Transforming Nursing Care at Patients' Bedside in Low Resource Settings: A Study of Four Hospitals in Southern Nigeria (original) (raw)
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Background:The challenges in Human Resources for Health Management and Development are global. It is particularly worst in sub Saharan Africa which has been strewn with crisis. Investments in the training of the much needed professionals do not seem to match requirement and therefore does not make the expected impact. A number of other factors have also been assigned to the low level of health worker concentration in areas where their services are needed in Africa. The quality of care that nurses provide is influenced by individual nurse characteristics such as knowledge and experience, as well as human factors such as fatigue.
Adequate nurse-patient ratio is of paramount importance in the determination of quality of care in the health care setting. The study was conducted in the General Hospital, Iwo Osun State Nigeria. The study was carried out among the patients, nurses and midwives in 6 wards within the hospital. The wards are male and female medical and surgical wards as well as labour and post-natal wards. Each ward had a bed capacity of 28. Through simple random sampling, 80 respondents (A) and 35 respondents (B) were chosen as study sample. Respondents A were patients while respondents B were 30 nurses and 5 midwives. After obtaining respondents' consent, data collection was carried out on 3 rd and 4 th November, 2014. A self developed questionnaire and checklist were used as the study instrument. The psychometric property of the questionnaire using Chronbatch's coefficient of alpha showed 0.75. The questionnaire was administered to respondents A Checklist was used to observe the nurses' and midwives' compliance to items on the list during nursing procedures. Data analysis was by descriptive statistics making use of tables, percentages, means and standard deviation. Results of the study shows the age range of respondents A to be 17 – 74 with a mean 34 ± 4.7 and that of respondents B as 25-59 with a mean 31 ± 2.4. Also, the number of respondents B per shift within each ward ranged from 2 to 3 making nurse-patient ratio of 1:14 to 1:9. The percentage bed occupancy in each ward ranged from 75.0-92.8%. It was observed that morning and afternoon duty shifts were 8hours each while the night duty was 12hour duration. When respondents A were asked about the adequacy of nursing staff per shift, 75% believed that nurses were not adequate, 15% believed they were adequate while 10% were undecided on this. Also, only 27% or respondent A were satisfied with the nursing care received, the rest 73% believed they received poor nursing care because of the inadequacy of nurses to take care of their numerous needs. It was also observed that nurses at the study location were not making use of nursing care plan in rendering care. The results of the study further shows that 12% of respondents A developed complications which could have been avoided if nurse – patient ratio had been adequate. The complications observed were: pressure sore in debilitated patients (9%), urinary tract infection in catheterised patients (11%) and foul smelling wound (17%). The study was concluded with a suggestion that the Nursing and Midwifery Council of Nigeria and the National Association of Nigerian Nurses and Midwives should work together to designed standard of nurse-patient ratio for various ailments based on the level of nursing attention required by each ailment, and that each and every health facility with deficient number of nursing staff should employ more so that quality nursing care could be guaranteed at all times.
Background: Quality of nursing care is nursing response to physical, psychological, social and spiritual needs of patients in carrying purposes. Stress because of heavy workload, inappropriate tasks, insufficient resources, poor management, shortage of health care professionals, problem identification, resolution and prevention are the challenges to provide quality of care in developing countries. A few studies were present that deals about the quality of care provided for the patients in inpatient departments.
International Journal of Nursing, Midwife and Health Related Cases
Patient satisfaction has become an established outcome indicator of the quality and the efficiency of the health care systems. Patient satisfaction with nursing services is considered the most important factor in the moulding of the overall patient satisfaction with hospital services, and reflects the ability of the provider to meet the patients’ needs. This study therefore sought to investigate patients’ satisfaction with rendered nursing care and services in Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria. This study adopted descriptive survey research design. The study population were in-patients who have spent at least one night on admission in Medical, Surgical, Obstetrics and Gynaecology wards. Convenient non-probability sampling technique was used in recruiting the 151 respondents of this study. The instrument for data collection was a pretested semi-structured self-administered questionnaire consisting of 4 Sections (A-D). The instrument was validated...
