Participation of Unit Nurses

It is possible for some hospitals to extensively and successfully implement the principles of Transforming Care at the Bedside (TCAB), a nurse-led, quality improvement program, according to this evaluation of the experiences of the 13 hospitals involved in the second pilot phase of TCAB. However, even these hospitals, which were selected due to their previous experience with innovation and quality improvement, do not necessarily sustain the TCAB processes beyond the first year. More research is needed to determine whether this trailing off of formal TCAB mechanisms is an efficient adaptation, reflecting that nurses are now a continual source of ideas for improvement, or an indication that nurses are no longer being engaged in change processes. This paper appears in a special supplement to the American Journal of Nursing.