The critical role of nurses to the successful implementation of the National Safety and Quality Health Service Standards
Diane E. Twigg A B D , Christine Duffield C and Gemma Evans AA School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA 6027, Australia. Email: g.evans@ecu.edu.au
B Sir Charles Gairdner Hospital, Hospital Ave, Nedlands, WA 6009, Australia.
C Director, Centre for Health Services Management, Faculty of Nursing, Midwifery and Health, University of Technology, Sydney, NSW 2007, Australia. Email: christine.duffield@uts.edu.au
D Corresponding author. Email: d.twigg@ecu.edu.au
Australian Health Review 37(4) 541-546 https://doi.org/10.1071/AH12013
Submitted: 3 December 2012 Accepted: 19 May 2013 Published: 21 August 2013
Abstract
The National Safety and Quality Health Service Standards requires health service compliance by 2013 and covers several areas including governance arrangements, partnerships with consumers and eight key clinical processes. Nurses in Australia comprise 62% of the hospital workforce, are the largest component and hence play a critical role in meeting these standards and improving the quality of patient care. Several of the standards are influenced by nursing interventions, which incorporate any direct-care treatment that the nurse performs for a patient that may be nurse or physician initiated. The ability for nurses to undertake these interventions is influenced by the hours of care available, the skill mix of the nursing workforce and the environment in which they practice. Taking into consideration the predicted nursing shortages, the challenge to successfully implement the National Safety and Quality Health Service Standards will be great. This paper examines the role of nursing in the delivery of the National Standards, analyses the evidence with regard to nursing-sensitive outcomes and discusses the implications for health service decision makers and policy.
What is known about the topic? The National Safety and Quality Health Service Standards have been endorsed for implementation by the Australian Health Ministers. Compliance with the National Safety and Quality Health Service Standards is required by Health Services in 2013. Nurses play a critical role in providing high-quality patient care and meeting accreditation standards. A decline in nursing standards is associated with inadequate staffing levels and skill mix and a lack of effective leadership and results in an increase in patient mortality.
What does this paper add? The role of nurses in achieving compliance with the standards is discussed. We demonstrate that the capacity for nurses to undertake interventions is influenced by prevailing workforce characteristics. Significant nursing shortages have been identified as possible challenges to successfully implementing the National Safety and Quality Health Service Standards.
What are the implications for practitioners? Practitioners need to review nursing hours of care, skill mix and the practice environment as part of the actions required to achieve the National Quality and Safety Standards. The Australian Commission on Safety and Quality in Health Care has the opportunity to take the lead by including such indicators in the measurement of hospital performance.
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