2016
Nurses have become central to many lives but how well nurses have fulfilled clients’ expectations is often a matter of great concern. Therefore, this study was conducted to examine fulfillment of nursing needs and expectations of patients in teaching hospitals in Northern Nigeria. Descriptive cross-sectional survey design was adopted for the study. Questionnaire, structured interview and focus group discussion (FGD) were used as instruments for data collection. The quantitative data was coded and analysed using descriptive methods such as frequency tables, percentages and measure of central tendencies while inferential statistics (chi-square analysis) was used to test the hypothesis. These were triangulated with the content analyses of information from the focus group discussions. The finding showed that the mean age of respondents is 41 years and they cut across socio-economic classes and units of the hospitals. Some (41.5%) of the respondents said their social needs/expectations w...
IJMNHS & TWCMSI International, 2021
Nursing is conferred with the responsibility of providing quality care at every level of health service delivery. Nurses’ major contest is how to ensure that quality nursing service is delivered to all patients to gain patients’ trust and satisfaction. This study assessed the determinants of patients’ satisfaction with nursing care from patients who had received care during hospitalization in selected general hospitals of Ondo state. The study is a crosssectional descriptive study. The study was carried out in nine selected general hospitals using Multi-stage random sampling technique to recruit 243 patients as participants. A self-structured Questionnaire was the instrument used for data collection. The questionnaire consists of four sections with reliability coefficient ranging from 0.819 to 0.923. Data was analysed using descriptive statistics. Findings revealed that 146 respondents representing 34.5% had moderate level of satisfaction with nursing care received. The strongest factor determining patients’ satisfaction with nursing care was revealed to be health talk with average weighted mean of 3.18 followed by nursing care (3.02), hospital environment (2.51), discharge practices and aftercare (2.39), admission procedure (2.33) and patient autonomy (1.85). The study concluded that health Nursing is conferred with the responsibility of providing quality care at every level of health service delivery. Nurses’ major contest is how to ensure that quality nursing service is delivered to all patients to gain patients’ trust and satisfaction. This study assessed the determinants of patients’ satisfaction with nursing care from patients who had received care during hospitalization in selected general hospitals of Ondo state. The study is a crosssectional descriptive study. The study was carried out in nine selected general hospitals using Multi-stage random sampling technique to recruit 243 patients as participants. A self-structured Questionnaire was the instrument used for data collection. The questionnaire consists of four sections with reliability coefficient ranging from 0.819 to 0.923. Data was analysed using descriptive statistics. Findings revealed that 146 respondents representing 34.5% had moderate level of satisfaction with nursing care received. The strongest factor determining patients’ satisfaction with nursing care was revealed to be health talk with average weighted mean of 3.18 followed by nursing care (3.02), hospital environment (2.51), discharge practices and aftercare (2.39), admission procedure (2.33) and patient autonomy (1.85). The study concluded that health talk, nursing care and hospital environment are the major factors determining patients’ satisfaction with nursing care. Therefore, nurses should be more present in care by developing active listening skills and be sensitive to patients' needs.
