Nursing quality assurance: a process, not a tool.

A meaningful quality assurance program comes only with appropriate knowledge, communication, and accountability for all quality assurance functions among nurses at all levels. Describing the implementation of their quality assurance program, these authors tell of their eventual realization that, in fact, they had merely implemented a quality assurance tool that brought the nursing staff little benefit and a lot of grief. Highlighting the identified problems, the factors contributing to the program's failure, and the actions they took to develop and meet appropriate objectives, they detail their later, successful implementation of the concept and the process of quality assurance. Their experience provides readers with food for thought and stimulus for critical evaluations of their own quality assurance programs.