Thesis:

Assessment of Strategies on Patient Safety Practices Among Healthcare Providers at Nakuru County Referral Hospital, Kenya

Quality care is achieved through integrating all components within the healthcare delivery system. Patient safety involves increasing awareness about errors made due to human factors in the process of delivering healthcare services that may lead to harm and adverse effects. This study was on Assessment of strategies on patient safety practices among healthcare providers at Nakuru County Referral Hospital, Kenya. The study objectives were to: Examine the organizational processes on patient safety practices, determine the communication strategies on patient safety practices, assess monitoring strategies on patient safety practices, and determine patient advocacy strategies on patient safety practices among healthcare providers at Nakuru County Referral Hospital, Kenya. The study was anchored on General Service Readiness Theory, Anderson Model of Health Services Utilization and Donabedian Model for Assessment of Quality of Care. The study adopted descriptive cross-sectional study design. The sampling technique was purposive, stratified random sampling and proportionate with a sample size of 310 healthcare providers drawn from various cadres. Data collection tools were questionnaire, interview schedule and observational checklist. Quantitative data was analyzed using descriptive statistics and inferential statistics. Spearman’s correlation analysis was used for inferential statistics to determine the association between organizational processes, communication strategy, monitoring strategy, patient advocacy on patient safety practices using 20th version of Statistical Package for the Social Sciences (SPSS) with 0.05 level of significance. Data was presented in tables, pie charts and graphs forms. A Permit was obtained from National Commission for Science, Technology and Innovation, through an introductory letter provided by Mount Kenya University Research Ethical Committee and authority from health directorate of Nakuru County. The study findings established that Nakuru County Referral Hospital had effective organizational processes on patient safety practices indicated by mean of 3.6 and standard deviation of 1.2 with need for implementation of quality improvement programmes having strongest correlation with patient safety practices (R = 0.922 and P + 0.028). There were effective communication strategies on patient safety practices with early clarification of information and efficient dissemination of information facilitating timely service delivery. There was complete handover of information, access to electronic records, prescribing systems and coordination of patient flow, mitigating delayed diagnosis, treatment and adverse events ( mean = 3.6, standard deviation = 1.0, R value = 0.893 and P value = 0.021).However, patients were found not to be adequately compensated in cases of erroneous medical procedures (mean = 2.8, standard deviation = 1.2, R value = 0.945 and P value = 0.014), indicating strong correlation with patient safety practices. The study recommends the need for implementation of quality improvement programmes to patient safety practices. The hospital administration should ensure there is coordination in ensuring patient flow which enhances mitigation of delayed diagnosis, treatment and adverse events. There is need for meetings to review and share ideas on patient safety thus achievement oforganizational culture in relation to safety. The hospital should also improve on patient involvement in decision making while receiving healthcare services and clear guidance that ensures patients are adequately compensated in-case of medical errors.