RNOtherAdvances in neonatal care : official journal of the National Association of Neonatal Nurses2026

Nurse-Driven Quality Indicators for Neonatal Intensive Care: A Delphi Consensus on Family-Integrated Priorities in NICUs.

Danmin Chen, Zhangbin Yu, Mengna Li and 4 others

PMID 41805200

WHAT IT FOUND

A Delphi consensus of Chinese neonatal experts narrowed 22 potential nursing quality indicators to nine for NICUs.

Family-centered care, lactation, and parental satisfaction were included, while pain assessment and noise incidents were excluded.

Key findings

01Nine nursing-sensitive quality indicators were established for Chinese NICUs, including nurse-to-patient ratio, hand hygiene compliance, and family-centered care rate.

02Five initial indicators were excluded after the first round of expert consultation, including pain assessment completion and incidence of noise.

03The final indicator set includes family-centered care rate, lactation rate, and parent satisfaction rate, which the authors describe as validated for the first time in China's NICUs.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

The expert panel consisted solely of Chinese clinicians, so the applicability of these indicators to other healthcare systems is limited. The study established the indicators through expert consensus but did not test them in clinical practice, so their real-world feasibility and relevance remain unverified. The panel included 19 doctors and 13 nurses, meaning the 'nursing-sensitive' indicators were heavily influenced by physician perspectives.

The easy way to misread this

Do not assume these nine indicators have been proven to improve patient outcomes or are feasible in daily practice. The study only established expert consensus on which metrics should be tracked; the authors explicitly state that empirical validation of these indicators in clinical settings has not yet been conducted.

Read it on PubMed →

Nurse-Driven Quality Indicators for Neonatal Intensive Care: A Delphi Consensus on Family-Integrated Priorities in NICUs. — Applied Evidence