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Flynn, J 2007, 'Nurses' perceptions of quality nursing care : a grounded theory study of overloading', PhD thesis, Southern Cross University, Lismore, NSW.

Copyright J Flynn 2007


This PhD study aimed to explore nurses’ perceptions of quality nursing care and why they were unable to provide this. The specific aims of this study were to; compare actual quality of care provided to patients by clinical nurses rather than perceived quality of care that should be provided; identify significant nursing care issues impacting on quality; and make recommendations on behalf of nurses working in the clinical area with patients for the purpose of improving the quality of nursing care.

For these nurses, who work directly with patients, in clinical hands on roles, care comprises up to 90% of their daily activities. Worldwide, various Nursing Boards and Regulatory Bodies have developed standards of practice, which identify what a nurse should do, as well as ensuring safe and competent practice (QNC Scope of Nursing Practice 2005; American Nurses Association, 1998).

The findings from this research indicate that the ability of nurses to provide quality nursing care is being raised as a significant issue with practicing nurses, with nurses now questioning their ability to provide patients with the care they should have, rather than what they have time to provide. By exploring nurses’ perceptions of what they believed constituted quality-nursing care, nurses’ described what quality nursing care means to them within their own clinical areas. This research was able to identify that nurses do indeed take shortcuts in their endeavours to complete their daily activities.

For this study, I utilised a Grounded Theory (GT) methodology, using a systematic set of procedures to arrive at a theory about basic social processes (Glaser, 1992). The aim of this approach was to discover underlying social forces that shape human behaviour and in particular clinical nurses working directly with patients. This was achieved via interviews utilising open-ended questions, skilled observation and various forms of documentation, such as nurse’s notes, professional standards and job descriptions.

The value of using a qualitative research method such as GT is often emotional and embedded in the subjective. With an emphasis on understanding quality from a practicing nurse’s perspective, a descriptive study such as GT seems logical as its aim is to generate rather than verify theory (Glaser and Strauss, 1967). Simultaneous analysis guides GT, with data collection and data analysis informing each other.