31: CHALLENGES OF HUMAN RESOURCES MANAGEMENT IN QUALITY IMPROVEMENT BY CLINICAL RISK MANAGEMENT: A QUALITATIVE STUDY ON IRANIAN NURSES' EXPERIENCES

摘要

Abstract Background and aims: In recent years serious deficiencies have been identified in the quality of care and patient safety. Clinical risks have created concerns and challenges throughout the healthcare. In 2000, the Institute of Medicine in a report published about 44 000 to 98 000 people die annually as a result of failures in healthcare. After this report hospitals focused on quality improvement using the clinical risk management (CRM) system. This process involves management of human resources, but limitations and shortcomings exist in these resources. The aim of this study was to explore nurses' experiences related to the challenges of human resources management in implementing CRM in the hospitals context. Methods: This qualitative study was based on the conventional content analysis of the Lundman and Graneheim approach. The purposive sampling method was used to choose 22 nurses from three hospitals affiliated with the Kerman University of Medical Sciences in southeast of Iran. Data were collected through semi-structured and deep interviews. Results: According to the nurses' experiences, human resources management was not suitable, because challenges had created negative perceptions about it. Efficient and competent human resources are effective in achieving the objectives of a CRM system. But, human resource management is accompanied by many challenges. The challenges were described in the following six dimensions: 1) Inadequate productivity, 2) Recession of empowerment, 3) Inappropriate evaluation of performance, 4) Lack of motivation, 5) Personal characteristics and professional competencies, 6) Ethical and professional commitments. Conclusion: A suitable context must be provided for nurses by their managers. They must be preparing the infrastructure of human resources management. When the organizational context is improved, nurses will be more satisfied and have a greater tendency to implement and integrate CRM in practice. Therefore, in hospitals, planning for empowerment and improvement of human resources should be placed in a strategic program. Educational programs should be correct, principled, based on the needs of nurses, in line with the purposes of CRM, and continued constantly.