Improving The Implementation Status Of Nursing Care Standards Process At Medical Surgical Wards In Jogel General Hospital Hararethiopia.

Background:-Despite the important role of nursing care standard practice plays for the rnbetterment of the health care, its implementation status is far below expected, particularl y inrndeveloping countries. Similarly, the baseline assessment in this study showed that thernimplementation of Nursing Care Process in Jogel general hospital is poor. Thus, in light of thernnational and regional efforts to improve health care deliver y& improve a health care Quality. it isrncritically important to improve the implementation status of the Nursing care Process in JogelrnGeneral Hospital. rnObjectives: To improve implementation of Nursing/midwifery Care Standard Practice from 42rn% to 70% in Medical & surgical wards of Jogel Hospital, by the end of June, 2019. rnMethodology: A facilit y based pre- post interventional study will be conducted from March tornJune, 2019 in Jogel General Hospital, Harar, Ethiopia. The interventions include give in servicerntraining for ward nurses; strengthening internal supportive supervision, nursing audit committee,rnand provide the update nursing care format preparation .observational questionnaires about thernchallenges in implementation of the standards for a total of 80 staff nurse(40 pre-40post). A totalrnof 60 Medical Records (MR) have been reviewed ( 30 at baseline and 30 will be at the end ofrnthe study) to assess & compare the medical record completeness about t he at t ached &rncompl et e document at i on of necess ar y format s during pre and post-intervention periodsrnrespectivel y. The proportion of standard checklists which wi l l me et Nursing Care StandardrnPractice with complete services, and observational self prepared questionnaires with10 item totalrnof 100 inpatient admitted(50 pre-50 post intervention) about the nursing care quality and clientrnsatisfactions documentation a addition reviews standard 10item contain checklists fill andrnconduct focus discussion with a total of 14 staff (CEO, Matron, 2director of nurses a n d rn1 2 s t a f f n u r s e ) of formats, and Chi-square test is calculated to test the difference in thernoutcome of interest between the pre –and post –intervention periods. rnResult:- The percentage of patient cards with complete Nursing Care Process increased from 42%rnin baseline to 70% after intervention. This change was statistically significant at (df = 1.44, Prn=0.0403). Similarly, the implementation of all components of the Nursing Process has increased:rnNursing Admission Assessment (from 56% to 82% / P =0.0201), Nursing Diagnosis (from 38% torn78%, P =.0.0301); Nursing Care Plan (from 54% to 66% / P =0.0225); Nursing Implementationrn(from 47% to 64% / P =0.0152) and Nursing Evaluation (from 31% to 59%/ P = 0.0173), with allrnchanges showing statistically significant at P < 0.05. rnConclusion and Recommendations: - continuous on job training continuous flow of relatedrnforms can improve the implementation of the Nursing Process followed by. Continuous internalrnSupportive Supervision of Nurses in wards. Jogel general hospital managers should considerrnstrengthening the internal Supportive Supervision to improve their health facility.

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