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Biomedical subjects

A Kitson

Publications and source records attributed to A Kitson.

At least 37 records · Page 2Linked to original sources

Quality improvement of nursing care in hospitals in India: the dynamic approach.

A workshop was held in Calcutta in August 1992 by the Nurses' Research Society of India (NRSI), in partnership with the Royal College of Nursing of the UK, Dynamic Quality Improvement Programme (DQIP), to introduce an approach to quality improvement to nurses in India interested in evaluating and improving the care they provide. Since then, three sites have implemented the system for standard setting and audit (Dynamic Standard Setting System) which is the method for evaluating care used within that approach. An appraisal of the progress of the sites to date indicates that, in the clinical setting, nurses are progressing well with the writing of standards and have experienced little difficulty in understanding the theory and processes involved. They are currently revising the standards written with a view to implementing them and auditing them in the near future. This article outlines the introduction of dynamic quality improvement and the Dynamic Standard Setting System to the nurses in India and describes the progress of one of the test-sites currently working on its implementation.

Group Processes↗

Criteria formulation and application: an evaluative framework.

This paper critically examines how criteria are formulated and applied in quality assurance or quality improvement systems. It begins by drawing attention to the division that exists between criteria derived by so-called expert groups and those developed more locally by practitioners. In seeking to analyse the strengths and weaknesses of these two contrasting approaches, it explores the more fundamental questions of how criteria are formulated in general and how they can best be applied. An evaluative framework is offered as a working checklist for practitioners involved in criteria formulation. The framework identifies three main areas: actual construction of criteria; procedures for formulation and issues related to application. An example of each area is offered from results of the ODySSSy Project. The paper concludes by recommending more systematic studies in this highly complex area.

Delphi Technique↗

Post-operative pain management: a literature review.

The appropriateness of any set of criteria generated to measure the quality of a particular intervention is dependent upon a thorough, up-to-date assessment of the current state-of-the-art. Few areas in nursing have received as much research attention as that of pain control, particularly post-operative pain control. The following review of the literature* on this subject complements earlier reviews undertaken by Seers (1988) by organizing the information according to four distinct categories, namely environmental issues, nursing actions, patient outcomes and a review of a number of pain measures. This particular format was selected in order to help in the development of structure, process and outcome criteria on the topic of post-operative pain management. The section on measurement is to inform practitioners about pain-assessment charts and provide ideas about auditing this area.

Analgesia↗

A comparison of expert- and practitioner-derived criteria for post-operative pain management.

A comparison of two methods of criteria formulation was carried out as part of a 3-year research study looking at the effectiveness of a nursing quality assurance system (the Royal College of Nursing's Dynamic Standard Setting System). In particular, the study wished to explore whether and to what extent criteria sets derived from an expert group differed from criteria generated by local practitioner groups. One expert group and five local groups were helped to develop criteria on the topic of post-operative pain management. Results showed that the expert group underwent a much more controlled and systematic approach to the task than any of the local groups who were supported by newly trained facilitators. Despite this difference, two of the five local groups had criteria convergence scores of more than 55%, demonstrating that the local knowledge on the topic was acceptable. Whether the lower convergence of the groups was due to lack of knowledge or a combination of difficult group processes and novice facilitation is difficult to say. However, what the study did show was that local groups can generate criteria sets comparable to expert groups, given proper facilitation and support.

Adult↗

Doing the right thing right.

Is clinical effectiveness just a fancy way of getting nurses to do more with less? No, argues Professor Alison Kitson in a discussion on the issues and challenges clinical effectiveness presents for nurses and nursing.

Clinical Competence↗