediatric Nursing / Q000592:standards* / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D014481:United States