Nursing Quality & Safety

The Nursing Quality & Safety Program at Boston Children's Hospital

The Nursing Quality & Safety Program at Boston Children's Hospital provides the ongoing improvement of the delivery, quality, efficiency and outcomes of patient care and services. We accomplish this through a systematic examination of data we generate at the hospital. 

We use this information for decision-making, evaluation and improvement activities. We also use it to identify care issues that may benefit from performance improvement or focused evidence-based initiatives. All quality activities are done in accordance with standards of professional health care practices, regulatory and licensing agencies and in support of the overall hospital mission and strategic plans.

Ongoing Initiatives 

  • Fall Prevention
  • Pressure Ulcer Prevention
  • Pain Management

Nursing/Patient Care Services Executive Committee for Quality

Boston Children's Hospital's Nursing/Patient Care Services Executive Committee for Quality (NPCSECQ) monitors quality performance and makes quality management decisions directed toward:

  • improving care delivery
  • organizational performance
  • patient outcomes

The NPCSECQ uses the best available evidence and data obtained through comprehensive, ongoing monitoring of patient processes and outcome indicators identified from established practice standards or the generation of new knowledge to make clinical and organizational decisions and policy development.

A Look at Our Data: ICU Staffing Ratios

MGL c. 111, sec. 231 was signed into law by Governor Deval Patrick on June 30, 2014. The law establishes patient assignment limits for registered nurses in intensive care units (ICUs) in acute hospitals licensed by the Massachusetts Department of Public Health and in hospitals operated by the Commonwealth. The law provides in part that “in all intensive care units the patient assignment for the registered nurse shall be 1:1 or 1:2 depending on the stability of the patient." 

Please see the table below for the staffing ratios in each of our intensive care units (ICUs) at Boston Children’s Hospital.

ICU Registered Nurse Staffing

Reporting Period:

 

7N NICU

7S MSICU

8S Cardiac ICU

11S Medicine ICU

January 1, 2017 - March 31, 2017

Average Daily Patient Census

21.3

26.3 26.5 14.1

Average Daily Staff Nurse Census

16

24 24.6 12.2

Average Daily Staff Nurse-to-Patient Ratio

1:1.34

1:1.09

1:1.07

1:1.16

April 1, 2017 - June 30, 2017

Average Daily Patient Census

22.4

26.4

28.2

14.4

Average Daily Staff Nurse Census

16.7

24.4

25.7

11.9

Average Daily Staff Nurse-to-Patient Ratio

1:1.34

1:1.08

1:1.09

1:1.20

July 1, 2017 - September 30, 2017

Average Daily Patient Census

22.00

25.31

25.80

13.60

Average Daily Staff Nurse Census

15.30

22.87

23.90

13.30

Average Daily Staff Nurse-to-Patient Ratio

1: 1.43

1: 1.06

1: 1.07

1: 1.02

October 1, 2017- December 31, 2017

Average Daily Patient Census

22.36

26.18

24.33

15.20

Average Daily Staff Nurse Census

15.52

23.31

22.41

12.52

Average Daily Staff Nurse-to-Patient Ratio

1: 1.44

1: 1.12

1: 1.08

1: 1.21


ICU Registered Nurse Staffing

Reporting Period:

 

7N NICU

7S MSICU

8S Cardiac ICU

11S Medicine ICU

January 1, 2016 - March 31, 2016

Average Daily Patient Census

21

27 28 11

Average Daily Staff Nurse Census

15

24 25 9

Average Daily Staff Nurse-to-Patient Ratio

1:1.4

1: 1.1

1:1.1

1:1.2

April 1, 2016 - June 30, 2016

Average Daily Patient Census

22

26

28

11

Average Daily Staff Nurse Census

16

24

25

9

Average Daily Staff Nurse-to-Patient Ratio

1:1.4

1:1.1

1:1.10

1:1.20

July 1, 2016- September 30, 2016

Average Daily Patient Census

22

25

28

9

Average Daily Staff Nurse Census

16

24

25

9

Average Daily Staff Nurse-to-Patient Ratio

1: 1.41

1: 1.04

1: 1.10

1: 1.00

October 1, 2016- December 31, 2016

Average Daily Patient Census

22

26

27

13

Average Daily Staff Nurse Census

16

24

25

12

Average Daily Staff Nurse-to-Patient Ratio

1: 1.40

1: 1.09

1: 1.10

1: 1.09