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J Clin Nurs. 2019 Jul;28(13):2589-2598. doi: 10.1111/jocn.14845. Epub 2019 Apr 04.

Development of a suite of metrics and indicators for children's nursing using consensus methodology.

Journal of clinical nursing

Maria Brenner, Catherine Browne, Anne Gallen, Susanna Byrne, Ciara White, Mary Nolan


  1. School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland.
  2. Department of Nursing and Health Sciences, Institute of Technology, Tralee, Co.Kerry, Ireland.
  3. Nursing & Midwifery Planning and Development Unit North West, Ballyshannon, Co. Donegal, Ireland.
  4. Nursing & Midwifery Planning and Development Unit for Dublin South, Palmerstown, Dublin, Ireland.
  5. Nursing & Midwifery Planning and Development Unit Dublin North, Swords, Co. Dublin, Ireland.
  6. Nursing and Midwifery Planning and Development Unit Midlands, Tullamore, Co Offaly, Ireland.

PMID: 30830707 PMCID: PMC7328790 DOI: 10.1111/jocn.14845


AIM AND OBJECTIVES: To develop a suite of metrics and indicators to measure the quality of children's nursing care processes. The objectives were to identify available metrics and indicators and to develop consensus on the metrics and indicators to be measured.

BACKGROUND: The Office of Nursing and Midwifery Services Director, Health Service Executive, in Ireland established seven workstreams aligned to the following care areas: acute, older persons, children's, mental health, intellectual disability, public health nursing and midwifery.

DESIGN: A comprehensive design included stakeholder consultation and a survey with embedded open-ended questions.

METHODS: A two-round online Delphi survey was conducted to identify metrics to be measured in practice, followed by a two-round online Delphi survey to identify the associated indicators for these metrics. A face-to-face consensus meeting was held with key stakeholders to review the findings and build consensus on the final metrics and indicators for use. A STROBE checklist was completed.

RESULTS: A suite of eight nursing quality care process metrics and 67 associated process indicators was developed for children's nursing.

CONCLUSIONS: By creating a national suite of metrics and indicators, more robust measurement and monitoring of nursing care processes can be achieved. This will enable the provision of evidence for any local and/or national level changes to policy and practice to enhance care delivery.

RELEVANCE TO CLINICAL PRACTICE: The roll-out of the metrics and indicators in clinical practice has commenced. This national suite of metrics and indicators will ensure that a robust system of measurement for improvement is in place to provide assurance to Directors of Nursing of the quality of nursing care being provided to children and their families. It supports the value of nursing sensitive data to inform change and improvement in healthcare delivery and to demonstrate the contribution of the nursing workforce to safe patient care.

© 2019 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

Keywords: children’s nursing; indicators; metrics; quality; safety


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