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Evaluation of the effect of a Nursing System Framework on Nurse Sensitive Indicators, mortality and readmission in an NHS Trust

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journal contribution
posted on 2023-08-28, 02:51 authored by Ann-Marie CannabyAnn-Marie Cannaby, V Carter, K Warren, J Gwinnett, K Bailey, S Mahmud, Richard GrayRichard Gray
In 2018, an NHS Trust (UK) implemented an innovative Nursing System Framework (NSF). The NSF formalized a two-year strategy, which provided teams with clear aims and measurable objectives to deliver care. Failures of coordination of nursing services are well-recognized threats to the quality, safety and sustainability of care provision. Aim: To evaluate the efficacy of introducing a NSF in an NHS Trust, using nursing sensitive indicators and pre-selected mortality, data outcome measures. Design: A before and after implementation, observational study. Methods: 105,437 admissions were extracted at an admission record level. Data was extracted from 1st September 2018 through to the 31st August 2019. Results: Using SQUIRE guidelines to report the study, insufficient evidence was found to reject a null hypothesis with a chi-squared test of association between in-hospital death and the NSF intervention period, with a p-value of.091. However, trends were seen in the data, which suggested a positive association. Conclusion: The NSF is a complex intervention, which provides direction for improvements but requires further research to understand the benefits for nurses, Midwives, Health Visitors and patients.


Publication Date



Nursing Open






(p. 953-966)





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© 2022 The Authors. Nursing Open published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.