Quality Improvement in Nursing

Quality improvement in burns is at the heart of all we do. We firmly believe that training should have a clear element of follow up, to gauge how knowledge is used in practice, and its impact on patient care. In 2019 we applied the concept of implementation science to burn care through developing a practical 8-step approach. We also streamline Quality Improvement as a distinct topic in our face-to-face training programmes.

In February 2023, ABC (Nursing) was delivered at Muhimbili National Hospital, Dar es Salaam to 35 nurses from Tanzania, Sierra Leone and South Sudan. At the end of the week, teams were asked to present ideas for small-scale projects which they could realistically implement as nurses in their own burn units.

Regular online supervision and face-to-face support was given over the following 12 months by mentors from Malawi and Ghana, led by Interburns Nursing Lead. At the end of this period, projects were reviewed and presented to hospital management and staff with recommendations and next steps.

Challenges included: lack of support in implementing changes if they are only seen as individual projects; high staff rotation; limited managerial or ministerial support; and mixing burn patients with other patients on the ward. High points included: clear commitment to sustaining QI and providing training; good teamwork; evidence of dissemination within the unit; and measurable change for burn patients. The three projects were:

·      Improving Hand Hygiene in the Unit in Bugando Medical Centre, Mwanza led by Glory Onesmo Urassa;

·      Improving Wound Assessment in the Paediatric Unit, Muhimbili National Hospital, Dar Es Salaam led by Judith Ally Mbata;

·      Improving Fluid Monitoring in the Paediatric Unit, Dodoma Region Referral Hospital led by Tatu Suleiman.

We would like to thank all participants who led the projects as well as the management and staff at the above hospitals. Special appreciation to the mentors / trainers

Maria Holden Nurse, Assistant Professor, Child Health, Nottingham University

Ziphilly Sichinga Burn Nurse (Malawi)

Patricia Kamanga Burn Nurse (Malawi)

Abubakari Safianu Burn Nurse (Ghana)

Dominique Potokar, Interburns Nurse Lead (France)