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Quality Assurance in Nursing
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PRESENTED BY: Sathish RAJAMANI
Quality control : Refers to the activities that are used to evaluate, monitor or regulate services
rendered to the client.
Quality management : Refers to the system of management of quality with in the institution - the design, structure and functioning of the quality system
Quality Assessment : Involves assessing the standards of an institution against external criteria
Quality audit : Refers to the systematic & official examination of record, process,
structure, environment or account to evaluate
performance.
Standards : : Standards are desired & achievable levels of performance against which actual performance in practice is compared.
Quality Improvement : This is a process that uses clinical and technical skills to produce service.
The focus is on whole systems, not just on the performance of individual.
“ Quality Assurance refers to the process of achieving excellence in the service rendered to every client”
“ Quality Assurance is the defining of Nursing practice through well written Nursing standards and the use of those standards as a basis for evaluation on improvement of client care”- Marker (1998)
According to Jonas (2002), the two main Objectives are :-
To ensure the delivery of quality client care To demonstrate the efforts of the health care providers to
provide the best possible results
Other specific Objective of the Nursing process are :-
Formulate plan of care Attend to the patient’s physical and non-physical needs Evaluate achievement of Nursing care Support delivery of Nursing care with Administrative and
Managerial Services
There are two different approaches to ensure Quality
a)Quality by Inspection
b)Quality as Opportunity
A. GENERAL APPROACH: Credentialing Licensure Accreditation Certification
B. SPECIFIC APPROACHES: Peer Review Standard Nursing Audit
Standard is a Quantitative or Qualitative measure against which someone or something is judged, compared or used to service as a example
The ANA Standard of Practice Include:– Standard 1 : Data collection
Standard 2 : Nursing diagnosis
Standard 3 : Goals
Standard 4 : Priorities & prescribed Nursing approach
Standard 5 : Nursing action (health maintenance)
Standard 6 : Nursing action (maximize health capabilities)
Standard 7 : Evaluation (progress or lack of progress is assessed)
RETROSPECTIVE AUDITS: This refers to an in depth assessment of
quality after the patient has been discharged and uses the patients chart as the source of data.
CONCURRENT AUDITS: Its an evaluation method to inspect the Nursing
staff’s compliance with predetermined standards and criteria while the nurses are providing care.
OTHER AUDITS:a) Internal Auditb) External Audit
I. A SYSTEMATIC MODEL FOR IMPLEMENTATION OF UNIT BASED QUALITY ASSURANCE
Basic Components of system are Input Throughout Output Feed back
ANA MODEL FOR QUALITY ASSURANCE:
1) Establishment of standards or criteria
2) Identify the information relevant to criteria.
3) Determine ways to collect information
4) Collect and analyze information
5) Compare collected information with established criteria
6) Make judgment about quality
7) Provide information and if necessary take corrective action regarding findings of appropriate sources
8) Determine ways to collect the information
Lack of resources Personnel problems Improper maintenance Unreasonable patient and attendants Absence of well informed population Absence of accreditation law Lack of incident review procedures Lack of goods & hospital information system Absence of patient satisfaction surveys Lack of nursing care records Miscellaneous factors