Defining "quality nursing care"

[dlp777]

Just wondering: with the development of general quality standards from the National Institute of Health and Clinical Excellence (NICE) in the UK,can quality care be defined at such a level, or should standards be much more localised and situation-specific? After all, dementia care (my particular area of expertise) is different when considered from a general hospital setting from a day hospital or community setting.

This is my proposed area of interest for my PhD and I would appreciate any views on this.

What do you think?

[llg, PhD, RN]

I think that the role of national level standards is different from that of local standards. It like comparing "apples vs oranges" in that while they are not the same thing, one is not better than the other. The role of national standards is either to establish broad principles of care that should be followed regardless of setting (e.g. respecting patients' rights) or to establish outcome targets for broad groups (aggregates) of patients (e.g. an acceptable rate or a specific complication).

The role of more local standards is to interpret those broad, national standards in a way that "fits" the local situation. The local standards should be congruent with the national ones ... and assist in helping the region meet those national standards and goals by providing a local perspective on how to proceed at the point of care.

It shouldn't be a case of "either / or" -- it should be the more complex perspective of "both" simultaneously.

Just my $.02