PROCESS EVALUATION OF NURSING CARE SERVICE IN ADULT MEDICAL WARD ADMITTED PATIENT AT UNIVERSITY OF GONDAR COMPREHENSIVE SPECIALIZED HOSPITAL, NORTHWEST ETHIOPIA, 2021.

Abstract

Abstract Background: Nursing care is one of the major factors that contribute for improving the quality of health services. Poor nursing care is a main contributor to poor patient outcomes to low and middle-income countries that have limited resources. Federal Ministry of Health update the nursing guideline (2011) in to nursing care practice standards’ and has been used by nurses. However, there is no evaluation conducted on implementation status of nursing care service. Although evaluation findings help stakeholder to improve service quality. Objective: To evaluate nursing care service implementation for admitted patients in adult medical ward, in University of Gondar Comprehensive Specialized Hospital, 2021. Methods: Facility based single case study design with concurrent qualitative and quantitative data collection method was employed to evaluate nursing care service. This evaluation focused on process components with dimensions of; availability, compliance and client’s satisfaction in acceptability dimension with formative evaluation approach. Systematic random sampling technique was used to recruit 421 clients and a structured interviewer administered questionnaires were used for the quantitative survey of satisfaction dimension. In the qualitative design, 32 observations, 9 key informants interviewee, 225 patients document reviewed, and resource inventory, were conducted for compliance and availability dimensions. Quantitative data was entered into EPI DATA and exported in to SPSS window version 20 for analysis. For satisfaction dimension multivariable logistic regression analysis was used. Qualitative data was analyzed manually under each thematized area. Results: The overall implementation evaluation of nursing care service level according to the judgmental parameter was found 59.4%. Resources availability was 58.39%, compliance of nurses with national guideline was 58.42% and client satisfaction on nursing care was 61.41%. Educational status (AOR=3.11, 95 % CI, 1.17-8.27), length of hospital stay (AOR=9.78, 95 % CI, 5.61-17.02), frequency of hospital admission (AOR= 4.32, 95 % CI, 1.6-11.6), and patient experience on institutional aspects (AOR= 5.52, 95 % CI, 2.94-10.34), were positively associated with client satisfaction. Conclusion: The overall implementation evaluation of nursing care service was judged to be fair based on the judgment parameter and it needs improvement. Nurses should be trained, medical equipment’s need to be supplied in all nursing stations. Key-words: Nursing care service, availability, compliance, acceptability.