OTHER FACTORS AFFECTING QUALITY PATIENT CARE

(1) Lack of resources: In sufficient resources, infrastructure, equipment, consumable money for recurring expenses and makes it impossible for output of a certain quality to be turned out under the prevailing circumstances.

(2) Personnel problem: Lack of trained, skilled and motivated employees, staff indiscipline affects the quality care.

(3) Improper maintenance: Buildings and equipments require proper maintenance for efficient use. If not maintained properly the equipments cannot be used in giving nursing care. To minimize equipment down time it is necessary to ensure adequate after sale service and service manuals.

(4) Unreasonable patients and attendants: Illness, anxiety, absence of immediate response to treatment, unreasonable and uncooperative attitude that in turn affects the quality of care in nursing.

(5) Absence of well informed population: To improve quality of nursing care it is necessary that the people become knowledgeable and assert their rights to quality care. This can be achieved through continuous educational program.

(6) Absence of accreditation laws: There is no organization empowered

by legislations to

lay down standards in nursing and medical care so as to regulate the quality of care. It requires a legislation that provides for setting of a stationary accreditation.

7) Lack of incident review procedure: During

a patients hospitalization reveals incidents

may occur which have a bearing on the treatment and the patient's final recovery.

8) Lack of good hospital information system: A good management information system is essential for the appraisal of quality of care including,

a) Work load, admission procedures and length of stay b) Activity audit and scheduling of procedures

(9) Absence of patient Satisfaction Surveys: Ascertained patient satisfaction at fixed points on an ongoing basis. Such surveys carried out through questionnaire, interviews by social workers, consultant groups, help to document patient satisfaction with respect to variables that are,

(a) (b)

delay in attendance by nurses, doctors etc. Incident of incorrect treatment.

(10) Lack of improper nursing care records: Nursing care records

are perhaps the most

useful sources of information on quality of nursing rendered. The records (a) detail the patient's condition (b) document all significant interaction between the patient and the nursing personnel (c) contain information regarding response to treatment.

(11) Communication and IPR

(12) Knowledge and knowledge advancement

(13) Tech advancements

(14) Lack of EBP

(15) Therapeutic touch

(16) Lack of autonomy for nurses

(17) Patient safety

(18) Miscellaneous Factors: Lack of good supervision.

Absence of knowledge about philosophy of nursing care. Lack of policy and administrative manual. Sub standard education and training. Lack of evaluation technique. Lack of written job description and job specification. Lack of in-service and continuing educational programs. Conflict among departments.