Journal of patient safety · 2026
Impact of Nursing Leadership for Surgical Excellence Program on Perioperative Care and Patient Safety in Low-Income Countries: A Mixed-Methods Study.
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Worku Teshager, Karimi Belinda, Bitew Senait, Kajubi Richard, Mammo Tihitena N
Аннотация
BACKGROUND: To evaluate the impact of the NLSE program on perioperative nurse capabilities, nurse and patient satisfaction, nursing practices, and patient safety, and to explore experiences related to leadership, workflow, safety culture, and standardization in 3 Ethiopian hospitals.
METHODS: A prospective quasi-experimental pre/postintervention mixed-methods study design was conducted from December 2023 to August 2024 at 3 major Ethiopian hospitals. The NLSE intervention comprised tailored training, mentorship, and nurse-led quality improvement initiatives. Quantitative data were collected from 9 fellows, 3 facility mentors, 112 perioperative nurses (65 at baseline, 47 postintervention), and 257 surgical patients using validated Likert-scale questionnaires. Statistical analyses, including paired t tests, χ 2 tests, and ordinal logistic regression, were performed using SPSS Version 27. Qualitative data from 18 key informant in-depth interviews were analyzed thematically using ATLAS.ti.
RESULTS: Nurse fellows demonstrated significant improvements in self-reported capabilities (knowledge, skills, and confidence) on quality improvement (QI), evidence-based practice, patient safety, and clinical leadership (mean difference: 0.2-0.8; P <0.001). Patient satisfaction scores also increased, with courtesy, comfort, privacy, and a quiet environment as significant predictors. Nurse satisfaction improved in areas such as motivation, recognition, and support. Qualitative findings supported these results, highlighting enhanced teamwork, communication, and patient safety culture.
CONCLUSIONS: The NLSE program significantly enhanced perioperative nurse capabilities, nurse and patient satisfaction, and patient safety practices. These findings support the adoption of multimodal, nurse-led interventions to strengthen perioperative care and outcomes in low-resource settings. We highly recommend scaling up the NLSE program framework in such environments.
METHODS: A prospective quasi-experimental pre/postintervention mixed-methods study design was conducted from December 2023 to August 2024 at 3 major Ethiopian hospitals. The NLSE intervention comprised tailored training, mentorship, and nurse-led quality improvement initiatives. Quantitative data were collected from 9 fellows, 3 facility mentors, 112 perioperative nurses (65 at baseline, 47 postintervention), and 257 surgical patients using validated Likert-scale questionnaires. Statistical analyses, including paired t tests, χ 2 tests, and ordinal logistic regression, were performed using SPSS Version 27. Qualitative data from 18 key informant in-depth interviews were analyzed thematically using ATLAS.ti.
RESULTS: Nurse fellows demonstrated significant improvements in self-reported capabilities (knowledge, skills, and confidence) on quality improvement (QI), evidence-based practice, patient safety, and clinical leadership (mean difference: 0.2-0.8; P <0.001). Patient satisfaction scores also increased, with courtesy, comfort, privacy, and a quiet environment as significant predictors. Nurse satisfaction improved in areas such as motivation, recognition, and support. Qualitative findings supported these results, highlighting enhanced teamwork, communication, and patient safety culture.
CONCLUSIONS: The NLSE program significantly enhanced perioperative nurse capabilities, nurse and patient satisfaction, and patient safety practices. These findings support the adoption of multimodal, nurse-led interventions to strengthen perioperative care and outcomes in low-resource settings. We highly recommend scaling up the NLSE program framework in such environments.