Exploring factors influencing the implementation of clinical risk management programs by nurses in public hospitals: a case study of the Mbagathi Hospital in Nairobi Kenya

Abstract

As patient safety becomes a priority issue in health systems, clinical risk management (CRM) continues to gain prominence. CRM refers to strategies aimed at identifying, analyzing, and managing potential risks in healthcare organizations. Evidence shows that implementing CRM among nurses can be difficult in low-resource settings. This study explored the perspectives and experiences of nurses in implementing CRM in the context of a Kenyan public hospital, the Mbagathi Hospital in Nairobi Kenya. The study specifically explored how organizational culture and leadership, and resource availability affect the ability of nurses to implement clinical risk management activities at the Hospital. A qualitative approach was taken. This entailed interviewing up to 20 purposively selected nurses, ensuring that their experiences were captured at different levels of the hospital system. Data was collected using an open-ended interview guide, developed building on the objectives of the study. Data were transcribed and transferred into NVIVO for thematic analysis. The study findings revealed that the main resource factors that affect the implementation of CRM programs were the limitations of human, financial, and physical, and IT resources. This study also identified leadership factors like poor safety culture, poor leadership support and commitment, and poor collaboration and communication to affect CRM programs. This study concluded that although nurses are expected provide high quality and safe care, these challenges have created an unconducive environment to effectively integrate CRM programs into their professional practice. This study suggests that hospitals should provide a favorable working environment, foster leadership commitment, and support, and avail the necessary resources for the successful implementation of CRM programs. The findings of this study were disseminated by giving written feedback to study participants and the hospital management in form of emails. Dissemination will also be done by publishing the study in a peer-review journal to inform management of other public hospitals on strengthening the implementation of clinical risk management activities, and also to inform research on related topics.