Quality Assurance Practices in the Nursing Services at a Secondary Hospital in Cagayan de Oro City, Philippines: A Qualitative Case Study

Abstract

Background: Quality assurance is integral to healthcare delivery, particularly in nursing services, where patient safety, clinical effectiveness, and service quality are important indicators of organisational performance. Secondary-level hospitals face increasing pressure to maintain quality standards while adapting to a changing healthcare landscape. Objective: This study sought to explore and comprehensively describe the quality assurance practices implemented within the nursing services of a secondary hospital in Cagayan de Oro City, Philippines. Methods: A descriptive qualitative case study design was employed to explore quality assurance practices in the nursing services of a secondary hospital in Cagayan de Oro City, Philippines. Eight nursing staff members were purposively selected to participate in semi-structured interviews. Data collection proceeded following ethical approval, and all interviews were audio-recorded and transcribed verbatim. Thematic analysis, following Braun and Clarke’s framework, was used to identify key themes. Methodological rigour was supported through member checking, audit trails, and adherence to ethical protocols. Results: Six main themes emerged: (1) leadership as a driver of quality improvement; (2) bridging local and international quality standards; (3) continuous performance monitoring and evaluation; (4) involvement of nursing staff in quality initiatives; (5) barriers to quality assurance implementation; and (6) patient feedback as a tool for service improvement. The findings indicated that effective leadership, continuous professional development, routine auditing, and collaborative decision-making were important to the delivery of quality nursing care. Challenges included resource limitations, staff shortages, and resistance to organisational change. Conclusion: Quality assurance is fundamental to the delivery of safe, effective, and patient-centred nursing care in secondary hospitals. Sustained leadership, staff engagement, ongoing evaluation, and innovation are critical to maintaining and improving the quality of nursing services.