A Dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree
Of Masters of Science in Nursing
Johannesburg 2018 / Background: Despite the availability of policies, procedures and clinical guidelines developed to improve patient safety in correctly completing the pre-operative assessment records, there is poor adherence to compliance. Therefore the aim of this study was to determine if the introduction of an in-service education programme will improve the completion of the pre-operative assessment records.
Objective: The objective of the study was to improve the completion of the pre-operative assessment records in two private hospitals in Gauteng.
Method: The setting for this study was two private hospitals in the Gauteng Province; each hospital conducting approximately 900 surgical procedures over a three monthly period. A one group pre-test-post-test design and a survey were conducted in this study. A retrospective chart review was conducted using a simple random sampling method in the pre-and post-test selection of the pre-operative assessment records. The pre-test was conducted between September and October 2016 and the post-test between May and June 2017. The researcher audited (n=187) pre-operative assessment records in the pre-and post-test. The data were collected using an approved audit tool currently in use at both Private Hospitals included in the current study. The data obtained in the first chart review (pre-test audit) was used to develop and implement the in-service education programme for the nursing staff at the two private hospitals where the study was conducted. The in-service education programme was conducted in February 2017 following the gaps identified in the incompleteness of the pre-operative assessment records in the first chart review. The second chart review (post-test audit) was conducted after the introduction of the in-service education programme to evaluate if the education programme had positively influenced the improvement of the completion of the pre-operative assessment records. A survey was designed by the researcher and was completed by the respondents that had attended the in-service education programme. The aim of the survey was to explore the respondents’ satisfaction of the training programme. The data obtained from the questionnaire was captured on an excel spread sheet and analysed by descriptive statistics and presented on frequency tables.
Results: Eleven of the 16 discrete variables tested in the course of the pre-and post-test analysis in Hospital A and B, demonstrated significant (p<0.05) change following the in-service education programme. In each instance the change represented improved recording of the pre-operative assessment records, which is an important finding and one in which evidences the need for and value continued in-service education. The criteria that showed recording improvement post-education programme were: patient received in theatre noted (44.9%); booked procedure same as patients’ description (12.8%); premedication administered (41.2%); patient kept nil per mouth (23%); identity band applied (20.3%); signatures with handover (10.2%); fluid start and end times (11.7%); fluid volumes start and completion (20.9%); fluid running total (18.7%); intravenous site checked (25.6%).The results provide evidence that the education programme did influence the compliance in some of the criterion in completing the pre-operative assessment records correctly. Of the completed feedback questionnaires received (n=45: an overall response rate of 96.1%), 14 discrete answers were collated and 28% of the respondents answered the questions, including the respondents who indicated “nothing” as an answer. All respondents indicated the nurses who attended the training felt it was beneficial, with 35.7% indicating that the training should be repeated and held frequently; ensuring that the Doctors and agency nursing staff attended alongside the nurses was deemed important by 28.6% of the respondents. Additional training on the pre-operative assessment process and care was requested by 14.3% of the nurses and post-operative care was specifically noted by 21.4% of those respondents.
Conclusion: This study provided evidence that after the introduction of the education programme to the nurses there was an overall improvement in the completion of the pre-operative assessment records. Although there was a disappointing note of compliance in completing the fluid balance record, the results indicated and overall improvement of the compliance in completion in most of the criterion of the pre-operative assessment records partially fulfilling the aims of this study. However it is strongly indicated that there is a need for further improvement in completing the pre-operative assessment records.
Keywords: Pre-operative Assessment; Patient Safety; Patient Records; In-Service Educational Programme; Improving Quality. / E.K. 2019
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/28167 |
| Date | January 2018 |
| Creators | Rajkumar, Evashini |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | Online resource (238 leaves), application/pdf |
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