A pilot study on assessing the gap between nurses' task performances and knowledge pertaining the same with reference to " I COUGH" initiative- a call for promoting patient 'care bundle' assignments in low-income nations.

Sunil Munakomi,Sangam Shrestha,Anita Luitel

doi:10.12688/f1000research.18815.1

Abstract

Background:The health sector in low-income nations has been crippled owing to low resources, lack of trained staff and a scarcity of effective health-related reforms. Amidst such a scenario, implementation of patient-centered care bundle approaches could help reprise the autonomy and standards of care for healthcare providers as well as safeguard patient safety. Methods:We sought to determine the gap between task performance and the underlying knowledge pertaining the same among nurses from intensive and high dependency neurosurgical units within three hospitals in Nepal through a questionnaire-based approach focusing on task assignments to prevent pulmonary complications among their patients and scoring them with references to the variables of 'I COUGH', a similar patient care bundle initiative. Results:There is a gross discrepancy between the patterns of task performance and the knowledge regarding the rationale behind the same tasks among nurses working in critical care neurosurgical units. In reference to I COUGH, nurses had below 50% knowledge on interventions aimed to prevent pulmonary complications among their patients, irrespective of the level of experience attained in the units. Furthermore, none of them had complete knowledge regarding all components of effective chest physiotherapy. Conclusion:There is the utmost need for the implementation of patient-focused care bundle approaches in upraising the health delivery standards, especially in low-income nations. Such initiatives can promote autonomy amongst healthcare professionals on patient care as well as assuring better patient outcomes by minimizing complications.

Highlights

Among surgical specialties worldwide, there is alarmingly high incidence of post-operative pulmonary complications, being reported as high as 40%, and leading to 30 days post-surgery mortality for almost 20%1
A total of 101 nurses working in the intensive care and high dependency neurosurgical units were enrolled for our study within three different teaching hospitals under Kathmandu University
The average scores obtained by the nurses from three hospitals were below 50% scores (37.83%, 40.83% and 42.33% respectively) in terms of their knowledge while comparing to the I COUGH strategy items (Figure 1)

Summary

Introduction

There is alarmingly high incidence of post-operative pulmonary complications, being reported as high as 40%, and leading to 30 days post-surgery mortality for almost 20%1. Recruitment of nurses is low in national hospitals with many opting to go abroad owing to higher salaries, improved facilities and relatively better scope for career building opportunity. The health sector in low-income nations has been crippled owing to low resources, lack of trained staff and a scarcity of effective health-related reforms Amidst such a scenario, implementation of patient-centered care bundle approaches could help reprise the autonomy and standards of care for healthcare providers as well as safeguard patient safety. Methods: We sought to determine the gap between task performance and the underlying knowledge pertaining the same among nurses from intensive and high dependency neurosurgical units within three hospitals in Nepal through a questionnaire-based approach focusing on task assignments to prevent pulmonary complications among their patients and scoring them with references to the variables of ‘I COUGH’, a similar patient care bundle initiative. Conclusion: There is the utmost need for the implementation of patient-focused care bundle approaches in upraising the health

Methods

Results

Discussion

Conclusion