Strategies to optimize quality of nursing care of patients in public hospitals in the Bono Region, Ghana

Title : Strategies to optimize quality of nursing care of patients in public hospitals in the Bono Region, Ghana

Abstract:

The quality of nursing care delivery is closely tied to positive patient outcomes and satisfaction. However, in Ghana's public hospitals, particularly in the Bono region, the standard of nursing care often falls short. Media reports have highlighted instances of poor nursing care, leading to increased patient morbidity and mortality in this area. Consequently, this study aimed to develop strategies that could be implemented by stakeholders to optimize the quality of nursing care for patients in public hospitals within the Sunyani municipality in the Bono region of Ghana. The Donabedian model of quality was the theoretical framework that underpinned this study. A qualitative, explorative, descriptive and contextual research design was employed.

The study was conducted in four phases:

Phase One: This empirical phase explored and described participants' perceptions of nursing care quality in Bono region's public hospitals. Data were collected through semi-structured interviews including purposively selected patient participants (n=18), professional nurses (n=18) and nurse managers (n=3) and analyzed qualitatively following Creswell and Tesch’s (2021) six-step process. From this analysis, three main themes related to perceptions emerged-facilitators of, barriers to and outcomes of quality nursing care—and were thoroughly discussed.

Phase Two: An integrative literature review was conducted to search, select, appraise, extract, and synthesize existing relevant literature on quality nursing care in public hospitals of lower to middle-income countries (LMICs). This review followed four stages recommended by Whittemore and Knafl (2005). The identified literature was critically appraised using the John Hopkins Nursing Evidence and Non-Research Evidence appraisal tools. The appraised literature was analyzed, yielding nine strategies for optimizing the quality of nursing care in public hospitals from 12 articles under two themes: “Daily nursing care-related strategies” and “Organizational related strategies”.

Phase Three: The findings from Phases One and Two were synthesized to develop a conceptual framework for strategies to optimize quality nursing care in Bono region's public hospitals. This framework was based on Dickoff et al.’s (1968) theory development outline. The resulting framework guided the drafting of the (I-CARE) strategies, an acronym for Implementing organizational strategies, Commitment to attributes and practices, Augmenting outcomes, Rendering holistic and patient-centered care, and Enhancing resources and support for quality nursing care.

Phase Four: The I-CARE strategies were reviewed and validated by four experts with extensive backgrounds in strategy development and quality nursing care. The experts' modifications and recommendations were incorporated in finalizing the strategies. The strategies, when implemented, are expected to enhance the optimization of nursing care quality in Bono region's public hospitals, ultimately leading to better patient outcomes and satisfaction.

Biography:

Dr. Ba-Etilayoo Atinga studied Doctor of Nursing at the Nelson Mandela University, South Africa and graduated as in 2024. He holds an M.Phil. in Human Anatomy and Forensic Science, Kwame Nkrumah University of Science and Technology (KNUST), Ghana in 2017, M.Ed. in Teaching in Higher Education, University of Cape Coast, Ghana in 2023, BSc Nursing (KNUST) in 2010, Diploma in Nursing (UG, Legon) in 2008 and a Registered General Nursing Certificate, Ghana. His research focuses on a wider range of field in nursing, human anatomy and forensic science. In nursing he focuses on quality nursing care, patient centred care, patient safety and satisfaction; and evidence-based practice. He is also having a competing edge for forensic nursing a gray area in Ghana. In Human Anatomy and forensics, Ba-Etilayoo’s research interest concentrates on dermatoglyphics, osteometry and facial morphology. Dr Ba-Etilayoo is currently a lecturer at the University of Energy and Natural Resources, Ghana. Nationally, he is the financial secretary of the Ghana Academic of Forensic Scientist (GAFS) and a founding member of the Anatomical Society of Ghana (GAF), Ghana. Ba-Etilayoo has started a Centre for Nursing Care Quality and Patient Safety (CENQAPS) with a focus on improving health care quality and patient safety within Ghana and West Africa. He has published research articles in various selected peer reviewed journal.