الفهرس 
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Abstract
Nursing rounds are generally used to improve the use of evidence in nurses’ practice. They provide a forum to maintain currency and competence, model expertise and leadership, decrease staff isolation, promote professional development, and foster their clinical decision-making, communication, and presentation skills. However, the current provision of nursing care offers few opportunities for interaction and shared problem solving within the nursing team. The nursing round as conducted by head and staff nurses seems to be inadequate. Therefore, the present study was conducted to improve nursing round knowledge and practice among them through a training program, which can reflect positively on their work practice environment.
This study was aimed at determining the effect of nursing round improvement strategy on nurses’ work practice environment. It was carried out at the Arab Contractors Medical Center using a one-group open label quasi-experimental design with pre-post-follow-up assessment. It involved a group of 21 head nurses and 21 of their assistants, in addition to a group of 160 staff nurses.
Three tools were used in data collection, namely a knowledge questionnaire consisting of 20 multiple choice questions (MCQs) covering the nursing round definition, goals, process, head nurse role, staff nurse role, and influencing factors; a nursing round observation checklist to assess the performance during the three stages of the nursing round; and the work practice environment scale for assessment of the perception of nurses regarding the work practice environment. Different forms were used for the head nurses and their assistants, and the staff nurses.
The fieldwork lasted from August 2020 to July 2021 and included preliminary assessment, planning, implementation and evaluation phases. The training program was prepared based on preliminary assessment and related literature. It covered all theoretical and practical aspects of nursing rounds. It was implemented for eight weeks per small group (5-8 nurses), 2-3 hours/week. Three days/week. Various teaching methods and educational media were used. Handouts prepared by the researcher were distributed to participants for reference. The effect of the program was evaluated through a post-test carried out after the end of the program implementation and a follow-up test three months after the program implementation.
The main study findings were as following.
Head nurses and their assistants:
o The age of head nurses and their assistants ranged between 30 and 58 years, with only one (2.4%) male, and median experience of 21.0 years.
o Almost all head nurses and their assistants in the study sample reported having previously attended training courses in administration (95.2%).
o None of the head nurses or their assistants (0.0%) had satisfactory total knowledge at the pre-intervention phase; this increased to 100.0% at both post-intervention and follow-up (p<0.001) phases.
o Only 28.6% of the head nurses or their assistants had adequate total practice of nursing rounds at the pre-intervention phase; it increased to 100.0% at both post-intervention (p<0.001) and follow-up (p<0.001) phases.
o None (0.0%) of the head nurses or their assistants had high total perception of work practice environment at the pre-intervention phase; it improved reaching 100.0% at both post-intervention (p<0.001) and follow-up (p<0.001) phases.
o Statistically significant strong positive correlations were revealed among head nurses and assistants’ scores of knowledge, practice, and perception, the strongest being between their knowledge and practice (r=0.898).
o In multivariate analysis the study intervention was a significant positive predictor of head nurses and assistants’ knowledge and practice scores, whereas the knowledge score was a significant positive predictor of the perception score.
Staff nurses:
o Staff nurses’ age range between 22 and 54 years, 66.3% were females, with median experience 11.0 years.
o None of the staff nurses (0.0%) had satisfactory total knowledge at the pre-intervention phase; this increased to 100.0% at post-intervention (p<0.001) and follow-up (p<0.001) phases.
o None (0.0%) of the staff nurses had adequate total practice of nursing rounds at the pre-intervention phase; this increased to 100.0% at post-intervention (p<0.001) and follow-up (p<0.001) phases.
o Only 55.6% of the staff nurses had high total perception of work practice environment at the pre-intervention phase, which improved reaching 100.0% at post-intervention (p<0.001) and follow-up (p<0.001) phases.
o Significantly higher perception was noticed among those who did not attend training courses.
o Significant strong positive correlations were revealed among staff nurses scores of knowledge, practice, and perception of work practice environment, the strongest correlation was between their knowledge and perception scores (r=0.890).
o A significant weak positive correlation was shown between their perception scores and the level of qualification.
o In multivariate analysis, the study intervention was a main positive predictor of staff nurses’ knowledge and practice scores, while the knowledge score was a significant positive predictor of their perception score.
o Practice score, positive predictors were the knowledge and perception scores, while the level of qualification was a negative predictor.
Statistically significant strong positive correlations were revealed among the scores of knowledge, practice, and perception of the head nurses and their assistants from one side and their staff nurses from the other side.
After adjustment for the intervention effects, significant stronger almost perfect positive correlations were shown among their knowledge (r=0.988), practice (r=0.937), and perception (r=0.967) scores.
In conclusion, the implementation of the training program is effective in improving the deficient knowledge and practice of nursing rounds, and perception of work practice environment among the head nurses and their assistants and their subordinate staff nurses. The scores of these three domains are strongly and positively correlated, and the knowledge scores positively predict the perception scores, and thus the study hypothesis is accepted.