The development of an evaluation tool for unit-based quality assurance.

A great deal of time, research, and effort was expended in converting the LRMC nursing division from a centralized plan to a decentralized focus. Inherent in the process was the belief that unit-based QA programs offer an excellent opportunity for change, empowering the staff nurse to act as the change agent in improving patient care and enhancing nursing practice. A necessary component in the QA process is evaluation, enabling nurses to step back from the "busyness" of a unit-based committee to identify documented improvements in patient care and to provide validation for changes in nursing practice. The process of evaluation allows nurses the means to appraise the worth and merit of their unit-based QA program. For all levels of nursing, time is a scarce commodity. The realities of the nursing shortage dictate that all programs with staff nurse involvement be examined carefully. For these reasons, thorough and meaningful annual appraisal is critical to ensure that the time spent in implementing and maintaining a unit-based QA program is worth the effort.