Florence Nightingale introduced the concept of quality nursing care in 1855. Quality assurance aims to provide care efficiently, effectively and economically through cost analysis and quality control programs. It involves setting standards, measuring care against standards, collecting data, and making recommendations. Quality assurance originated in manufacturing to ensure customer satisfaction and is now a process through which nurses are accountable for the quality of care provided.
A NURSE IS A…..
Patient care consultant
Educator
Manager
Recruiter
Therapist
Researcher
Administrator
Case manager
The list goes on…
A simple definition
FIVE RIGHTS
THE RIGHT PATIENT,
AT THE RIGHT TIME,
IN THE RIGHT SETTING,
RECEING THE RIGHT CARE
AT THE RIGHTTIME
IN THE RIGHTCOST.
Quality assurance
“Quality assurance as the monitoring of the activities of client care to determine the degree of excellence attained to the implementation of the activities”. (Bull, 1985)
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 (Maker 1998).
QA in nursing comprise of set of related elements such as
planning for quality,
development of objectives setting and
actively communicating standards,
developing indicators,
setting thresholds,
collecting data to monitor compliance with set standards for nursing practice
and applying solutions to improve care
UALITY ASSURANCE PROCESS:
Establishment of standards or criteria
Identify the information relevant to criteria
Determine ways to collect information
Collect and analyze the information
Compare collected information with established criteria
Make a judgment about quality
Provide information and if necessary, take corrective action regarding findings of appropriate sources
Determine ways to communicate the information
1) Credentialing:
2) Licensure:
3) Accreditation:
3)CERTIFICATION
1) Credentialing
It is the formal recognition of professional or technical competence and attainment of minimum standards by a person or agency. According to Hinsvark (1981) credentialing process has four functional components
a) To produce a quality product
b) To confer a unique identity
c) To protect provider and public
d) To control the profession.
2) Licensure
Individual licensure is a contract between the profession and the state, in which the profession is granted control over entry into and exists from the profession and over quality of professional practice. The licensing process requires that regulations be written to define the scopes and limits of the professional’s practice.
3) Accreditation:
The indian nursing council has established standards for inspecting nursing education’s programs in india(NLN-US). In the part the accreditation process primarily evaluated on agency’s physical structure, organizational structure and personal qualification
4. Certification
Certification is usually a voluntary process with in the profession. A person’s educational achievements, experience and performance on examination are used to determine the person’s qualifications for functioning in an identified specialty area.
A nursing care standard
is a descriptive statement of desired quality against which to evaluate nursing care.
It is guideline. A guideline is a recommended path to safe conduct, an aid to professional performance.
A NURSE IS A…..
Patient care consultant
Educator
Manager
Recruiter
Therapist
Researcher
Administrator
Case manager
The list goes on…
A simple definition
FIVE RIGHTS
THE RIGHT PATIENT,
AT THE RIGHT TIME,
IN THE RIGHT SETTING,
RECEING THE RIGHT CARE
AT THE RIGHTTIME
IN THE RIGHTCOST.
Quality assurance
“Quality assurance as the monitoring of the activities of client care to determine the degree of excellence attained to the implementation of the activities”. (Bull, 1985)
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 (Maker 1998).
QA in nursing comprise of set of related elements such as
planning for quality,
development of objectives setting and
actively communicating standards,
developing indicators,
setting thresholds,
collecting data to monitor compliance with set standards for nursing practice
and applying solutions to improve care
UALITY ASSURANCE PROCESS:
Establishment of standards or criteria
Identify the information relevant to criteria
Determine ways to collect information
Collect and analyze the information
Compare collected information with established criteria
Make a judgment about quality
Provide information and if necessary, take corrective action regarding findings of appropriate sources
Determine ways to communicate the information
1) Credentialing:
2) Licensure:
3) Accreditation:
3)CERTIFICATION
1) Credentialing
It is the formal recognition of professional or technical competence and attainment of minimum standards by a person or agency. According to Hinsvark (1981) credentialing process has four functional components
a) To produce a quality product
b) To confer a unique identity
c) To protect provider and public
d) To control the profession.
2) Licensure
Individual licensure is a contract between the profession and the state, in which the profession is granted control over entry into and exists from the profession and over quality of professional practice. The licensing process requires that regulations be written to define the scopes and limits of the professional’s practice.
