Counties Manukau Health District Health Board, Middlemore Hospital, Auckland, New Zealand.
Institute for Innovation and Improvement, Waitemata District Health Board, North Shore Hospital, Takapuna, Auckland, New Zealand.
J Clin Nurs. 2018 Jun;27(11-12):2360-2372. doi: 10.1111/jocn.14250. Epub 2018 Feb 12.
The project aimed to develop a unit-level quality measurement and improvement programme using evidence-based fundamentals of care.
Feedback from patients, families, whānau, staff and audit data in 2014 indicated variability in the delivery of fundamental aspects of care such as monitoring, nutrition, pain management and environmental cleanliness at a New Zealand District Health Board.
A general inductive approach was used to explore the fundamentals of care and design a measurement and improvement programme, the Patient and Whānau Centred Care Standards (PWCCS), focused on fundamental care.
Five phases were used to explore the evidence, and design and test a measurement and improvement framework.
Nine identified fundamental elements of care were used to define expected standards of care and develop and test a measurement and improvement framework. Four six-monthly peer reviews have been undertaken since June 2015. Charge Nurse Managers used results to identify quality improvements. Significant improvement was demonstrated overall, in six of the 27 units, in seven of the nine standards and three of the four measures. In all, 89% (n = 24) of units improved their overall result.
The PWCCS measurement and improvement framework make visible nursing fundamentals of care in line with continuous quality improvement to increase quality of care.
Delivering fundamentals of care is described by nurses as getting ?back to basics'. Patient and family feedback supports the centrality of fundamentals of care to their hospital experience. Implementing a unit-level fundamentals of care quality measurement and improvement programme clarifies expected standards of care, highlights the contribution of fundamentals of care to quality and provides a mechanism for ongoing improvements.
该项目旨在使用循证护理基础知识制定单元级别的质量衡量和改进计划。
2014 年，来自患者、家属、家庭、员工和审计数据的反馈表明，在新西兰地区卫生局，护理的基本方面（如监测、营养、疼痛管理和环境卫生）的提供存在差异。
采用一般归纳方法探索护理基础知识并设计衡量和改进计划，即患者和家庭为中心的护理标准（PWCCS），重点关注基本护理。
使用五个阶段探索证据，并设计和测试衡量和改进框架。
确定了护理的九个基本要素，用于定义预期的护理标准，并开发和测试衡量和改进框架。自 2015 年 6 月以来，已经进行了四次为期六个月的同行审查。护士长利用结果确定质量改进。在七个标准中的七个和四个指标中的三个方面，在 27 个单元中的六个单元中显示出整体显著改善。共有 89%（n=24）的单元提高了整体结果。
PWCCS 衡量和改进框架使护理基础知识的护理质量可视化，符合持续质量改进，以提高护理质量。
护士将提供基本护理描述为“回归基础”。患者和家属的反馈支持基本护理对其住院体验的核心地位。实施单元级别的基本护理质量衡量和改进计划，可以明确预期的护理标准，突出基本护理对质量的贡献，并为持续改进提供机制。
