Conditions Affecting Quality of Nursing Care in Burn Centers of Tehran

Nursing care in burn centers requires a heavy work which is influenced by many factors. The quality care of nurses as the largest group care providers in burn centers is of great importance and complexity and pan dimensionality of the care in these centers requires multiple interpretations that necessitate exploring and describing the perspectives of whom involved in care giving to understand the factors affecting the quality of care. The study was carried out with the aim of exploring and describing the factors involved in quality nursing care in burn centers of Tehran. Grounded theory was used as method. Thirty- eight participants were recruited through purposeful and theoretical sampling. Data were generated by unstructured interviews and participant observations. Constant comparison was used for data analysis. Data revealed that two categories of structural factors including intra and extra organizational conditions have influenced the quality of care. Intra organizational conditions included conditions related to administrators, staff, financial problems, workload, team members, facilities and equipments, environmental elements, and patients. Extra organizational conditions included self-management of burn centers, lack of supportive organizations for patients and heavy expenses of treatment, high living expenditure and low salary of governmental personnel, lack of employment permission, inattention of senior managers and inspectors to the work processes and their over attention to documentation, troublesome rules related to official violations, physicians governorship, and negative social perspective into nursing profession. Interaction between intra and extra organizational conditions resulted in physical and psychological stress, loss of motivation and dissatisfaction of staff nurses and poor quality of care. Findings were suggestive of correcting and modifying the intra and extra organizational factors and implementing stress reduction programs.