Nursing productivity: from data to definition.

Abstract

Analysts hesitate to measure human services' productivity because crucial elements appear so intangible. Furthermore, during contacts or incremental exchanges, servor and served consume emerging products of mutual efforts as they are produced. The served, primarily the patient, inputs first a certain physical, psychosocial and economic status, then a stream of information and responses. The nurse, as the primary, inpatient servor continually present at the site of service exchange, personally applies certain professional competencies and material resources, schedules others' activities, diffuses technology, and gathers records and transmits information. The records nurses generate and/or keep can define leading indicators of all these inputs and their interrelationships. Thus, their various impacts upon nursing services--in general, in individual categories, and in individualized course--can be usably quantified. Outcomes, too, are definable through comparisons of actual results with common expectations shaped within the process and with the results achieved by others. Patient classification and staffing ratios are indicators of availability of a requisite variety of resources. Data on errors, recidivism and referrals act as reliability measures and also yield data on durability in achieving anticipated individual results. On this basis, the author proposes graded descriptions of factors conditioning productivity and a formula evaluating nursing's contributions to it.