Background: The National Professional Standard of Nursing states that nurses should provide professional and compassionate care with respect and confidentiality. Therefore, the Dutch Nurses' Association V&VN has set up a quality programme in which clinical guidelines for caregivers, registered nurses and nurse practitioners have been developed. In addition, the information from these guidelines is standardised and implemented into electronic health records.
Objectives: This quality programme supports the nursing decision-making process in daily practice. The aim is to enhance the quality of nursing care, by reducing unwanted variation in care, guiding nurses in decision making and monitoring the results and outcomes of interventions with nursing sensitive indicators.
Methods: V&VN started a pilot study for wound care by nurses. Clinical nursing guidelines related to wound care were studied by experts. These guidelines were converted into decision trees. Then, standardised nursing information (based on detailed clinical models and SNOMED CT terminology) was integrated into the decision trees. Feasibility aspects of these decision trees were tested in multiple institutions, including hospitals and community care centres.

Results: Decision trees for pressure ulcer, acute wound, oncological ulcer, skin tears, diabetic foot, burns and ulcus cruris are developed leading to improved quality of nursing care and comparable and exchangeable information. In the future, nursing sensitive indicators provide national information about the quality of care, safety and outcomes of nursing interventions.

Conclusions: This nursing quality programme focuses on the development of nursing guidelines and standardised decision-trees and integrating these decision-trees into the electronic health records. Standardised nursing information allows consistent retrieval of clinical information for nursing research, transparency and accountability purposes, developing the body of knowledge, and improves the exchange of nursing information within and across different healthcare sectors and settings. This information provides new insights for the development or revision of guidelines.