The aim of the article is to describe experiences from a project on quality assurance of nursing care in a county hospital. Assessment and improvement of the quality of care were mainly based on an earlier developed modified Swedish version of the Rush Medicus Nursing Process Quality Monitoring Instrument (RMI-MSV). Two hundred and forty patients and 57 registered nurses (RNs) representing surgical, medical and orthopaedic care units participated in the study, which was divided into two quality assessment occasions. An experiment-control design was used with intervention to the experiment units after the first quality assessment occasion. All the E-units improved their quality levels in almost all main areas in the second assessment occasion. The E-units together in relation to the C-units together obtained statistically significant improvements (p<0.05) in the main area concerning documentation (E-units minus C-units occasion 2 minus occasion 1). The overall experience is that the RMI-MSV can be used for quality assurance of nursing care in a Swedish acute hospital, but needs to be further refined.
Svensk författningssamling. Hälso-och sjukvårdslag. SFS1982:763.
2.
Socialstyrelsens författningssamling. Kvalitetssäkring i hälso- och sjukvård inklusive tandvård. SOSFS1993:9.
3.
World Health Organization, Revised version of Targets for health for all. The health policy for Europe. Summary of the updated edition September 1991, p. 47. EUR/ICP/HSCO13 Copenhagen: WHO Regional Office for, Europe, 1992.
4.
BeauchampTLChildressJF. Principles of biomedical ethics. Oxford: Oxford University Press, 1983.
5.
HackmanJROldmanGR. Development of the job diagnostic survey. In: EpplerM.NelanderB.Kartläggning och omformning av den psykosociala arbetsmiljön på ett sjukhus – en arbetslivspedagogisk studie. Malmö: Liber Förlag, 1984, s. 45–52, Akademisk avhandling
6.
MalmströmSGyorkiISjögrenPA. Bonniers svenska ordbok. Otava: Keuruu, 1988.
7.
ISO 9000 International Standards for Quality Management. Svensk version. Stockholm: SIS-standardise-ringskommissionen i Sverige, April, 1992.
8.
CarnevaliDLMitchelPHWoodsNFTannerCA. Diagnostic reasoning in nursing. Philadelphia: JB Lippincott Company, 1984.
9.
AttreeM.An analysis of the concept of «quality» as it relates to contemporary nursing care. International Journal of Nursing Studies, 1993, vol. 30, no. 4, p. 355–69.
10.
WildeB.Quality of care: Models, instruments, and empirical results among elderly. Göteborg: Göteborgs universitet, 1994, Akademisk avhandling
11.
VouriH.Quality assurance of health services – concepts and methodology. Copenhagen. World Health Organisation, Regional Office For Europe, 1982.
12.
LangN.Quality assurance in nursing. AORN JOURNAL, 1975, 2, 180–186.
13.
LangNMClintonJF. Assessment and assurance of the quality of nursing care. A selected overview. Evaluation and the Health Professions, 1983, vol. 6, no. 2, June, 211–231.
14.
JohanssonIWildeBAthlinELarssonG.DySSSy i Värmland – exempel på kvalitetssäkringsarbete vid Centralsjukhuset i Karlstad. In: UdénG. red. Kvalitetssäkring i omvårdnad – olika perspektiv. Lund: Studentlitteratur, 1994, s. 113–129.
15.
AthlinE.Kvalitetssäkring utifrån ett helhetsperspektiv – förändringsarbete vid kirurgkliniken i Umeå. In: UdénG. red. Kvalitetssäkring i omvärdnad – olika perspektiv. Lund: Studentlitteratur, 1994, s. 130–153.
16.
AnderssonIS. Utveckling av metoder för mätning av vårdkvalitet – med inriktning mot omvårdnad. Linköping: Linköpings universitet, 1995. Akademisk avhandling
17.
DonabedianA.The quality of care. How can it be assessed?Journal of American Medical Association, 1988, Sept. 23/30, vol. 260, no. 12, p. 1743–1760.
18.
da SilvaA. BarbosaEtiska aspekter på kvalitetssäkring. In: UdénG. red. Kvalitetssäkring i omvårdnad – olika perspektiv. Lund: Studentlitteratur, 1994, s. 95–111.
19.
JelinekRCHaussmannRKHegyvarySTNeumanJFJr. A methodology for monitoring quality of nursing care. Bethesda, Maryland: US Department of Health, Education and Welfare, 1975.
20.
GötherströmC.Assessment of the quality of care as the base for continuous quality assurance. Testing of two tools for somatic short-term care. Linköping: Linköpings universitet, 1994. Licentiat avhandling
21.
HegyvarySTHaussmannRKD. Monitoring nursing care quality. Journal of Nursing Administration, 1976, November, vol. 6, no. 9, p. 3–9.
22.
HaussmannRKDHegyvaryST. Monitoring quality of nursing care. Part III. Professional review for nursing: An empirical investigation. Bethesda, Maryland: US Department of Health, Education and Welfare, 1977.
23.
FabriciusKFlensburgA.Kvalitetsmålning i sygeplejen – ud fra fastlagde kriterier. Copenhagen: Dansk Sygeplejeråd, 1985.
24.
EhrenbergA.Mätning av omvård-nadskvalitet. Översättning och bear-betning av Rush Medicus Process Instrument samt redovisning av pilotförsök vid infektionskliniken, Falu lasarett. Lokala utvecklingsgruppen, Mellersta Dalarnas hälso- och sjukvård, 1986. Rapport nr 1
25.
GrimbyU.En Studie av den psykosociala arbetsmiljön och omvårdnadskvaliteten på fyra allmänmedicinska vårdavdelningar. Göteborgs universitet 1990. Licentiatavhandling
26.
GötherströmC.Modifierad svensk version av Rush Medicus Nursing Process Quality Monitoring Instrument, RMI-MSV. Institutionen för omvårdnadsforskning, Hälsouniversitetet i Linköping, 1995. FoU-rapport 5
27.
KerlingerFN. Foundations of behavioral research. 3. ed.London: Rinehardt and Winston, 1986.
28.
HegyvaryST. Issues in outcomes research. Journal of Quality Assurance, 1991, vol. 5, no. 2, p. 1–6.
29.
EhnforsMSmedbyB.Patient satisfaction surveys subsequent to hospital care: Problems of sampling, nonresponse and other losses. Quality Assurance in Health Care, 1993, vol. 5, no. 1, pp. 19–23.
30.
HamiltonGA. Measurement of outcomes. Vård I Norden, 1992nr 3/4, s. 50–55.
31.
HeapK.Handledning i socialt arbete. Stockholm: Wahlström & Widstrand, 1986.
32.
JerlockMSegestenK.Att dokumentera omvårdnad – svårigheter och motstånd. Sjukskötersketidningen, 1994, nr 2, s. 43–48.
33.
Svensk författningssamling. Patientjournallag. SFS1985:562.
34.
EngströmBAxelssonKAthlinESandmanPO. Mätning av omvårdnadskvalitet. Bearbetning och utprövning av Rush medicus process instrument. Vård I Norden, 1992, nr 3/4, s. 45–49.
35.
RonRBar-TalY.Quality nursing care survey, 1988–1990. Quality Assurance in Health Care, 1993, vol. 5, no. 1, pp. 57–63.
36.
LarssonGWildeB.Kvalitetssäkring och organisationsutveckling – några teoretiska reflektioner. In: UdénG. red. Kvalitetssäkring i omvårdnad – olika perspektiv. Lund: Studentlitteratur, 1994, s. 68–75.
