STRATEGIES TO ENHANCE NURSING QUALITY: A PROPOSAL FOR HEALTH SYSTEM SUSTAINABILITY

Objective: to reflect on the relationship between the quality of nursing care and its costs through initiatives that strengthen the nursing profession. Discussion: Advanced Practice Nursing improves access, coverage, and quality of care. Clinical Ladder Programs promote excellence and professional growth among nurses, with positive impacts on satisfaction and retention, and consequently, on the quality of care. Nursing-sensitive indicators allow for the monitoring of nursing-related outcomes and the impact of programs. Decisions regarding advanced practice and clinical ladder programs should consider opportunity costs and assess long-term cost-effectiveness. Solid evidence such as nursing-sensitive indicators and cost comparisons supports these decisions, including the optimization of nurse staffing. Conclusion: investing in the nursing workforce prevents adverse events, improves satisfaction and quality of care, and reduces costs, achieving institutional sustainability and efficiency. Supporting decision-making with cost-effectiveness studies is essential for the incorporation of such nursing strategies.