STRUCTURAL AND PROCESS ANALYSIS OF A RWANDAN ICU SETTING IN PROMOTING QUALITY PATIENT CARE

Abstract

The purpose of this study was to explore and describe the structure and processes of quality patient care at the University Central Hospital of Kigali (CHUK)/Intensive Care Unit (ICU), using Donabedian’s model and the Joint Faculty of Intensive Care Medicine (JFICM) minimum standards for quality patient care. A descriptive and exploratory quantitative study was conducted using self-reporting questionnaires for healthcare workers and a self-developed checklist for document analysis. The sample consisted of 32 healthcare workers in the ICU and the researcher observed the files of 20 patients during the period of data collection from 20 June 2010 to 20 July 2010. The results showed that while the ICU was in a self-contained area, access to other departments was not easy; and, the actual work environment did not comply with the recommendations of the JFICM minimum standards for ICUs. The equipment was not adequate for the workload in the unit. The documents showed that policies, procedures, guidelines and protocols were not available. Patient assessment and monitoring were done without any guidance. The findings demonstrated that quality patient care was inadequate and needed improvement.