Quality of Immediate Postoperative Nursing Care for Patients in Public and Private Hospitals in Erbil City, Iraq- Comparative Study

  • Sideeq Sadir Ali Department of Nursing, College of Nursing, Hawler Medical University, Erbil, Iraq.
Keywords: Quality of Immediate Postoperative, Nursing Care, Patient, Public Hospitals, Private Hospitals


Background and objective: The 1 to 2 hours for the first 24 hours after surgical operation is a crucial time to perform patient care. The study aimed to assess and compare quality of immediate post-operation nursing care for patients undergoing surgeries in the public and private hospitals in Erbil City.
Methods: A comparative study design was conducted on non-probability and purposive sample of 106 nurses (53 nurses of public hospitals and 53 nurses from private hospitals) in the surgical unit in all public and some private hospitals in Erbil city. The data was collected between February and July, 2019 by direct observation and using an observational questionnaire.
Results: The majority of the nurses were young adults who had graduated from a nursing institute who were of middle income and lived in an urban area. The duration of experience as a nurse was between 1 to 10 years. The majority of the nurses (98.1%) in the pub-lic hospitals they practiced poor nursing care practice, while most of the nurses (69.8) in the private hospitals practiced good nursing care practices. Very high significant difference found between immediate post-operation nursing care in public and private hospitals (P <0.000).
Conclusion: The study concluded that; postoperative nursing care is very important to improve health services, but the quality of the nursing care in the public hospitals as a generally was very poor when compared with the private hospitals. We recommended improving their skills by implementation job description, opening training course and monitoring of the nurses as well as awareness and follow-up.


