ORIGINAL RESEARCH ARTICLE | Nov. 6, 2020
Nurses’ Knowledge and Attitudes Regarding Administration of Oral Morphine to Adult Cancer Patients in Medical Wards, Kenyatta National Hospital, Kenya
Florence W. Maina, Catherine W. Mwaura
Page no 284-288
Administration of oral of morphine for pain management to adult cancer patients has remained a great challenge. Nurses working in medical wards of Kenyatta National hospital have been faced with challenges of inadequate knowledge and attitudes of oral morphine administration to adult cancer patients. Oral morphine would provide relieve of pain in adult patients suffering from moderate or severe pain resulting from cancer. The main objective of the study was to establish nurses’ knowledge, and attitudes on administration of oral morphine for pain management to adult cancer patient in medical wards, Kenyatta National Hospital. A descriptive study was carried out and a total of 34 nurses participated in the study. Data was collected using structured, open-ended questionnaires for respondents. Data was analysed using the Scientific Package for Social Sciences (SPSS) software version twenty-one. Majority of the respondents 71.2% (n=24) received training on administration of oral morphine through on job training, (48.1%) respondents were undecided on administering oral morphine. Majority at (76.9%) nurses underestimated patients’ pain and all nurses agreed their reluctant to administer oral morphine because of respiratory depression. The study concludes that adult cancer patients with pain are not adequately relieved of pain and majority of nurses have inadequate knowledge and attitudes on administration of oral morphine. This study recommends continuing education programs on administration of oral morphine to adult cancer patient for nurses to facilitate acquisition of skills of oral morphine administration to relieve pain to adult cancer patients.
ORIGINAL RESEARCH ARTICLE | Nov. 6, 2020
Competence of Health Promotion Officers at Public Health Center (Puskesmas) in Empowering Integrated Health Service Post (Posyandu) Cadres in Aru Island District
Richard Alex Romroma, Suriah, Nurhaedar Djafar, Muhammad Syafar, Stang, Syamsiar S. Russeng
Page no 289-292
Health promotion officers at Public health center need to have competition in implementing and managing health promotion programs. This study aims to determine the competence of health promotion officers at Public health center in the aspect of empowering Posyandu cadres for toddlers in Aru Islands District. This research is a qualitative research with a case study approach. The informants in the study were thirteen people who have criteria as main informants and supporting informants. The informants are determined using purposive sampling technique. Data were collected using in depth interviews, FGD (Focus Group Discussion), document review, observation and data were analyzed using constant comparison methods. The results showed that the ability of health promotion officers at the Public health center, both with a background in health promotion education and a non-health promotion background, in the process of empowering Posyandu cadres for the awareness stage of toddlers, have not been able to grow and increase awareness of cadres because activities are still limited to refreshing cadres once a year, guidance and direction to cadres by involving cross-programs at the Public health center. There is a need for training and technical guidance for health promotion officers at Public health center to empower Posyandu cadres.
ORIGINAL RESEARCH ARTICLE | Nov. 9, 2020
A Qualitative Analysis on the Clinical Experiences of Undergraduate Nursing Students in Kenya
Wachira Serah, Karani Anna, Kimani Samuel, Mageto Irene
Page no 293-298
Background/aim: There is a need to assess students’ reflective work to identify learning enhancers and barriers to improve nurse training. Although reflective writing has been an ongoing clinical nurse education practice globally, analysis of journal reflections to identify student nurses’ clinical experiences is scanty, especially in the local Kenyan setting. Therefore, the purpose of this study was to evaluate the lived clinical experiences of student nurses to identify learning enhancers and barriers. Methods: This research was the qualitative part of a mixed-method approach. Qualitative content analysis was utilized to scrutinize 138 reflective journal entries of 36 undergraduate nursing students in the second and third years of practice. The participants were from a Public University, School of Nursing, in Kenya. The students documented their clinical experiences during their medical-surgical clinical attachment at a National Referral Hospital in Kenya between February and August 2018. The average entries per student were four with a range of 2-6 entries per journal. Gibb’s reflective model guided documentation of reflections. NVIVO version 11 was used to code, transcribe, and analyze the journal narratives. Results: Four main themes emerged from the analysis; Gaining new skills and knowledge, confidence levels, professional practice gaps, and professional support system. Conclusion: Nursing students’ experience is focused on gaining new knowledge and skills and building their confidence to practice. However, positive and negative encounters develop their buoyancy and frustrate their desire to learn, respectively.
