Linkages Between Nursing and the Quality of Patient Care: A 2-Year Comparison

Naylor, Mary D. PhD, RN, FAAN*; Volpe, Ellen M. PhD, MSN*; Lustig, Adam MS; Kelley, Heather J. MA*; Melichar, Lori PhD; Pauly, Mark V. PhD§

doi: 10.1097/MLR.0b013e3182894848
Original Articles

Background: In 2005, the Robert Wood Johnson Foundation established the Interdisciplinary Nursing Quality Research Initiative (INQRI) program to produce rigorous evidence regarding linkages between nursing and quality of health care. The purpose of this paper is to describe scientific advances in understanding relationships between nursing, care processes, and the outcomes of the people supported by this discipline in 2004 (year before INQRI’s launch) and in 2009 (5 years after INQRI was established).

Methods: Comprehensive literature reviews for the years 2004 and 2009 were conducted using a conceptually based search strategy and multidisciplinary engines. The designs, methods, results, and conclusions of included papers were summarized, synthesized, and analyzed.

Results: The literature search identified 389 studies (161 in 2004; 228 in 2009), which examined the relationship between nursing and patient care quality. The number of published papers in all categories of study designs—nonexperimental (72 in 2004; 97 in 2009), quasi-experimental (55 in 2004; 80 in 2009) and experimental (34 in 2004; 51 in 2009)—increased between the years 2004 and 2009. This line of inquiry also has expanded its reach through publications in a greater diversity of journals and journals with higher impact ratings.

Discussion: The body of evidence regarding linkages between nursing and quality of care has increased in the nature and depth of science between 2004 and 2009, as seen in higher rates and quality of publications, enhanced methodological rigor, and evidence of stronger interdisciplinary collaboration. Although the unique contribution of INQRI to this expanded body of knowledge is unclear, the evidence supports the increased importance of INQRI’s goal of measuring and enhancing nursing’s contributions to the quality of patient care.

*NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia, PA

National Pharmaceutical Council, Washington, DC

Robert Wood Johnson Foundation, Princeton, NJ

§Department of Health Care Management, University of Pennsylvania Wharton School of Business, Philadelphia, PA

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Supported by the Robert Wood Johnson Foundation (RWJF). L.M., the RWJF senior program officer, provided support to the codirectors of the INQRI program, together forming the lNQRI leadership team.

The authors declare no conflict of interest.

Reprints: Heather J. Kelley, MA, 3615 Chestnut Street, Office 326, Philadelphia, PA 19104. E-mail:

© 2013 Lippincott Williams & Wilkins, Inc.