Nurse‐sensitive quality and benchmarking in hospitals striving for Magnet® or Pathway® designation: A qualitative study

Aim To examine if and how selected German hospitals use nurse‐sensitive clinical indicators and perspectives on national/international benchmarking. Design Qualitative study. Methods In 2020, 18 expert interviews were conducted with key informants from five purposively selected hospitals, being the first in Germany implementing Magnet® or Pathway®. Interviews were analyzed using content analysis with deductive‐inductive coding. The study followed the COREQ guideline. Results Three major themes emerged: first, limited pre‐existence of and necessity for nurse‐sensitive data. Although most interviewees reported data collection for hospital‐acquired pressure ulcers and falls with injuries, implementation varied and interviewees highlighted the necessity to develop additional nurse‐sensitive indicators for the German context. Second, the theme creating an enabling data environment comprised building clinicians' acceptance, establishing a data culture, and reducing workload by using electronic health records. Third, challenges and opportunities in establishing benchmarking were identified but most interviewees called for a national or European benchmarking system. Conclusion The need for further development of nurse‐sensitive clinical indicators and its implementation in practice was highlighted. Several actions were suggested at hospital level to establish an enabling data environment in clinical care, including a nationwide or European benchmarking system. Implications for the Profession and Patient Care Involving nurses in data collection, comparison and benchmarking of nurse‐sensitive indicators and their use in practice can improve quality of patient care. Impact Nurse‐sensitive indicators were rarely collected, and a need for action was identified. The study results show research needs on nurse‐sensitive indicators for Germany and Europe. Measures were identified to create an enabling data environment in hospitals. An initiative was started in Germany to establish a nurse‐sensitive benchmarking capacity. Patient or Public Contribution Clinical practitioners and nurse/clinical managers were interviewed.