Egypt’s Improving Performance of Nurses Project Helps Cardiac Patients in Qena General Hospital

A nurse, trained through the Improving Performance of Nurses (IPN) Project in Egypt. {Photo credit: MSH.}Photo credit: MSH.

It is 2:00 a.m., and Arabey El Sayed has been transported from a village 5km away to the emergency department of Qena General Hospital with severe chest pain. He is a 75 year old farmer, and is married with five grown children. Dr. Ahmad, the physician on duty, is assisted by Abeer and Shimaa, two nurses trained through the Improving Performance of Nurses (IPN) Project. They work together quickly to provide the patient with the necessary emergency care. A nurse administers the ECG, and the patient is diagnosed with myocardial infarction and moved to the Cardiac Care Unit. Fifteen days later, he is comfortable, stable and able to return home.The IPN project is funded by USAID and implemented by Management Sciences for Health in Aswan, Luxor and Qena Governorates in Upper Egypt. The project combines leadership development with quality improvement and collaborative learning approaches. Nurses learned how to share a common vision, identify a priority health challenge, analyze its root causes, and design and implement an action plan to address the challenge. They also applied the Work Climate Assessment (WCA) tool, and worked as a team to improve the work climate for better work relations and service quality.

In an improved work climate, the Qena General Hospital team of nurses defined their cardiac care unit goal, presented their case to their managers (including the Hospital Manager), and implemented their action plan to reach their goals. As an indicator of their improved work climate, their WCA score increased from 2.43 to 4.8 out of 5.0, an achievement of 97.5% of their target. The nurse team improved cardiac care by increasing the number of nurses who can apply standard ECG procedures from 12 to 50. Shimaa, an IPN trained nurse, stated, “Now we are able to discuss our needs with the head of the department. We can meet the hospital director and request supplies from the head nurse. We are now working as one team.” This most recently trained group of nurses are applying their new skills in the emergency, internal medicine, surgery, orthopedics and urology departments of the hospital.

The Improving Performance of Nurses (IPN) project started in Luxor International Hospital in November 2010. Twenty-eight nurses initially participated in MSH’s Leadership Development Program (LDP) to develop their leadership and management skills, and worked in four teams to identify challenges affecting the quality of health services. They implemented action plans to address these challenges, and achieved the following results:

  • The percentage of nurses working in operating theatres and surgical nephrology departments following MOH preoperative preparation standards increased by 49%.
  • Nurses who practiced proper cautionary measures while handling sharp instru ments increased by 21%.
  • The percentage of nurses capable of prop erly separating and coding high risk medi cations increased by 78%.

Nurse teams at all of the IPN supported hospitals continue to use the skills they learned in the LDP to improve performance in the departments where they work. Some nurses also work with other hospitals to transfer the skills they have learned to additional nurses.

Improving Performance of Nurses (IPN) is a USAID funded project implemented in Upper Egypt by Man agement Sciences for Health. The goal of the program is to build the leadership and management capacity of hospital and primary health care (PHC) facility nurses in the areas of infection control, basic nursing skills, communication, and primary health care service deliv ery in the governorates of Aswan, Luxor, Qena, Sohag and Assiut.