Iran Journal of Nursing

Introduction
The quality of services is crucial for any organization's growth, success, and sustainability. Service quality refers to the ability to meet customers' needs and ensure their satisfaction with product delivery or service provision. In healthcare, service quality refers to providing services (in individual or group format) that yield positive care outcomes. Today, managing service quality poses challenges for organizations. Research highlights the importance of providing superior services in organizational success, which can create a satisfying environment. It can lead to patient satisfaction, boost employee morale, and reduce healthcare service costs. 
The escalating costs of service provision, particularly the continuous increase in hospital tariffs, are key concerns for hospital managers and patients. People want to know how the huge funds for hospital infrastructure benefit them, expecting high-quality services to be commensurate with their payments. Complaints about the lack of justice and quality in service provision and customer dissatisfaction further underscore the pivotal role of service quality. Quality assessment is the first and most important factor in improving the quality of care. In quality assessment, the evaluation of nurses' activities in providing nursing care to patients is crucial because nurses carry a greater role due to their close interactions with patients and providing emotional and spiritual support to them alongside medical treatment. 
 In Iran and other countries, several studies have been conducted for measuring the quality of hospital and nursing services by employing quality assessment models such as SERVQUAL, which of which have revealed a gap between expected and perceived quality and variations in patients', nurses', and doctors' care quality perceptions, underscoring the need for quality improvements. Addressing discrepancies in SERVQUAL dimensions, such as empathy, remains crucial in enhancing nursing services. Therefore, this study aims to assess the nurses' perceptions of the quality of nursing services, considering their personal and professional characteristics, in hospitals affiliated to Iran University of Medical Sciences (IUMS), Tehran, Iran.

Methods
This descriptive cross-sectional study was conducted in 2021 on 265 nurses from hospitals affiliated to the IUMS. They were selected using a stratified sampling technique with proportional allocation, which lasted for two months from July to August 2021. The instruments included a demographic form and the Scale of Perception of Nursing Activities that Contribute to Nursing Care Quality (EPAECQC), which had 25 items assessing seven dimensions: Patient satisfaction, health promotion, prevention of complication, self-care/well-being, functional readaptation, nursing care organization, and responsibility/rigor. The questionnaires were completed based on the self-report method.

Results
The mean age of participants was 34.32±7.39 years; most of them were female (67.2%), married (67.92%), with no children (55.06%), and with a bachelor's degree (83.40%). The mean total EPAECQC score was 76.35 (Table 1), and the dimension of responsibility/rigor had the highest mean score (3.28), while the dimension of health promotion had the lowest score (2.79).




Conclusion
According to nurses, the overall quality of nursing services of hospitals affiliated to IUMS is at the optimal level. In the dimension of responsibility/rigor, the quality had the highest score, while it was at the lowest level in the dimension of health promotion. In the nursing curriculum, it is better to integrate the educational materials related to nursing service quality dimensions such as patient satisfaction and health promotion, or in-service training on nursing service quality should be provided to nurses.

Ethical Considerations

Compliance with ethical guidelines
This study was approved by the Ethics Committee of Iran University of Medical Sciences (code: IR.IUMS.REC.1399.1013). We explained the study objectives to the participants, and their written informed consent was obtained. 

Funding
This article was extracted from the master’s thesis of Reyhaneh Haroonzadeh funded by Iran University of Medical Sciences.

Authors' contributions
Design: Alice Khachian and Reyhaneh Haroonzadeh; Data Analysis and Interpretation: Shima Haghani and Reyhaneh Haroonzadeh; Intervention: Reyhaneh Haroonzadeh; Editing and Review: Masoud Rezaei and Tahmineh Salehi.

Conflict of interest
The authors declare no conflict of interest.

Acknowledgments
The authors would like to thank all nursing managers and supervisors from Firouzgar, Rasoul-eAkram, and Hashemi Nejad hospitals, as well as the nurses who participated in this study for their cooperation.



 

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