Phase one of the Nursing and Health Outcomes Project work began in 1999 and was completed in 2001.

An Expert Panel on Outcomes (EPO) was established. Members included researchers with expertise in outcomes and/or databases who worked on the identification of health outcomes reflective of nursing practice.

An Outcomes Feasibility and Outreach Committee (OFOC) consisting of representatives of nursing organizations such has the Registered Nurses Association of Ontario (RNAO), the Registered Practical Nurses Association of Ontario (RPNAO), the College of Nurses of Ontario (CNO) and the Ontario Nurses' Association (ONA) was organized. The committee provided feedback to the Expert Panel on outcomes.

As a first step, it was determined that a literature review with a specific focus on nurse-sensitive outcomes should be conducted. A key issue was to determine and define the nature of the outcomes against which to measure performance. Outcomes are affected by a variety of inputs and environmental factors. Provider characteristics, system characteristics such as how care is organized, and consumer/patient behaviours are all elements contributing to outcomes would have to be better understood.

Nursing sensitive outcomes were defined as those that are relevant, based on nurses domain and scope of practice, and for which there is empirical evidence linking nursing inputs and/or interventions to the health outcome. [Doran et al., 2001].

There was evidence that nurses influence such patient outcomes as-morbidity, mortality, health status, self-care, symptom control and patient satisfaction with care, as well as adverse events such as infection rates, falls, skin breakdown and nosocomial infections.

Research was commissioned to provide an in-depth analysis of specific nurse-sensitive outcomes and where they might be captured on existing databases along with information on the research and instruments used to assess the outcomes. The research work was conducted by Drs. Diane Irvine, principal investigator, Souraya Sidani, Linda McGillis Hall, Judy Watt-Watson, and Claire Mallette, Faculty of Nursing, University of Toronto, and Dr. Heather Laschinger, School of Nursing, University of Western Ontario.

Phase one achievements :

• Phase One Report, 2001
• Executive Summary, Phase One Report, 2001
• Proceedings, Invitational Symposium, March, 2001
• A set of evidence based outcome measures for collection-functional status, therapeutic self-care, symptom status (pain, nausea, dyspnea, fatigue), safety outcome measures (pressure ulcers, falls) and patient satisfaction with nursing care.
• Critical appraisal of the literature leading to the development of a nursing text - Nursing Sensitive Outcomes : State of the Science - that reviews the quality of the evidence, and provides direction for the selection of outcome variables and approaches to their measurement.
• Identification of the nurse staffing and quality work environment indicators to link with and complement health outcomes information