Does what nurses do affect clinical outcomes for hospitalized patients? A review of the literature

Health Serv Res. 1999 Dec;34(5 Pt 1):1011-32.


Objective: Through a review of the literature, to identify and describe (1) empirical studies of inpatient nursing care quality that evaluate links between nursing care processes and health-related patient outcomes, (2) nursing care processes for which process-outcome links have been established, and (3) important nursing care processes that have not yet been evaluated.

Data sources/study setting: Published empirical studies of inpatient nursing care quality that evaluated links between processes of nursing care and health-related patient outcomes.

Study design/data collection/extraction methods: This literature review used a five-step article search and review method.

Principal findings: Of 257 data-based studies of nursing care quality identified, 135 investigated a process-outcome link but only 17 met study inclusion criteria. The literature provides evidence that the quality of nursing care processes affects health-related patient outcomes during and after hospitalization. Gaps in the literature that evaluates nursing quality are identified.

Conclusions: Although some nursing care processes affect health-related patient outcomes, the full extent of nursing process-outcome links is relatively understudied. Further evaluation of the interrelationships between nursing care processes and outcomes is critical.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Humans
  • Nursing Process*
  • Nursing Research
  • Nursing Staff, Hospital*
  • Outcome and Process Assessment, Health Care*
  • Quality of Health Care
  • Treatment Outcome