Essentials of care (EOC) is an evaluation and improvement framework underpinned by the principles of practice development. The framework was established to appraise amd build on the essential components of care through the particpation of clinicians at Unit level using reflective and critical inquiry processes. The aim is to improve the quality of nursing care delivery at Unit level.

The nine global domains of care identified by the project are: personal care, documentation and communication, promoting self care, medication / IV products, preventing risk and promoting safety, clinical monitoring, clinical interventions, privacy /dignity and learning and development. Care outcomes and benchmarking indices for each domain are linked to the Renal Society of Australasia competencies and clinical practice standards, enabling integration of evidence into nursing practice.

EOC was introduced into the Renal Unit at Prince of Wales Hospital in August 2008. This involved an initial period of observation of the clinical environment and detailed audit. A collaborative analysis of both the quantitive and qualitative data was undertaken with all nursing staff for the purpose of theming the data and developing actions to improve aspects of caring for patients with kidney disease. Some of the themes which have emerged from the data are infection control practices, clinical assessment, patient education and clinical handover.

This framework provides an iterative process for improving the quality of care provision at unit level involving all staff. The purpose of this paper is to outline the processes undertaken and discuss the progress of action planning and evaluation.