The level of nursing care provided and its effects on clients are assessed by using the nursing process to examine client outcomes

1. Methods of assessment include audits of open and closed records, peer review, questionnaires filled out by clients' families, and direct observation by the nurse

2. Sources of nursing care standards include state nurse practice acts and other rules and regulations that legally define nursing

3. Nurses regularly complete performance improvement/quality assurance procedures:

• they identify standards, goals, and methods of performing quality assurance activities

• they measure actual performance

• they compare results of measured performance with standards and goals

• they take action to correct weaknesses and reinforce strengths