Quality assurance in occupational health nursing was discussed. According to the author, nursing involves four steps: assessing the needs of the client, developing a plan to meet the identified needs, implementing the plan, and evaluating the care given. Quality assurance refers to the last step, evaluating the quality of care. Quality assurance programs are basically systematic ongoing peer review processes with the goal of providing high quality nursing care. Approaches to performing quality assurance evaluations were described. The approaches can be categorized as being based on structure, process, and outcome. The structure approach evaluates the organizational characteristics of nursing services, the facilities, equipment, staff, and policies. The process approach considers the nurse's actions, what is actually done. The outcome approach resembles the process approach, but focuses on the end results of the nurse's actions. Steps for implementing a quality assurance program were outlined and discussed. They consist of identifying values (the attitudes of the nurse toward health and health care services, the company, and the public); identifying structure, process, and outcome standards and criteria; making the measurements needed to determine the extent that the criteria and standards have been met; interpreting the strengths and weaknesses uncovered by the measurements; identifying possible courses of action; and selecting an appropriate action.
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