ORIGINAL RESEARCH ARTICLE | Nov. 14, 2020
Nurses Knowledge and Practice to Prevent and Control Neonatal Nosocomial Infection in Maternal and Neonatal Units at Rajshahi Medical College Hospital- Bangladesh
Mousumi Adhikary, Mahfuza Khanam
Page no 299-306
Background: Neonatal hospital infections, in addition to being the cause of a significant number of perinatal, neonatal, and postnatal deaths, are also associated with increased health care costs. This is because hospitalization of infected children is up to threefold longer than that of non-infected children. Objective: Our objective is to assess the nurse’s knowledge and observe their practice to prevent and control neonatal nosocomial infection in maternal and neonatal unit at Rajshahi Medical College Hospital. Results: Age distribution shows highest percentage 48 % in between 40-49 years. All of the respondents were female. Most of the nurses 90% were Muslim, 8% were Hindu. About 100% of the respondents have S. S. C., 30% have H. S. C. and 4% have B.A. / B.Sc. degree, Remaining 4% of the respondents having Masters or others degree. Regarding professional qualification 100% of respondent’s have diploma in nursing and midwifery, 20% of B.Sc. in public health, and remaining 14% have M.P.H. In service about 6% of respondent’s job experience was1-5years, 12% had 6-10 years and the 24% had 11-15 years, 20% had 16-20years, 10% had 21-25 years and remaining 28% had 26-30years experience. The grading of the knowledge was about 73.5% of nurses had complete knowledge, 15% had partial knowledge, 5.33% gave wrong answer and 6.16% said that they do not know the answer. About 50% of the neonatal age was 5- 10 days, about 20% of 11-16 days, nearly 18% was 17-22 days, and the remaining 12% was 23-28 days. Among them 56% was male and 44% was female. Among the responding parents, family type was mainly nuclear 62% and joint 38%. Educational qualification of the father’s was about 22% illiterate, 20% able to write their name, 18% was primary educated, 20% was secondary,14% higher secondary and 6% was graduate. On the other hand mother’s educational qualification was about 30% illiterate, 20% was able to write their name, primary education complete about 24% and secondary 18% and higher secondary 8%.According to the data collection the respondents residence in the Rajshahi division was 100%, residence in the rural 70% and urban about 30%. Conclusion: Current global evaluations confirm that commitment to improving newborn health makes meaningful socio-economic contributions. Various reasons can be attributed to why the health of the newborn has been neglected despite the huge mortality rates and why most neonatal deaths are unseen and undocumented.
