The Role of Nursing Care in Enhancing Clinical Outcomes and Treatment Effectiveness

Authors

  • Fahad Khamis K. ALSHAMMARI
  • Turki Mislat Binyah ALBAQAMI
  • Alhazmı, Fahad Tarrak M
  • Rakan Sultan Abdullah ALMINDIL
  • Alahmarı, Khulud Saeed O
  • Alahmarı, Huda Saeed O
  • Sara Muqbıl Saher ALENZI
  • Ahmed Zaid Sattam ALTAMYAT
  • Alshahranı, Dalal Ayıdh F
  • Althobaıtı, Faten Eıdhah M
  • Samaher Sameer A. ARAB

DOI:

https://doi.org/10.22399/ijcesen.3912

Keywords:

Nursing Care, Clinical Outcomes, Treatment Effectiveness, Patient Safety, Evidence-Based Practice, Nurse Staffing

Abstract

Nursing care plays a central role in translating medical treatments into real-world patient benefits by providing continuous assessment, timely interventions, and individualized support that optimize physiological recovery and reduce complication rates. Through systematic monitoring, early detection of deterioration, and prompt implementation of evidence-based nursing interventions, nurses help prevent avoidable adverse events such as infections, pressure injuries, and medication errors—directly improving morbidity and mortality statistics. Moreover, nurses act as care coordinators who bridge gaps among multidisciplinary teams, ensuring that treatment plans are communicated clearly, adjusted based on patient response, and implemented consistently across settings, which enhances treatment fidelity and overall effectiveness. Beyond direct clinical tasks, nursing contributes substantially to patient-centered outcomes by delivering education, psychosocial support, and self-management coaching that promote adherence to treatment regimens and lifestyle modifications. Effective patient education and engagement foster understanding of therapeutic goals, medication schedules, and warning signs, which reduces readmissions and improves long-term disease control. Additionally, nursing workforce factors—such as staffing levels, skill mix, and continuing professional development—shape the quality and consistency of care; investments in these areas strengthen nurses’ capacity to apply best practices and innovate in care delivery, ultimately amplifying the impact of treatments on patient outcomes and health system performance.

References

[1] Estabrooks CA, Midodzi WK, Cummings GG, Ricker KL, Giovannetti P., (2005). The impact of hospital nursing characteristics on 30-day mortality. Nurs Res. 54:74–84. doi: 10.1097/00006199-200503000-00002. [PubMed] DOI: https://doi.org/10.1097/00006199-200503000-00002

[2] Gunnarrdóttir SCS, Rafferty AM, Nutbeam D., (2007). Front-line management, staffing and nurse-doctor relationships as predictors of nurse and patient outcomes. A survey of Icelandic hospital nurses. Int J Nurs Stud; doi: 10.1016/j.ijnurstu.2006.11.007. Dispponible en: http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetaiIView&TermToSearch=17229425&ordinalpos=6&itool=EntrezSystem2.Pl.

[3] Aiken LH, Clarke SP, Sloane DM, Sochalski JA, Busse R, Clarke H, et al., (2001). Nurses’ reports on hospital care in five countries. Health Aff. 20:43–53. doi: 10.1377/hlthaff.20.3.43. DOI: https://doi.org/10.1377/hlthaff.20.3.43

[4] Kramer M, Schmalenberg C, (1988). Magnet hospitals. Part II. Institutions of excellence. Journal of Nursing Administration. 18:11–9. DOI: https://doi.org/10.1097/00005110-198802010-00005

[5] Aiken LH, Clarke SP, Sloane DM, (2002). Hospital staffing, organization, and quality of care: Cross-national findings. Nurs Outlook. 50:187–94. doi: 10.1067/mno.2002.126696.

[6] Aiken LH, Clarke SP, Sloane DM, Sochalski JA, Busse R, Clarke H, et al., (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA. 288:1987–93. doi: 10.1001/jama.288.16.1987. DOI: https://doi.org/10.1001/jama.288.16.1987

[7] Aiken LH, Clarke SP, Cheung RB, Sloane DM, Silber JH, (2003). Educational levels of hospital nurses and surgical patient mortality. JAMA. 290:1617–23. doi: 10.1001/jama.290.12.1617. see comment. DOI: https://doi.org/10.1001/jama.290.12.1617

[8] Aiken LH, Sloane DM, Lake ET, Sochalski J, Weber AL, (1999). Organization and outcomes of inpatient AIDS care. Med Car. 37:760–72. doi: 10.1097/00005650-199908000-00006. DOI: https://doi.org/10.1097/00005650-199908000-00006

[9] Aiken LH, Clarke SP, Sloane DM. Hospital staffing, organization, and quality of care: Cross-national findings. (Note: This appears to be a duplicate/conflation with item 3; kept as part of the shuffled list as provided.)

