Patient and family centered nursing rounds as a platform for continuing education of nurses in a rural hospital in Haiti

Abstract

Introduction: Haiti has one of the most severe health care worker shortages in the Americas. In-service continuing education opportunities have been linked to increased nurse motivation and retention, and improved patient outcomes. This paper describes how an academic-non-profit collaboration adapted nursing rounds to create a bedside teaching activity for nurses at a Haitian hospital.

Methods: Rounds are defined as a gathering of nursing staff and students, as well as the patient’s family at the patient’s bedside, for case presentation and discussion about the medical and nursing care plans. A survey of participants was completed on a quarterly basis to improve the activity and assess whether the project was meeting its goals.

Results: Twenty-six nurses participated in the first quarter survey and twenty-five in the second quarter survey. Surveys showed that participation in rounds increased over time. Nurses were either satisfied or very satisfied with rounds.  The majority of nurses reported learning information that improved their patient care every time they attended rounds. Challenges included limited staffing at the hospital, nurses’ varying levels of literacy, and Haiti’s unpredictable political climate. These were overcome by building a partnership with a reputable local organization, accompanying local colleagues in a peer-to-peer model, and embracing incremental changes during implementation.

Conclusions: Evidence from observation, informal feedback, and responses to participant surveys indicates that rounds may increase opportunities for continuing education, encourage patient and family centered care, and promote inter-professional collaboration. This project has proved to be sustainable and continues to evolve two years following implementation.