Nurses’ and managers’ perceptions of quality nursing care in public hospitals in Ghana

Abstract

Background: Quality improvement is a global healthcare priority. In Ghana, consistent delivery of high-quality nursing care remains challenging, and the perspectives of nurses and nurse managers are often underrepresented in discussions on care quality. Exploring these perspectives is essential to inform practice, management and policy. Aim: This study explored nurses' and nurse managers' perceptions of quality nursing care in public hospitals in the Bono Region of Ghana. Setting: The study was conducted at three public hospitals in Ghana. Methods: A qualitative, exploratory-descriptive design was adopted. Semi-structured face-to-face interviews were conducted with 18 professional nurses and three nurse managers purposively selected from three public hospitals. Data were analysed thematically using Tesch's method, guided by Creswell's qualitative data analysis framework. Results: Three themes emerged: (1) attributes of quality nursing care, including individualised, ethical and evidence-based practice; (2) barriers to quality care, such as inadequate resources, limited supervision and negative staff attitudes; and (3) the impact of nursing care on patient outcomes and healthcare delivery. Interpersonal relationships and organisational constraints were found to influence care quality. Conclusion: Quality nursing care is underpinned by clinical competence, ethical practice, teamwork and institutional support. Gaps in these areas compromise patient outcomes and staff satisfaction. Strengthening professional development, ethical standards, collaboration and organisational support is essential to enhance care quality. Contribution: This study provides context-specific insights into quality nursing care from the perspectives of nurses and nurse managers in Ghana, contributing evidence to inform nursing management practices, policy development and quality improvement initiatives in similar resource-constrained settings.