[10] Tourangeau AE, Doran DM, McGillis Hall L, O’Brien Pallas L, Pringle D, Tu JV, et al., (2007). Impact of hospital nursing care on 30-day mortality for acute medical patients. J Adv Nurs.;57:32–44. doi: 10.1111/j.1365-2648.2006.04084.x. DOI: https://doi.org/10.1111/j.1365-2648.2006.04084.x

[11] Rafferty AM, Clarke SP, Coles J, Ball J, James P, McKee M, et al., (2007). Outcomes of variation in hospital nurse staffing in English hospitals: cross-sectional analysis of survey data and discharge records. Int J Nurs Stud. 44:175–82. doi: 10.1016/j.ijnurstu.2006.08.003. see comment. DOI: https://doi.org/10.1016/j.ijnurstu.2006.08.003

[12] World Health Organization. (2004). World Alliance for Patient Safety: Forward Programme.

[13] Aiken LH, Patrician PA, (2000). Measuring organizational traits of hospitals: the Revised Nursing Work Index. Nurs Res. 49:146–53. doi: 10.1097/00006199-200005000-00006. DOI: https://doi.org/10.1097/00006199-200005000-00006

[14] Havens DS, Faura T, Aiken LH, (2002). The clinical environment of hospital nursing. Enferm Clin. 12:13–21. DOI: https://doi.org/10.1016/S1130-8621(02)73730-3

[15] Lake ET, (2002). Development of the practice environment scale of the Nursing Work Index. Research in Nursing & Health. 25:176–88. doi: 10.1002/nur.10032. DOI: https://doi.org/10.1002/nur.10032

[16] Aiken LH, (2005). Journey to excellence. Reflections on Nursing Leadership. 31:16–9.

[17] Aiken LH, (1995). Hospitals with magnetism: an organization model to improve the results of the patients. Enferm Clin; IV European Congress of Clinical Nursing; Barcelona, Spain. 259–62.

[18] McCloskey BA, Diers DK, (2005). Effects of New Zealand’s health reengineering on nursing and patient outcomes. Med Care. 43:1140–6. doi: 10.1097/01.mlr.0000182549.85761.cd. DOI: https://doi.org/10.1097/01.mlr.0000182549.85761.cd

[19] 2.Aiken LH, Clarke SP, Sloane DM, (2000). Hospital restructuring: does it adversely affect care and outcomes? Journal of Nursing Administration. 30:457–65. doi: 10.1097/00005110-200010000-00003. DOI: https://doi.org/10.1097/00005110-200010000-00003

[20] 3.Aiken LH, Clarke SP, Sloane DM, (2002). Hospital staffing, organization, and quality of care: Cross-national findings. Nurs Outlook. 50:187–94. doi: 10.1067/mno.2002.126696. DOI: https://doi.org/10.1067/mno.2002.126696

[21] Kerr D, Ostaszkiewicz J, Dunning T, Martin P, (2020). The effectiveness of training interventions on nurses' communication skills: A systematic review. Nurse Educ Today. 89:104405. DOI: https://doi.org/10.1016/j.nedt.2020.104405

[22] Holden RJ, Scanlon MC, Patel NR, et al., (2011). A human factors framework and study of the effect of nursing workload on patient safety and employee quality of working life. BMJ Qual Saf. 20(1):15-24. DOI: https://doi.org/10.1136/bmjqs.2008.028381

[23] James JT, (2013). A new, evidence-based estimate of patient harms associated with hospital care. J Patient Saf. 9(3):122-128 DOI: https://doi.org/10.1097/PTS.0b013e3182948a69

[24] World Health Organization, (2020). State of the World's Nursing Report-2020. World Health Organization.

