Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2020

01-12-2020 | Care | Research article

Significant influencing factors and practical solutions in improvement of clinical nursing services: a Delphi study

Authors: Sarieh Poortaghi, Abbas Ebadi, Mahvash Salsali, Afsaneh Raiesifar, Nayyereh Davoudi, Nima Pourgholamamiji

Published in: BMC Health Services Research | Issue 1/2020

Login to get access

Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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.
Appendix
Available only for authorised users
Literature
1.
Williams L, Wilkins. Five keys to successful nursing management. Philadelphia: Lippincott Williams & Wilkins; 2003.
2.
Marquis BL, Huston CJ. Leadership roles and management functions in nursing: Theory and application. Philadelphia: Lippincott Williams & Wilkins; 2009.
3.
Conway PH, Mostashari F, Clancy C. The future of quality measurement for improvement and accountability. JAMA. 2013;309(21):2215–6.CrossRef
4.
Marshall M, Pronovost P, Dixon-Woods M. Promotion of improvement as a science. Lancet. 2013;381(9864):419–21.CrossRef
5.
Mitra A. Fundamentals of quality control and improvement. New Jersey: Wiley; 2016.
6.
Hagbaghery MA, Salsali M, Ahmadi F. A qualitative study of Iranian nurses’ understanding and experiences of professional power. Hum Resour Health. 2004;2(1):9.CrossRef
7.
Timby BK, Smith NE. Essentials of nursing: Care of adults and children: Lippincott Williams & Wilkins; 2005.
8.
Kunaviktikul W, Anders RL, Srisuphan W, Chontawan R, Nuntasupawat R, Pumarporn O. Development of quality of nursing care in Thailand. J Adv Nurs. 2001;36(6):776–84.CrossRef
9.
Aiken LH, Sermeus W, Van den Heede K, Sloane D, Busse R, McKee M, et al. Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ. 2012;344:e1717.CrossRef
10.
You LM, Aiken L, Sloane D, Liu K, He G-p HY, et al. Hospital nursing, care quality, and patient satisfaction: cross-sectional surveys of nurses and patients in hospitals in China and Europe. Int J Nurs Stud. 2013;50(2):154–61.CrossRef
11.
Kapoor P. Why quality in healthcare. Med J Armed Forces India. 2011;67(3):206.CrossRef
12.
McKenna HP, Ashton S, Keeney S. Barriers to evidence‐based practice in primary care. J Adv Nursing. 2004;45(2):178–89.CrossRef
13.
Mc CJ. Five Keys to Successful NursingManagement. Philadelphia: Lippincott Williams & Wilkins; 2003.
14.
McSherry R, Pearce P. Clinical governance: a guide to implementation for healthcare professionals. New Jersey: Wiley; 2011.
15.
Mohamed N, Gabr H. Develop accreditation standards for nursing departments at Mansoura University Hospital. J Educ Practice. 2013;4(7):37–48.
16.
Davis BA, Kiesel CK, McFarland J, Collard A, Coston K, Keeton A. Evaluating instruments for quality: testing convergent validity of the consumer emergency care satisfaction scale. J Nursing Care Qual. 2005;20(4):364–8.CrossRef
17.
Lee L-L, Hsu N, Chang S-C. An evaluation of the quality of nursing care in orthopaedic units. J Orthop Nursing. 2007;11(3):160–8.CrossRef
18.
Mrayyan M, Acorn S. Nursing practice issues in Jordan: student‐suggested causes and solutions. Int Nursing Rev. 2004;51(2):81–7.CrossRef
19.
Poortaghi S, Salsali M, Ebadi A, Rahnavard Z, Maleki F. Findings From a Nursing Care Audit Based on the Nursing Process: A Descriptive Study. Nursing Midwifery Stud. 2015;4(3):e30181.CrossRef
20.
Hsu C-C, Sandford BA. The Delphi technique: making sense of consensus. Pract Assess Res & Eval. 2007;12(10):1–8.
21.
