Nurses in Upper Egypt Improve Care for Special Needs Patients

[Nurse speaking sign language with patient in Aswan, Egypt]Nurse speaking sign language with patient in Aswan, EgyptIn many developing countries where resources are scarce, patients must struggle to get their health care needs met, whether seeing a doctor, obtaining medicines, or arranging for lab tests. For patients with special needs – the deaf, the blind, those with impaired mobility – there are even more obstacles, and, too often, overburdened health workers in these countries don't have the training to provide the quality care this group needs.  In Aswan, Egypt, however, a group of nurses is tackling this challenge head-on, improving the care of patients with special needs.

The change began six months ago, when nurses from Kom Ombo District Hospital enrolled in a Leadership Development Program as part of the US Agency for International Development-funded Improving the Performance of Nurses in Upper Egypt Project, led by Management Sciences for Health (MSH). When the program began, teams of nurses were asked to focus on one challenge they face daily in their hospital. One team identified the gap in services for special needs patients, noting that communication with these patients – particularly those who were hearing impaired – was inadequate, as was the hospital's physical infrastructure, which lacked wheelchair accessible corridors, entrances, and emergency exits. The team decided that their challenge over the six months of the Leadership Development Program (LDP) was to improve the communications with and care of special needs patients in the outpatient clinic.

Using the new skills and practices they learned through the LDP, such as how to align stakeholders and mobilize resources, the nurses developed an action plan to improve the services offered to special needs patients. One key activity to achieve this goal was learning how to effectively advocate for more resources with the hospital administration. 

This was a particularly difficult challenge for the women, because, in Egypt, nurses are, unfortunately, viewed as the least important link in the health care system and their professional opinions are often undervalued. 

In this case, the leadership training paid off:  the team convinced the hospital administration to mobilize funding to improve wheelchair accessibility. Under guidance from the Kom Ombo nursing team, new corridors, entrances and exits for special needs patients were completed between August and September 2010.  

The nurses also successfully sought outside resources to build their skills. Specifically, they discovered that another international organization was providing training on communication with special needs patients. They expressed interest in this offering and were able to participate in an eight-day training workshop which included sign language training and lessons on how to build patients' self-confidence. As a result of this training, two nurses at Kom Ombo Hospital are now able to communicate effectively with hearing-impaired patients using sign language.

Finally, to supplement the renovations and training, the team launched an awareness campaign to improve hospital staff knowledge about communicating with special needs patients, explain their patients' rights, and introduce all staff to the new and improved services provided by the hospital.

The two nurses trained in sign language conducted a course for service providers and now, two physicians and three nurses are also trained in sign language.

An evaluation on project progress showed marked improvements in the level of the staff's communication skills with disabled patients. A recent survey conducted by the working team in Kom Ombo hospital showed an increase of 65% in the level of communication with disabled patients since the baseline survey. Team members have also received very positive feedback from special needs patients attending the hospital.

The Improving the Performance of Nurses in Upper Egypt project is an Associate Award under  the Leadership, Management and Sustainability (LMS) Program, and is a partnership between MSH and the Nursing Program of the Om Habibeh Foundation, an affiliate of the Aga Khan Foundation. The project is funded by USAID/Egypt.