Under the interprofessional collaborative practice model (World Health Organization, 2011), all professionals should maintain a high degree of awareness regarding their responsibilities, the responsibilities of others, and the unique contributions of each in providing total healthcare (Golom & Schreck, 2018; Institute of Medicine [US], 2003). The effectiveness of nursing interventions in patient care is rarely considered explicitly in outcome studies, and little empirical evidence is available to support the claim that quality of care is advantageously affected by nursing interventions. Moreover, assessing the effect of the input of specific nursing interventions on quality is constrained by the limited data available.
The nature of nursing was articulated in Hung (1992) using two models. The first of these models is graphically represented using a series of overlapping circles (Figure 1). The circle filled with parallel lines at the center of the illustration represents nursing, with the other circles representing healthcare disciplines such as medicine, psychology, pharmacology, and sociology, among others. Nursing encompasses parts of these other disciplines but lacks its own, well-defined core. In the second model, a central circle represents nursing, with the other circles representing fields such as medicine, biology, sociology, and pharmacology, among others (Figure 1). In this model, nursing, theoretically, has a well-defined core, which makes its contribution explicit. Thus, the core area must be defined if nursing is to be a full-fledged profession. The question of whether empirical evidence of a link between quality of care and nursing interventions exists should be explored further.
Successful quality assurance must be grounded in reliable and valid information regarding the effectiveness of the nursing practice. Thus, the science of nursing must develop useful practice tools that are specific and sensitive to both the nursing process and the nursing care outcomes. However, an underlying problem preventing the pursuit of this strategy is the lack of specific and sensitive instruments that are able to measure the delivery of health services by nurses and the contribution that nurses make to the health system. In developing these instruments, adopting the blunt or general tools used in other disciplines should be avoided because they pose serious barriers to measuring the unique contributions and outcomes of nursing.
As a profession, nursing should show discipline-specific outcomes. Nursing interventions and nurse-sensitive outcomes are appropriate focuses for nursing studies. In this issue of The Journal of Nursing Research, our authors' efforts in the important realms of instrument development and measure validation provide a good starting point for measuring nursing intervention and quality of care.
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