Abstract
M.Cur.
The nursing service manager is responsible and accountable
for ensuring quality health care in a nursing service. The
principle of liability requires a formal quality improvement
programme in the nursing service according to which a specific
level of quality nursing can be maintained.
It is therefore clearly evident that a quality improvement
programme, objectively maintain and evaluate the quality of a
service. Opportunities for improvement are identified, and a
mechanism is provided for taking remedial steps to bring
about and maintain improvement, The abovementioned is of
utmost importance and implies a constant commitment to
health care service of a high quality.
The overall objective of this study is to formulate and describe
guidelines for a quality improvement programme for the
nursing service of a referral hospital in the Gauteng Province.
This study is an explorative, descriptive, qualitative and
contextual research aiming to investigate the perceptions of
quality in nursing/midwifery which will facilitate the
exploration and description of a value clarification on quality,
by the chief professional nurses, senior professional nurses,
administrative personnel and patients within the nursing
service of the referral hospital in the Gauteng Province. Focus
group interviews, naive sketches and interviews as methods of
data gathering was conducted.
A simple random sampling method was used. A total number
of three focus group interviews were conducted: one with seven
chief professional nurses, one with fourteen senior professional
nurses and one with twelve administrative personnel using
tape recordings with the written consent of the participants.
Naive sketches were obtained from the same groups. An
expert psychiatric nurse, with a master's degree in the field
and whose daily activities involved interviewing of the
psychiatric nursing students and psychiatric patients,
conducted the focus group interviews. The researcher
conducted thirty individual patient interviews.
Trustworthiness in this research was done according to Guba's
model (!!! Krefting, 1991:214-222). Data analysis was done
according to Tesch's (1990, in Creswell, 1994:155) protocol. An
external coder with expertise in the field of coding in
qualitative data was utilised to analyse and categorize the data.
The researcher and the independent coder had consensus
discussions for the formulation of the main categories and sub
categories. Consensus discussions were also conducted with
the study leader. The results were quantified based on the
number of respondents whose perception on quality had
reference to the same categories. The structured coding was
based on the principles of quality: structure, process and
outcome.
A description of the conceptual framework was developed
from the data analysis and a literature study. This framework
with its content and criteria serves as scientific and theoretical
basis of the quality improvement programme and are based
on the values/value clarification on quality of the different roleplayers
in the nursing service. Fifteen belief statements/values
were described from the value clarification.
The guidelines for the quality improvement programme of the
nursing service in the referral hospital were described, based
on the eight steps of the quality assurance model of Laing and
Nish (Booyens, 1998: 576). A description of values is the first
step and from these values on quality in the nursing service,
the formulation of management standards was deduced in
conjunction with the conceptual framework and the
nursing/midwifery practice standards of the Nursing
Department of RAU.
Lastly the evaluation, limitations, recommendations and
conclusion of the study were done.