INTRODUCTION

• Patient experience is emerging as a crucial qualitative metric for evaluating healthcare environments. Since 2017 in South Korea, the "Patient Experience Evaluation" has been conducted on discharged patients to assess medical services. The results are made public to promote improvement in healthcare quality.
• Despite the comprehensive nursing and caregiving services provided in the Integrated Nursing Care Service Ward, where caregivers are not present, there was a significant decrease of 4.3 points in the overall experience index and a 12.4-point decrease in the willingness to recommend the hospital in the 2022 patient experience evaluation compared to 2021.

AIM

• The aim was to improve patient experience and reduce pressure sores and falls through effective nursing interventions for patients in the Integrated Nursing Care Service Ward.

METHOD

• This research was conducted at a university hospital's Integrated nursing Care Service Ward in Seoul from April 2023 to September 2023, spanning six months.
• In Phase 1 (April 2023 to June 2023), the scores obtained from the patient experience evaluation of the ward were used to confirm reasons for medication and treatment, explain side effects, and identify the patient's perception of an insecure environment. For nursing interventions related to medication and tests, commonly used drugs in the ward were investigated, and educational materials for patients related to tests were developed. To provide a safer environment perceived by patients, the usability of the nurse call bell was improved, and nursing interventions involving nursing managers and nurses were added for high-risk patients for falls and pressure sores. Additionally, an indicator light for safe medication administration was created.
• In Phase 2 (July 2023 to September 2023), the developed patient education materials were provided during admission and when additional tests or medication were prescribed. A weekly environmental assessment was conducted for high-risk patients for falls and pressure sores. The medication indicator light was used during chemotherapy and administration of high-risk drugs to create a safe environment where nurses could focus solely on medication administration.

RESULT

• To enhance patient satisfaction, 15 educational materials for common tests and 6 for medication were developed.
• On the other hand, the number of reported falls per 1,000 patient days increased from 1.18 cases in 2022 to 2.46 cases after nursing intervention. Analysis of the circumstances at the time of the falls revealed that 50% of the reported falls occurred during urination or defecation in toilet, and most of these patients were taking diuretics or antihypertensive medications. Additionally, the number of reported pressure ulcers per 1,000 patient days increased from 0.6 cases in 2022 to 1.85 cases. Among the patients with pressure ulcers, 85% were in a bed-ridden state.

CONCLUSION

• Due to effective nursing interventions, patient satisfaction scores in patient experience assessments have increased. Positive feedback has been received indicating that patients are participating in the treatment process due to sufficient explanations provided. The scores for the "Safe Environment" item also increased for patients at high risk of falls and pressure sores, thanks to strengthened rounds by nursing managers and the creation of a medication indicator light for high-risk drug administration. Enhanced nursing rounds targeting high-risk patients for pressure ulcers and falls, coupled with the implementation of medication alert lights during high-risk drug administration, resulted in an increase in the "Safe environment" scores experienced by patients.
• However, subsequent interventions revealed an unexpected rise in the incidence of falls and pressure ulcers. Therefore, additional nursing interventions such as improving restroom facilities, providing patient education on medication side effects, and conducting skin assessments for patients at risk of pressure ulcers are deemed necessary.