[Methods of nursing performance measurement]

ABSTRACT

Nurses play a critical role in health promotion of their society due to their professional importance. To continue this role, exact methods of nursing performance measurements are necessary. Performance measurement and evaluation is the most difficult stage in control process because it requires collecting data and designing scientific models. Measurement methods presented by researchers consist of patient point managed per nurse[PPMN 1974], therapeutic intervention scoring system with 76 therapeutic procedures [TISS28 1983] and its simplified version with 28 therapeutic procedures [TISS28 1997], time oriented score system [TOSS 1991], measurement of nursing diagnosis for nursing severity index [1992], nine equivalents of nursing man power use score [NEMS 1997], and nursing activity score[NAS 2003]. Prospective payment system that changed performance measurement and evaluation of hospitals' therapeutic personnel was approved in U.S congress in early 1980. In this system, the amount of insurance payment by companies has been identified in advance for each diagnostic related group of patients, based on their diagnosis. On the contrary, nursing services are provided according to human responses not just medical diagnosis. Continuing measurement leads to improved quality care. Measuring quantity of nursing care is much easier than measuring its quality. However, its importance has not been well recognized. It is evident that if authorities do not have enough knowledge about heavy work load of nursing care, they can not apply correct evaluation methods. In Iran, payments for nursing services at home or outpatient clinics have been identified but these services are not recognized in hospitals. Payments for nursing services in hospitalized patients constitute only a little amount of medical expenses under the coverage of insurance companies. Measuring nursing services can be a solution for this problem which will be discussed in this article