AIMOlder people's views of prioritization in health care. The applicability of an interview study. Old age has been stated as a criterion for prioritization 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 prioritization in health care.DESIGNDescriptive, with a qualitative and quantitative approach. Fifty-four persons, 32 women and 22 men (aged 60-93 years), were asked to participate in a structured, tape-recorded interview covering their experience and views of the priorities applied in health care.RESULTSThe questions in the interview manual appeared to be applicable for collecting data concerning views of prioritization, 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 emphasized the equal value of all human beings and that age is not a basis for prioritization within health care. The respondents also showed an unwillingness to precede anyone in rank.IMPLICATIONSThe 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 prioritization, which will require exploring gender and age differences as well as other aspects that may explain variations.

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 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 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.

Quality assurance by developing strategical and professional nursing care goals. The purpose of this study was to develop strategical and professional nursing care goals. The theoretical base for the study was the 'VIPS-model' This model includes four concepts: well-being, integrity, prevention and safety, from which a taxonomy is generated. In order to measure the quality of nursing care the DySSSy-model was used. Four standards, based on the previously mentioned concepts were developed and evaluated at two surgical wards. The ward nurses were asked through a questionnaire how they valued the strategical and professional nursing care goals. The conclusion from the study is (1) that the taxonomy can be useful for structuring strategical and professional nursing care goals (2) that three of the developed standards are useful at surgical wards, and (3) that the questionnaire can be used as an instrument for defining how nurses value the chosen nursing care goals.