Authors: Mildred E. John, Patience E. Samson-Akpan, Alberta D. Nsemo.
As the largest group of health care professionals, nurses are in a nodal position to ensure achievement of healthcare goals. Transforming Care at the Bedside (TCAB) is a global initiative whereby nurses implement innovative practices for patient satisfaction. However, the initiative has not been the focus of studies in Nigeria. This study examined TCAB practices among nurses in four hospitals in Southern Nigeria; and determined the effectiveness of capacity building on selected TCAB activities and outcomes. Triangulation (observation, descriptive and quasi-experimental) design was used to collect data from 224 randomly selected nurses working in medical and surgical units of four hospitals in two States of Southern Nigeria. Validated Observation checklist and two validated researcher-developed Questionnaires were utilized to collect data. The Intervention involved capacity building on 21 TCAB activities in four core areas: safe and reliable care; vitality and teamwork; patient-centred care; value-added care processes. The study followed ethical processes. Data were analysed using descriptive and inferential statistics on SPSS 20. After capacity building, nurses' practice of most TCAB activities improved significantly (p≤0.05), except for work redesign, and improving the work environment. Nurses also spent significantly more time on value-added activities and less time on non-value-added activities after the intervention. Practice of TCAB activities was significantly associated with patient and family satisfaction, nurses' satisfaction, patients' wellbeing, nurse: patient interactions and quality of care (p <0.001). Nurses in the four hospitals implemented many TCAB activities, and this significantly increased nurse: patient interactions, patient wellbeing and satisfaction in the hospitals studied. The TCAB initiative is therefore feasible and relevant in low resource settings like Nigeria.
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