Department of Community Health Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
BMC Health Serv Res. 2019 Dec 31;20(1):3. doi: 10.1186/s12913-019-4781-y.
Clinical services evaluation with specific indicators are very helpful to identify improvable points. This study was conducted to analyze the factors affecting the quality of clinical nursing services and offer practical solutions for accreditation of clinical nursing services.
The present study was conducted using Delphi method with two rounds. At the beginning of the study a questionnaire was prepared using results of another project (clinical nursing services audit). This questionnaire was sent to 47 nursing and accreditation professionals. After the first round, causes and solutions were categorized. Then participants were asked to comment on the significance of each strategy on the prepared questionnaire.
In the first round of Delphi in response to the question about the main causes and solutions of low quality of nursing clinical services, 394 causes and 212 solutions were mentioned by the participants. In the second round, considering moralists and specialization in the selection of nursing managers, staffing according to workload and attendance in comprehensive exam after graduation and before entering clinical fields attained the most importance.
Mismatch of human resources with workload and lack of clarity with regard to duties have maximum correlation with poor quality of care. Organizational structure and communication program categories gained the highest and lowest importance respectively. This information could be used by nursing managers and policy makers to plan programs in order to improve the quality of clinical nursing services.
使用特定指标对临床服务进行评估非常有助于确定可改进的方面。本研究旨在分析影响临床护理服务质量的因素，并为临床护理服务认证提供切实可行的解决方案。
本研究采用两轮 Delphi 法进行。研究开始时，使用另一项项目（临床护理服务审核）的结果编制了一份问卷。该问卷被发送给 47 名护理和认证专业人员。在第一轮之后，对原因和解决方案进行了分类。然后，要求参与者对准备好的问卷上的每个策略的重要性进行评论。
在第一轮 Delphi 中，针对护理临床服务质量低下的主要原因和解决方案的问题，参与者提到了 394 个原因和 212 个解决方案。在第二轮中，考虑到道德主义者和护理管理人员选拔的专业化、根据工作量配置人员以及在毕业前进入临床领域前参加综合考试，被认为是最重要的。
人力资源与工作量不匹配以及职责不明确与护理质量差之间存在最大相关性。组织结构和沟通计划类别分别获得了最高和最低的重要性。这些信息可由护理管理人员和政策制定者用于计划方案，以提高临床护理服务质量。
