International Journal of Management (IJM)

Volume 11, Issue 10, October 2020, pp. 2380-2386. Article ID: IJM_11_10_233
Available online at https://iaeme.com/Home/issue/IJM?Volume=11&Issue=10
ISSN Print: 0976-6502 and ISSN Online: 0976-6510
DOI: https://doi.org/10.17605/OSF.IO/BS85M

© IAEME Publication Scopus Indexed

AN OVERVIEW OF FACTORS INFLUENCING

QUALITY MANAGEMENT WITH REFERENCE
TO NURSING SERVICES
Thomas Maliakkal
Full Time Research Scholar, PG and Research Department of Management,
Rajagiri Dawood Batcha College of Arts and Science,
Papanasam, Tamil Nadu, India.

Dr. G. Vani, Ph.D.

Assistant Professor and Research Advisor, PG and Research Department of Management,
Rajagiri Dawood Batcha College of Arts and Science,
Papanasam, Tamil Nadu, India.

ABSTRACT
The present article shows the profile of respondents and factors influencing
quality management with reference to nursing services. The nature of the research
is descriptive as well as empirical and it has been conducted by using primary as well
as secondary data collected for this purpose. The present research work is an attempt
to study the factors influencing quality management with reference to nursing services.
The data needed for the study has been collected from the respondents through
questionnaires and through direct interviews. The sample for the study was selected
from a hospital with reference to nursing services. The study was mainly carried out by
empirical investigation through the collection of primary data from the hospital
management with reference to nursing services. There were only 150 at management
with reference nursing services. Hence, the entire populations were selected as the
samples for the study. Nurses are a patient’s direct contact in a medical institution and
are responsible for providing whatever information or care they require and hence
quality management begins with them.. According to existing researches, nurses have
participated in the monitoring of the quality of client care for many years, and Quality
Assurance has long been an institution within nursing in the hospital setting. Truth be
told, quality management is not a new concept. It has been practiced for decades but
has evolved and attained new forms throughout the years.
Key words: Nurses, Quality management, Organizations, Hospital environment.
Cite this Article: Thomas Maliakkal and G. Vani, An Overview of Factors Influencing
Quality Management with Reference to Nursing Services, International Journal of
Management (IJM), 11(10), 2020, pp. 2380-2386.
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 An Overview of Factors Influencing Quality Management with Reference to Nursing Services

1. INTRODUCTION
The major factor that affects the quality of care provided by the nurses which is directly
depended on them includes the competence level of the personnel. As patients suffer from
multiple illness or diseases, the complexity of care increases which in turn increase the
workloads of nurses. This impetrates the need for well trained nurses to provide complex patient
care which is safe as well as patient centred in a hospital environment. In order to work with
professionalism, nurses need to possess certain competencies, namely social skills, expertise &
experience and ability to prioritize the work.
Social skills such as positive attitude and behaviour, composure, finding time for patients,
willingness to listen to them and to have empathy towards them are important nursing
competencies to create a trustful care relationship. These skills are in the real time that are
expressing the sense of commitment towards the patient fraternity and also play an important
role in quality management.
Three key aspects related to expertise and experience which includes knowledge, technical
skills and communicative capabilities also influence the quality of care provided by the
personnel. Nurses must possess a concrete knowledge related to their profession and should
maintain as well as understand both existing developments and new insights developing in the
professional scenario. To be able to provide effective as well as safe nursing care to the patients,
the professionals must possess technical skills. Also nurses serve as spokespersons for patients
as they are easily accessible and can act as a link between the patient and other professionals in
a hospital environment.
As a nurse is concerned, various activities can occur simultaneously during the daily care
of patients. Hence it is important that nurses should be able to assess what care is required by
the patient at the moment and then flexibly coordinate various nursing care activities with each
other. Prioritisation is all about the organization of nursing care in the most appropriate manner.
Nurses must decide upon what the appropriate choices are to be made, what is critical and what
is not. Those choices influence patient experiences.

