A PRACTICAL GUIDE TO QUALITY IMPROVEMENT FOR BURN CARE in Low-Resourced Settings
INTRODUCTION TO THE PARTICIPANTS AND THEIR QI PROJECTS
Olive and Ziphilly Ziphilly and Olive are two nurses from Malawi who created a QI project with the aim of improving vital sign recording and fluid monitoring for patients in the burn high dependency unit (HDU) from 50%- 90% over a three-month period. They found that a lack of recording material, high workload, knowledge deficit and unavailability of visible guidelines all contributed to poor recording. To help with this problem they worked hard to provide monitoring equipment such as pulse oximetry and thermometers specifically for burn HDU nurses to use. Orientation and reorientation of nurses on monitoring and documentation of HDU observation charts was organised for both new and existing nurses. from patients and their families about the lack of privacy during dressing changes, Ephrem and Kibrom decided to implemented a QI project which championed the use of a screen during dressing changes. This project aimed to increase privacy for patients, especially between men and women on the same wards, by providing a screen to create male and female areas. They communicated the plan to use screens when undertaking wound dressings at the weekly all-staff meetings. The changes were picked up by his colleagues and the project has increased patient privacy and health worker professionalism.
Daniel Daniel, a nurse from Malawi, created a QI project which aimed to improve documentation of dressing changes. He felt the current system did not help with continuity of patient care, timely care or communication between health workers. Once he had assessed the baseline issues, the main problems were a gap in knowledge surrounding documentation of dressing change and time pressure. He created a short wound dressing documentation form to prompt assessment and maintain an accurate record of progress. After creating this form, in collaboration with colleagues, he provided an orientation for staff and a visual display of how to complete the form. The aim of the new form was to shorten the time to complete it and provide a uniform, step by step approach in dressing change documentation. Daniel’s aim was to improve documentation completion from the baseline of 44% to 90%. After three months a positive change was reported, when 85% of dressing changes had accurate documentation.
Ephrem and Kibrom Ephrem and Kibrom are nurses working in different hospitals in Ethiopia. After hearing of a number of complaints
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