3) Accreditation:
The indian nursing council has established standards for inspecting nursing education’s programs in india(NLN-US). In the part the accreditation process primarily evaluated on agency’s physical structure, organizational structure and personal qualification
4. Certification
Certification is usually a voluntary process with in the profession. A person’s educational achievements, experience and performance on examination are used to determine the person’s qualifications for functioning in an identified specialty area.
A nursing care standard
is a descriptive statement of desired quality against which to evaluate nursing care.
It is guideline. A guideline is a recommended path to safe conduct, an aid to professional performance.
Nursing Audit Dr. Rangappa. S .Ashi SDM Institute of Nursing sciences Shri D...rangappa
Nursing audit one of the control tools, responsible for controlling the activities of the nurses that focuses on providing the best possible nursing care. The actual nursing rendered is compared with the standards. This is mainly refers to clinical nursing audit. The nursing management audit is an evaluation of nursing management as a whole. It is critically examination of the entire nursing management process.
quality assurance slides include components, models, approaches, cycle of quality assurance is included in the slides.
the slide gives a brief ides regarding all the points and gives a comprehensive picture of the topic.
A NURSE IS A…..
Patient care consultant
Educator
Manager
Recruiter
Therapist
Researcher
Administrator
Case manager
The list goes on…
A simple definition
FIVE RIGHTS
THE RIGHT PATIENT,
AT THE RIGHT TIME,
IN THE RIGHT SETTING,
RECEING THE RIGHT CARE
AT THE RIGHTTIME
IN THE RIGHTCOST.
Quality assurance
“Quality assurance as the monitoring of the activities of client care to determine the degree of excellence attained to the implementation of the activities”. (Bull, 1985)
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 (Maker 1998).
QA in nursing comprise of set of related elements such as
planning for quality,
development of objectives setting and
actively communicating standards,
developing indicators,
setting thresholds,
collecting data to monitor compliance with set standards for nursing practice
and applying solutions to improve care
UALITY ASSURANCE PROCESS:
Establishment of standards or criteria
Identify the information relevant to criteria
Determine ways to collect information
Collect and analyze the information
Compare collected information with established criteria
Make a judgment about quality
Provide information and if necessary, take corrective action regarding findings of appropriate sources
Determine ways to communicate the information
1) Credentialing:
2) Licensure:
3) Accreditation:
3)CERTIFICATION
1) Credentialing
It is the formal recognition of professional or technical competence and attainment of minimum standards by a person or agency. According to Hinsvark (1981) credentialing process has four functional components
a) To produce a quality product
b) To confer a unique identity
c) To protect provider and public
d) To control the profession.
2) Licensure
Individual licensure is a contract between the profession and the state, in which the profession is granted control over entry into and exists from the profession and over quality of professional practice. The licensing process requires that regulations be written to define the scopes and limits of the professional’s practice.
3) Accreditation:
The indian nursing council has established standards for inspecting nursing education’s programs in india(NLN-US). In the part the accreditation process primarily evaluated on agency’s physical structure, organizational structure and personal qualification
4. Certification
Certification is usually a voluntary process with in the profession. A person’s educational achievements, experience and performance on examination are used to determine the person’s qualifications for functioning in an identified specialty area.
A nursing care standard
is a descriptive statement of desired quality against which to evaluate nursing care.
It is guideline. A guideline is a recommended path to safe conduct, an aid to professional performance.
A NURSE IS A…..
Patient care consultant
Educator
Manager
Recruiter
Therapist
Researcher
Administrator
Case manager
The list goes on…
A simple definition
FIVE RIGHTS
THE RIGHT PATIENT,
AT THE RIGHT TIME,
IN THE RIGHT SETTING,
RECEING THE RIGHT CARE
AT THE RIGHTTIME
IN THE RIGHTCOST.
Quality assurance
“Quality assurance as the monitoring of the activities of client care to determine the degree of excellence attained to the implementation of the activities”. (Bull, 1985)
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 (Maker 1998).
