تقييم معايير الجودة والاداء لدى ممرضي وممرضات اقسام غرف العمليات في المستشفيات الحكومية في الضفة الغربية
أسماء محمد أحمد عبد الحق
asma mohammad ahmad abdelhaq
Background: Improving the quality of health care becomes the primary concern of all health care institutions. Operating Room (OR) nurses are part of the healthcare providers and they should be knowledgeable about the quality of health services in order to perform their roles in improving patient‘s safety. Aim: The purpose of this study was to assess the application of quality care and nurses performance standards in operating rooms in the Palestinian governmental hospitals in the West Bank. Method: A quantitative cross sectional descriptive design was used. The population of the study consisted of all operating room nurses working at 10 Governmental Hospitals in the West Bank/Palestine. A self-administered questionnaire was distributed to 129 nurses, out of which (77.5%) responded, Data was analyzed by using the statistical package of social science (SPSS) version 17. Findings: The results of this study showed that the overall level of quality care standards application was moderate in the following standards; nursing assessment (63.2%), cleaning and sterilizing surgical instruments (81.3%), positioning patients according to the type of surgery (75.45%), using of homeostasis devices (71.25%), wound management(82.8%)andinfecationcontrol(77.78%). And it was high in the following standards; counts in surgery and sample preparation (91.5%), and preparation for surgery (89.36%). On the other hand low in reporting errors (58.68%). OR nurses, who were older, applied the quality care standards of cleaning and sterilizing surgical instruments more than younger (P< 0.035). Female nurses applied preparation for surgery standards more than male nurses (P<0.028). On the other hand there was no significant difference in the application of quality care standards in the operating rooms this is due to the academic level, training period, training site, years of experience. Also, results showed that OR nurses who worked in hospitals that have less numbers of operating rooms, applied quality standards (cleaning and sterilizing surgical instruments (P<0.008%)preparation for surgery P<0.017, positioning patients according to the type of surgery (P<0.001), wound management (P<0.014%), reporting errors (P<0.002) more than those who work in hospitals that have more numbers of operating rooms. OR nurses who work in hospitals that have low numbers of nurses applied quality standards of Using homeostasis devices (P<0.002) and Infection control (P< 0.011) more than those work in hospitals that have more numbers of nurses in OR wards. The overall application of performing standards was moderate in standard of Ethics (71.8%)، but it was low in the following standards; resources utilization (58.25%), professional practice evaluation 58.95%,leadership 57.1%, education 44.58%, quality of practice 44.3% and collaboration 28.08%). Nurses who had less experience years, applied performance standard of Education more than more experienced (P< 0.019). On the other hand there was no significant difference for academic level, training periods، scientific qualification, training site, age, gender, and standards of performance application. Also results showed that OR nurses who work in hospitals which have high numbers of OR nurses ( more than 13) applied the following performance standards: ethics (P< 0.017), collaboration (P<0.003), resources utilization (P<0.028), leadership (P<0.001) more than who work in hospitals that have low numbers of OR nurses. And OR nurses who work in hospitals which have less numbers of operating rooms (1-3) applied the following performance standards: professional practice evaluation (P<0.001), resources utilization (P<0.000), quality practice (P<0.009), Education (P<0.009), Ethics (P<0.020), more than those work in hospitals that have more numbers of operating rooms.Conclusions and recommendations: The study employed an assessment of the quality standards and nursing performance of perioperative nursing care in operating rooms at Governmental Hospitals in the West Bank. The compliance of OR nurses with quality standards was moderate whereas the compliance with performance standards was low which was reflected on nurses's performance and patient safety. So, there is a need for improving quality culture in Governmental Hospitals by introducing a policy and strategies for applying quality standards and performance appraisal of OR nurses. Additional studies needed to clarify the causes that prevent the application of quality and performance standards.
السياسات والاداره الصحية , Policies & Health Management