Keeney S, Hasson F, McKenna HP. A critical review of the Delphi technique as a research methodology for nursing. Int J Nursing Stud. 2001;38(2):195–200.CrossRef
22.
Landeta J. Current validity of the Delphi method in social sciences. Technol Forecasting Soc Change. 2006;73(5):467–82.CrossRef
23.
Powell C. The Delphi technique: myths and realities. J Adv Nursing. 2003;41(4):376–82.CrossRef
24.
Fry M, Burr G. Using the Delphi technique to design a self-reporting triage survey tool. Acc Emerg Nursing. 2001;9(4):235–41.CrossRef
25.
Manca DP, Varnhagen S, Brett-MacLean P, Allan GM, Szafran O, Ausford A, et al. Rewards and challenges of family practice Web-based survey using the Delphi method. Can Fam Physician. 2007;53(2):277–86.PubMedCentral
26.
Aiken LH, Clarke SP, Sloane DM. Hospital staffing, organization, and quality of care: cross-national findings. Nursing Outlook. 2002;50(5):187–94.CrossRef
27.
Oshvandi K, Zamanzadeh V, Ahmadi F, Fathi-Azar E, Anthony D, Harris T. Barriers to nursing job motivation. Res J Biolog Sci. 2008;3(4):426–34.
28.
Zarea K, Negarandeh R, Dehghan‐Nayeri N, Rezaei‐Adaryani M. Nursing staff shortages and job satisfaction in Iran: Issues and challenges. Nursing Health Sci. 2009;11(3):326–31.CrossRef
29.
Spetz J, Given R. The future of the nurse shortage: Will wage increases close the gap? Health Affairs. 2003;22(6):199–206.CrossRef
30.
Mousavi SMH, Agharahimi Z, Daryabeigi M, Rezaei N. Implementation of clinical governance in hospitals: challenges and the keys for success. Acta Medica Iranica. 2014;52(7):493.PubMed
31.
Nasiriani K, Vanaki Z, Ahmadi F. Clinical supervision in rocky roads. Hakim. 2012;14(4):191–202.
32.
Ravaghi H, Rafiei S, Heidarpour P, Mohseni M. Facilitators and barriers to implementing clinical governance: A qualitative study among senior managers in Iran. Iran J Public Health. 2014;43(9):1266.PubMedPubMedCentral
33.
McSherry R, Pearce P, Grimwood K, McSherry W. The pivotal role of nurse managers, leaders and educators in enabling excellence in nursing care. J Nursing Manag. 2012;20(1):7–19.CrossRef
34.
Baghaei T, Saleh Moghadam A, Seydi M. Management principles and nursing managers. Iran J Nursing. 2004;17(40):62–9.
Metadata
Title
Significant influencing factors and practical solutions in improvement of clinical nursing services: a Delphi study
Authors
Sarieh Poortaghi
Abbas Ebadi
Mahvash Salsali
Afsaneh Raiesifar
Nayyereh Davoudi
Nima Pourgholamamiji
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Care
Published in
BMC Health Services Research / Issue 1/2020
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-019-4781-y

Other articles of this Issue 1/2020

BMC Health Services Research 1/2020 Go to the issue

Research article

Achieving self-sustainability of service delivery in an eye care program in Madagascar using time-driven activity based costing

Research article

Acceptability of point-of-care viral load testing to facilitate differentiated care: a qualitative assessment of people living with HIV and nurses in South Africa

Research article

Process evaluation of Prompt Mental Health Care (PMHC): the Norwegian version of Improving Access to Psychological Therapies

Research article

Experience of emergency department use among persons with a history of adverse childhood experiences

Correction

Correction to: Comparing methods to estimate incremental inpatient costs and length of stay due to methicillin-resistant Staphylococcus aureus in Alberta, Canada

Research article

Normalizing inconvenience to promote childhood vaccination: a qualitative implementation evaluation of a novel Michigan program