1.1. Nurses and Total Quality Management

Nurses are a patient’s direct contact in a medical institution and are responsible for providing
whatever information or care they require and hence quality management begins with them.
But as one can imagine, it’s no easy feat and even requires the nurses to participate in
managerial strategies way out of their comfort zone to fully engage in quality management
programmes on top of being in direct contact with their patients. According to existing
researches, nurses have participated in the monitoring of the quality of client care for many
years, and Quality Assurance has long been an institution within nursing in the hospital setting.
Truth be told, quality management is not a new concept. It has been practiced for decades but
has evolved and attained new forms throughout the years.

2. REVIEW OF LITERATURE
Suganya and Panneer selvam, (2017). Nowadays the health care organizations are looking
forward committed multitask quality from the nursing professionals, because they play an
important role in providing the quality care to patients and their family members. They face
more challenges to cope with the standards. But the responsibility for quality control lies not
only on nursing professionals or the health care organization but in reality it is a shared one.
Each one in the organization has equal responsibility to provide a quality care.
Elyrose Sousa Brito Rocha and Maria AuxiliadoraTrevizan, (2009),The study aimed to
know the opinion of nurses in relation to the Quality Management implemented in a hospital
service. This is an exploratory and descriptive study carried out with a sample of 17 individuals.

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 Thomas Maliakkal and G. Vani

The main results, among the 14 principles of quality, reveal that the seventh principle “adopt
and institute leadership” received the highest score. On the other hand, the lowest scored
principle was the third: “cease the dependency of mass inspection”. The obtained results,
coupled with theoretical knowledge on the subject and professional experience on the
management of nursing services, lead us to the conclusion that nurses consider Total Quality a
practical philosophy to be implemented in the services under their responsibility and accept the
challenge of overcoming barriers related to tradition, going from discourse to practice.
Mary Cruickshank, (2003), In Australia, the traditional Quality Assurance approach used
in the hospital setting has played an important role in nursing practice. During the past decade,
nurses have begun making a paradigm shift from Quality Assurance to Total Quality
Management but scant attention has been paid to quality management practices in nursing in
the higher education sector. This paper reports on a quantitative study examining the
perceptions of nurse academics to the applicability of TQM to nursing in universities. The
findings identified how TQM could be applied to suit the nursing culture in the higher education
sector.
Berra YilmazKuşakli, (2020), As a result of this practice, clinical-based drug and medical
consumables management of nursing services, job analysis of responsible nurses and related
job descriptions were determined and procedures for drug management and medical
consumables management were arranged. Pharmaceutical and medical consumables
management is provided by the procedure. Application integrity between clinics was ensured.
It is recommended that this practice be developed to cover other nursing practice areas within
the institutional framework.

3. STATEMENT OF PROBLEMS
Effective quality care management will always focus on the needs of the patients, because they
are the ultimate authority to judge the effectiveness of treatments and the service provided.
Patient expectations and needs change over time to time consequently, sound quality
management calls for constant surveillance of the patients’ satisfaction and progress with the
service. Therefore, it is the most remarkable and commonly used instrument for measuring the
quality of health care. It affects the efficient, timely and patient centred mode of quality health
care. Patient satisfaction is thus a proxy but a very effective index to measure the competency
of doctors and hospitals.

4. OBJECTIVES OF THE STUDY

The present article carry out following objectives are
• To find out the profile of respondents and factors influencing quality management with
reference to nursing services

5. METHODOLOGY OF THE STUDY

The nature of the research is descriptive as well as empirical and it has been conducted by using
primary as well as secondary data collected for this purpose. The present research work is an
attempt to study the factors influencing quality management with reference to nursing services.
The data needed for the study has been collected from the respondentsthrough questionnaires
and through direct interviews.The sample for the study was selected from a hospital with
reference to nursing services

5.1. Sampling Technique

The study was mainly carried out by empirical investigation through the collection of primary
data from the hospital management with reference to nursing services. There were only 150 at

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 An Overview of Factors Influencing Quality Management with Reference to Nursing Services

management with reference nursing services. Hence, the entire populations were selected as
the samples for the study.

