School nurse sensitive indicators: The devil is in the details

It is critical for child health and education leaders to measure and articulate the impact school nurses have on student outcomes. The development of accepted nurse sensitive indicators facilitates research on the effectiveness of school nurse intensity, credentials and interventions on the child health and educational achievement. School nursing leaders have identified a long list of potential structure, process, and outcome indicators to measure and evaluate care. Before a Delphi process could take place to prioritize those measures for research, each indicator had to be defined and analyzed for suitability. Criteria for suitable measures are Importance, Scientific Acceptability, Usability, and Feasibility. The process and the challenge of defining and analyzing each potential measure will be described. Several examples of both optimal and troublesome measures will be discussed. The knowledge created through research that utilizes nurse sensitive outcome measures provides direction for the investment in effective care delivery systems that achieve the Triple Aim of care, health and cost. This important workforce and quality issue is applicable to all public health nurse(population-based) specialties.