Hi Ruby,

I think you're question relies on the premise/assumption that there is a beneficial relationship between acreditation and perception of nurses. I hope that you made this assumption on the basis of your literature review because if not, it may be worth validating first the assumption and then working from that point onwards to finding out the relationship between the two variables.

I am only speaking in terms of my experience in nursing in both countries, i.e. the Philippines and in the UK. I must say that my opinion is based solely on anecdotal and the following propositions may also be based on a potential assumption. As far as I am concerned as practitioner, accreditation is very culturally-defined (i.e. depends on how utilitarian it is to the role of the nurse). For instance, in the Philippines, accreditation of a hospital is sought after by the administration in order to boost the confidence of patients and increase its profile. I can only assume that it means a lot to nurse administrators (as it would mean high patient numbers=high profit) but not so much to the frontline nurses. To some degree, I think it may boost the morale of the nurses if the accreditation provides them with a sense of pride in belonging to such institution. However, I think this is not always the case and maybe a totally wrong assumption at all. Accreditation in the Philippines to the frontline nurses does not hold a lot of practical value, hence, may not be beneficial at all.

On the other hand, accreditation here in the UK, works very differently (accreditation perhaps is not a very accurate term). There is such a thing as a CQC inspection on every healthcare institution and we are legally bound to ensure that we are meeting the minimum standards. So in terms of utilitarian value, accreditation (in this sense) means a lot to us as nurses. It is an affirmation that we are doing our jobs well (again something that needs to be confirmed) and it also means that continued funding for services would flourish.

I hope this has somehow given you some sort of help to what you are looking for. It may be that you have to contextualised your question to facilitate the answer (i.e. specify the accreditation, operationalised the definition of accreditation, specify the location).

I agree with Harry De Jesus that 'accreditation is culturally defined'. I am a midwife and a nurse, and the question posed here is very relevant to midwifery. The context must be put into consideration - so that whatever guideline(s) to be used in the accreditation process should be context specific/relevant. I will question the use of the term/phrase 'international accreditation' given the difference in the way healthcare is funded and organized internationally.

If I understand your question  

So healthcare accreditations are focused in process or output not focuses on staff satisfaction. Staff satisfaction is an indicator of system or management function that omitted in system evaluation.

According to my opinion health care accreditation have very wide scope that have low consider on staff.  

Now, if nursing have a good corporation in their systems accreditations, maybe they acquired their position and importance in it. It has very benefit for them and their system.

Here in the US, CMS (Center for Medicare/Medicaid) funding is linked to accreditation. The Joint Commission (TJC) formerly JCAHO, is a required accreditation to receive Medicare/Medicaid payments. Under this guise, accreditation is invaluable. It(accreditation) also sets standards to be employed specifically: Standards, Elements of Performance, Scoring and Accreditation Policies. This plane is where accreditation holds merit in total. As a Staff Nurse, accreditation means almost nothing. I have personally never considered accreditation status in my years as a Staff Nurse. Now, as a Health Care Administrator, I absolutely hold accreditation as a heavy priority.

Provides a framework to help create and implement systems and processes that

improve operational effectiveness and advance positive health outcomes .

Improves communication and collaboration internally and with external stakeholders.

Strengthens interdisciplinary team effectiveness .

Demonstrates credibility and a commitment to quality and accountability .

Decreases liability costs; identifies areas for additional funding for health care

organizations and provides a platform for negotiating this funding .

Sustains improvements in quality and organizational performance .

Supports the efficient and effective use of resources in health care services .

Enables on-going self-analysis of performance in relation to standards.

Ensures an acceptable level of quality among health care providers .

Enhances the organization’s understanding of the continuum of care.