Quality assurance is a process of quality management that is focusses on maintaining the standards of nursing care and delivering quality nursing care to the patients.

1. QUALITY ASSURANCE
IN NURSING
PRESENTED BY:
Ms Mamta Bisht
Lecturer 1

2. • The expense of quality is an interactive
process between customer & provider.
quality assurance usually focuses on
material, good work & service provided
effectively.
• Any lack in service provided causes
decrease in quality
INTRODUCTION
Presented By Mamta Bisht 2

3. QUALITY
• It is degree to which health services for
individuals & population increase the
likelihood of desired health outcomes &
are consistent with current professional
knowledge.
-Joint Commission on
Accreditition of health care organization
,2002 (JCAHO)
Presented By Mamta Bisht 3

4. ASSURANCE
It is statement or indication that inspires
confidence.
Presented By Mamta Bisht 4

5. QUALITYASSURANCE
• Quality assurance is an on-going, systematic,
comprehensive evaluation of health care
services & impact of those services on health
care services.
-Kozier
• Quality assurance is defined as all activities
undertaken to predate & prevent poor quality.
-Neetvert
Presented By Mamta Bisht 5

6. OBJECTIVES
1.To ensure quality of nursing care
2.To provide cost effective care.
3.To refine existing methods of health care.
4.To provide assistance in correcting the
system deficiencies.
Presented By Mamta Bisht 6

7. NEED & PURPOSE
• To ensure the delivery of quality client care.
• To demonstrate efforts of health care
providers to provide good results.
• To formulate plan of care.
• To evaluate achievement of nursing care.
Presented By Mamta Bisht 7

8. • To appreciate importance of practicing
standard safety measures.
• To support delivery of nursing care
with administrative & managerial
services.
• To identify appropriate management
techniques to be used for managing
resources in given situation.
NEED & PURPOSE
Presented By Mamta Bisht 8

9. Standards of
care
Evaluates care
Takes action
FUNCTIONS OF QUALITY ASSURANCE PROCESS
Presented By Mamta Bisht 9

10. QUALITY ASSURANCE CYCLE
Presented By Mamta Bisht 10

11.  GENERAL APPROACH
 SPECIFIC APPROACH
APPROACHES FOR QUALITY
ASSURANCE PROGRAMME
Presented By Mamta Bisht 11

12. • CREDENTIALING
• LICENSURE
• ACCREDITATION
• CERTIFICATION
• RECOGNITION
GENERAL
APROACHES
• PEER REVIEW
• UTILIZATION REVIEW
• EVALLUATION STUDIES
• NURSING AUDIT
SPECIFIC
APPROACHES
Approaches to quality assurance
programme
Presented By Mamta Bisht 12

13. An official body evaluates a person or
agencies’ ability to meet established criteria or
standards at a given time.
IT INCLUDES:
 CREDENTIALITY
 LICENSURE
 ACCREDITATION
 CERTIFICATION
GENERAL APPROACH
Presented By Mamta Bisht 13

14. Formal recognition of professional or technical
competence and attainment of minimum
standards by a person or agency.
Components
To produce a quality product.
To protect provider and public.
To control the profession.
CREDENTIALING
Presented By Mamta Bisht 14

15. It is a contract between the profession and
the state, in which the profession is granted
control over entry into and exit from the
profession and over quality of professional
practice.
LICENSURE
Presented By Mamta Bisht 15

16. It evaluates on agency’s physical structure,
organizational structure and personal
qualification.
ACCREDITATION
Presented By Mamta Bisht 16

17. A person’s educational achievements,
experience and performance on examination
are used to determine the person’s
qualifications.
CERTIFICATION
Presented By Mamta Bisht 17

18. Methods used to evaluate identified instances
of providers and client interaction.
They are:
Peer review
Utilization review
Evaluation studies
SPECIFIC APPROACHES
Presented By Mamta Bisht 18

19. 1.PEER REVIEW COMMITTEE
• These are designed to monitor client
specific aspects of care appropriate for
certain levels of care.
• The audit is used by peer review
committee to ascertain quality of care.
Presented By Mamta Bisht 19

20. 2.Utilization Review
Utilization review activities
are directed towards
assuring that care actually
needed and that the cost
appropriate for the levels
of care provided
Presented By Mamta Bisht 20

21. TYPES OF UTILIZATION REVIEW
• Prospective: It is an assessment of the
necessary of care before giving services.
• Concurrent: A review of the necessity of
care while the care is being given.
• Retrospective: It is analysis of the necessity of
the services received by the client after the
care has being givenPresented By Mamta Bisht 21

22. It is designed to assist clients to avoid unnecessary
care.
It may serve to encourage the considerationof care
options by providers such as home healthcare
rather than hospitalization.
It can provide guidelines for staff of program
development.
It provides a measure of agency accountability to
the customer.
Advantages of Utilization Review
Presented By Mamta Bisht 22

23. 3.EVALUATION STUDIES
1. System model
2. Donabedian’s Structure-Process-Outcome model
3. ANA quality assurance model
4. Quality health outcome model
Presented By Mamta Bisht 23

24. System Model
• System model is used for implementation of
• unit based quality assurance program. It
• involves making changes in organizational
• structure & individual roles. In system model,
• task is broken down into manageable
• components based on defined objectives.
MODELS OF QUALITY
ASSURANCE
Presented By Mamta Bisht 24

25. • Input- The input can be compared to the
present state of systems.
• Throughput- It is developmental process.
• Output- It is finished product or result.
• Feedback- It is essential component of
system because it maintains & nourishes
growth.
Basic Components of System
Models
Presented By Mamta Bisht 25

26. It is a model proposed for the structure,
process and outcome of quality. This linear
model has been widely accepted as the
fundamental structure to develop many other
models in QA.
Donabedian Model (1985)
Presented By Mamta Bisht 26

27. Donabedian Model (1985)
STRUCTURALELEMENTS
Community
Institution
Provider
patient
OUTCOME
Death
Adverse events
Readmission
Quality of life
Complications
Resources(cost&length of stay in hospital)
PROCESS ELEMENTS
Treatment process
Stage of treatment
Appropriateness
service
Presented By Mamta Bisht 27

28. This first proposed and accepted model of
quality assurance was given by Long & Black in
1975. This helps in the self- determination of
patient and family, nursing health orientation,
patient‘s right to quality care and nursing
contributions.
ANA Quality Assurance Model
Presented By Mamta Bisht 28

29. Identify structure,
standards and
criteria
Apply the process
standards and
criteria
Evaluate outcome of
standards and criteria
ANA Quality Assurance Model
Presented By Mamta Bisht 29

30. The uniqueness of this model proposed by
Mitchell & Co is the point that there are
dynamic relationships with indicators that not
only act upon, but also reciprocally affect the
various components.
Quality Health Outcome Model
Presented By Mamta Bisht 30

31. SYSTEM
(individual, group, organization)
INTERVENTION OUTCOME
CLIENT
(individual, family, community)
Quality Health Outcome Model
Presented By Mamta Bisht 31

32.  It is an exercise to find out whether good
nursing practices are followed.
 It is a means by which nurses themselves can
define standards from their point of view and
describe the actual practice of nursing.
4. NURSING AUDIT
Presented By Mamta Bisht 32

33. FACTORS AFFECTING QUALITY
ASSURANCE
• Lack of resources
• Personnel problems
• Improper maintenance
• Poor supervision
• Poor legislation.
• Inadequate hospital information systemPresented By Mamta Bisht 33

34. Thank you
Presented By Mamta Bisht 34