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Fiona Morris describes how the implementation of a framework to assess nursing practices and care has helped to enhance standards, accountability and leadership
Abstract
In 2008, Salford Royal NHS Foundation Trust introduced a ward-based performance assessment framework, the Nursing Assessment and Accreditation System, which is designed to foster a culture of safety by helping nurses monitor the quality of care. It is based on the trust's Safe, Clean and Personal Every time approach to service provision and is designed to support communication, accountability, teamworking and leadership, attention to safety and quality improvement, to ensure that patients are placed at the centre of the care services provided.
Keywords
Framework, quality, standards, patient care, nursing assessment, multidisciplinary working
The government expects the NHS to have robust measures in place to capture assurance on the fundamentals of nursing and medical care (Department of Health (DH) 2008). All trusts must account for the quality of care delivered, therefore, and ensure that care is evidence based and relevant to patient needs.
Measuring the quality of care delivered by individuals and teams can be difficult, and the performance assessment framework discussed in this article incorporates the DH (2001) Essence of Care standards and key clinical indicators, national and trust specific, and provides evidence that the trust is meeting the standards set by the Care Quality Commission (CQC) 2010) and the NHS Litigation Authority (NHSLA) (2012).
The Nursing Assessment and Accreditation System (NAAS) framework developed at the trust also enables staffto document patients' experience through patient interviews by including questions relating to their care and treatment.
Framework
In 2008, Salford Royal launched its quality improvement strategy, which focused on reducing patient harm and mortality with the aim of making it the safest hospital in the UK.
International experts at the Institute for Healthcare Improvement (2007) cite the following aspects of a hospital's culture as paramount to patient safety:
** Open communication about patient safety.
** Local accountability for outcomes and improvement.
** Good multidisciplinary teamwork focused on improvement.
** Visible leadership committed to safety and quality.
NAAS is a vehicle for assessing ward care that promotes these four aspects of safety. It uses a systematic approach to assessment and supports the embedding of practice that is developed through the trust's quality-improvement...