Khurshid Khowaja.
An envolving patient safety framework at Aga Khan University Hospital (AKUH).
Isra Med J Jan ;5(1):3-8.

OBJECTIVE: To evaluate and improve the nursing competences in different fields. STUDY DESIGN: A prospective analytic study. PLACE AND DURATION: An analysis of the concept of Dr. Donabedian's model of structure, process and outcome (SPO) at Aga Khan University Hospital, from 2005 to 2007 METHODOLOGY: Using Donabedian's Model of Quality Care of Structure, Process and Outcome (SPO) a Patient Safety Framework (PSF) was developed and implemented at Karachi, Aga Khan University Hospital, Pakistan. This newly-developed framework determined failures in structures and processes which were below benchmarks and improved patient outcomes through nursing practice. RESULTS: After application of Patient Safety Model the Nursing staffing levels were improved to 88% to 90% from 76%, in 2006 and nurse staffing skill mix was 98-100% from 80% in 2006, and nursing competencies 90% from 70% in 2006. Fall rate was 0.103 percent in 2007 against the National Database of Nursing Quality Indicator (NDNQI) benchmark of 3.12, pressure ulcers decreased from 6.33 in 2003 to 4.76 in 2007 medication error rate was 5.5%, VAP reduced to 3.2, BSI rate 2.9 and patient satisfaction improved from 3.68 to 3.78 with nursing practice. CONCLUSION: Positive outcomes resulting from application of framework has resulted positive image of the nursing profession and more self respect on the part of individual nurses.

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