Nurses’ Perception of the Quality of Patient Care in Selected County Hospital Critical Care Units in Kenya

Abstract

The global Intensive Care Units perception of quality of patient care remains below average with poor indicators such as high mortality and high infection rates been reported despite the technological advancements. Studies have reported characteristics among the nurses and the institution to have a profound impact on the perception of the quality of care the patient receives. This study assessed the perception of quality patient care, the association between nurses’ characteristics and the perception of patient care, the association between institutional characteristics and perception of patient care and the predictors of the perception of care in selected hospitals critical care units in Kenya. The study was a correlational study that’s used stratified sampling and census sampling to collect data in selected counties critical care units in Kenya. The study findings revealed that one third (33%) of the nurses rated the quality of care as good while the rest two thirds (67%) rated the quality of care in their unit as fair or poor. Test for association (Chi-square) was conducted to investigate demographic characteristics and nurses’ perception of quality of patient care and revealed that years worked in ICU (p<0.001), specialization in CCU (p=0.023) and nursing cadre (p<0.001) were significantly associated with the nurses’ perception of quality patient care. The findings also revealed that all institutional factors assessed were significantly associated with the nurses’ perception of quality patient care (p<0.001) apart from multidisciplinary teamwork in the unit where there was no association found (p =0.253). Regression analysis revealed that determinants like: years of experience in CCU, specialized in CCU, adherence to aseptic procedure, moisture and incontinence checks and availability of VAP management resources were independently associated with the nurses’ perception of quality patient care. This study concluded that nurses’ perceptions of quality of patient care in selected critical care units was below average and was greatly influenced by nurses’ experience, specialization, nursing cadre and institutional characteristics.