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Pediatric nurse-sensitive outcomes: A systematic review of international literature

Amatt, Natalie; Marufu, Takawira; Boardman, Rachel; Reilly, Lesley; Manning, Joseph


Natalie Amatt

Takawira Marufu

Rachel Boardman

Lesley Reilly

Joseph Manning


Natalie Amatt

Takawira Marufu

Rachel Boardman

Lesley Reilly

Joseph Manning
Project Leader


Background: Nurse-sensitive outcomes are measures for improvement and evaluation of the quality of nursing care delivered. The specific outcomes that need to be measured will be determined by the patient population, as well as the field and scope of practice, in which nursing care is being delivered. Currently, there is no internationally agreed upon set of nurse-sensitive outcomes for pediatric nursing, which provides specialist care to infants, children, and young people. Aim: To identify and evaluate nurse-sensitive outcomes for pediatric nursing. Methods: A systematic review was conducted. Five electronic databases (British Nursing Index, CINAHL, EMBASE, MEDLINE, and EMCARE) were searched in the period up to February 2022. Studies were selected for inclusion using title and abstract screening using predetermined criteria. The Critical Appraisal Skills Programme tool was used for quality assessment. A narrative synthesis of the results was performed. Results: A total of 633 studies were identified from online searches, with 14 studies meeting the inclusion criteria. All studies had moderate to high methodological strength. A total of 57 nurse-sensitive outcomes were identified from all included studies. Using the nurse-sensitive outcome conceptual analysis framework, 25 (45%) of the items were classified as outcome attributes, 20 (35%) as process attributes, and 13 (23%) as structure attributes. The most frequently reported nurse-sensitive outcomes included pressure ulcers, nosocomial infections, hospital-acquired infections, peripheral intravenous infiltration, failure to rescue, and staffing levels. Conclusions: This review provides an up-to-date and comprehensive list of nurse-sensitive outcomes for use in pediatric nursing and describes their frequency of use. However, further work is required to achieve consensus for an international core nurse-sensitive outcome set for pediatric nursing with policy recommendations to ensure agreed-upon minimum standards. Implications for nursing and health policy: Policy initiatives and guideline recommendations on nurse-sensitive outcome frameworks as part of patient safety should be a part of key priorities for policy makers. The commonly reported nurse-sensitive outcomes should be incorporated into daily bedside pediatric clinical nursing practice as a mechanism to evaluate and improve the quality of care, enhancement of patient safety, and better outcomes.


Amatt, N., Marufu, T., Boardman, R., Reilly, L., & Manning, J. (2023). Pediatric nurse-sensitive outcomes: A systematic review of international literature. International Nursing Review, 70(2), 160-174.

Journal Article Type Article
Acceptance Date Sep 8, 2022
Online Publication Date Oct 23, 2022
Publication Date 2023-06
Deposit Date Sep 9, 2022
Publicly Available Date Oct 24, 2023
Journal International Nursing Review
Print ISSN 0020-8132
Electronic ISSN 1466-7657
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 70
Issue 2
Pages 160-174
Keywords General Nursing
Public URL
Publisher URL
Additional Information This is the peer reviewed version of the following article: Amatt, N., Marufu, T., Boardman, R., Reilly, L., & Manning, J. (2022). Pediatric nurse sensitive outcomes: a systematic review and narrative synthesis of international literature. International Nursing Review,, which has been published in final form at The article must be linked to Wiley’s version of record on Wiley Online Library.


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