5.2. Period of the Study

The present study covers the period of 2 years from 2018 to 2020. The primary data covered is
from the period December 2018 to March 2020.

5.3. Tools and Technique used

Some of the statistical tools are used to analyse and interpret the data. This Project report used
the following tools and techniques. Percentage, Chi-Square Test and Analysis of Variance
[ANOVA]

Table 1 Profile of Respondents of the Nursing Services of Hospital Management.

Sl. Total Grand Total
Particulars Factors
No. T.N.R % T.N.R %
1 Age Groups 20-25 25 16.67
26-35 88 58.67 150 100
36-45 37 24.67
2 Gender Male 63 42
150 100
Female 87 58
3 Marital Status Single 47 31.34
Married 72 48
150 100
Divorced/Separated 17 11.34
Widowed 14 9.34
4 Nursing Education Bachelor’s degree 61 40.67
Master’s degree 12 8
150 100
Diploma / GNM 74 49.34
Any Other specialization 3 2
5 Experience details Below 1 18 12
1-2 22 14.67
150 100
3-5 49 32.67
6 and above 61 40.67
6 Residential area Rural 28 18.67
Semi 91 60.67
150 100
. urban
Urban 31 20.67
7 Current Position Staff nurse 65 43.33
Senior staff nurse 50 33.33 150 100
Head nurse 35 23.34
Sources: Primary Data 2020.T.N.R(Total Number of Respondents)
The above table reveals the profile of the respondents. From the 150 respondents, the
predominant age group of 88 respondents are between 26-35 years, 37 respondents are between
the age group of 36-45 years and remaining 25 respondents are between the age group of 20-
25 years. Out of 150 respondents 63 respondents are male and a good majority of remaining 87
respondents are female. Majority of 72 respondents are married 47, 17, 14 respondents are
single, divorced and widowed respectively. From 150 Respondents, 74 respondents have
completed Diploma/GNM, 61 respondents have bachelor’s degree,12 Respondents have
Master’s degree and minimum of 3 Respondents are specialized in other discipline.The
experience details of respondent’s shows that a majority of 61 respondents have more than 6
years of experience and a minimum of 18 respondents have below one year of experience.

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 Thomas Maliakkal and G. Vani

Majority of 91 Respondents are living in the Semi-Urban areas, 31 Respondents living in Urban
and 28 Respondents are living in rural areas. Out of 150 Respondents, 65 Respondents are
working as Staff Nurse, 50 Respondents positioned as Senior Staff Nurse and 35 respondents
are working as Head Nurse.

Table 2 Age Vs Factors Influencing Nursing Quality

Ho: There is no relationship between Age and factors influencing nursing quality of
respondents of the organization related factors.
Source of Sum of Mean Table Value
D.F F Result
Variation Squares Square At 1%
Between Groups 6.222 4 6.222 1.207 6.54
Not
Within Groups 836.450 146 2.272
Significant
Total 842.672 150
Sources: Primary Data 2020.
The calculate F Value is (1.207) less than the table value (6.54) at 1 percent level of
significance. Further, there is no significant relationship among age and factors influencing
nursing quality of the respondents in the organization. Hence, the null hypothesis (H2) is
accepted.

Table 3 Gender Vs Factors Influencing Nursing Quality

Ho: There is no relationship between gender and factors influencing nursing quality of the
respondents in the hospital management related factors.
Source of Sum of Mean Table Value
D.F F Result
Variation Squares Square At 1%
Between Groups 16.222 6 7.202 2.217 6.34
Within Groups 726.40 144 3.232 Not Significant
Total 842.672 150
Sources: Primary Data 2020.
The calculate F Value is (2.217) less than the table value (6.3 4) at 1 percent level of
significance. Further, there is no significant relationship among gender and factors influencing
nursing quality of the respondents of the hospital management. Hence, the null hypothesis (H2)
is accepted.

