Marzieh Khodaei Goki - Ph.D. Candidate, Department of Public Administration, Islamic Azad University, Kerman Branch, Kerman, Iran
Hamdollah Manzari Tavakoli - Assistant Professor, Department of Management, Islamic Azad University, Kerman Branch, Kerman, Iran
Navid Fatehi Rad - Assistant Professor, Department of Management, Islamic Azad University, Kerman Branch, Kerman, Iran
Zahra Shokoh - Assistant Professor, Department of Management, Islamic Azad University, Kerman Branch, Kerman, Iran

Background: Accreditation is a team effort to improve service quality. Nurses, as key members of the care team, play an important role in implementing accreditation standards. This study aimed to explain the challenges and strengths of the implementation of fourth-generation accreditation from the perspective of nurses. Methods: The present study was a qualitative one conducted using content analysis. The research population included nurses of Afzalipour hospital in Kerman, Iran. Using purposive and snowball sampling, ۵ nurses, ۵ head nurses, and ۳ supervisors were selected for accreditation. The data were collected through semi-structured interviews. The interviews were transcribed, coded, categorized, and analyzed separately. Then, using content analysis, the data obtained from the interviews were reduced and given a structure and system. Data analysis was performed using MAXQDA software (version ۱۰). Results: The most important challenges in this study were increasing nurses’ workload and working pressure and weakening nurses’ relationship with the patient. Moreover, there was no adequate infrastructure to implement accreditation. The strengths of implementing accreditation standards included increasing nurses’ awareness, improving reporting and documentation, increasing patient safety, and improving organizational processes. Conclusion: The results of this study emphasized the need to implement accreditation standards to integrate working methods and improve the quality of services and patient safety. Solving the existing challenges is a way to ensure the quality and continuous improvement of nursing services. In general, the results of this study provide useful information to policy makers and senior managers of the health system to reform the structure of hospital accreditation.

Challenges, Strengths, Standards, Accreditation