THE IMPACT OF NURSING GRADE ON THE QUALITY AND OUTCOME OF NURSING-CARE

The large industry which has grown up around the estimation of nursing requirements for a ward or for a hospital takes little account of var iations in nursing skill; meanwhile nursing researchers tend to concen trate on the appropriate organisation of the nursing process to delive r best quality care. This paper, drawing on a Department of Health fun ded study, analyses the relation between skill mix of a group of nurse s and the quality of care provided. Detailed data was collected on 15 wards at 7 sites on both the quality and outcome of care delivered by nurses of different grades, which allowed for analysis at several leve ls from a specific nurse-patient interaction to the shift sessions. Th e analysis shows a strong grade effect at the lowest level which is 'd iluted' at each succeeding level of aggregation; there is also a stron g ward effect at each of the lower levels of aggregation. The conclusi on is simple; you pay for quality care.