Summary of Proposed Research Program for Master of Philosophy Title: The Delivery of Quality Nursing Care: A Grounded Theory Study of the Nurses' Perspective Abstract
The purpose of this study is to explore and describe the delivery of quality nursing care from the perspective of practising nurses working in the acute public hospital setting of Western Australia (WA). The study will examine the actions and interactions attributed to quality, and factors identified as enhancing or inhibiting the delivery of quality nursing care. A grounded theory approach is proposed. The sample for the study will be drawn from nurses working in an acute public hospital located in Perth, WA. Data will be collected using semi-structured interviews and some observation. It is estimated that approximately 10-15 interviews will be performed. Theoretical sampling will guide the selection of participants. The significance of this research will be to increase understanding of this complex phenomenon and contribute to efforts aimed at improving and maintaining quality nursing care within the current context of the WA health care system. A substantive theory explaining the process of quality care, focussing on the nurses' perspective, in an acute public hospital setting, will be developed. Implications for practice will be discussed and directions for further research in this area will be provided. Objectives
The purpose of this study is to explore and describe the delivery of quality nursing care from the perspective of practising nurses, working in the acute public hospital setting of WA. The study will examine the actions and interactions attributed to quality, and factors identified as enhancing or inhibiting the delivery of quality nursing care. The objectives guiding this proposed study are: 1. To explore and describe nurses' perceptions of the meaning of quality nursing care. 2. To describe nurses' experiences in the delivery of nursing care given to patients in hospital and to compare these with their expectations of quality nursing care. 3. To explore factors identified by nurses as enhancing and as inhibiting quality nursing care. 4. To develop a substantive theory which explains the process used to deliver quality nursing care in an acute public hospital setting, as perceived by nurses.
The provision of quality patient care is a priority in all health care institutions (Erith-Toth & Spencer, 1991). Formal definitions of what constitutes quality are numerous (Ambler Peters, 1991), as are the approaches used to assess the quality of patient care (Harvey, 1991; MacGuire, 1991). Although much has been written about the phenomenon of quality care, significant variations exist in its interpretation and use, "unaware or undeterred by the conceptual confusion, quality care continues to be assured, controlled, evaluated and managed in the Health Service today" (Attree, 1993, p.355). Furthermore, definitions and assessment of quality have rarely considered the reality faced by nurses on a daily basis, in the practice and delivery of quality care.
Quality nursing care has been studied from various perspectives using different methods. Much of the research reported in the literature has been quantitative in nature and undertaken in countries other than Australia, particularly North America. Some studies have focussed on the measurement of quality nursing care (Gilloran, McGlew, McKee, Robertson & Wight, 1993; MacGuire, 1991; Pearson, Durant & Punton, 1989; Kitson, 1985), or the meaning of quality nursing care from either the nurses' perspective (Janhonen, 1993; Forchuk & Kirkpatrick, 1991; Whelan, 1988; Jenkins, 1988) or the patients' perspective (Irurita, 1993; Erith-Toth & Spencer, 1991; Deeny & McCrea, 1991; Rempusheski, Chamberlain, Picard, Ruzanski & Collier, 1988). Other studies have compared the perceptions of quality nursing care from the perspective of nurses and patients (Norman,...