The actions of nurses have a significant impact on patient outcomes; therefore, a vital component of improving health care is to measure the quality of nursing care.

The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) is currently developing Women’s Health and Perinatal Nursing Care Quality (NCQ) measures.

View AWHONN’s position statement on Nursing Support of Laboring Women.


The development of AWHONN’s Women’s Health and Perinatal NQC Measures is a multi-step, multi-year process that will take place in four phases.

Phase I: The NCQ draft measures were published and the public comment period began on April 23, 2013 and ended August 1, 2013 (Association of Women’s Health, Obstetric and Neonatal Nurses [AWHONN], 2013).  In January, 2014, AWHONN published a new position statement entitled, “Nursing Care Quality Measurement” (AWHONN, 2014).

Phase II: The draft measures were refined based on the public comments received.  Subsequently, testing of the refined draft measures for feasibility, validity, and reliability will occur.  AWHONN estimates that measurement testing will take 1-2 years to complete.

Phase III: Endorsement of the tested measures by the National Quality Forum (NQF).  Adjustments to electronic health records and procedure codes by stakeholders.

Phase IV: Implementation and on-going maintenance of the NQF-endorsed NCQ measures.  Ongoing identification and development of additional Women’s Health and Perinatal NCQ measures.

AWHONN recognizes that the nurse’s expert knowledge confers the authority to shape the care environment and to influence decisions of patients. AWHONN’s pioneering efforts to support the measurement of the quality of care that registered nurses provide to women throughout their lives, before, during, and after birth, and to newborns is fundamental to the well-being of women and newborns.

 The Joint Commission Perinatal Care Core Measure Set Complementary Association of Women’s Health, Obstetric and Neonatal Nurses Nursing Care Quality Measures (Under Development)* 
PC-01: Elective Delivery  01 – Triage of a Pregnant Woman and Her Fetus(es)
 PC-02: Cesarean Section  02 – Second Stage of Labor: Mother-Initiated, Spontaneous Pushing;
10a – Labor Support;
10b – Partial Labor Support;
11 – Freedom of Movement during Labor
 PC-03: Antenatal Steroids
 PC-04: Health care — Associated Bloodstream Infections in Newborns
 PC-05: Exclusive Breast Milk Feeding  03 – Skin-to-Skin is Initiated Immediately Following Birth;
04 – Duration of Uninterrupted Skin-to-Skin Contact;
05 – Eliminating Supplementation of Breast Milk Fed Healthy, Term Newborns
 06 – Protect Maternal Milk Volume for Premature Infants Admitted to NICU
 07 – Initial Contact with Mothers Following a Neonatal Transport
 08 – Perinatal Grief Support
 09 – Women’s Health and Wellness Coordination throughout the Life Span

*Association of Women’s Health, Obstetric and Neonatal Nurses. (2014). Women’s health and perinatal nursing care quality. Refined draft measures specifications. Washington, DC: Author.



In 2012, AWHONN’s Women’s Health and Perinatal Nursing Care Quality Measures Advisory Panel developed an introductory set of nursing care quality measures (NCQ Measures).  The development of these NCQ Measures (sometimes referred to as “nurse- sensitive” measures) is one of many steps AWHONN is taking to lead and support efforts to improve the quality of healthcare provided to women and newborns.  This is the first published set of draft nursing care quality measures to specifically address the women’s health and perinatal populations.

These draft nursing care quality measures are being shared publicly at this stage, prior to validity and reliability testing, in an effort to stimulate and promote the further development, refinement, and utilization of women’s health and perinatal nursing care quality measurement in the US.