Factors Predicting the Quality of Care Among Nurses in Tertiary Hospitals in Fiji: A Cross-sectional Study

Abstract

Quality of care by nurses is a key factor in determining the success of healthcare delivery around the globe, which is impacted by a shortage of nurses, excessive workloads, and unfavorable working conditions, including in the Republic of Fiji Islands. Using the Quality Health Outcome Model, this descriptive-predictive, cross-sectional study examined the quality of care and its predictors among 744 Fijian registered nurses from three tertiary hospitals. Instruments for data collection were the Demographic Data Sheet, the Quality of Care Scale, the Participation in Decision Making Scale, the Relational Coordination Survey, the Perception of Organizational Change Scale, the Job Satisfaction Scale, and the Organizational Commitment Questionnaire. Descriptive statistics and logistic regression analysis were applied to analyze the data. This study’s findings are informative and offer a glimmer of hope since 72.58% of participants perceived the overall quality of care as good/excellent, indicating a positive baseline. Two factors, relational coordination and job satisfaction, significantly affected the perception of the quality of care. The study model explained 8.90% of the variance in quality of care, with relational coordination being the strongest predictor. These findings provide a clear path to improvement. A comprehensive model should be developed and tested to better understand the factors predicting Fiji’s quality of care before it can be used to design an effective intervention. Developing nursing skills, improving good communication and work environments, and providing high-quality education and training among nurses can significantly improve the quality of care. In addition, support from the government for appropriate medical equipment, recruitment and retention strategies for nurses, and promotion of standard of care from the Ministry of Health and Medical Services are recommended to enhance the quality of care, further bolstering this hopeful outlook. Further Fijian nursing research is clearly needed on this topic in the future.