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Abstract：
OBJECTIVE: The project aimed to develop a unit-level quality measurement and improvement programme using evidence-based fundamentals of care.
BACKGROUND: 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.
METHODS: 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.
METHODS: Five phases were used to explore the evidence, and design and test a measurement and improvement framework.
RESULTS: 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.
CONCLUSIONS: The PWCCS measurement and improvement framework make visible nursing fundamentals of care in line with continuous quality improvement to increase quality of care.
CONCLUSIONS: 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.
BACKGROUND: 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.
METHODS: 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.
METHODS: Five phases were used to explore the evidence, and design and test a measurement and improvement framework.
RESULTS: 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.
CONCLUSIONS: The PWCCS measurement and improvement framework make visible nursing fundamentals of care in line with continuous quality improvement to increase quality of care.
CONCLUSIONS: 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.
摘要：
目的：该项目旨在使用循证护理基础开发一个单位级别的质量测量和改进计划。
背景：来自患者的反馈，家庭,whānau,2014年的工作人员和审计数据表明，在提供基本护理方面存在差异，如监测、营养,新西兰地区卫生局的疼痛管理和环境清洁。
方法：使用一般归纳方法来探索护理的基本原理，并设计测量和改进计划，患者和Whānau中心护理标准（PWCCS），专注于基础护理。
方法：使用五个阶段来探索证据，并设计和测试一个测量和改进框架。
结果：使用了9个确定的护理基本要素来定义预期的护理标准，并开发和测试了测量和改进框架。自2015年6月以来，已经进行了四次六个月的同行评审。负责护士经理使用结果来确定质量改进。总体上证明了显著的改善，在27个单位中的6个，九项标准中的七项和四项措施中的三项。总之,89%(n=24)的单位提高了他们的整体结果。
结论：PWCCS测量和改进框架使可见的护理基础与持续质量改进相一致，以提高护理质量。
结论：护士将提供基础护理描述为“回归基础”。患者和家人的反馈支持护理基础在他们的医院体验中的中心地位。实施护理质量测量和改进计划的单元级基础，阐明了预期的护理标准，强调护理基础对质量的贡献，并提供持续改进的机制。
背景：来自患者的反馈，家庭,whānau,2014年的工作人员和审计数据表明，在提供基本护理方面存在差异，如监测、营养,新西兰地区卫生局的疼痛管理和环境清洁。
方法：使用一般归纳方法来探索护理的基本原理，并设计测量和改进计划，患者和Whānau中心护理标准（PWCCS），专注于基础护理。
方法：使用五个阶段来探索证据，并设计和测试一个测量和改进框架。
结果：使用了9个确定的护理基本要素来定义预期的护理标准，并开发和测试了测量和改进框架。自2015年6月以来，已经进行了四次六个月的同行评审。负责护士经理使用结果来确定质量改进。总体上证明了显著的改善，在27个单位中的6个，九项标准中的七项和四项措施中的三项。总之,89%(n=24)的单位提高了他们的整体结果。
结论：PWCCS测量和改进框架使可见的护理基础与持续质量改进相一致，以提高护理质量。
结论：护士将提供基础护理描述为“回归基础”。患者和家人的反馈支持护理基础在他们的医院体验中的中心地位。实施护理质量测量和改进计划的单元级基础，阐明了预期的护理标准，强调护理基础对质量的贡献，并提供持续改进的机制。
