Date of Graduation

Spring 5-20-2022

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

Program

MSN project

First Advisor

Mahmoud Kaddoura

Abstract

Problem: This quality improvement project implements AIDET, Commit to Sit, and culturally-competent care to improve patient satisfaction and communication between providers and patients in a diverse pediatric outpatient surgery microsystem setting. The microsystem’s NRC patient satisfaction scores from September to September is below the 85th percentile, and there is an immense desire to improve the overall scores by the staff. The detractors of the overall performance derived from the patients feeling that the staff needs to work together to meet patients’ needs, care providers not taking enough time to explain and listen, wanting to trust providers with care, procedures not beginning on time, and a huge detractor stemmed from the need to show more courtesy and respect by the nurses. AIDET and Commit to Sit are communication tools used to improve deficits. Culturally-competent care is to bring awareness to the delivery of culturally sensitive care to diverse pediatric patient populations.

Context: The microsystem assessed for this project is a pediatric outpatient surgery setting specialized in general surgery. The pediatric population in this microsystem ranges from two to eighteen years old. The microsystem comprises pediatric surgeons, operating room nurses, anesthetists, child life specialists, and surgical technicians. The outpatient setting also includes an influx of parents and family members of the pediatric patients. As the demographics for this microsystem are diverse and of Caucasians, African Americans, Asians, American Indians, and Hispanics, part of this QI project is to ensure that the staff, mainly Caucasians, are culturally aware and well-equipped with resources to provide culturally-competent care while serving the diverse communities.

Interventions: AIDET, Commit to Sit, and culturally-competent care are implemented by educating the staff through a PowerPoint presentation and three interactive roleplay-simulation scenarios 3 focused on culture, language, and discharge instructions. The purpose is to standardize the utilization of AIDET and Commit to Sit as a communication tool and to provide culturally-competent care.

Measures: Multiple measurement tools were used to track data for this quality improvement project. National Research Company, NRC, was utilized to identify the changes necessary to improve patient satisfaction scores. The pre-implementation NRC data over the course of a year from September to September and post-implementation NRC data from March were collected and analyzed. Pre-education surveys were given to the staff to understand their perceived knowledge of communication tools introduced six months ago and potential barriers to provide culturally-competent care. Post-implementation surveys were collected to gather staff input about their final thoughts regarding role-play simulation scenarios, feedback, and concerns about the changes.

Results: The implementation of AIDET, Commit to Sit, and culturally-competent care is aimed at improving the patient satisfaction scores at the diverse patient populations within the microsystem. The implementation of Commit to Sit improved Nurse Communication scores, and overall patient experience scores, and is a helpful tool for nurses to deliberately connect and care for patients and their families on the ongoing journey to positively impact the patient experience (Lidgett, 2016). AIDET is a communication enhancer with patients that have been shown to improve patients’ satisfaction and perception of care (Blanchard et.al., 2019). The Healthcare system is largely composed of minority patients and more than 37% of the U.S population is made up of ethnic and minority groups, and it is expected to grow to be the majority by 2043 (Duquesne University, 2020).

Conclusions: AIDET and Commit to Sit have been shown to increase patient compliance, decrease patient and family anxiety, optimize patients’ perception of care, build patient-provider trust and allow patients to feel heard. They should be core communication tools integrated into the hospital 4 systems to increase patient satisfaction scores by improving patient-provider communication. The ability to provide culturally-competent care in a diverse patient population setting is an optimal tool to provide the best and personalized care, build trust with the patients, and higher patient satisfaction.

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