Salazar de la Guerra R, Ferrer Arnedo C, Labrador Domínguez M J, Sangregorio Matesanz A
Unidad de Enfermería, Hospital Guadarrama, Madrid, España.
Unidad de Enfermería, Hospital Guadarrama, Madrid, España.
Rev Calid Asist. 2014 Nov-Dec;29(6):350-4. doi: 10.1016/j.cali.2014.10.003. Epub 2014 Dec 19.
To certify the nursing services using a quality management system, taking an international standard as a reference, and based on a continuous improvement process.
The standard was revised, and the Quality Management System documentation was updated, consisting of a Quality Manual and 7 control procedures. All the existing procedures were coded in accordance with the documentation control process. Each operational procedure was associated with a set of indicators which permitted to know the results obtained, analyze the deviations and to implement further improvements.
The system was implemented successfully. Twenty-eight care procedures and eleven procedures concerning techniques were incorporated into the management system. Thirty indicators were established that allowed the whole process to be monitored. All patients were assigned to a nurse in their clinical notes and all of them had a personalized Care Plan according to planning methodology using North American Nursing Diagnosis Association (NANDA), Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC) international rankings. The incidence of falls, as well as the incidence of chronic skin wounds, was low, taking into account the characteristics of the patient and the duration of the stay (mean=35.87 days). The safety indicators had a high level of compliance, with 90% of patients clearly identified and 100% with hygiene protocol. The confidence rating given to the nurses was 91%.
The certification enabled the quality of the service to be improved using a structured process, analyzing the results, dealing with non-conformities and introducing improvements.
以国际标准为参考，在持续改进过程的基础上，使用质量管理体系对护理服务进行认证。
修订标准，更新质量管理体系文件，包括质量手册和7个控制程序。所有现有程序均按照文件控制流程进行编码。每个操作程序都关联了一组指标，以便了解所取得的结果、分析偏差并实施进一步改进。
该系统成功实施。28项护理程序和11项技术相关程序被纳入管理体系。建立了30项指标以监测整个过程。所有患者在其临床记录中都被分配了一名护士，并且根据使用北美护理诊断协会（NANDA）、护理干预分类（NIC）和护理结果分类（NOC）国际排名的规划方法，他们都有个性化的护理计划。考虑到患者的特征和住院时间（平均=35.87天），跌倒发生率以及慢性皮肤伤口发生率较低。安全指标的合规水平较高，90%的患者身份明确，100%符合卫生协议。护士的信心评级为91%。
该认证通过结构化过程、分析结果、处理不符合项和引入改进措施，提高了服务质量。