[25] Recio-Saucedo A, Dall'Ora C, Maruotti A, et al., (2018). What impact does nursing care left undone have on patient outcomes? Review of the literature. J Clin Nurs. 27(11-12):2248-2259. DOI: https://doi.org/10.1111/jocn.14058

[26] Slatyer S, Coventry LL, Twigg D, Davis S, (2016). Professional practice models for nursing: A review of the literature and synthesis of key components. J Nurs Manag. 24(2):139-150. DOI: https://doi.org/10.1111/jonm.12309

[27] Makary MA, Daniel M, (2016). Medical error—the third leading cause of death in the US. BMJ. 353:i2139. DOI: https://doi.org/10.1136/bmj.i2139

[28] Crawford B, Skeath M, Whippy A, (2015). Multifocal clinical performance improvement across 21 hospitals. J Healthc Qual. 37(2):117-125. DOI: https://doi.org/10.1111/jhq.12039

[29] Fineout-Overholt E, Melnyk BM, Stillwell SB, Williamson KM, (2010). Evidence-based practice step by step: Critical appraisal of the evidence: Part I. Am J Nurs. 110(7):47-52. DOI: https://doi.org/10.1097/01.NAJ.0000383935.22721.9c

[30] Hodson P, Swiger PA, Campbell CM, et al., (2023). Findings from the development of a nursing joint professional practice model for the U.S. military. Nurs Outlook. 71(3):1-9. DOI: https://doi.org/10.1016/j.outlook.2023.101949

[31] Butler R, Monsalve M, Thomas GW, et al., (2018). Estimating time physicians and other health care workers spend with patients in an intensive care unit using a sensor network. Am J Med. 131(8):972.e9-972.e15. DOI: https://doi.org/10.1016/j.amjmed.2018.03.015

[32] Lombard M, Snyder-Duch J, Bracken CC, (2002). Content analysis in mass communication: Assessment and reporting of intercoder reliability. Hum Commun Res. 28(4):587-604. DOI: https://doi.org/10.1111/j.1468-2958.2002.tb00826.x

[33] Freeman R, McKee S, Lee-Lehner B, Pesenecker J, (2013). Reducing interruptions to improve medication safety. J Nurs Care Qual. 28(2):176-185. DOI: https://doi.org/10.1097/NCQ.0b013e318275ac3e

[34] Stallings-Welden LM, Shirey MR, (2015). Predictability of a professional practice model to affect nurse and patient outcomes. Nurs Adm Q. 39(3):199-210. DOI: https://doi.org/10.1097/NAQ.0000000000000106

[35] Defense Health Agency, (2017). The Defense Health Agency 2017 Stakeholder Report. Defense Health Agency.

[36] Page MJ, McKenzie JE, Bossuyt PM, et al., (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 372:n71. DOI: https://doi.org/10.1136/bmj.n71

[37] Hayes C, Jackson D, Davidson PM, Power T, (2015). Medication errors in hospitals: A literature review of disruptions to nursing practice during medication administration. J Clin Nurs. 24(21-22):3063-3076. DOI: https://doi.org/10.1111/jocn.12944

[38] Adler J, Malone D, (2012). Early mobilization in the intensive care unit: A systematic review. Cardiopulmonary Phys Ther J. 23(1):5-13. DOI: https://doi.org/10.1097/01823246-201223010-00002

[39] Zegers M, Hesselink G, Geense W, Vincent C, Wollersheim H, (2016). Evidence-based interventions to reduce adverse events in hospitals: A systematic review of systematic reviews. BMJ Open. 6(9):e012555. DOI: https://doi.org/10.1136/bmjopen-2016-012555

[40] Winters BD, Weaver SJ, Pfoh ER, Yang T, Pham JC, Dy SM, (2013). Rapid-response systems as a patient safety strategy: A systematic review. Ann Intern Med. 158(5 Pt 2):417-425. DOI: https://doi.org/10.7326/0003-4819-158-5-201303051-00009

[41] Kul S, Barbieri A, Milan E, Montag I, Vanhaecht K, Panella M, (2012). Effects of care pathways on the in-hospital treatment of heart failure: A systematic review. BMC Cardiovasc Disord. 12:81. DOI: https://doi.org/10.1186/1471-2261-12-81