Open Journal of Nursing, 2021
Globally, patient-centered care has become the focus of the healthcare system. It is imperative to note that during a global pandemic crisis, patient-centered care principles seek to empower partnering approaches in Primary Health Care (PHC), and have recently gained prominence in nursing practice and applied nursing research. However, nurses are faced with challenges in achieving the desired results in the PHC system. Thus, the study aimed to explore the factors that influence PCC utilization in the PHC facilities in Nigeria. A qualitative exploratory-descriptive design was used for this study. Data collection was conducted with the nurses from PHC facilities through individual interviews. Data saturation was achieved with 35 participants from 30 PHC facilities in Osun State, Nigeria, using a purposive sampling technique. All interviews were audio-recorded, later transcribed verbatim, and analyzed using the thematic analysis approach. NVivo 12 software was used for data management. The results from this study were categorized into two factors: Organizational factors and individual factors. Six themes that emerged from the study include inadequate management support, insufficient opportunities for further training, work overload and time constraints, health personnel readiness to use PCC, dearth enthusiasm for change, and poor nurses' Accountability. The study shows that nurses encountered diverse challenges in providing patient-centered care. To improve the quality of healthcare delivery in the PHC facilities, there is a need to reinforce adequate management support, education, continued training, and the internal motivation of nurses to achieve transformative health outcomes in the community.
Journal of Education and Training Studies, 2016
Objectives: The main purpose of this study was to determine knowledge practice and outcome of quality nursing care among nurses in University of Calabar Teaching Hospital (UCTH). Three research questions and one hypothesis were formulated to guide this study. Literature related to the variables under study was reviewed according to the research questions and hypothesis formulated to guide the study. Survey research design was adopted for the study. Methods: The design involves the collection of data to accurately and objectively describe existing phenomena, and to make inferences about the population. A total sample of one hundred and forty (140) respondents was randomly selected for the study. The selection was done through the simple random sampling technique. This was to give each and every members of the population equal and independent opportunity of being selected for the study. The main instrument used for the collection of data, was the questionnaire. It was administered personally by the researchers with the help of two research assistants. To answer the research questions and test the hypotheses, frequencies, percentages, and contingency chi square analysis were considered the most appropriate statistical techniques because of the nature of the variables involved in the research questions and the formulated hypothesis directing the study. The hypothesis was subjected to testing at .05 level of significance with critical values and degree of freedom and the following results were obtained; Nurses at the University of Calabar teaching hospital have knowledge associated with the quality of nursing care rendered to patients at the hospital, Nurses at the University of Calabar teaching hospital Practiced quality nursing care. Nurses at the University of Calabar teaching hospital Rendered Quality nursing care which was reflected in the positive responses by patients in the hospital. There was a significant influence of knowledge on the practice of quality nursing care among nurses in University of Calabar Teaching Hospital. Conclusion: it was concluded among others that the hospital management should always remind nurses of their obligations to patients through continuing education this will help nurses to improve on quality nursing care to patients.
Open Journal of Internal Medicine, 2021
Introduction: Quality healthcare is a major contributor to health disparities and inequalities in resource limited settings. Patient satisfaction remains an important and valuable method of assessing the quality of care. Aim: This study assessed patients' satisfaction with quality of inpatient clinical care in a mission hospital in a semi urban setting. Methods: The study was a cross-sectional study carried out on 140 inpatients at a mission hospital in Afikpo, South East Nigeria. Data was collected using pretested structured questionnaires designed on a five-point likert scale with 1 indicating the lowest and 5 indicating the highest scale. Knowledge of factors contributing to quality of care and satisfaction in the following domains: patient-staff relationship, patient-staff (doctors/nurses) communication, facility convenience, technical aspect of care (availability of equipment, drugs and adequacy of staff) and overall general satisfaction were measured. Operationally, patients who rated 3 points and above were considered satisfied while ratings less than 3 points were considered dissatisfied. Results: Knowledge of factors contributing to quality of care was 4.65 ± 0.48. General satisfaction rated 4.22 ± 0.52. Specifically, the different domains had the following scores: inter personal relationship 4.28 ± 0.81, technical aspect of care (availability of drugs, equipment and medical personnel) 4.29 ± 0.57 and facility convenience 4.21 ± 0.51. Conclusions: Knowledge of factors contributing to quality of care and overall patients' satisfaction with inpatient care were good and comparable with patients' satisfaction with tertiary health institutions in Nigeria. Mission hospitals may serve as excellent alternatives to government hospitals in resource limited settings to promote health equity across populations.