MSN, RN, Research Assistant, Department of Nursing, Health Science Faculty, Çankırı Karatekin University, Turkey.
PhD, RN, Professor, Department of Nursing, Health Science Faculty, Gazi University, Turkey.
J Nurs Res. 2020 Jun;28(3):e91. doi: 10.1097/JNR.0000000000000368.
Quality management program implementations in health services are team endeavors that involve all health service personnel. Because they are direct providers of care, nurses are best able to evaluate the influence of quality management program implementations on the health services and quality of care provided by hospitals.
The aim of this study was to develop an instrument to determine how nurses perceive the implementation of quality management programs in hospitals. Furthermore, the nurses' perceptions of the influence of these implementations on the quality of patient care and their job satisfaction were examined.
A descriptive, comparative, cross-sectional online survey was conducted using a convenience sample (N = 388) of practicing nurses working at public and university hospitals where quality management programs were implemented. Nurses' perceptions of the implementations were analyzed using confirmatory factor analysis, whereas the influence of nurses' perceptions of quality management implementations on patient care and job satisfaction was measured using structural equation modeling approaches.
This study revealed that the instrument is valid and reliable for the measurement of participant perceptions of quality management program implementations. Nurses' perceptions were generally negative, and they exhibited negative attitudes toward the implementation of quality management in the institutions where they work. However, the quality management program implementations had little influence on perceptions of the quality of patient care. Participant job satisfaction was lower than average, and the quality management program implementations conducted in the hospitals negatively affected job satisfaction. On the other hand, participants who worked at university hospitals perceived quality management program implementations more affirmatively; patient care quality and job satisfaction were viewed more positively as well.
CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Because nurses do not participate effectively in quality management program implementations, they perceive these efforts as unnecessary and the responsibility of the quality control department. It is very important to ensure that all care-service providers participate to effectively implement quality management programs in hospitals and to encourage the adoption of a culture of patient safety in all institutions.
卫生服务质量管理计划的实施是一项团队努力，涉及所有卫生服务人员。由于护士是直接的护理提供者，因此他们最能够评估质量管理计划实施对医院提供的卫生服务和护理质量的影响。
本研究旨在开发一种工具，以确定护士如何感知医院质量管理计划的实施。此外，还检查了护士对这些实施对患者护理质量和工作满意度的影响的看法。
使用便利样本（N=388）对在实施质量管理计划的公立医院和大学医院工作的在职护士进行了描述性、比较性、横断面在线调查。使用验证性因子分析分析护士对实施的看法，而使用结构方程建模方法测量护士对质量管理实施对患者护理和工作满意度的看法的影响。
这项研究表明，该工具对于衡量参与者对质量管理计划实施的看法是有效和可靠的。护士的看法普遍负面，他们对所在机构实施质量管理持消极态度。然而，质量管理计划的实施对患者护理质量的看法影响不大。参与者的工作满意度低于平均水平，医院实施的质量管理计划对工作满意度产生了负面影响。另一方面，在大学医院工作的参与者对质量管理计划的实施有更肯定的看法；他们对患者护理质量和工作满意度的看法也更为积极。
结论/对实践的意义：由于护士没有有效地参与质量管理计划的实施，他们认为这些努力是不必要的，是质量控制部门的责任。确保所有护理服务提供者参与医院的质量管理计划的有效实施，并鼓励在所有机构中采用患者安全文化非常重要。
