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Measurement and Validation of Primary Care Nursing Indicators Based on a Wound Care Tracer Condition

Dufour, Émilie RN; Duhoux, Arnaud PhD; Contandriopoulos, Damien PhD

doi: 10.1097/NCQ.0000000000000403
Original Article: PDF Only

Background: Access to both valid and reliable nursing-sensitive indicators is currently limited in primary care.

Purpose: The objectives were to (1) measure primary care nursing indicators using a wound care tracer condition and (2) study the associations between process and outcome indicators.

Methods: We conducted a longitudinal study in an ambulatory care clinic in Quebec, Canada. The sample included 482 episodes of care. We studied 5 indicators related to processes and 3 to outcomes.

Results: Performance levels were moderately high for indicators of initial assessment and duration and low for those of continuity and education. Associations between nursing follow-up and continuity indicators and 3 outcome indicators were highly significant.

Conclusion: Continuity and nursing follow-up are associated with improved outcomes. Increasing these indicators' performance level can improve both nursing processes and patient outcomes.

Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada (Ms Dufour and Dr Duhoux); CR-CSIS (Centre de Recherche—Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé), Université de Sherbrooke, Longueuil, Quebec, Canada (Dr Duhoux); and School of Nursing, University of Victoria, Victoria, British Columbia, Canada (Dr Contandriopoulos).

Correspondence: Émilie Dufour, RN, Faculty of Nursing, Université de Montréal CP 6128, succ Centre-Ville Montreal, Quebec H3C 3J7, Canada (

The first author received a master's grant from the Research Chair Policies, Knowledge and Health funded from the Applied Public Health Chairs Program of the Canadian Institutes of Health Research.

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Accepted for publication: February 25, 2019

Published ahead of print: April 8, 2019

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