Quality assurance: Independent and interdependent nursing functions

The problem of this study was to describe the extent to which hospital nursing quality assurance program instruments reflected both the independent and interdependent functions of nursing. Program instruments included in the sample were those forwarded by hospitals willing to participate in the study. Using the Quality Assurance Program Analysis Instrument, a group of panelists analyzed the program instruments and classified the criteria of each instrument as reflecting independent or interdependent functions. The interdependent functions were further classified as bureaucracy/agency-directed or physician-directed. Independent functions were classified as assessing, diagnosing, or planning. Findings were: (a) a major portion of the program instruments reflected interdependent nursing functions, (b) of the interdependent functions, the bureaucracy/ agency-directed functions were a large majority, and (c) of the independent functions, the smallest portion of criteria reflected diagnosing. Conclusions were: (a) nurses in hospital settings are held accountable for bureaucratic directed functions, and (b) nursing diagnosis is minimally addressed in the program instruments.