Challenges experienced by nurses in the implementation of a healthcare reform plan in Iran

Abstract

IntroductionThe Healthcare Reform Plan is counted as a plan for improving healthcare services in Iran. Undoubtedly pros and cons can be seen either in plan or implementation. This study was conducted to describe nurses’ challenges in implementing healthcare reform in Iran.MethodsA qualitative method centered upon conventional content analysis was applied. We used purposive sampling and data saturation was obtained by 30 participants. Data were analyzed using MAXQDA software.ResultsChallenges experienced by nurses in the implementation of this reform include; unsuitable infrastructure, unfavorable vision, a complicated challenge, the necessity of monitoring, control plan outcomes, the impact on nurses, people’s misconceptions and solutions.ConclusionsThe Healthcare Reform Plan in Iran is a solution to establish equality in the health system, however, to eliminate these challenges, revision and appropriate foundation of infrastructures is called for.

Quality of work life and factors associated with it among nurses in public hospitals, Iran

“…Salarvand et al came to the conclusion that the HSEP has led to increasing workloads, capped salaries, staff shortages, and negative impacts on physical, mental, social, and professional outcomes which were previously identified as factors that decreased hospital nurses' work satisfaction. Furthermore, the implementation of this reform has intensified the burnout among nurses [23].…”

Health care reform in Iran: Implications for nurses’ moral distress, patient rights, satisfaction and turnover intention

“…The findings of this study align with previous research that has shown that when implementing such reform plans, patient rights tend to suffer and thus more attention should be paid to the unintended outcomes of reforms that manifest in increased workload and shortages of personnel (Gerlinger, ; Jones, ; Parekh & Barton, ). Such reforms put more pressure on health workers, especially nurses (Dyrbye & Shanafelt, ; Salarvand, Azizimalekabadi, Jebeli, & Nazer, ). When workload increases, nurses are more likely to face moral tensions and to experience moral distress (Corley et al., ; Karanikola et al., ).…”

A critical analysis of Iran health system reform plan

“…Among the reasons for informal payments and in turn high out-of-pocket payment are patients’ demand for better care services,[ 23 ] Physicians trying to lure patients into private clinics,[ 24 ] and the concerns about health personnel's lack of motivation to provide quality health services or about nonstandard care. [ 25 ] Such informal payments deprive others with less revenue from quality health services, widen the social class gap, affect the social image of Physicians, and destroy the patient–nurse relationship.…”

“…[ 29 ] Patients thronging public health facilities while these facilities are not equipped to support the increasing demand was one of the main causes of dissatisfaction of nurses with their salary. [ 18 24 28 ] Limitations on recruiting new personnel and nurses, which are still in place, added to the complexity. [ 6 ] Given the excessive increase in the workload, nurses demand a higher salary and welfare, along with just and equal organizational promotion.…”