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Exploring responsibilities for delivering quality nursing care using the Healthcare Quality Framework

  • Lynette Cusack
    Correspondence
    Corresponding author: Dr Lynette Cusack, The University of Adelaide, Faculty of Health and Medical Sciences. North Terrace Adelaide. South Australia. 5005
    Affiliations
    University of Adelaide. Adelaide Nursing School. Health and Medical Sciences Building. North Terrace. Adelaide. South Australia. 5000

    Northern Adelaide Local Health Network SA Health. Lyell McEwin and Modbury Hospitals. Haydown Road, Elizabeth Vale. South Australia. 5112
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  • Karleen Thornton
    Affiliations
    Northern Adelaide Local Health Network SA Health. Lyell McEwin and Modbury Hospitals. Haydown Road, Elizabeth Vale. South Australia. 5112
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  • Janelle Brytan
    Affiliations
    Northern Adelaide Local Health Network SA Health. Lyell McEwin and Modbury Hospitals. Haydown Road, Elizabeth Vale. South Australia. 5112
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      ABSTRACT

      Background

      Nurses have a professional obligation to provide safe, quality practice responsive to the needs of people they care for. The Healthcare Quality Framework designed to describe nurses’ responsibilities in healthcare quality, was utilised to explore nurses’ perceptions of quality care to improve patients’ experience.

      Methods

      Qualitative exploratory descriptive design conducted in two stages, in a South Australian metropolitan health service. First stage involved eight focus groups attended by 41 participants, comprising enrolled and registered nurses delivering direct patient care. Discussions recorded digitally, transcribed and thematically analysed. Second stage involved mapping and synthesis of focus group data against 61 elements located across seven domains of the Healthcare Quality Framework.

      Findings

      First stage: Eleven themes identified that described nurses’ skills and responsibilities to deliver quality nursing care. Most frequently reported were effective communication, delivering basic elements of care, team work, supportive environment and compassionate, respectful, dignified care. Second stage: Out of 61 elements of the Healthcare Quality Framework, twenty-four gaps were identified related to domains: Management of the Environment; Promotion of Safety; Clinical Leadership and Governance.

      Discussion and Conclusion

      Nurses’ narratives focused on delivery of quality care within their unit/ward. Participants did not identify how they may influence the healthcare team and health service to improve care. The Healthcare Quality Framework enabled a broader reflection on nurses’ responsibilities for quality care, identifying improvement initiatives. One initiative could be a specifically designed and evaluated mentorship program, based on the Healthcare Quality Framework that is accessible to all nurses after their transition year.

      Key words

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