The St. Augustine Province, Africa is a Religious Organisation member of the Hospitaller Order of St. John of God, whose headquater is in Rome(Italy).

In Africa, the Province comprises of religious houses and Apostolic centres in Ghana, Sierra Leone, Liberia, Cameroon, Senegal, Mozambique, Kenya and Zambia. We are dedicated to offer Curative, Preventive and Pastoral services as part of the healing Ministry of Christ. We run General Hospitals, Orthopaedic & Traumatolgy hospitals, Psychiatric Hospitals, Primary Health Care centres, Nursing training schools, Rehabilitation centres and children with disability centres.

So many authors have indeed tried to defined what Quality of care is all about. Let me mention here what the Institute of Medicine defines it. It says, that Quality of care is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.?From my opinion, when one tries to define clearly quality care, it must integrate it with ethical principles of value, beneficence, prudence and justice. When this is applied to health care, it will infer that the pursuit of highquality or excellent health care is an ethical obligation of nurses and other health-care providers.?From the ethical and economic perspective, one could synthesized the meaning of quality care as follows:

Quality is the presence of socially acceptable, desired attributes within the multifaceted holistic experience of being and doing. It encompasses, at least the 4 interrelated concepts:?Value, Beneficence, Prudence and Justice.

• Value: defined as something intrinsically desirable relative worth, utility, or importance A fair return in goods, services, or money for something exchanged.
• Beneficence: it encompasses harmlessness.
• Prudence:
  • as?good judgment in setting realistic goals
  • good judgment and skill in using personal resources to achieve goals.
• Justice: as fairness, which has these two components.
  • distributive justice, using common resources proportionately to the individuals contribution to those resources
  • corrective?justice,?correcting an injustice by finding the mean between the extremes of profit and loss (J.H. Larrabee, 1996, Emerging Model of Quality).

As Direct-care nurses, we have the personal goal of providing the best care to our clients with each client encounter. When we as nurses perceive that we can provide the best care to our clients and have control of our practice, we can then say that we are experiencing job satisfaction and we are likely to intend to remain with the employer.

But when we as nurses perceive that we can not provide the best care to our clients and that challenges in the work environment are the reason, we then can say that we are experiencing job dissatisfaction and more likely to intend to seek a different work setting. My dear friends readers, let us acknowledge that turnover of RNs compromises the work environment by the loss of experienced nurses and by adding to the work load of the remaining nurses.