Health Systems and Policy Research

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Improvement in Adherence to Ethiopian Hospitals Reform Implementation Guideline nursing standards in Asella Referral Teaching Hospital: A Pre-post Study

Tadesse DM, Demissie HF, Segni MT

Background: Nursing standards help to ensure that patients are receiving high quality care. The standards support implementation of the basics of nurses’ profession. Despite the importance of nursing care standards, implementation of the standards is lacking in most of the developing countries, including Ethiopia. The objective of this study was to see Improvement in Adherence to Ethiopian Hospitals Reform Implementation Guideline nursing standards in Asella Referral Teaching Hospital. Methods: A pre-post intervention measure of nursing care was conducted from January to August, 2013. A nationally tested and accepted instrument, the Ethiopian Hospitals Reform Implementation Guideline tool, was used to measure the performance on nursing standards and patient satisfaction towards care provided by nurses. The sampled patients were allocated proportionally for all wards in the hospital. Data related to patient satisfaction was collected consecutively through exit interview and nursing standards through observational methods. Data quality was controlled through supervision, translation, and training of data collectors. Completed data were coded and entered in to Epi-Data and exported to SPSS version 16. Odds Ratio with 95% CI and multiple logistic regression model were used and p?values with <0.05 were declared significant. Results: A total of 768 adult patients and five head nurses were participated. The overall patient satisfaction score (pooled estimate) improved significantly from 0.147 to 0.615 pre and post intervention respectively. There was a statistically significant association between overall patient satisfaction level and improved adherence to nursing standards. Education and sex are important predictors of patient satisfaction. Conclusion and Recommendation: Nursing service without Ethiopian Hospitals Reform Implementation Guideline nursing standards was low in Asella referral hospital. Applying problem solving and quality improvement techniques in nursing can be effective in enhancing patient satisfaction. Longer follow? up is required to assess the sustainability of the improvements accomplished.