EMPIRICAL STUDIES doi: 10.1111/j.1471-6712.2010.00833.x Improvement in the nursing care quality in general surgery wards: Iranian nurses’ perceptions Zahra Molazem MScN, BScN (PhD Candidate) 1 , Fazlollah Ahmadi PhD, MScN, BScN (Associate professor) 1 , Eesa Mohammadi PhD, MScN, BScN (Associate professor) 1 and Shahram Bolandparvaz MD (Associate professor) 2 1 Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran, 2 General Surgeon, Trauma Research Center of Shiraz University, Shiraz, Iran Scand J Caring Sci; 2011; 25; 350–356 Improvement in the nursing care quality in general surgery wards: Iranian nurses’ perceptions Improving care quality is one of the duties of almost all health service providers. Although it is of much signifi- cance to identify the factors influencing nursing care quality in specific clinical settings, a few studies have been conducted to improve our knowledge in this regard. This study aimed to determine Iranian nurses’ perceptions of the factors influencing quality of nursing care in general surgery wards. A qualitative approach was adopted using content analysis of semi-structured interviews carried out with 15 nurses working in general surgery wards of two educational hospitals. The following themes and subthe- mes emerged from the analysis: ‘beyond daily routine tasks’, ‘cooperation and the promotion of effective rela- tionship’ and ‘updating education’. The second theme consisted of two subthemes: ‘relationship among care team members’ and ‘communication between nurses, patients and relatives’. Providing qualified nursing care in Iran is complicated contextually and is somehow controversial. The study participants believed that in this context, proper delivery of appropriate nursing care is difficult for nurses owing to the barriers mentioned. Therefore, as a primitive action health care policy makers and managers are required to bring sensible changes into health care system through legislating suitable rules to guarantee the quality of nursing cares. Keywords: content analysis, Iran, nursing care, nurses’ perspectives, patient, quality of care. Submitted 8 May 2010, Accepted 6 August 2010 Introduction Quality has been defined as the features and characteristics of a service that influence the ability to satisfy or meet the user’s implied needs (1). Nursing care in general surgery wards plays an important role in modern health care (2). Surgery patients face outcomes such as disease, discomfort, disability and dissatisfaction (3). The quality of nursing cares delivered to surgery patients is one of the main fac- tors that influence these outcomes. Concerns and problems in the quality of nursing care for surgery patients motivated many researchers to carry out qualitative and quantitative studies on such an important issue. Some of the studies focused on patients’ perception of the nursing care quality (4, 5) and nurses’ perception of nursing care quality (6, 7). Some other researchers attempted to compare nurses’ perception on nursing care qualities with that of patients (8, 9). Reviewing patients’ experiences show that there are some problems that hindered the quality of nursing care such as lack of access to information, net being able to meet educational needs, lack of physical comfort and emotional supports and unfavourable communications in care delivery systems (10–12). Similar results have been found by studies conducted in Iran (13, 14). The evidence shows that despite technological and scientific progress in the last two decades, health care delivery has not had an acceptable safety and quality (15). However, the problem that has been less explored is related to finding the main barriers to quality nursing care delivery. Moreover, the studies rarely take into consideration the realities that nurses face in their daily practices and care delivery (16), whereas nurses’ perception of the factors influence the development and promotion of quality of care is of great significance. Therefore, to maintain care standards that lead to patients and nurses’ safety, it is necessary to understand the realities which the nurses face with in the hospitals (7, 16, 17). Correspondence to: Fazlollah Ahmadi, Department of Nursing, Faculty of Medical Sci- ences, Tarbiat Modares University, Tehran, Iran. E-mail: Ahmadif@modares.ac.ir Ó 2010 The Authors 350 Scandinavian Journal of Caring Sciences Ó 2010 Nordic College of Caring Science