The purpose of the present study was, by means of a literature review, to describe and analyse the characteristics of clinical indicators used to assess and promote quality improvement in nursing care. It was found that a generally accepted definition of a clinical indicator is a 'quantitative measure that can be used as a guide to monitor and evaluate the quality of important patient care and support service activities'. By the seriousness of the event and the degree to which it can be avoided, clinical indicators are described as sentinel event or rate-based indicators. They can measure structure, process or outcome of care. Authors have had different approaches in focus when selecting and developing indicators viz. specific aspects of care/nursing diagnosis, medical diagnosis, generic aspects of care and clinical areas. These different points of departure were influenced by research knowledge, theories/frameworks, or by the opinions of patients or staff. The threshold of an indicator is essential when measuring the quality of care as it describes a critical level between what is considered good or not. Thresholds should be dynamic, realistic, and improve over time. However, the literature on how to establish specific thresholds is limited. The review has also revealed that there is an uncertainty regarding the use of terms such as indicators, standards, norm, criteria and aspects of care.

The aim of this study was to find out clinical nurses' perceptions of important aspects of nursing care that might have an impact on quality of care in surgical wards. A qualitative approach using focus group interviews was used. The data analysis revealed 15 categories of important aspects of care which could be condensed into two dimensions, here called 'prerequisites' (i.e., staffing, routines and attitudes) and 'elements of performance' (i.e., detecting and acting on signs and symptoms and acting on behalf of the patients). These aspects could be a starting point for developing quality indicators. Carper's four fundamental patterns of knowing were used to make a theoretical interpretation, and three of them were identified.

The purpose of this study was to investigate patients' experiences of care in connection with hip fracture. The care process was examined through non-participant observation, informal field interviews and healthcare records. The findings showed that many factors in the healthcare services directly or indirectly influence patients' perceptions of the quality of care. Some of these factors may depend upon a varying knowledge and empathy, while others are due to a lack of agreed protocols/procedures. Patients' needs with respect to pain relief and nutrition are discussed.

The purpose of the study was to evaluate the usefulness of a tentative model, based on important aspects of surgical nursing care, for designing strategic and clinical quality indicators. Objective postoperative pain management was chosen for the model because it is a priority area in surgical nursing care. Items within a questionnaire were designed by using the tentative model as a base and by means of a literature review. The questionnaire, directed to clinical nurses (n = 233), was compiled to establish the validity and the usefulness of the indicators. Fourteen items were assessed as essential for achieving high quality outcomes in postoperative pain management (11 as realistic to carry out, and 13 as possible for nurses to influence) with mean scores > or = 4 (on a 5-point scale). The conclusion reached was that the tentative model combined with a literature search was found to be effective for designing items that might be useful as strategic and clinical indicators of quality in postoperative pain management.

Older people's views of prioritization in health care. The applicability of an interview study.Werntoft, Elisabet; Edberg, Anna-Karin; Rooke, Liselotte; Hermerén, Göran; Elmståhl, Sölve; Rahm Hallberg, Ingalill Link to publication Citation for published version (APA): Werntoft, E., Edberg, A-K., Rooke, L., Hermerén, G., Elmståhl, S., & Rahm Hallberg, I. (2005). Older people's views of prioritization in health care. The applicability of an interview study. Journal of Clinical Nursing, 14 Suppl 2(8B), 64-74. DOI: 10.111164-74. DOI: 10. /j.136564-74. DOI: 10. -270264-74. DOI: 10. .2005 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Take down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. ABSTRACTOld age has been stated as a criterion for prioritisation in health care, although older people are seldom asked for their opinions. The aim of this pilot study was to investigate the applicability of a questionnaire as a base for an interview study to explore older people's experiences and views of prioritisation in health care. Design -Descriptive, with a qualitative and quantitative approach. Methods -Fifty-four persons, 32 women and 22 men (aged 60-93) were asked to participate in a structured, tape-recorded interview covering their experience and views of the priorities applied in health care. Results -The questions in the interview manual appeared to be applicable for collecting data concerning views of prioritisation, but the analysis revealed that certain questions, particularly on economic matters, were missing.The procedure, a personal structured interview had advantages, for example, in capturing the respondents' reflections on the questions. The respondents emphasised the equal value of all human beings and that age is not a basis for prioritisation within health care. The respondents also showed an unwillingness to precede anyone in rank. Implications -The questions used proved to be adequate but to be really complete further questions need to be added. This pilot study indicates that older people's views on priorities in health care differ from those expressed by the younger population. The study therefore needs to be replicated in a larger sample to be fully able to understand older people's views of prioritisation, which will require exploring gender and age differences as well as other aspects that may explain variations.