title: [Nursing service certification. Norm UNE-EN-ISO 9001-2008].
abstract: OBJECTIVE
  To certify the nursing services using a quality management system, taking an international standard as a reference, and based on a continuous improvement process.
  
  
  METHODS
  The standard was revised, and the Quality Management System documentation was updated, consisting of a Quality Manual and 7 control procedures. All the existing procedures were coded in accordance with the documentation control process. Each operational procedure was associated with a set of indicators which permitted to know the results obtained, analyze the deviations and to implement further improvements.
  
  
  RESULTS
  The system was implemented successfully. Twenty-eight care procedures and eleven procedures concerning techniques were incorporated into the management system. Thirty indicators were established that allowed the whole process to be monitored. All patients were assigned to a nurse in their clinical notes and all of them had a personalized Care Plan according to planning methodology using North American Nursing Diagnosis Association (NANDA), Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC) international rankings. The incidence of falls, as well as the incidence of chronic skin wounds, was low, taking into account the characteristics of the patient and the duration of the stay (mean=35.87 days). The safety indicators had a high level of compliance, with 90% of patients clearly identified and 100% with hygiene protocol. The confidence rating given to the nurses was 91%.
  
  
  CONCLUSIONS
  The certification enabled the quality of the service to be improved using a structured process, analyzing the results, dealing with non-conformities and introducing improvements.
authors.affiliation: Unidad de Enfermería, Hospital Guadarrama, Madrid, España. Electronic address: rosam.salazar@salud.madrid.org.
authors.forename: R
authors.initials: R
authors.lastname: Salazar de la Guerra
authors.affiliation: Unidad de Enfermería, Hospital Guadarrama, Madrid, España.
authors.forename: C
authors.initials: C
authors.lastname: Ferrer Arnedo
authors.affiliation: Unidad de Enfermería, Hospital Guadarrama, Madrid, España.
authors.forename: M J
authors.initials: MJ
authors.lastname: Labrador Domínguez
authors.affiliation: Unidad de Enfermería, Hospital Guadarrama, Madrid, España.
authors.forename: A
authors.initials: A
authors.lastname: Sangregorio Matesanz
mesh_terms: D002568:Certification; D019983:Guideline Adherence; D006757:Hospital Units; D006920:Hygiene; D009729:Nursing / Q000592:standards*; D061214:Patient Safety; D011785:Quality Assurance, Health Care / Q000331:legislation & jurisprudence; D058996:Quality Improvement / Q000458:organization & administration; D019984:Quality Indicators, Health Care; D012308:Risk Management; D013030:Spain
keywords: Certificación servicios enfermeros; Nursing services certification; Safety; Seguridad; UNE-EN- ISO Q4 9001-2008; UNE-EN-ISO 9001-2008