Table 4 Marital Status Vs Factors Influencing Nursing Quality

Ho: There is no relationship between marital status and factors influencing nursing quality of
the respondents of organization related factors.
Source of Sum of Mean Table Value
D.F F Result
Variation Squares Square At 1%
Between Groups 26.222 1 5.112 2.170 7.24
Not
Within Groups 636.40 149 2.142
Significant
Total 4842.672 150
Sources: Primary Data 2020.
The calculate F Value is (2.170) less than the table value (7.24) at 1 percent level of
significance. Further, there is no significant relationship among the marital status and the factors
influencing nursing quality of the respondents of the organization. Hence, the null hypothesis
(H2) is accepted.

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 An Overview of Factors Influencing Quality Management with Reference to Nursing Services

Table 5 Gender Vs of Nursing Education

Nursing Education
Gender Any other Total
Bachelor Masters Diploma
Specialization
Male 21 8 43 0 72
(74.35) (80) (43) (0) (48)
Female 18 2 57 1 78
(46.15) (20) (57) (1) (52)
Total 39 10 100 1 150
Sources: Primary Data 2020.
A maximum number of 52 percent of respondents are female in that 43 respondents
completed diploma and 80 respondents completed master’s degree and minimum of 48
respondents are male.
Gender Vs of Nursing Education
Chi-squre value D.F Table value at 1% Result
159.1 3 12.271 Significant

The calculated chi square value is 159.1 greater than the table value12, 271 at percent level
of significance. Therefore, there is a significant relationship among gender and nursing
education of the respondents. Hence the null hypothesis h2 is rejected

6. SUGGESTIONS
• From the perspective of the patients, it is important that both patient and the nurse should
develop an understanding between each other so as to bring about the results of the
service rendered by the nurses. This impetrates the need of best possible communication
and co-operation between them. It is suggested that nurses develop a better
communication skill and convincing capacity to improve the care quality provided by
them.
• Among the management related factors, the most important factor that affected nursing
quality as identified from the research was staff development activities, followed by
hospital facilities, organizational structure and processes and managerial support.

7. CONCLUSION
The major nurse related challenges faced in the process of quality management in nursing care
are lack of nursing knowledge and competency, instability in nursing team, lack of motivation
among nurses, lack of authority of nurses to make autonomous decision, unwillingness of
nurses to adapt to new technologies, lack of professional discipline of nurses and emotional
detachment of nurses with patients. Similarly, the major management related challenges faced
in the process of nursing quality management are lack of co-operation between nurses and other
staff, inadequate resources and facilities, shifts and duty rotations without the consent of nurses,
ensuring safety and security of nurses during day and night shifts, lack of management
leadership and orientation, lack of planning in adjusting work hours of nurses and lack of
patients trust in nurses.

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 Thomas Maliakkal and G. Vani

REFERENCES
[1] Suganya and Panneer selvam, (2017). Quality Assurance a Key to Success in Nursing: An
Overview, International Journal of Health Sciences & Research, Vol-7, pp 234-239
[2] Mary Cruickshank, (2003), A study of quality management practices in nursing in
universities in Australia, A study of quality management practices in nursing in universities
in Australia, Vol 26 • No 1, PP 200-206.
[3] Elyrose Sousa Brito Rocha and Maria Auxiliadora Trevizan, (2009), Quality Management at
A Hospital’s Nursing Service, Disponible en castellano/ Disponível emlíngua portuguesa
ScieloBrasil, pp 240-245.
[4] Berra YilmazKuşakli, (2020), Material Management in Nursing Services: Organization
Development Study, Journal of International Health Sciences and Management, pp-54-64.

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