The Center for Research & Innovation in Patient Care

California Nursing Outcomes

Coalition (CalNOC) Overview

Introduction

The California Nursing Outcomes Coalition (CalNOC) is a collaborative initiative engaging a diverse team of staff nurses, advanced practice clinicians, educators, researchers, administrators and leaders in nursing in attaining the shared vision of designing, systematically implementing, and evaluating a statewide nursing outcomes database. The CalNOC project is the largest ongoing nursing quality measurement research and development project in progress in the nation. The aim of the California Nursing Outcomes Coalition (CalNOC) Project is to become the standard for clinical, administrative, and scientific quality measurement in nursing statewide. In order to realize the vision, CalNOC is building and sustaining the CalNOC database repository, conducting research to advance evidence-based administrative and clinical decision-making and providing data to resolve public policy and clinical dilemmas in the cost and efficacy of patient care delivery. The CalNOC Project has successfully completed Phase I (1995-1996) and Phase II (1997-1998), and has launched Phase III (1999-2002). This paper presents an overview of findings for Phase II and early Phase III.

Design & Methods

CalNOC is one of ANA’s six state nursing quality indicator research and development projects (AZ, TX, MN, ND, VA) (Grobe, 1998; Redmond, Riggleman, Sorrell & Zerull, 1999). During Phase II CalNOC expanded its volunteer convenience sample of acute care sites from 11 to 43 hospitals, nearly 10% of the California acute care marketplace, with 38 sites actively collecting nursing quality indicator data using CalNOC’s standardized definitions/coding derived from the ANA standards for the emerging National Database for Nursing Quality Indicators (NDNQI).

CalNOC Indicators and Findings

The CalNOC database currently contains data from more than 50 pressure ulcer prevalence studies conducted in 33 hospitals with information on more than 5,000 patients; descriptive details on 4000 patient falls; and staff hours, skill mix, and patient days for 249 hospital units. This presentation will describe CalNOC’s first public data release and will compare the percentages of RNs, LVNs, and other caregivers; agency use; and nursing hours per patient day by hospital size (average daily census) and type of unit. The same categories will then be used to describe the number of falls and injury falls per 1,000 patient days and pressure ulcer prevalence (both hospital and community acquired). We will also discuss issues involved in combining the “real world” of hospital data collection with the scientific integrity of a “research” database, as well as reliability and validity of the data and the estimates of systematic error rates.

References

Grobe SJ, Becker H, Calvin A, Biering P, Jordan C, Tabone S. Clinical data for use in assessing quality: lessons learned from the Texas Nurses' Association Report Card Project. Semin Nurse Manag. 1998 Sep;6(3):126-38.

Redmond G, Riggleman J, Sorrell JM, Zerull L. Creative winds of change: nurses collaborating for quality outcomes. Nurs Adm Q. 1999 Winter;23(2):55-64.

View photos from CalNOC 2005 Conference.

Back to top- - -

- - - - -

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -