Factors Affecting the Implementation of Nursing Services Accreditation Standards in a General Hospital

Abstract

Accreditation is a process of assessment carried out by the external, independent evaluation to estimate the extent to which the performance of the health facility with the criteria set in advance "by the accreditation body". The primary objective of the accreditation is to develop systems and procedures which provide the service to improve the quality of health care rendered and thereby improving the desired outcome of treatment (Nail, 2012). The American Nurses Association, (2010), considered review data, identify areas for improvement, formulate goals, and improve patient care and work environment are the most important nurses role in quality improvement and accreditation. This study aimed to identify the factors affecting the implementation of nursing services accreditation standards in a general hospital through: assessing nursing staff awareness about hospital accreditation, identifying the factors affecting the implementation of nursing services accreditation standards in the hospital. The subjects of this study consisted of (156) nurses who working at Elmonira General Hospital, divided as follows: (18) nurse managers and (138) staff nurses. Data were collected by using self- administered questionnaire sheet consists of two parts: 1st tool: It consists of two parts: first part: aimed to collect socio demographic data about study subjects, such as: age, marital status - qualification - years of experience and attending training courses. 2nd part: aimed to assess nursing staff awareness about hospital accreditation and consist of (5) components: the concept of quality and accreditation (7), preparation for the accreditation (9), outcomes from accreditation (9), hospital manager (11), and pre- requisites (6). 2nd tool: Identifying the factors affecting the implementation of nursing services accreditation standards in the hospital it was divided into(106) factors as; factors related to the top management of the organization (15), factors related regulations, policies and procedures governing the work(14), factors related to understanding of the philosophy of quality and accreditation(15), factors related to incentives ( financial and moral) (18), factors related to education and training(10), factors related to medical records and information management(8), factors related to continuous improvement(16), and other factors(12). The present study revealed that the following findings:  The higher percentage of nurse managers (77.78%), and (63.77%) of staff nurses had moderate awareness about hospital accreditation.  More than half of nurse managers had high awareness score about preparation for accreditation and outcomes from accreditation (61.11% & 55.56%) respectively. Meanwhile, more than two thirds of the staff nurses (69.57%) had high awareness score about outcomes from accreditation. Factors affecting the implementation of nursing services accreditation standards in the hospital:  More than one third of nurse managers (38.89%), and more than half of staff nurses (57.97%), had moderate agreement of total factors affecting the implementation of nursing services accreditation standards in the hospital.  Majority of nurse managers (94.44%),and more than four fifths of staff nurses (88.41%) were agreeing upon management confirms that excellence is always at the service of patients is the most important objectives.  More than four fifths of nurse managers (83.33%) were agreeing upon the policies and procedures known to the nursing staff, while (87.68%) of staff nurses were agreeing the presence of written policies and procedures for the organization of work.  (83.33%) of nurse managers in the study subjects were agreeing in relation to accreditation standards are considered a tool for measuring the implementation of quality, and the quality must be concrete and measurable, while (76.09% &75.36% respectively) of staff nurses were agreed upon avoid responsibility hinders the implementation of accreditation standards, there is a lack of awareness and understanding of nurses to the concept of quality and accreditation, and experience is considered the basics of the application of standards.  More than three quarters of nurse managers (77.78%), and majority of staff nurses (89.86%) were agreeing upon lack of incentives hinder the implementation of quality and accreditation, lack of funding to provide the material needs hinders the implementation of quality and accreditation and being obtained bonuses and annual increases on a regular basis.  (72.22%) of nurse managers were