quality assurance

2. Submitted by
Ms.Abhilasha chaudhary

3.  Introduction of quality and quality
assurance.
 Objectives of quality assurance.
 Approaches for quality assurance.
 General approach.
 Specific approach.
 Models used in evaluating quality
assurance .
 Systematic model .
 ANA quality assurance model.
 Purposes of quality assurance model.

4.  Research evidence.
 Conclusion

6.  Quality is defined as the extent of
resemblance between the purpose of
health care and truly granted care.
Actually, quality is interactive process
between customer and provider.

8.  Quality assurance is a judgement concerning
the process of care, based on the extent to
which that cares contributes to valued
outcomes(Donabedian 1982)

9.  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 the improvement of
client care.(Maker 1989)

10.  To ensure the delivery of quality client care.
 To provide technical assistance in
correcting systemic deficiencies.
 To refine existing methods for ensuring
optional quality health care.
 To provide the best possible results.

11. Approaches
General approach Specific approach

12. General
approach
Credentialing
Accreditation Certification
Licensure

13.  It involves large governing of official body
evaluation of a person’s or agency’s ability
to meet established criteria or standards at
a given time.

15.  It is the process through which a healthcare
professional or agency is determined
qualified to have certain medical privileges
and have predetermined criteria.

17.  It is the mandatory process by which a
governmental agency grants time-limited
permission to an individual to engage in a given
occupation after verifying that he or she has met
predetermined and standardized criteria.
 Examples: Licensed Estate nurse , Licensed
Practice Nurse

18. CERTIFICATION

19.  It is a Voluntary process by which a
nongovernmental body grants a time-
limited recognition to an individual after
verifying that he or she has met
predetermined and standardized criteria.
 Examples:Certified Meeting Planner,
certified dialysis nurse trainer

21.  It is a voluntary process by which a
nongovernmental body grants a time-
limited recognition to an organization after
verifying that it has met predetermined and
standardized criteria.
 Eg. Accredited healthcare facility

22. SPECIFIC
APPROACH
Peer review
Utilization
review
Evaluation
studies
Client
satisfaction
Incident
review

24.  These are designed to monitor client
specific aspects of care appropriate for
certain levels of care. The audit has been
the major tool used by peer review
committee to ascertain quality of care.

25.  Utilization review activities are directed
towards assuring that care is actually
needed and that the cost appropriate for
the level of care provided.

27.  Prospective: Assessment of the necessity of
care before giving services.
 Concurrent :Review of care while the care is
being given.
 Retrospective : Analysis after the care has
being given.

28.  Three major models have been used to
evaluate quality they are:
Donabedian’s
structure process
outcome model
The tracer model The sentinel model

30.  Measure both process and outcome of care.
 Provides nurses with data to show the
differences in outcomes as a result of
nursing care standards.

31.  It is an outcome measure for examining
specific instances of client care .
 Eg. cases of disability, deaths,morbidity
mortality etc.

32.  It can be assessed using person or
telephone interviews and mailed
questionnaire.

33.  The critical incidents may be delayed
attendance, incorrect medications, lack of
cleanliness, lack of asespsis leading to
infection, carelessness in carrying out nursing
procedures.

34. MODELS OF QUALITY
ASSURANCE

35. MODELS OF QUALITY
ASSURANCE MODELS
A SYSTEMATIC MODEL
AMERICAN NURSES
ASSOCIATION (ANA)
QUALITY ASSURANCE
MODEL

36.  It is the system approach in which the task is
broken down into manageable components
based on defined objectives.

37. 1.INPUT
2.THROUGHPUT
3.OUTPUT
4.FEEDBACK

38. AMERICAN NURSES
ASSOCIATION (ANA) QUALITY
ASSURANCE MODEL

39. 1)Identify values
2)Identify
structure,
process and
outcome
3)Select
measurement
4)Make
interpretation
5)Identify
course of action
6)Choose action
7)Take action 8)Reevaluate

40.  To ensure quality nursing care provided by
nurses in order to meet the expectations of
the receiver,management and regulatory
body.

41.  Title : “Donabedian's structure-process-
outcome quality of care model: Validation in
an integrated trauma system.”
 Journal :The journal of trauma and acute
care surgery,2015.
 Authors :Moore l, lavoie A, Borgeois G,
Lapointe J.

42.  According to Donabedian's health care
quality model, improvements in the
structure of care should lead to
improvements in clinical processes that
should in turn improve patient outcome.
 The objective of this study was to assess
the performance of an integrated trauma
system in terms of structure, process, and
outcome and evaluate the correlation
between quality domains.

43.  The study evalauated quality of care for patients
treated in a Canadian provincial trauma system in
2005-2010 in 57 centers, n = 63,971) using
quality indicators (QIs) developed and validated
previously.
 Outcome performance was measured using risk-
adjusted rates of mortality, complications, and
readmission as well as hospital length of stay
(LOS). Correlation was assessed with Pearson's
correlation coefficients.

44.  Statistically significant correlations were
observed between structure and process ,
process and outcome.
 This study suggest that Donabedian's
structure-process-outcome model is a valid
model for evaluating trauma care. Trauma
centers that perform well in terms of
structure also tend to perform well in terms
of clinical processes, which in turn has a
favorable influence on patient outcomes.

45.  Quality assurance is the monitoring of the
activities of client care to determine the
degree of excellence attained to the
implementation of the activities.There are
general and specific approach to assure
quality.ANA quality assurance model and
systematic models are the models of quality
assurance.

46.  Quality assurance is monitoring the activities
of client care to determine the degree of
excellence attained to the implementation of
the activities and it is very essential to
optional quality health care.

49.  A) Peer review
 B)Accreditation
 C)Utilization review
 D)Evaluation studies
 B)Accreditation

50. 1)Donabedian’s structure process outcome
model
2)The tracer model
3)The sentinel model.

51.  Basher Shebeer.p, khan S.yaseen. A concise
textbook of advanced nursing practice. 1st ed.
Banglore: Emmess medical publishers; p.50-
55
 Soni Samta. Textbook of advance nursing
practice.1st ed. Newdelhi: jaypee brothers
medical publishers; p.14-22.