QA in nursing comprise of set of related elements such as
planning for quality,
development of objectives setting and
actively communicating standards,
developing indicators,
setting thresholds,
collecting data to monitor compliance with set standards for nursing practice
and applying solutions to improve care
UALITY ASSURANCE PROCESS:
Establishment of standards or criteria
Identify the information relevant to criteria
Determine ways to collect information
Collect and analyze the information
Compare collected information with established criteria
Make a judgment about quality
Provide information and if necessary, take corrective action regarding findings of appropriate sources
Determine ways to communicate the information
1) Credentialing:
2) Licensure:
3) Accreditation:
3)CERTIFICATION
1) Credentialing
It is the formal recognition of professional or technical competence and attainment of minimum standards by a person or agency. According to Hinsvark (1981) credentialing process has four functional components
a) To produce a quality product
b) To confer a unique identity
c) To protect provider and public
d) To control the profession.
2) Licensure
Individual licensure is a contract between the profession and the state, in which the profession is granted control over entry into and exists from the profession and over quality of professional practice. The licensing process requires that regulations be written to define the scopes and limits of the professional’s practice.
3) Accreditation:
The indian nursing council has established standards for inspecting nursing education’s programs in india(NLN-US). In the part the accreditation process primarily evaluated on agency’s physical structure, organizational structure and personal qualification
4. Certification
Certification is usually a voluntary process with in the profession. A person’s educational achievements, experience and performance on examination are used to determine the person’s qualifications for functioning in an identified specialty area.
A nursing care standard
is a descriptive statement of desired quality against which to evaluate nursing care.
It is guideline. A guideline is a recommended path to safe conduct, an aid to professional performance.
Nursing Audit Dr. Rangappa. S .Ashi SDM Institute of Nursing sciences Shri D...rangappa
Nursing audit one of the control tools, responsible for controlling the activities of the nurses that focuses on providing the best possible nursing care. The actual nursing rendered is compared with the standards. This is mainly refers to clinical nursing audit. The nursing management audit is an evaluation of nursing management as a whole. It is critically examination of the entire nursing management process.
quality assurance slides include components, models, approaches, cycle of quality assurance is included in the slides.
the slide gives a brief ides regarding all the points and gives a comprehensive picture of the topic.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
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Agriculture: Engineering crops resistant to pests and harsh environments.
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One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
2. INTRODUCTION:
The field of quality assurance is an old as modern nursing. “FLORENCE
NIGHTINGALE” introduced the concept of quality nursing care in 1855
while attending the soldiers in the hospital during the Crimean war.
Quality assurance necessitates that institutions and health
professionals render care in a most efficient, effective and economical
manner. This entails a cost benefit analysis to define strategies for
optimum utilization of resources, focus on cost effective methods and
introduce systematic ongoing quality control programmes to
continuously monitor and improve the quality of care rendered.
3. DEFINITION
A quality assurance programme is an ongoing systemic process
designed to evaluate and promote excellence in the health care
provided to the clients.
- KOZIER-
It is a sequential process that involves setting standards of care,
measuring patient care, according to those standards, gathering
data from chart review, observing patient care, interviewing patient
care givers and then making recommendations for improvement.
- F.A.DAVIS-
4. CONCEPTS
Quality assurance originated in manufacturing industry. The
idea was to ensure that the product consistently achieved
customer satisfaction.
quality assurance is dynamic process through which nurses
assume accountability for quality of care they provide.
It is a guarantee to the society that services provided by nurses
are being regulated by members of profession.
5. APPROACHES
General approach:
it involves large governing of persons or agency ability to meet
established criteria or standards at a given time.
Specific approach:
Quality assurances are methods to evaluate identifies
instances of providers and client interaction.
6. GENERAL APPROACH
CREDENTIALING:
Credentialing refers to ways in which professional competence is
ensured and maintained. Three processes are used for credentialing
in nursing. They are accreditation, licensure and certification.
LICENSURE:
Licensure is a specialized form of credentialing based on laws passed
by a state legislature. A license is a legal document that permits a
person to offer to the public skills and knowledge in a particular
jurisdiction, where such practice would otherwise be unlawful
without a license.
7. ACCREDITATION:
State legislative bodies have authority to enact laws controlling
occupational and professional groups. Nursing is one of the groups
operating under state laws that promote the general welfare by
determining minimum standards of education through accreditation
of school of nursing.
CERTIFICATION
Where as licensure measures entry-level competence, certification
validates specialty knowledge, experience and clinical judgment.
Nursing certification is offered by professional organizations.
8. SPECIFIC APPROACH
PEER REVIEW:
Peer review is an organized effort whereby practicing
professionals review the quality and appropriateness of
services ordered or performed by their professional peers.