REVIEW ARTICLE | Nov. 17, 2020
Effects of Healthcare Providers Overtime Duties and Patient Outcomes
Edwin K Wamukoya, David Kaniaru, Anthony Muchiri W
Page no 307-315
Most hospital staff nurses' work schedules extend beyond the typical 9:00 a.m. to 5:00 p.m., Monday through Friday workday, to provide continuous nursing care to patients. Simultaneously, most hospitals in the United Counties exclusively use 12-hour shifts. Thus, staff nurses who work overtime may work more than 12 hours within 24 hours and return to work quickly without sufficient rest and sleep. Nurses' fatigue may continue the following work regardless of regular or overtime shifts. Working overtime among nurses is a prevalent practice used to control chronic understaffing and a standard method used to handle normal patient census variations. According to the 2004 National Sample Survey of Registered Nurses (NSSRN), more than 40% of Kenya registered community health nurses (KRCHN) worked more than 40 hours per week . According to the ministry of health, fifty-four percent of the respondents to the 2018 NSSRN worked more than 39 hours per week in their principal nursing position (2010). The purpose of this study was two-fold. The first step was to examine the relationship between mandatory nurse overtime regulations and nurse injuries and adverse patient events. The second step was to assess the mediating effect of nurse overtime on the relationship between the regulations and outcomes after controlling for other nurse work characteristics. A cross-sectional design was used, incorporating data from staff RNs working in hospitals in two counties (Kakamega & Bungoma). A sample size above 250 is suggested by Cohen's guidelines . SPSS version 22.0 and Stata version 10 were used for the data analysis. Univariate, descriptive statistical analyses were conducted to examine the sample characteristics; 15.6% of RNs worked mandatory overtime (either paid or unpaid) while 34.1% worked voluntary overtime (either paid or unpaid) in a typical week. In the current study, the associations between mandatory overtime regulations and nurse and patient outcomes among a sample of 173 nurses in Kakamega and Bungoma were examined. Findings indicated that mandatory nurse overtime regulation did not have any association with nurse injuries. On the other hand, there were statistically significant associations found between the regulations and adverse patient events. The findings of this study should be viewed with the following limitations in mind. Even though the sample was selected randomly to represent the population in both Counties, and the Dillman Tailored Design Method with three survey mailings and reminder postcards was used in an attempt to increase the response rate and to recruit a sufficient sample to ensure the statistical power, the final response rate was 29.8% (226 RNs). Given this response rate, it is impossible to generalize the study findings due to the potential for self-selection bias among respondents. This study did not find any relationship between mandatory overtime regulations and nurses' overtime hours. As a result, although there were significant relationships between the regulation and adverse patient events, the regulations did not impact patient outcomes. Mandatory overtime regulations were not related to nursing injuries.
ORIGINAL RESEARCH ARTICLE | Nov. 20, 2020
Impact of Clinical Pharmacist Interventions on Improving Nurses’ Practice of Tube Occlusion Management in Patients on Enteral Feeding Tubes (EFT)
Page no 316-318
A high number of patients in the hospital setting are dependent on Enteral Feeding Tubes (EFT) due to varying reasons like disease related disabilities or swallowing difficulties. Tube occlusion is a very common complication occurring in patient on EFT. The nurses are many times unaware for the proper techniques to be followed in case of tube occlusion events. This study aims at assessing the routine practices followed by nurses related to management of tube occlusions and the impact of training provided by clinical pharmacist on the same. A prospective interventional study was carried out in a tertiary care hospital of Kerala state of India. Clinical pharmacist led training programmes and guideline development was performed during the intervention phase. The pre interventional and post interventional data were compared and statistically analyzed using SPSS version 13. In the post intervention phase proper use of warm water and use of alkalinized solution of pancreatic enzymes increased significantly (P<0.001). Changing of the tube reduced from 74.6% to 21.4% which was significant (p<0.001). The study shows that clinical pharmacist interventions through training, auditing and implementation of guidelines can significantly improve the tube occlusion management in patients on EFT and ensure quality and safety of therapy.