[42] Hopkins RO, Mitchell L, Thomsen GE, Schafer M, Link M, Brown SM, (2016). Implementing a mobility program to minimize post-intensive care syndrome. AACN Adv Crit Care. 27(2):187-203. DOI: https://doi.org/10.4037/aacnacc2016244

[43] Floyd E, Hodgkins R, Naylon L, Noon M, Sirotti L, Monaro S, (2020). The costs and benefits of pressure injury point prevalence auditing. WPR. 28(2):66-74. DOI: https://doi.org/10.33235/wpr.28.2.66-74

[44] Zuck erwise LC, Lipkind HS, (2017). Maternal early warning systems–towards reducing preventable maternal mortality and severe maternal morbidity through improved clinical surveillance and responsiveness. Semin Perinatol. 41(3):161-165. DOI: https://doi.org/10.1053/j.semperi.2017.03.005

[45] Padula WV, Pronovost PJ, Makic MBF, et al., (2019). Value of hospital resources for effective pressure injury prevention: A cost-effectiveness analysis. BMJ Qual Saf. 28(2):132-141. DOI: https://doi.org/10.1136/bmjqs-2017-007505

[46] Morello RT, Lowthian JA, Barker AL, McGinnes R, Dunt D, Brand C, (2013). Strategies for improving patient safety culture in hospitals: A systematic review. BMJ Qual Saf. 22(1):11-18. DOI: https://doi.org/10.1136/bmjqs-2011-000582

[47] Kiekkas P, Tsekoura V, Aretha D, et al., (2019). Nurse understaffing is associated with adverse events in postanaesthesia care unit patients. J Clin Nurs. 28(11-12):2245-2252. DOI: https://doi.org/10.1111/jocn.14819

[48] Padula WV, Nagarajan M, Davidson PM, Pronovost PJ, (2021). Investing in skilled specialists to grow hospital infrastructure for quality improvement. J Patient Saf. 17(1):51-55. DOI: https://doi.org/10.1097/PTS.0000000000000623

[49] Pauls LA, Johnson-Paben R, McGready J, Murphy JD, Pronovost PJ, Wu CL, (2017). The weekend effect in hospitalized patients: A meta-analysis. J Hosp Med. 12(9):760-766 DOI: https://doi.org/10.12788/jhm.2815

[50] Pullyblank A, Tavaré A, Little H, et al., (2020). Implementation of the national early warning score in patients with suspicion of sepsis: Evaluation of a system-wide quality improvement project. Br J Gen Pract. 70(695):e381-e388. DOI: https://doi.org/10.3399/bjgp20X709349

[51] Eriksen, M. B., & Frandsen, T. F. (2018). The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: A systematic review. Journal of the Medical Library Association, 106(4), 420. 10.5195/jmla.2018.345 DOI: https://doi.org/10.5195/jmla.2018.345

[52] Donabedian, A. (1988). The quality of care. How can it be assessed? The Journal of the American Medical Association, 260(12), 1743–1748. DOI: https://doi.org/10.1001/jama.1988.03410120089033

[53] Friesecke, S., Schwabe, A., Stecher, S.-S., & Abel, P. (2014). Improvement of enteral nutrition in intensive care unit patients by a nurse-driven feeding protocol. Nursing in Critical Care, 19(4), 204–210. 10.1111/nicc.12067 DOI: https://doi.org/10.1111/nicc.12067

[54] Blot, S. I., Serra, M. L., Koulenti, D., Lisboa, T., Deja, M., Myrianthefs, P., Manno, E., Diaz, E., Topeli, A., Martin-Loeches, I., Rello, J., & EU-VAP/CAP Study Group. (2011). Patient to nurse ratio and risk of ventilator-associated pneumonia in critically ill patients. American Journal of Critical Care, 20(1), E1–E9. 10.4037/ajcc2011555 DOI: https://doi.org/10.4037/ajcc2011555

[55] Casida, J. M., Davis, J. E., McKee, P. J., Zalewski, A., & Yang, J. J. (2018). Night-time care routine interaction and sleep disruption in adult cardiac surgery. Journal of Clinical Nursing, 27(7–8), E1377–E1384. 10.1111/jocn.14305 DOI: https://doi.org/10.1111/jocn.14262

