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Despite the $2.3 trillion spent on U.S. health care, public and private payers still have a hard time measuring whether the kind of care they are paying for is of the highest value and produces the best outcomes. Nurses represent the largest group of health care professionals in the United States and have a direct affect on patient care, yet quality measures historically have focused on treatment of conditions or diseases, not on the care delivered by nurses. That changed in 2004, when the National Quality Forum (NQF) endorsed the first set of nationally standardized performance measures to assess the quality of care provided by nurses who work in hospitals.
By focusing on patient centered outcome measures such as prevalence of pressure ulcers and falls, as well as restraint use and frequency of catheter-associated infections, the NQF began to examine the link between what nurses do and the quality of care they provide. INQRI has played an important role in adding to the evidence about the utility of the NQF-endorsed Nursing Sensitive Measures by promoting the development and testing of new measures designed to both improve care and nursing performance, as well as reduce costs.