ORIGINAL RESEARCH ARTICLE | Nov. 23, 2020
Prevalence of COVID-19 Positive Admitted Patients in Cardiac Center Hail During Month of July and August 2020
Rechel Mates, Rayhannah Lamalan, Analyn Lazaro, , Christelle Keith Tiamson, Dr. Mohamed Fahmy Ibrahim
Page no 319-326
Background: The coronavirus COVID-19 pandemic is the defining global health crisis of our time and the greatest challenge we have faced since World War II. Since its emergence in Asia late last year, the virus has spread to every continent except Antarctica. In our center, 36 out of 180 Health Care Workers (20%) of CCH staff were diagnosed with COVID-19 in the month of June – August 2020 and 32 out of 281 admissions (11.39%) in cardiac patients. For the first two months (March and April) of COVID-19 pandemic in Hail region, there were no infections noted in our center. Routine admission of ST-Elevation Myocardial Infarction (STEMI) patients in Catheterization Laboratory was allowed with awaiting swabbing result. Proper precautionary measures and Personal Protective Equipment (PPE) were strictly observed to highly suspicious COVID-19 high-risk cardiac patients. Methods: Between July– August 2020, this retrospective study was conducted for almost 2-month period based on prospective data collection at Cardiac Center Hail (CCH). Data collection through MEDICAPLUS documentation, daily COVID-19 scoring of both healthcare practitioners (Online Visual Triage) and patients (Respiratory Triage Checklist) were practiced, assessment and review of the laboratory results of admitted patients were done by the cardiac specialists. Daily recording of COVID-19 positive cardiac patients done by the unit heads and supervisors were gathered as reference of this study. This study is conducted to show the prevalence of COVID-19 positive admitted cardiac patients in our facility and discuss the importance of routine swabbing. Also, to contribute to research platforms in hopes of learning from the current pandemic response to better prepare for the next unforeseen crisis. Results: For two-month study period, there were 281 cardiac admissions from Emergency Room in Coronary Care Unit and Cardiac Ward, of which 32 (11.39%) were cases of COVID-19 positive. Due to the increasing number of infected healthcare workers (doctors, nurses and technicians) most especially in Cardiac Catheterization Laboratory, all symptomatic and exposed medical and nursing staff were mandated to undergone COVID-19 swabbing on the month of July. The routine was to triage patients with scoring system (attached one) if score > 4, swabbing is done, if <4 admit without swab. Routine swabbing of admitted patients and decreasing the number of on-duty staff in the facility reduced unnecessary exposure to positive cases in Catheterization Laboratory, number of infected health care workers and also to reduce complications due to intervention on positive cases. Conclusion: Without testing there is no data. Tests allow us to identify infected individuals, guiding the medical treatment that they receive and it can help allocate medical resources and staff more efficiently. Through this study, the patients and health care practitioners were working together to deliver essential services, limit the spread of COVID-19 and to cushion the potentially devastating impact it may have on vulnerable people.
REVIEW ARTICLE | Nov. 23, 2020
IUDs: Maternity Nurses’ Practices of Infection Control Measures
Amera Bekhatroh Rashed, Nevin Adel Amer, Zeinab A.Ali
Page no 327-334
Background: The consistent use of recommended infection prevention practices is a critical component of quality health services, as well as a basic right of every patient, client, or staff member in a health care setting. Summary: This review of literature includes three sections. The first section is an overview about IUD; the second section is devoted to infection control measures in family planning unit while the third explain maternity nurses' practice of such measures.
ORIGINAL RESEARCH ARTICLE | Nov. 25, 2020
Mothers’ Knowledge, Attitude and Practice about Infant Feeding and Weaning Food in Sylhet: An Empirical Study
Md. Abdul Hadi Suhag, Mahbuba Akter
Page no 335-345
A cross-sectional descriptive study was carried out to assess the knowledge, attitude and practice about infant feeding and weaning food among the mothers of under 2 years children. The study was conducted at M. A. G. Osmani Medical College Hospital, Sylhet period December 2015 to February 2016 by interviewing a total 100 respondents in paediatric ward by using semi-structured questionnaire. Modes of thermoregulation identified included knowledge 81% respondents were known duration of exclusive breast feeding 6 months. 75% respondents did not know about benefits of breast milk. 45% respondents known about breast feeding had contraceptive benefits, 55% respondents were did not known about breast feeding had contraceptive benefits. Modes of face washed before feeding included 80% respondents did not know and 20% respondents were known about washed the hands before feeding. 91% respondents were known started time of weaning food after 6 months. Breast milk protect child from illness 85% respondents were did not know and only 15% respondents were known. Modes of weaning food included 68% respondents given hotchpotches as a first weaning food and only 16% mothers were given cerelac as first food. 50% respondents given complementary feeding 2-3 meals/ day and 28% were given 4-5 meals/day. 78% respondents said that bottles feed safer for baby. Modes of colostrum identified included 80% respondents known about to feed the baby, 17% respondents threw it. 45% respondents were known about breast feed the baby as soon as possible soon after delivery, 27% respondents were known within half an hour.75% respondents said that other food given besides breast milk before 6 months. Finding of the study showed that 69% infant mothers had average knowledge, 23% had good knowledge & 8% had poor knowledge. Among infant mothers nearly 54% had positive attitude and 46% had very positive attitude about infant feeding and weaning.
