The results of interviews showed an increase in the levels of tensions between those leading the health care fraternities for quality care and those that deliver quality care, that is, the frontline nursing staff. Making of decisions in health care organizations comes under challenge due to the limited measures of the quality of care in the nursing in the many diverse roles that exist for community nurses.

The study concludes that the community leaders of nurses and the community nurses on the frontline need to clearly define how they want to work on ensuring the nursing care quality is appreciated and actively define the ways to attain these goals. The eventual implications to nursing management is that the nursing leaders have to learn mechanisms that ensure the safety of patients, look at the major aspects of the policy agenda for good quality care for nursing in the community. Nursing and nurse leaders in the community should work to ensure quality service.

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