الفهرس 
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Abstract
uality of nursing performance is concerned with
measuring the efficiency and effectiveness and
determining the competency of the nursing process and
activities used by the individual nurse in the care of clients. In
the same context, quality of nursing performance integrates the
performance appraisal function with other human resources
systems to help align nurses‗ work behaviors with the
organization‗s goals (Zhao & Fan, 2016).
Maternal and Child Health (MCH) refer to care given to
women during pregnancy, child birth and postpartum periods to
ensure good health outcomes of the woman and baby; comprise
antenatal care (ANC), labour and delivery (maternity) care and
postnatal care (Abimbola et al., 2015). Maternal and child
health (MCH) care is the health service provided to mothers
(women in their child bearing age) and children. The targets for
MCH are all women in their reproductive age groups, 15 - 49
years of age, children, school age population and adolescents
(Keats et al., 2017).
Aim of the Study:
This study aimed to assess quality of performance among
nurses in maternal and child health centers through:
Q
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1) Assessing knowledge of nurses related to their roles in
MCH centers.
2) Assessing quality of practices done by nurses for mother
and child health care.
3) Assessing level of mothers’ satisfaction on practice of
nurses in MCH centers.
Research question:
1) What is the knowledge of nurses related to their roles in
MCH centers?
2) What are the practices of nurses related to mothers and
child health care?
3) What is mothers’ level of satisfaction related to health
services provided?
4) Is there a relation between knowledge and quality of
practices of nurses for maternal and child health care?
Subjects and Methods:
Research design:
A descriptive design was used to conduct this study.
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Setting:
The study was be conducted in 8 MCH centers
according to highest density in Tanta city, Gharbai Governorate
(First care of child,Second care of child, Third care of child,
Fourth care of child, Fifth care of child, Saeed Street Center,
Segar Center, Hay Elsalaam Center).
Subjects:
A convenient sample of all nurses who worked in
maternal and child health centers & all mothers attended the
MCH centers during 6 months.
Size:
100 mothers were included in this study.
100 nurses were included in this study.
Tools of data collection:
Three tools were used in this study and classified as the
following:
First tool: Self-administered questionnaire:
It was developed by the investigator after reviewing the
relevant, current and recent literature and jury opinion of the
supervisors and it was written in simple Arabic language and it
included 2 parts:
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Part I: Socio demographic characteristics of nurses such
as age, marital status, education level, job title and years of
experience (question No 5).
Part II: Nurses knowledge related to their roles in MCH
center such as roles toward mothers at pregnancy stages (9)
question, knowledge about delivery (5) question, role toward mother
at postpartum stage (5) question and role toward child in maternal
and child health centers (7) question. Total question (26).
Second tool: Nursing performance observational checklist:
This tool was adapted from (Zahra, 2012), (Mahfouz,
2017) and was modified by the investigator to evaluate the
performance of nurses in MCH, including (care for pregnant
women (11) items, care of mother in delivery stage (19) items,
care of mother and child in the puerperium (17) items, family
planning (13) items, child immunization (17) items, caring of
child under 5 years (11) items, growth and development in
children (7) items and health education (27) items. Total items
(120).
Third tool: Mothers satisfaction scale:
Assessment of mothers ’ satisfaction about nursing
performance at MCH centers it was adapted from Zahra 2012,
(Laschinger et al., (2005), and was modified by investigator,
about maternal and child health care provided in MCH centers
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135
including: place of service (12)items, quality of service
(14)items and service providers (19). Total items (45).
Results
The findings of the current study results can be summarized as:
According to the demographic characteristics the mean age
of studied nurses 35.70 ± 7.12 years. In relation to their
marital status, 65% of them were married and 25% were
single. In accordance to their educational level, 52% of them
have technical institute As regards their job title, 82% of
them were nurses. And 34% of them had less than 10 years
of experience.
According to total knowledge about their role in maternal
and child health centers 56% of them have satisfactory
knowledge level about their role in maternal and child
health centers.
According to total practice of nurses in maternal and child
health centers 66% of them have competent practice, while
34% of them have incompetent practice.
Regarding to total satisfaction of patients about maternal
and child health centers 70% of clients were satisfied with
MCH centers services provided for mother &child.
Regarding to relations between socio demographic
characteristics of the studied nurses and their total
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136
knowledge about their role in maternal and child health
centers there is a highly statistical significant relation
between total knowledge of nurses and their educational
level and years of experience as p value < 0.005. While
there is a statistical significant relationship between total
knowledge of nurses and their age, job title and years of
experience as p value < 0.05.
According to relation between socio demographic
characteristics of the studied nurses and their total practice
in maternal and child health centers there is a highly
statistical significant relation between total practice of
nurses and their socio-demographic characteristics
especially educational level and years of experience as p
value < 0.005.
According to correlation between total knowledge of the
studied nurses and total satisfaction of the mothers related to
research question No 4 there is a highly statistical
correlation between knowledge of the nurses and
satisfaction of the patients as p value <. 000.
Regarding to correlation between total practice of the
studied nurses and total satisfaction of the mothers related to
research question No 4 there is a highly statistical
correlation between practice of the nurses and satisfaction of
the patients as p value <. 000.
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137
Regarding to correlation between total knowledge of studied
nurses and total practice there is a highly statistical
correlation between knowledge and practice of the nurses
and satisfaction of the patients as p value < 0.01.
Conclusion
Based on the study findings, it can be concluded that more half
of studied nurses had satisfactory level of knowledge about
their role in maternal and child health centers, about two thirds
of them had competent performance level of practice, and more
than two thirds of clients are satisfied with MCH centers
services provided for mother &child. There is a highly
statistical positive correlation between knowledge of nurses and
satisfaction of the mothers, in addition that highly statistical
positive correlation between nurses performance level of
practice and mothers satisfaction as p value < 0.01.
Recommendations
In the light of the findings of the current study the following
recommendations are suggested:
- Continuous training of the nurses at Maternal and Child
Health center is recommended as it may improve their
performance and consequently raise the quality level.
- Continuous monitoring of clients’ satisfaction with all aspects of
care could aid in improvement of the quality of services.