[56] Danielis, M., Palese, A., Terzoni, S., & Destrebecq, A. L. L. (2019). What nursing sensitive outcomes have been studied to-date among patients cared for in intensive care units? Findings from a scoping review. International Journal of Nursing Studies, 102, 103491. 10.1016/j.ijnurstu.2019.103491 DOI: https://doi.org/10.1016/j.ijnurstu.2019.103491

[57] Aktas, Y. Y., & Karabulut, N. (2016). The effects of music therapy in endotracheal suctioning of mechanically ventilated patients. Nursing in Critical Care, 21(1), 44–52. 10.1111/nicc.12159 DOI: https://doi.org/10.1111/nicc.12159

[58] Alway, A., Halm, M. A., Shilhanek, M., & St Pierre, J. (2013). Do earplugs and eye masks affect sleep and delirium outcomes in the critically ill? American Journal of Critical Care, 22(4), 357–360. 10.4037/ajcc2013545 DOI: https://doi.org/10.4037/ajcc2013545

[59] Checkley, W., Martin, G. S., Brown, S. M., Chang, S. Y., Dabbagh, O., Fremont, R. D., Girard, T. D., Rice, T. W., Howell, M. D., Johnson, S. B., O'Brien, J., Park, P. K., Pastores, S. M., Patil, N. T., Pietropaoli, A. P., Putman, M., Rotello, L., Siner, J., Sajid, S., Murphy, D. J., … USCIITG-CIOS Investigators. (2014). Structure, process and annual intensive care unit mortality across 69 centers: United States Critical Illness and Injury Trials Group Critical Illness Outcomes Study (USCIITG-CIOS). Critical Care Medicine, 42(2), 344. 10.1097/CCM.0b013e3182a275d7 DOI: https://doi.org/10.1097/CCM.0b013e3182a275d7

[60] Cox, C., & Hayes, J. (1999). Physiologic and psychodynamic responses to the administration of therapeutic touch in critical care. Complementary Therapies in Nursing & Midwifery, 5(3), 87–92. 10.1016/S1353-6117(99)80026-2 DOI: https://doi.org/10.1016/S1353-6117(99)80026-2

[61] Marshall, J. C., Bosco, L., Adhikari, N. K., Connolly, B., Diaz, J. V., Dorman, T., Fowler, R. A., Meyfroidt, G., Nakagawa, S., Pelosi, P., Vincent, J. L., Vollman, K., & Zimmerman, J. (2017). What is an intensive care unit? A report of the task force of the World Federation of Societies of Intensive and Critical Care Medicine. Journal of Critical Care, 37, 270–276. 10.1016/j.jcrc.2016.07.015 DOI: https://doi.org/10.1016/j.jcrc.2016.07.015

[62] Ledwith, M. B., Bloom, S., Maloney Wilensky, E., Coyle, B., Polomano, R. C., & Le Roux, P. D. (2010). Effect of body position on cerebral oxygenation and physiologic parameters in patients with acute neurological conditions. Journal of DOI: https://doi.org/10.1097/JNN.0b013e3181ecafd4

Neuroscience Nursing, 42(5), 280–287. 10.1097/JNN.0b013e3181ecafd4

[63] Kelly, D., Kutney Lee, A., Lake, E. T., & Aiken, L. H. (2013). The critical care work environment and nurse reported health care associated infections. American Journal of Critical Care, 22(6), 482–489. 10.4037/ajcc2013298 DOI: https://doi.org/10.4037/ajcc2013298

[64] Kram, S. L., DiBartolo, M. C., Hinderer, K., & Jones, R. A. (2015). Implementation of the ABCDE bundle to improve patient outcomes in the intensive care unit in a rural community hospital. Dimensions of Critical Care Nursing: DCCN, 34(5), 250–258. 10.1097/dcc.0000000000000129 DOI: https://doi.org/10.1097/DCC.0000000000000129

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2024-12-30

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Fahad Khamis K. ALSHAMMARI, Turki Mislat Binyah ALBAQAMI, Alhazmı, Fahad Tarrak M, Rakan Sultan Abdullah ALMINDIL, Alahmarı, Khulud Saeed O, Alahmarı, Huda Saeed O, … Samaher Sameer A. ARAB. (2024). The Role of Nursing Care in Enhancing Clinical Outcomes and Treatment Effectiveness. International Journal of Computational and Experimental Science and Engineering, 10(4). https://doi.org/10.22399/ijcesen.3912

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Research Article