• community health nursing;
  • decision making;
  • population-based nursing;
  • program evaluation;
  • public health nursing standards;
  • quality management

ABSTRACT Objectives: Difficulties in recruiting nurses into public health settings threaten the public's health. Gaps in existing data make determining the health impact of workforce changes numbers difficult to perform. Public health practice leaders are left to make difficult staffing and program decisions without knowing how the health of their vulnerable populations will be affected. The objective of this study was to identify indicators that could be used to document the effect of the shortage of public health nurses (PHNs) on the health of a population.

Design and Sample: A consensus-building process was used. Nursing directors from 6 local health departments (LHDs) in 2 states participated along with 3 public health system researchers.

Results: The findings from this collaborative process suggest that it is possible to identify outcome indicators across states and multiple LHDs that may be sensitive to PHN staffing levels and interventions. Possible connections between PHN staffing and each population-patient care indicator (rates of Chlamydia, first trimester prenatal care, early childhood immunization) are presented.

Conclusions: The process used here in identifying these indicators and the proposed nursing-sensitive population outcome indicators themselves provide a template for the development and analysis of additional outcome indicators sensitive to the quality of nursing and other health care.