Introducing new technology: confusion or order?

A model is explained for assessing the components and potential relationships which should be considered before introduction of a new or updated piece of equipment, improved supplies or a new process in nursing care. Some principles are offered to direct the weighting of various factors involved in selecting and implementing the introduction of new technology. Use of such a model can reduce staff frustration and improve quality of patient care.

Reconsideration of the quality circle process as a contemporary management strategy.

The quality circle group problem-solving process contains the potential for finding solutions to today's health care challenges. It provides the mechanism to integrate the strongest problem-solving capabilities of both managers and staff. If the complex challenges that are occurring daily as well as those that have been carried forth from the last decade are to be solved, it is evident that there is a need to find a mechanism to combine the best and brightest insights of both managers and staff. The quality circle process is one such mechanism. Health care supervisors are invited to reconsider this process as a contemporary management strategy that blends in well with the current movement toward continuous quality improvement.

An analysis of job morale factors of community health nurses who report a low turnover rate. The research.

Nurse executives are continually faced with issues related to nursing turnover and staff morale. This sample included 217 registered nurses working in a state health department where the turnover rate was 8%. In this study, the authors found that nurses with advanced educational preparation, higher-level positions, or both, demonstrated increased levels of morale. Conversely, nurses with increased years of service and nursing experience had lower morale levels. These findings could be useful in delineating situations to improve morale and lower turnover rates.

Quality circles in the public health sector: implementation and effect.

Although the quality circle (QC) process has been used in health care, there is a conspicuous gap in the literature about its use in community health nursing. The purpose of this service/education project was to implement QCs in the public health nursing sector throughout a southern central state. The major objective was to provide QC training to approximately 250 supervisors and staff nurses so that this participative group problem-solving approach might be used as a systematic method of dealing with concerns related to quality of care. Evaluation tools, such as the Science Research Associates' attitude scale and the quality management maturity index, were used to determine whether or not the implementation of the QC program influenced the level of morale and quality management maturity. The data obtained reflected positive changes and favorable supervisory responses.

Role development: the nursing quality assurance coordinator.

This application of the Benner Model to the role experiences of the NQA coordinator demonstrates the usefulness of this framework to describe the progressive development of the role. In Benner's model, there are three distinct areas for discussion. First, as the nurse moves from the expert role of staff nurse or head nurse to the role of novice NQA coordinator, many very real situations are encountered that have the potential to create frustrations and adverse feelings within the nurse. It is equally important for the position holder, as well as the supervisor, to recognize these as the normal growth stage of the novice, so that appropriate actions can be taken to positively help the NQA coordinator through these early developmental stages. Secondly, initial acceptance of the NQA coordinator role creates feelings of anticipation, challenge, and excitement. However, in spite of this, the novice is soon likely to feel threatened and alone. This feeling is related to various situations, such as the lack of formal guidance and role preparation. As a result, the novice NQA coordinator often needs to accept the responsibility for self-direction in role preparation. At this point, it may be quite overwhelming for the NQA coordinator to take personal responsibility for obtaining the knowledge and skills necessary to be successful in the role. To be successful, it is vital for the novice and advanced beginner to identify developmental needs and to obtain the resources and support needed during these crucial stages. Finally, the personal reflection on the experiences of two NQA coordinators demonstrates that, although the developmental stages are relatively well defined, they may not always be clear-cut, and there may be vacillation between stages. These are normal phenomena for which strategies can be identified to enhance adaptation and growth within the particular stages of skill acquisition. The proposed time frames noted for each stage of role development may be somewhat arbitrary. Many variables, such as degree of specialization, urgency of the task, and characteristics of the position holder, organization, and health care environment will influence role development. Thus, the individual may not experience a straightforward and clear-cut progression but rather a back-and-forth movement through the various stages. The role experiences of the NQA coordinator are easily conceptualized using the Benner framework.(ABSTRACT TRUNCATED AT 400 WORDS)

The quality management maturity grid: a diagnostic method.

"Quality is free. It's not a gift, but it is free. What costs money are the unquality things--all the actions that involve not doing the job right the first time." Nurse executives can benefit from the challenge of this statement, the basis of Philip Crosby's Quality Management Maturity Grid. The authors discuss the Grid, used successfully in business as a diagnostic tool to assess organizational quality management, and its use in the health care setting.