A guidance framework to aid in the selection of nursing and midwifery care process metrics and indicators.

AIM: To describe the development of a guidance framework to assist nurses and midwives in selecting nursing and midwifery care process metrics and indicators for use in practice. BACKGROUND: Process metrics are measures of care provision activities by nurses and midwives. METHODS: Phase 1 was a rapid review assessment of the literature conducted to identify an initial framework. Six electronic databases were searched with Google Scholar and reference tracking performed. Phase 2 was expert review of the developing framework by nursing and midwifery experts in practice, academia and an international expert in quality care metrics. RESULTS: The literature assessment yielded 28 papers with 59 metric attributes identified. From this, a six-domain framework was developed. Following expert review, the framework was reduced to four domains: "Process Focused," "Important," "Operational" and "Feasible." CONCLUSIONS: This is the first framework specifically to guide nurses and midwives in selecting nursing and midwifery process metrics and indicators.

Measuring antenatal care use in Europe: is the content and timing of care in pregnancy tool applicable?

OBJECTIVES: Measuring of antenatal care utilisation is important from a public health perspective. The Content and Timing of care in Pregnancy tool (CTP) focuses on the care process and includes aspects on quality of care. The aim of the study is to gain insight in the applicability of the CTP tool across Europe. METHODS: National guidelines for routine antenatal care were examined, analysing the degree to which the four items in the CTP tool were included in these guidelines. RESULTS: From the 30 countries, 22 had a national guideline for routine antenatal care. The CTP tool is applicable in over 60% of the European countries with a national guideline. CONCLUSIONS: The CTP tool can be used to measure antenatal care delivery in Europe. The tool is useful to evaluate the care process, focusing on rates of interventions as the closest approximation to the delivery of health care, with a focus on content of visits rather than simply the number of visits. Together with indicators measuring structure and outcome of health care, conclusions about the quality of care can be made.