. (1990). Using research to identify why nurses do not meet established sexuality nursing care standards. Journal of Nursing Quality Assurance 4(3), 69-78. ALTHOUGH A main objective of quality assurance (QA) activities is to improve the nursing care given to patients. many QA activities focus on uncovering deficiencies rather than on developing strategies to assist nurses in meeting quality patient care standards. Intervention strategies may be quickly and poorly planned and often result in no improvement or only a temporary rise in monitoring scores. This article will examine a recurrent nursing QA problem experienced at the University of Kentucky Hospital and the research activities taken to discover the underlying reasons for failure to meet the department's care standards in the area of sexuality. The results of this research then served as the basis for developing a comprehensive intervention plan to change the practice of nurses within the institution. Made available courtesy ofThe philosophical framework of the department of nursing at the University of Kentucky Hospital is based on the concept that all people have the same eight basic human needs: oxygenation, nutrition. elimination, activity and rest, security, communication and sensation, sexuality, and self-esteem. All assessment. planning. documentation, and evaluation tools cover these eight basic human needs, with specific standards of care established to meet each one of these needs, including sexuality. The overall objective for the sexuality standard states: Each patient is assisted to cope effectively with interferences in his or her body image, role and sexual behavior." 1 A series of 24 individual standards has been adopted by the department as components of the overall sexuality objective. This format is similar to standards that have been established by professional nursing organizations. In 1974, the division of medical-surgical nursing of the American Nurses' Association (ANA) included sexuality as one of the areas warranting nursing assessment of function and status.2 The standards of the Nurses Association of the American College of Obstetricians and Gynecologists (NAACOG) include reference to health teaching about changes in sexual function in prenatal and postnatal patients and their families.3 The standards for oncology nurses set jointly by the Oncology Nursing Society (ONS) and the ANA include sexuality criteria across five standards for data collection. nursing diagnoses, planning, intervention, and evaluation.4 That these organizations have established nursing care standards that address the sexual concerns of patients validates the importance of ensuring that nurses meet these established standards.The clinical monitoring tool used by the University of Kentucky to evaluate the nursing process, the concurrent audit. reports scores for each of the basic human needs. Since 1985, scores for the human need ''sexuality" have consistently fallen below the standard minimum score of 85% set for each basic human need in all nursing divis...

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