Peer Review in Nursing is the process by which practicing
Registered Nurses systematically assess, monitor and make
judgments about the quality of nursing care provided by peers,
as measured against professional standards of practice.
ANA,1988
9. SPECIAL APPROACH
STANDARD:
Standard is a pre-determined baseline condition or level of
excellence that comprises a model to be followed and
practiced
CLASSIFICATION:
- Normative and empirical standard
- Ends and means standard
- Structure, process and outcome standard
10. SOURCES:
•Professional organization, e.g. Associations, TNAI,
•Licensing bodies, e.g. Statutory bodies, INC,
•Institutions/health care agencies, e.g. University Hospitals, Health
Centers.
•Department of institutions, e.g. Department of Nursing.
•Patient care units, e.g. specific patients' unit.
•Government units at National, State and Local Government units.
•Individual e.g. personal standards
11. NURSING AUDIT
DEFINITION:
Nursing audit is defined as “an evaluation of patient care and
analysis of the written records maintained by nurses in
patients treatment profile”.
TYPES OF NURSING AUDIT:
Concurrent nursing audit
Retrospective nursing audit
12. PURPOSE
To provide the evidence of the quality of nursing services being
rendered.
To evaluate nursing administrative, supervise nursing care practice.
To measure progress.
Identify problems.
To promote the maintenance of medical records.
To increase medico-legal protection..
14. MODEL OF QUALITY ASSURANCE
ANA MODEL OF QUALITY ASSURANCE:
1) Identify values
2) Identify structure, process and outcome standards and criteria
3) Select measurement
4) Make interpretation
5) Identify course of action
6) Choose action
7) Take action
8) Reevaluate
15. FACTORS AFFECTING QUALITY ASSURANCE
Lack of resources
Personal problems
Unreasonable patients and attendants
Improper maintenance
Absence of accreditation laws
16. • Legal redress
•Lack of incident review procedures
•Lack of good hospital information system
•Absence of conducting patient satisfaction surveys
17. FRAMEWORK FOR QUALITY ASSURANCE
Lang (1976):
•Identify and agree values
•Review literature, Known QAP
•Analyze available programmes
•Determine most appropriate QAP
•Establish structure, plans, outcome criteria and standards
•Ratify standards and criteria
18. Evaluate current levels of nursing practice against ratified
structures
•Identify and analyze factors contributing to results
•Select appropriate actions to maintain or improve care
•Implement selected actions
•Evaluate QAO
19. QUALITY ASSURANCE PROCESS
1.Establishment of standards or criteria
2.Identify the information relevant to criteria
3.Determine ways to collect information
4.Collect and analyze the information
5.Compare collected information with established criteria
20. ….
6.Make a judgment about quality
7.Provide information and if necessary, take corrective action
regarding findings of appropriate sources
8.Determine ways to collect the information
21. IMPACT OF QUALITY ASSURANCE IN
NURSING
Nurses are accountable for their actions
Nurses can deliver a high standard of care
Guaranteeing standards of care to the public
Nurses are actively involved in audit and consumer relations
Improves the overall quality of nursing care
22. Improves all type of documentation and communication
Helps in professional growth
Helps to maintain international standard
Helps to compare the standard with another institution
Avoids malpractice and bias
23. CONCLUSION:
Quality assurance programme will helps to improve the quality
of nursing care and professional development. Individuals with
the profession must assume responsibility for their
professional actions and be answerable to the recipients for
their care.
24. BIBLIOGRAPHY
Kozier, fundamental of nursing, Dorling Kindersley pvt.ltd, second edition,
2006, p.no: 202, 360-361.
F.A. Davis, legal ethical and political issues in nursing, Davis Company, second
edition, 1994, p.no: 231-244.
Carol Taylor, fundamental of nursing, Lippincott publications, sixth edition,
2005, p.no: 328-331.
Dugas, introduction to patient care, saunder publications, fourth publications,
2001, p.no: 97.
Potter and Perry, fundamental of nursing, Mosby publications, fourth edition,
1997, p.no: 44, 172-176.
25. JOURNAL:
Nurses of India, July 2006, vol-7, p.no: 9-10.
Nurses of India, July 15, 2008, vol – 9, p.no: 5-6.
Nursing journal of India, august 1999, vol-8, p.no: 173.
NET:
http:// currentnursing.com/nursing management/total
qualitymanagementhealthcare.html
www.indiannursingcouncil.com/qualityassuranceinnursing-standards.
