rss
Qual Saf Health Care 2002;11:308-314 doi:10.1136/qhc.11.4.308

Progress of unit based quality improvement: an evaluation of a support strategy

  1. L Wallin1,2,
  2. A-M Boström3,
  3. G Harvey4,
  4. K Wikblad5,
  5. U Ewald1
  1. 1Department of Women’s & Children’s Health, Uppsala University, Uppsala, Sweden
  2. 2Public Health & Caring Sciences, Uppsala University, Uppsala, Sweden and Dalarna University, Falun, Sweden
  3. 3Department of Nursing, Karolinska Institute, Stockholm, Sweden
  4. 4RCN Institute, Oxford, UK
  5. 5Medicine and Care, Linköping University, Linköping, Sweden
  1. Correspondence to:
 L Wallin, Dalarna University, Campus Falun, S-791 88 Falun, Sweden;
 lwa{at}du.se
  • Accepted 1 March 2002

Abstract

Objective: To evaluate a strategy for supporting nurses to work with quality improvement (QI).

Design: Post-intervention evaluation.

Study participants and intervention: 240 nurses participated in a uniformly designed 4 day basic training course in applying a model for QI. Of these, 156 nurses from over 50 healthcare institutions constituted the generic education (GE) group while 84 nurses from 42 neonatal units took part in a project to develop national guidelines, constituting the targeted intervention (TI) group.

Method: Postal questionnaire 4 years after the training courses.

Results: The response rate was 80% in the TI group and 64% in the GE group. Nurses in the TI group had a significantly higher rate in completing all phases of the QI cycle (p=0.0002). With no differences between the groups, 39% of all nurses were still involved in QI work 4 years after the training courses. Three factors were significantly related to nurses continuing their involvement in QI projects: remaining employed on the same unit (OR 11.3), taking courses in nursing science (OR 4.1), and maintenance of the same QI model (OR 3.1). Reported motives for remaining active in QI work were the enhancement of knowledge, influence over clinical practice, and development as a nurse. Reasons for discontinuation were organisational restructuring, a lack of facilitation and knowledge, and change of workplace.

Conclusions: Participation in a national guideline project, including a common focus for improvement, facilitation and opportunities for networking, seems to have enhanced the ability to carry out the process of QI, but not to sustain the QI work over a longer period.

Footnotes

    This Article

    1. Abstract
    2. Full text
    3. PDF

    Responses

    1. Submit a response
    2. No responses published

    Register for free content

    The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

    Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.