الفهرس 
AcknowledgmentOnly 14 pages are availabe for public view
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Abstract
Quality orientation is an organization philosophy or culture, which not only is a quality practice tool for elimination defect and processes but also represents the shift of organization vision and value toward quality at all level. Quality orientation plays a fundamental role in serves delivery, and high level of quality orientation engenders behaviors that foster service excellent and customer satisfaction. Employee loyalty is defined as employee’s attachment to the organization, organizational goals, objectives, and values and increases the retention possibility of the employees.
The present study was conducted with the aim to explore the effect of quality orientation educational program on nursing staff loyalty for the nursing staff working at South Egypt Cancer Institute.
The study subject was all nursing staff working in South Egypt Cancer Institute nursing staff (No= 100), head nurse (No=20) for assessment the needs of the participant and the researcher chose the participant (N=46) in the educational program who had 10 years of experience and more.
The present study tools included three parts namely:
Part (I): Tools for assessment of educational needs of the participants:
It includes three tools:
1sttool: Personal data for the study subject: Includes: Name, Age, Gender, Educational Qualification Years of Experience, and Marital Status, Previous Attendance any workshops or Training Programs and Previous Attendance any Workshops or Training Programs especially in Quality Orientation.
2ndtool: Quality orientation questionnaire: It was developed by Westbrook’s, (2020) to assess nursing staff knowledge about the quality orientation, it contained (20 items). Scoring system: the response for each item was based on three – points likert scale ranging from ”Disagree= 1” ”Uncertain=2” and ”Agree= 3” The scores was summed up and then converted into a percent score. A score of 60% or higher was considered as ”agree” and if less than 60% was considered disagree
3rdtool: Employees loyalty questionnaire: It was developed by Rashid, (2019) to assess nursing staff loyalty. It contains (42 items) divided into four factors: the constant concern for the hospital (5 items); the performs of professional duties (8 items); employee satisfaction (22 items) the relationship of superiors with subordinate (7 items). Scoring system: The response for each item was based on three-point Liker scale ranging from: ”Disagree=1” ”Uncertain=2” and ” Agree=3” The scores of each dimension was summed up and then converted into a percent score. The sum of the correct Answer total grad was computed if the scores present of responses were60% or less this means disagree knowledge but if more than 60% this means agree.
Part (II): This study tools used for program implementation:
It includes two tools:
Personal data for the study subject: used to collect data about the study subject who participated in the program Name, Age, Educational Qualification, Years of Experience, Previous attendance any workshops or Training Programs and Previous Attendance any Workshops or Training Programs especially in Quality Orientation.
Knowledge test (pre, post and follow up test): It was developed by the researcher to assess nursing staff knowledge regarding quality orientation and consisted of (11) questions classified into two categories. The participants’ responses by a correct scored (2) correct incomplete response scored (1) and incorrect scored (zero). The sum of correct answer total grade were computed if the scores percent of responses were ≥ 60% this means satisfied knowledge but ≤ 60% this means unsatisfied knowledge.
Part (III): Participants opinions questioners : It was developed by Ahmed, (2016) to evaluate the worth of the program from participants to point of view and consisted of (16) which classified into two categories
1- The program content (10 questions).
2- The appropriateness of the educational program (6 questions).
Scoring system: The Participants’ responses based on 5 points- likert scale ranging from (5) marks of excellent, (4) marks for very good, (3) marks for good, (2) marks for pass and (1) mark for the poor.
Methods: It was included three stages as the following:
1st stage: preparatory stage:
This stage used to assess the needs of the participants:
The face validity of the study tools (quality orientation questionnaire and employee loyalty questionnaire) was reviewed by the five experts of the Nursing Administration professor or staff - Faculty of Nursing – Assist University to check the relevance, coverage, and clarity of the questions.
An official approval to carry out this study was obtained from the Dean of Faculty of Nursing - Assist University, Dean of the South Egypt cancer institute, Nursing Director, and nurse of South Egypt cancer institute to collect the necessary data.
A pilot study on nursing staff (No=30) which represent (10%) from total study participants to ensure the clarity, accessibility and understandability of the study tools and for time estimation before actual data collection and included in this study.
Oral consent taken from the participants in the present study.
Written consent taken from the participants through document dating before the program implemented.
The program was planned and designed based on the needs assessment. The data were collected by the researcher through questionnaire with the nursing staff and analysis of the results of nursing staff needs their working at south Egypt cancer institute.
2nd stage: Implementation of the program:
The program was implemented by the investigator on the representative sample of 46 nursing staff, head nurse(12) , staff nurse (34) for two weeks, divided into two groups; every group was 23 to avoid shortage of nursing staff at all units. The total time of the program was 20 hours distributed into 10 sessions for each group and due to fill classroom courses, private workers during the implementation of the present program forced to split the participants into two groups. Teaching strategies these used: lecture, small group discussion, brain storming, and case study. Used teaching aids as: handout was provided to all participants, power point, flip charts and, photographs and drawing for illustrations and video presentation. After ending of the educational program distributed of the certificates for participants.
3rd stage: Participants opinions questioners:
The investigator used questions to evaluate the following:
Outcome of the program: It was used to evaluate knowledge level of nursing staff of program content through pre, post and follow up tests after three months.
Worth of the program: ”learner’s feelings about the program”: This can be evaluated through the use of:
-A structured questionnaire that asks the participants about the effectiveness of the program
-participation and attendance of participants in learning sessions
The result of the present study revealed that:
As regards to assessment phase:
The majority of nursing staff had lack of knowledge in pre- program assessment as regard quality orientation and employee loyalty.
After implementation of the educational program
It was a statistical significant difference between studying nursing staff knowledge regarding the all items of educational program content in three period tests (P. value = 0.001**) and a marked improvements in nursing staff knowledge immediately after implementation of the educational program (89.1%,87% & 100%) respectively.
Conclusion(s): There were statistically significant differences between pre& post and pre & follow up phase’s regarding Nursing staff knowledge about quality orientation and employee loyalty. There was an improvement immediately after implementation of the educational program. This improvement was mostly retained after three months (follow up) with a slight decline from immediate post program implementation and it was still higher when compared with pre implementation level.
In the light of the results of this study, the following (recommendations)are suggested:
Create a quality assurance unit at south Egypt Cancer Institute
Refreshing course about quality orientation should provide periodically, to help nursing staff acquainted with the new knowledge.
Encourage the nursing staff to improve and update their knowledge by reading. This can be achieved by establishing of small nursing library with hospital department.
The top manager provide professional quality orientation training to guarantee continuous improvement for the service provided, and develop new services will increase the organizations financial and non-financial performance.
The top manager has to take into consideration that continued quality orientation philosophy and developing new services will enhance the organization performance even if the organization has to pay additional cost for training employees and developing services.
Providing employees with quality orientation training will enhance the top manager approach to create quality orientation environment in the organizations staff.