This document discusses quality in nursing care. It defines quality as meeting customer expectations and being free from defects. Total quality management aims for quality, safety, effectiveness, efficiency, timeliness and equity of care. Quality indicators are measurable aspects of performance like infection rates and patient satisfaction. Quality improvement involves collecting data, identifying problems, setting goals and evaluating interventions. Methods to improve quality include certification processes, data collection, education, and protocol changes like using closed suction systems and bispectral monitoring.

1. Adriano Friganovic
Vedran Dumbovic

6. Quality definition
Total quality management
Quality indicators
Quality improvement of nursing care
Patient safety

8. Measure of excellence or state of being
free from defects, deficiencies and
significant variations. It is brought about
strict and consistent commitment to certain
standards that achieve uniformity of
product or service to satisfy specific
customer or user requirements.

9.  Safe: avoiding injuries to patients from the care that is supposed to
help them
 Effective: providing services based on scientific knowledge to all
who could benefit and refraining from providing services to those not
likely to benefit (avoiding underuse, misuse and overuse)
 Efficient: avoiding waste, in particular waste of equipment,
supplies, ideas, and energy.
 Timely: reducing waits and sometimes harmful delays for both
those who receive and those who give care.
 Patient Centered: providing care that is respectful of and
responsive to individual patient preferences, needs, and values and
ensuring that patient values guide all clinical decisions.
 Equity : providing care that does not vary in quality because of
personal characteristics, such as gender, ethnicity, geographic
location, and socioeconomic status.

10. In the ICU 1,7 errors/ patient/ 24 h

11. Who is responsible for quality controle?
Physician - nurse – other personal
Implementation

12. QA + QC + QI
_______________
TQM

14. Collecting
data
Nursing
diagnosis
Problem
Goal
Evaluation
Nursing
intervention

15. Cooperation and results
orientation
Loyalty and Integrity
Commitment to Quality
Responsibililty

16. Quality indicators are measurable,
objective,quantitative measures of key
system elements performance.
They indicate the extent up to which a
certain system meets the needs and
expectations of the customers.

17.  Number of nurses per hospital bed in ICU
 Skin integrity
 The amount of health care provided to
patients throughout the day
 Satisfaction with pain therapy
 Patient satisfaction with informations provided
in ICU
 Patient falls of the bed
 Intrahospital infections
 Satisfaction of Nurses

18. Process of certification
Standards of operative procedures
Data collection
Supervision

22. Use of closed suction system
Protocol of oral care
Organization changes

23. Team leaders
Education
Constant supervision

26. Reducing hours spent on mechanical
ventilation
Haemodinamic stability
Reducing VAP incidence – cost benefit

27. 20
10
Pacijenti
Pacijentice

28. 25.00
20.00
15.00
10.00
5.00
0.00
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
SA BIS-om
BEZ BIS-a

29. 0.00 1.00 2.00 3.00 4.00 5.00 6.00 7.00 8.00 9.00
BEZ BIS-a
SA BIS-om
6.46
8.97

30. Use of closed suction system during
cardiac surgery procedures
Use of bispectral index to all patients

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