9.2 Quality Care
Quality is defined in a variety of ways in health care that all impact nursing practice.
ANA Definition of Quality
The American Nurses Association (ANA) defines quality as, “The degree to which nursing services for health care consumers, families, groups, communities, and populations increase the likelihood of desirable outcomes and are consistent with evolving nursing knowledge.”[1] The phrases in this definition focus on three aspects of quality: services (nursing interventions), desirable outcomes, and consistency with evolving nursing knowledge (evidence-based practices). Alignment of nursing interventions with current evidence-based practices is a key goal for quality care.[2] Evidence-based practices (EBP) will be further discussed later in this chapter.
Quality of Practice is one of ANA’s Standards of Professional Performance. ANA Standards of Professional Practice are “authoritative statements of the actions and behaviors that all registered nurses, regardless of role, population, specialty, and setting are expected to perform competently.” See the competencies for the ANA’s Quality of Practice Standard of Professional Performance in the following box.[3]
Quality of Practice Competencies in ANA’s Standard of Professional Practice[4]
- Ensures that nursing practice is safe, effective, efficient, equitable, timely, and person-centered.
- Incorporates evidence into nursing practice to improve outcomes.
- Uses creativity and innovation to enhance nursing care.
- Recommends strategies to improve nursing care quality.
- Collects data to monitor the quality of nursing practice.
- Contributes to efforts to improve health care efficiency.
- Provides critical review and evaluation of policies, procedures, and guidelines to improve the quality of health care.
- Engages in formal and informal peer review processes of the interprofessional team.
- Participates in quality improvement initiatives.
- Collaborates with the interprofessional team to implement quality improvement plans and interventions.
- Documents nursing practice in a manner that supports quality and performance improvement initiatives.
- Recognizes the value of professional and specialty certification.
Reflective Questions
- What Quality of Care competencies have you already demonstrated during your nursing education?
- What Quality of Care competencies are you most interested in performing next?
- What questions do you have about ANA’s Quality of Care competencies?
This chapter will review content related to the competencies of the ANA’s Quality of Care Standard of Professional Performance. Additional information about peer review is discussed in the “Leadership and Management” chapter, and specialty certification is discussed in the “Preparation for the RN Role” chapter.
IOM Framework of Quality Health Care
A definition of quality that has historically guided the measurement of quality initiatives in health care systems is based on the framework for improvement create