Quality healthcare from the nurses' perspective

Abstract

A growing interest in evaluating quality of healthcare services has led to several initiatives geared towards quality improvement and increased efficiency by focusing on patient needs and collected evidence. Efforts designed to standardize quality healthcare delivery are difficult because of variation in perspectives and disagreement as to what actually indicates quality healthcare. To help bring more clarity to the topic of quality care this study performed a secondary analysis on data gathered from the ‘provider morale’ section of the ‘Managing Quality in Canadian Hospitals’ project. The purpose of this study was to address how nurses’ perceptions of distress, work place recognition and satisfaction influenced their assessment of quality care in Saskatoon hospitals. The conservation of resources (COR) theory was used as a theoretical framework to guide the development of an understanding of nurses’ perceptions through a focus on occupational distress, recognition, and job satisfaction as a potential means of observing environmental effects on quality of care. This research established that there were significant positive relationships between recognition-quality, satisfaction-quality and recognition-satisfaction; suggesting that recognition and satisfaction can be viewed as work related resources and indicators of nurses’ perceptions of quality care delivery. Significant negative relationships were found between distress-recognition and distress-satisfaction; suggesting that distress levels have an effect on perceptions of nursing work resources. The research findings also indicated that there was a significant difference in how nursing units perceived quality and distress, but no significant difference in perceptions of recognition or satisfaction; suggesting that work place resources have different effects, that there are other resources in play on units which affect perceptions, and that the impact of recognition and satisfaction on quality and distress perceptions differs between nursing units. The results of this study provide nurses, nursing managers, and healthcare organizations with a deeper understanding of how resources and stress processes in work environments effect the perception of quality care delivery.