[1] Williams LS, Hopper PD. Understanding Medical-Surgical Nursing. 2nd ed. US, Philadelphia: F.A. Davis Company Publishing; 2003.
[2] Lynn P. Taylor's clinical nursing skills: a nursing process approach. 3rd ed. London: Wiley-Blackwell Publishing; 2011.
[3] World Health Organization. Quality of care: a process for making strategic choices in health systems. Geneva Switzerland: WHO Library Cataloguing Publishing; 2006. Available from: http://www.health.org.uk/qquipp [Accessed: 18th Sep 2018].
[4] Renganayaki S, Sugunakumari S. Quality of Post-Operative Nursing Care among Patients Subjected to Cardiac Surgery. Journal of Nursing and Health Science (IOSR-JNHS). 2016; 5 (1): 71-3. Available from: DOI: 10.9790/1959-05137173[Accessed: 29th Jan 2019].
[5] Padilha KG, Stafseth S, Solms D, Hoogen-doom M, Monge FJ, Gomaa OH, et al. Nurs-ing Activities Score: an updated guideline for its application in the Intensive Care Unit. REVISTA DA ESCOLA DE ENFERMAGEM DA USP· 2015; 49 (Esp): 131-7. Available from: DOI: 10.1590/S0080-623420150000700019 [Accessed: 30 th Jan 2019].
[6] Timby BK, Smith NE. Introductory medical-surgical nursing. US Philadelphia: 10th ed. Wiley-Blackwell Publishing; 2010.
[7] Liddle C. Principles of monitoring postoperative patients. Nursing Times. 2013; 109 (22): 24-6. Available from: http// www.nursingtimes.net [Accessed: 1st Jan 2019].
[8] Dumolard P, Gök M, Le N. Nurses' responsibilities in postoperative pain management following total hip arthroplasty. Bachelor’s thesis. JAMK University of applied science. 2017; Available from: https://www.theseus.fibitstreamhandle/10024/131818/Dumolard_Pierre.PDF?sequence=1&isAllowed=y [Accessed: 3rd Jan 2019].
[9] Zhao SH, Akkadechanunt T. Patients perceptions of quality nursing care in a Chinese Hospital. International Journal of Nursing and Midwifery. 2011; Sep 30; 3(9): 145-9.
[10] Shawa E, Omondi L, Mbakaya B. Examining Surgical Patients’ Expectations of Nursing Care at Kenyatta National Hospital in Nairobi, Kenya. European Scientific Journal. 2017; Available from: doi: 10.19044/esj.2017.v13n24p344 [Accessed: 3rd Jan 2019].
[11] Ahmad MM, Alasad JA. Predictors of patients’ experiences of nursing care in medical-surgical wards. International Journal of Nursing Practice. 2004; 10 (5): 235-41.
[12] World Health Organization. Best Practice Protocols: Clinical Procedures Safety. WHO Surgical Care at the District Hospital 2003. Geneva 27, Switzerland. Available from: https://www.who.int/surgery/publications/BestPracticeProtocolsCPSafety07.pdf [Accessed: 3rd July 2019].
[13] Lynn P. LeBon M. Skill Checklists for Taylor’s Clinical Nursing Skills, A NURSING PROCESS APPROACH. 3rd ed. London: Wiley-Blackwell Publishing; 2011.
[14] Sun H, Okochili M. Patients' perceptions of the nurse patient relationship in postoperative care. Bachelor’s thesis. JAMK University of applied science. 2018; Available from: https://www.theseus.fi/bitstream/handle/10024/141453/THESIS%20Okochili%20Sun%20Bachelors%20Final%20BN..pdf?sequence=1&isAllowed=y. [Accessed: 4th Jul 2018].
[15] Jammer Ib. Perioperative interventions and postoperative outcomes (Doctoral dissertation). University of Bergen. University of Bergen, Norway. 2015; Available from: https://pdfs.semanticscholar.org/c399/beb4033a7afc0f4ddebad45f1676584b10ac.pdf [Accessed: 3rd Feb 2019].
[16] Shawa E. Patients' perceptions regarding nursing care in the general surgical wards at kenyatta national hospital (Doctoral dissertation). University of Nairobi, School of Nursing Sciences. Kenyatta. 2012; Available from:https://www.nursingrepository.org/bitstream/handle/10755/621210/Shawa_Thesis.pdf;jsessionid=A3E9E5369F69986A9BA776C716C974F0?sequence=1 [Accessed: 30 th Jan 2019].
[17] Serra MAAO, Filho FFS, Albuquerque AO, Santos CAA, Carvalho Junior FA, Silva RA. Nursing Care in the Immediate Postoperative Period: A Cross-sectional Study. Online Brazilian Journal of Nursing. 2015; 14 (2): 161-7. Available from: http://www.objnursing.uff.br/index.php/nursing/article/view/5082 [Accessed: 30 th Jan 2019].
[18] Hoogervorst-Schilp J, Van Boekel RL, De Blok C, Steegers MA, Spreeuwenberg P, Wagner C. Postoperative pain assessment in hospital-ised patients: National survey and secondary data analysis. International Journal of Nurs-ing Studies. 2016; Nov 1; 63: 124-31.
[19] Maurya A, Mendhe S. Prevention of Post-Operative Wound Infection in Accordance with Evidence-Based Practice. International Journal of Science and Research (IJSR). 2014; 3 (7): 1173-7.
[20] Gerensea H, Solomon K, Birhane M, Medhin BG, Mariam TH. Quality of nursing care among in-patient of medical-surgical ward in Axum St. Marry Hospital, Tigray, Ethiopia. Enzyme Engineering. 2015; 4 (2): Available from:doi:10.4172/23296674.1000132 [Accessed: 2nd Mar 2019].
[21] Merkouris A, Andreadou A, Athini E, Hatzim-balasi M, Rovithis M, Papastavrou E. Assessment of patient satisfaction in public hospitals in Cyprus: a descriptive study. Health Science Journal. 2013; 7 (1). 27-40.
[22] Sharma SK, Kamra PK. Patient satisfaction with nursing Care in Public and Private Hospitals. Nursing and Midwifery Research Journal. 2013; 9 (3): 130-41.
[23] Devi A, Saju A. Knowledge regarding post-operative care in adult, among the staff nurses and nursing students. International Journal of Applied Research. 2017; 3 (4): 674-7.
[24] Qadir DO, Younis YM. Quality of nursing care for patients with acute myocardial infarction at coronary units of Erbil city hospitals. Zanco Journal of Medical Sciences. 2015; 19 (2): 1011-8.
[25] Rahman HA, Mu’taman Jarrar MS. Nurse level of education, Quality of care and patient safety in the medical and surgical wards in Malaysian private hospitals: A cross-sectional study. Global Journal of Health Science. 2015; 7 (6): 331-7. Available from: doi:10.5539/gjhs.v7n6p331 [Accessed: 2nd Mar 2019].
[26] Wulff T. Knowledge and clinical practice of nurses for adult post-operative orthopaedic pain management (Doctoral dissertation, Stellenbosch: Stellenbosch University). 2012; Available from: http://www scholar.sun.ac.za [Accessed: 2nd Mar 2019].
[27] Silva KA, Medeiros SM, Paulino TS, da Costa Pereira FC, da Rocha KD, de Sousa Rosso IC, et al. Nurses’ Role in Post-Operative Imme-diately Myocardial Revascularization in In-tensive Care Unit. International Archives of Medicine. 2016; 9 (199): 1-7. Available from: doi: 10.3823/2070 [Accessed: 2nd Mar 2019].
[28] Charalambous M, Sisou G, Talias MA. Assessment of Patients' Satisfaction with Care Provided in Public and Private Hospitals of the Republic of Cyprus: A Comparative Study. International Journal of Caring Sciences. 2018; 11(1):125-35.
How to Cite
Ali, S. (2020). Quality of Immediate Postoperative Nursing Care for Patients in Public and Private Hospitals in Erbil City, Iraq- Comparative Study. Erbil Journal of Nursing and Midwifery, 3(2), 126 - 135. https://doi.org/10.15218/ejnm.2020.15
Original Articles