Abstract
Nursing quality is rapidly moving to center stage in health care. On October 1, 2008, reimbursement from the Centers for Medicaid and Medicare Services (CMS) made a dramatic change in the pay for performance schema of recent years. The carrot replaced the stick, and hospitals began declining to reimburse for eight hospital-acquired conditions (HAC), most of which have implications for practice. Among the eight HACs, quality issues such as pressure ulcers, falls with injury, and catheter-associated urinary tract infection are readily identified as nursing-sensitive quality indicators. Maas, Johnson, and Moorehead first coined the term nursing sensitive in 1996 to denote patient outcomes affected in large part by practice.1 In 2004, the American Nurses Association recognized nursing-sensitive quality indicators as measures and indicators that reflect the impact of action on outcomes.2
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