ORIGINAL RESEARCH ARTICLE | Nov. 25, 2020
Knowledge on Cervical Cancer among Undergraduate University Students
Most. Luthfa Begum
Page no 346-358
Cervical cancer is a typically slow-growing cancer that may not have symptoms, but can be early diagnosed by Pap smear and Visual Inspection of Cervix with Acetic Acid (VIA). According to WHO and UNPF, globally every year, around 500,000 women develop cervical cancer and almost 274,000 of them die from the disease. Participants in this study did not report engaging in risk factors associated with cervical cancer, they had poor knowledge of etiology, mode of transmission, symptoms, prevention methods, and different risk factors that increase the progression of cervical cancer as well as poor perception towards the chance of acquiring the disease. Using TV and Radio and having information on STI were the determinants of knowledge on cervical cancer. The result obtained in this study indicates how useful it established health education programs to increase students’ awareness and knowledge about cervical cancer. Health education interventions require improving the understanding of the factors that increases the risk and the prevention methods of cervical cancer in youth women to prevent before women engage in risky behaviors to develop healthy behavior and decrease the incidence of the disease. Governments and non-governmental organizations should work in collaboration in improving knowledge of cervical cancer and screening among youth women. For the reasons said above, this study was conducted among the tertiary level students at Gono Bishwabidyalay, Savar, Dhaka, Bangladesh.
ORIGINAL RESEARCH ARTICLE | Nov. 29, 2020
A Study to Assess the Knowledge and Practice on Water Borne Diseases and its Prevention Mothers of Under Five Children
Varalakshmi.E, Mahalakshmi R, Prashanth K
Page no 359-362
Water is the most indispensable nature resource in the world for every living being waterborne diseases most commonly are transmitted in contaminated fresh water. Infection commonly results during bathing, washing, drinking, in the preparation of food, or the consumption of food thus infected. Objectives: To assess the Level of Knowledge Regarding Water Borne Diseases and its Prevention among mothers of Under Five Children. To find the association of knowledge among mothers of under five children with selected demographic variables. Methodology: A quantitative approach with Descriptive research design was used. The independent variable in this study Water borne disease and its prevention. The dependent variables in this study are Knowledge of mothers of under five children on waterborne diseases and its prevention. A study was conducted in Erayamangalm village, Thiruvallur District The sample size consists of 60 under five children mothers. Who fulfils the inclusion criteria were selected by Convenient sampling technique sampling technique. Results: Major findings of the study were overall mean score is 26.83 with a mean percentage 89.43% and standard deviation 2.93. A significant relationship was observed between education, food pattern and source of information with the knowledge. Whereas age, occupation, monthly income and type of family do not show any relationship of mothers regarding water borne diseases and its prevention. Result of this study reveals that 8.33% of mothers were having moderate knowledge of water borne diseases and its prevention and 91.67% of mothers were having adequate knowledge on water borne diseases and its prevention. Conclusion: Waterborne diseases being the major health problem in children below five years of age and most of the mothers are unaware about its first aid home management and leads to complications. The study was done to assess the knowledge and practice on prevention of waterborne diseases among mothers of children below five years of age.