For professionals, providing quality service and striving for excellence are ethical responsibilities. In many hospitals in the U.S., however, there is evidence indicating current quality improvement (QI) involving nurses is not always driven by their professional accountability and professional values. QI has become more an administrative mandate than an ethical standard for nurses. In this paper, the tension between QI as nurses’ professional ethics and an administrative mandate will be described, and the implicit ideal-reality gap of QI will be examined. The threat to professional nursing posed by the current approach to QI will be examined, and ways to incorporate nursing professional values in a practical QI effort will be explored.
Keywords: nursing care, quality improvement, quality of healthcare, professional ethics