Quality improvement and critical care nursing.

Within the field of quality in health care there is a move away from quality assurance to a process of Continuous Quality Improvement. This change needs to be considered when designing a program to ensure quality within a critical care environment. There are several approaches available, one of which is the Dynamic Quality Improvement program. This involves solving problems and improving everyday practice whilst focusing on the recipients of the service. It utilises the Dynamic Standard Setting System (DySSSy) to define a professionally agreed level of performance for a chosen population. The standard must be achievable, observable, desirable and measurable. Patient focused nursing activities such as eye care and the prevention of pressure sores can be the basis for standard setting, audit and action to improve the care of the critically ill patient in a comprehensive program of quality initiatives.