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Quality of health care is the degree of the most optimal degree of health outcomes by delivery of effective, efficient and cost‐benefit professional health services to people and communities. As nurses are the largest groups among health care professionals and are legally liable and morally responsible for their care, thus their perspective on quality of nursing care is important. The purpose of this qualitative study is “to define and describe quality from the perspective of nursing experts and clinical nurses”.

In this paper data were collected in two phases (ten individual interviews and five focus group discussions). A total of 44 clinical nurses and ten nursing experts participated through a purposeful sampling frame. Data analysis was conducted by latent content analysis to achieve a definition of nursing care quality.

The findings in this paper show that, according to similarities and differences between nursing experts' and clinical nurses' perspectives on quality, the final definition is “delivery of safety care based on nursing standards which eventuates in patient satisfaction”. Findings reveal that in nurses' perspectives on quality definition two important aspects have been mostly considered: “standard of care” and “patient satisfaction”. Moreover, both participant groups have emphasized the benefits of collaborative work in health care (teamwork). Further in this study, organizational and socio‐cultural roles in delivering quality nursing care have been mentioned such as staffing, budget, leadership, and social perspectives about nursing as a highly educated profession.

The paper offers an overview of nurses' perspectives of quality of nursing care in Iran.

Describes alternative approaches to quality assurance in nursing and traces the historical shift from one approach to the other; quality as inspection to quality as opportunity. Early proselytizing approaches were superseded by an emphasis on quantitative measurement and attempts at “objective” evaluation which involved the development of the generic audit. More recently, the move has been towards locally developed audit and standard setting.

Nursing facility inspections routinely produce statistics revealing sharp disparities in care at both the facility and the state level. But whether high rates of deficiencies are more indicative of stringent enforcement of standards, leading to improved care, or ongoing poor quality care remains unclear. Until this question is answered, families of nursing facility residents, responsible public officials and interested professionals, are all unable to make sound decisions about long-term care quality. We employ cross-sectional, panel data to compare states on multiple indices of both care quality and enforcement stringency. We use the multi-method-multi-trait approach to distinguish these concepts. We find that low rates of deficiencies are positively associated with independent measures of high quality care. But, a prominent nursing facility enforcement index likely registers poor quality care more than stringency of enforcement since it is associated positively with independent indices of poor quality care and negatively with independent measures of enforcement. Attentive publics can have reasonable confidence that low rates of deficiencies indicate high quality care. High rates tend to reflect glaring deterioration in care quality. They are less signals of stringent enforcement than of obviously poor care which prompts more visible enforcement activities. Sadly, there is little evidence suggesting that these enforcement measures improve state-level care quality and thus reduce cross-state disparities in the quality of nursing facility long-term care. However, at least some of the factors responsible for sharp disparities in nursing facility care lie within the capacity of states to rectify even in the short term.

The purpose of this paper is to investigate the impact of nursing quality on Taiwan nursing homes, and differences of efficiency among different management types of nursing homes.

This study employs data envelopment analysis (DEA) to investigate the efficiency of nursing homes with and without quality variable. The impacts of nursing quality on the efficiency of nursing homes were studied. Finally, Tobit regression is used to explore the factors influencing efficiency in nursing homes.

The analysis shows that nursing quality has significant impacts on operating efficiency of nursing homes. When quality variables are included, all efficiencies were significantly improved, except scale efficiency of government-expense nursing homes (GEH); return of scale status of GEH decrease substantially; the licensed nursing staff can always improve efficiency; higher occupancy rate increase efficiency; private-operated veteran homes performs better than government-operated homes.

Nursing quality has a significant effect on the efficiency measures. Thus, the nursing quality cannot be ignored in assessing the performance of nursing homes. Otherwise, it may result in biased results. The efficiencies of private-operated nursing homes are better than the government operation. Government-operated nursing homes should take private nursing homes as the benchmark.

The paper demonstrates the nursing quality is an important factor in the efficiency measure of nursing homes. It also shows that privatized operation has higher efficiency than the government operation.

An area of increasing importance has been the use of quality measures in the study of health care. One specific application involves the performance of nursing homes. Previous studies using data envelopment analysis (DEA) methodology to study this problem have revealed several problems, including the selection of quality output measures and the assignment of weights to these measures that result in minimizing their impact. In this chapter, we will use weight restrictions as an effective means of including important quality measures in the DEA model and allowing the DEA results to discriminate among high- and low-quality performing nursing homes.

Federal and state governments collaborate on state Medicaid nursing facility long-term care (SMNF-LTC) programs. These programs are increasingly expensive as the baby-boomers retire. Yet serious resident outcome problems continue in spite of the Centers for Medicare and Medicaid Services’ (CMS) extensive process-focused regulatory efforts. This study identifies a promising and simpler auxiliary path for improving resident outcomes.

