Wie ist nach dem aktuellen Forschungsstand die Qualität der Pflege zu beurteilen? Und: Welchen Beitrag leisten die Ergebnisse der externen Qualitätssicherung in Bezug auf die Pflegequalität im Krankenhaus?

Abstract

Relevance / Background Quality and efficiency are used by policymakers as governance criteria in healthcare. This includes the question of the efficiency and quality of care quality in the hospital. The questions about the quality of care, however, can not currently be answered. In addition, qualified specialist staff is missing with increasing care needs. Research question How is the quality of care in the hospital to be assessed and which contribution do the two quality indicators from external inpatient quality assurance make to the quality of care in the hospital? What are supporting criteria for quality in the hospital and how can quality of care be reflected in the hospital at all levels? Methodology Literature review and concept analysis on the theoretical concepts and influencing factors on the quality of care in the hospital. Literature search for quality indicators and findings on decubitus incidence in the hospital. The research took place in the databases PubMed, Embase, Medline, CINAHL and the Cohrane Libery. Exclusion criteria have been defined and specified. A total of 198 studies, 58 reviews and 47 theoretical models and concept papers were included in the review and evaluated. Published data on the Dekubtius incidence of external inpatient quality assurance were used and evaluated. State of research Theoretical models and concept papers are based for the majority of models in the field of quality management and the continuous improvement process and the organization and system theory, less often are concepts of professional attitude and patient centering. Evidence was found from the studies that have a positive effect on the quality of results in the hospital and also on the nurse outcomes. Starting with structures and defined process descriptions on cultural aspects and personality traits of caregivers. Results The questions about the quality of care in the hospital remain open. There is a lack of studies in the German context and a common definition of care quality is lacking in order to be able to evaluate them. The findings on decubitus incidence also difficult to interpret. However, there are indications of criteria that have a positive effect on patient outcomes and nurse outcomes. There are quality indicators and instruments that are used internationally for quality measurement. However, these often only refer to errors and adverse events and only represent part of the quality of care. Discussion The quality control tools used by policy makers have not yet been evaluated for their effectiveness. The political discussion focuses on minimum numbers of employees and thus does not do equitable to the complexity of factors influencing the quality of care. There is a very elaborate quality assurance process with two quality indicators for care and over 400 medical quality indicators. Care quality can not be comprehensively mapped. It requires a definition of care quality, developed from the occupational group with the derivation and definition of quality indicators to comprehensively map and measure quality of care with quantitative and qualitative survey methods. There is a lack of national research on care quality in the hospital to map the complex influencing factors and to meet them.