Nurses’ perception on healthcare services quality in mission hospitals in Kiambu County, Kenya

Background: Despite adoption of quality improvement initiatives in Kenyan Health facilities, quality gains are not yet optimal in both public and private sector. The private sector, which includes mission hospitals, face myriad of challenges ranging from perception of poor regulation to unqualified staff and gaps in quality of care.Purpose: To assess nurses’ perception on healthcare services' quality in mission hospitals in Kenya.Method: A descriptive cross-sectional study using quantitative and qualitative methods of data collection. Simple random sampling was used to select 188 nurses for administration of selfadministered questionnaire. A total of 20 in-depth interviews and 4 focus group discussions were conducted. Descriptive statistics and linear regression analysis were used to analyze quantitative data using SPSS v20. Qualitative data was analyzed thematically using Nvivo v11.Results: Overall nurses' perception of quality of services was 3.62. The perceived quality of services processes was 3.5187. Length of patient-provider interaction (β=0.225, t=4.761, p=0.001), teamwork (β=0.170, t=3.550, p=0.001), upholding patients’ rights (β=0.178, t=3.773, p=0.001), capacity to conduct quality assessment (β =0.125, t=2.510, 0.013) and availability of effective quality improvement teams (β=0.550, t=12.556, p=0.001).Conclusion: urses' perceived quality of services to be fair with a substantial room for improvement. To achieve a competitive edge, it is imperative for the hospital's management to engage visionary and quality conscious leaders, capable of identifying quality gaps and implementing improvement initiatives. The initiatives should focus on institutionalizing team-based quality audits, developing a quality patient-focused culture in service delivery