1981
DOI: 10.1111/j.1365-2648.1981.tb03089.x
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Improvement of quality of nursing care: a goal to challenge in the eighties

Abstract: Some general thoughts on the use of the quality concept as a means to structure critical reflection on patient-client care and health services is discussed. The continuous request for more health care facilities and quality of services occupies not only the minds of the health workers, but also of the consumer who is becoming more aware of his rights and privileges. Health care should not be identified with curative care only. It involves prevention and promotion of people's status of health as well. Nurses ha… Show more

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Cited by 18 publications
(4 citation statements)
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“…The importance of clarifying the meaning of quality is as perceived by practising clmical nurses Taylor & highlighted by Crow (1981) who noted that standards of Haussman (1988) suggest that nursing has struggled since care are often used s}rnonymously with both quality of care the 1960s to capture the meaning of quality and the litera-and effectiveness of care For research purposes this can ture points to a large vocabulary under which the umbrella arguably affect validity, where concepts should be defined term of quality is used Quality has been termed as a at the outset (Van Maanen 1984) Bond & Thomas (1991) 'nebulous concept ' (Van Maanen 1981) because it lacks support this view by adding that, m the absence of clear constant definition m the literature (Redfem & Norman definitions, the assessment of what constitutes a good or 1990), with terms such as quality assuretnce, standards bad outcome is not determined of care and quality control often used interchangeably (Nielsen 1992) The Nightingale legacy Lang (1976) defined quality m nursing as a process " which seeks to attam the highest degree of excellence m Historically, it was Florence Nightingale who first recogthe delivery of patient care The suggestion that quality is nized the concept of quality for nursing practice By docua process adds weight to the argument put forward by Koch menting mortality statistics of soldiers and bringing these (1992) who suggests that defining quality is a frmtless to the attenbon of the Bntish government, she succeeded debate because quality is socially constructed and mflu-in bnngmg about improvements m both living standards enced by individual values, beliefs and attitudes Although and health services for soldiers (Lang & Clmton 1984) quality may have different meanings to different people.…”
Section: Towards a Definition Of Qualitymentioning
confidence: 99%
See 1 more Smart Citation
“…The importance of clarifying the meaning of quality is as perceived by practising clmical nurses Taylor & highlighted by Crow (1981) who noted that standards of Haussman (1988) suggest that nursing has struggled since care are often used s}rnonymously with both quality of care the 1960s to capture the meaning of quality and the litera-and effectiveness of care For research purposes this can ture points to a large vocabulary under which the umbrella arguably affect validity, where concepts should be defined term of quality is used Quality has been termed as a at the outset (Van Maanen 1984) Bond & Thomas (1991) 'nebulous concept ' (Van Maanen 1981) because it lacks support this view by adding that, m the absence of clear constant definition m the literature (Redfem & Norman definitions, the assessment of what constitutes a good or 1990), with terms such as quality assuretnce, standards bad outcome is not determined of care and quality control often used interchangeably (Nielsen 1992) The Nightingale legacy Lang (1976) defined quality m nursing as a process " which seeks to attam the highest degree of excellence m Historically, it was Florence Nightingale who first recogthe delivery of patient care The suggestion that quality is nized the concept of quality for nursing practice By docua process adds weight to the argument put forward by Koch menting mortality statistics of soldiers and bringing these (1992) who suggests that defining quality is a frmtless to the attenbon of the Bntish government, she succeeded debate because quality is socially constructed and mflu-in bnngmg about improvements m both living standards enced by individual values, beliefs and attitudes Although and health services for soldiers (Lang & Clmton 1984) quality may have different meanings to different people.…”
Section: Towards a Definition Of Qualitymentioning
confidence: 99%
“…The nobon of quality care within nursing compnsing a coUecbon of atbtudes and beliefs, underpinned by a substanbal Icnowledge base, is to be found throughout the literature Van Maanen (1981) states how it is difficult to define quality of care because the essence of nursing care IS underpinned by individual assessment of the pabent's needs Subsequently, quality of care is determined by the knowledge and skills of the nurse's assessment In order to deliver high quality care, the nurse must be able to perform effecbvely and must be competent in the applicabon of theory and skill m the climcal situation This requires possession of the necessary knowledge as well as mastery m psychomotor, cognibve and affective skills (Fitzpatnck et al 1992), the former reflecting the why and what of care and the latter reflecbng the how (Reilly 1978) Quality in nursing Masso (1989) postulates that a distmguishmg feature of quality care is that it has two dimensions, providers and clients, and suggests that quality of care is dependent on these two vanables In other words, nurses and pabents have different views about what consbtutes quality of care For Altschul (1982), nurses are somebmes puzzled because patients appear to be sabsfied with their care, when nurses can readily identify shortcomings From this standpoint it would appear evident that quality is a term depictmg favour to those people who judge it Quality of care thus becomes a subjecbve phenomenon because it means different thmgs to different people, pabents and nurses alike In summary, it can be seen that quality care is a complex but excibng phenomenon The word itself is subject to a mulbphcity of mterpretabons which make it difficult to define precisely It is evident that the nature of quality m nursmg involves such issues as competence and skill through the accountable pracbce of professional nurses There is also an element of subjecbvity because of the personal nature of quality which means different thmgs to different people This research was an attempt at describing this complex phenomenon by analysmg nurses' percepbons…”
Section: Nursing Skills As a Constituent Of Qualitymentioning
confidence: 99%
“…If an established criteria set is to be used it is important to assure that they have been tested for reliability and validity (see step 3). It is also important to note that most of the sets have been developed from American nursing and may have to be adapted for British use (Van Maanen 1981).…”
Section: Selecting Criteriamentioning
confidence: 99%
“…Generic instruments face a difficulty because their preformulated criteria inevitably become outdated by the changing nature of nursing. For example, important topics such as health promotion and prevention are not adequately addressed by most instruments because these instruments emphasise disease rather than health.20 22 Inter-rater agreement has been achieved with quality assessment instruments. For example, during the development of Monitor inter-rater agreement was high for both Patient Monitor (91%/o-99%) and for Ward Monitor (800/o-98%).5 In the original work on Qualpacs, correlation coefficients for interrater reliability ranged from 0-64 to 0-91 in three studies.9 Later research in the United States did not, however, achieve the predetermined standard of 0 75 for any of the subscales.…”
Section: Qualpacsmentioning
confidence: 99%