Drawing on a longitudinal (1997–2005), 48-state data set and panel-corrected, time-series regression, we compare the effects on resident outcomes of CMS process-focused surveys and four minimally regulated program structural features on which the states vary considerably.

We find that each of these four structural features exerts a greater effect on resident outcomes than process quality.

We suggest augmenting current process-focused regulation with a less arduous approach of more extensive regulation of these program features.

To date SMNF-LTC program regulation has focused largely on member facility processes. While regulating processes is appropriate, we show that regulating program structural features directly, an arguably easier task, might well produce considerable improvement in the quality of resident outcomes.

The purpose of this paper is to investigate the extent to which nursing leadership, perceived by nursing staff, influences nursing quality.

Data were collected between August and October 2011 in a Portuguese health center via a questionnaire completed by nurses. Our original sample included 283 employees; 184 questionnaires were received (65% response).

The theoretical model presents reasonably satisfactory fit indices (values above literature reference). Path analysis between latent constructs clearly suggests that nursing leadership has a direct (ß=0.724) and statistically significant (p=0.007) effect on nursing quality.

Results reinforce several ideas propagated throughout the literature, which suggests the relationship's relevance, but lacks empirical support, which this study corrects.

The purpose of this paper is to share insights, research findings and discuss key issues relating to quality practices and quality assurance in cross-border nursing education program development and implementation.

The authors used a qualitative, multiple case-study approach, by sampling local, national and international nursing education institutions, academia and nurse graduates to identify challenges and best operating practices in implementing and facilitating cross-border education.

The authors reveal that quality assurance affects cross-border nursing education program design, delivery and implementation.

Quality assurance plays an important role in cross-border nursing education, by enhancing the reputation and recognizing the effectiveness and capacity of the educational institution. These findings of this study can offer valuable insight to forthcoming as well as existing nursing education curriculum developers who plan to engage in national or international educational partnerships.

Quality assurance plays an important role in cross-border nursing education, by enhancing the reputation and recognizing the educational institution’s effectiveness and capacity. The findings offer valuable insight into forthcoming and existing nursing education for curriculum developers who plan to engage in national or international educational partnerships.

This paper explores inherent challenges in cross-border nursing education and maximized data collection opportunities by sampling participants from both national and international settings.

There is increasing evidence in the literature that patient outcome is strongly linked to the quality of nursing care. In practice, the process of measuring the quality of nursing care is complex and multifaceted as it is dependent not only on the skills and practices of the individual nurse, but also on the professional and organisational structure that is practised within. The expert panel concept was developed to address clinical standards and practice at The Royal Melbourne Hospital. The Nursing Expert Panel's purpose was to evaluate nursing practice, identify practice deficits, highlight areas of clinical innovation and excellence, and make recommendations where appropriate to improve patient outcome. The aim of this paper is to investigate this.

A pilot programme to evaluate eight clinical areas was developed and implemented. The key areas of evaluation included clinical care as well as the managerial and professional practices that support patient care. The Expert Panel, consisting of predominantly nursing staff, was recruited from within the organisation. During the evaluation, the panel collected qualitative and quantitative data using a variety of data collection tools. Data were then analysed and recommendations developed.

Five common themes of practice deficit were identified during the pilot period and the development of strategies for practice improvement is in progress.

Following successful implementation of the pilot phase, the Nursing Expert Panel process is now being implemented across the organisation. With ongoing evaluation and improvement of the Expert Panel Process, this quality initiative will become the foundation of nursing standards and practice evaluation at this organisation.

This paper aims to maintain the high service quality of the long-term care service providers by establishing a knowledge-based system so as to enhance the service quality of nursing homes and the performance of its nursing staff continually.

An intelligent case-based knowledge management system (ICKMS) is developed with the integration of two artificial intelligence techniques, i.e. fuzzy logic and case-based reasoning (CBR). In the system, fuzzy logic is adopted to assess the performance through the analysis of the long-term care services provided, nurse performance and elderly satisfaction, whereas CBR is used to formulate a customized re-training program for quality improvement. A case study is conducted to validate the feasibility of the proposed system.

The empirical findings indicate that the ICKMS helps in identification of those nursing staff who cannot meet the essential service standard. Through the customized re-training program, the performance of the nursing staff can be greatly enhanced, whereas the medical errors and complaints can be considerably reduced. Furthermore, the proposed methodology provides a cost-saving approach in the administrative work.

The findings and results of the study facilitate decision-making using the ICKMS for the long-term service providers to improve their performance and service quality by providing a customized re-training program to the nursing staff.

This study contributes to establishing a knowledge-based system for the long-term service providers for maintaining the high service quality in the health-care industry.