Master of EM & Critical Care Nursing

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End date: 2023

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    KNOWLEDGE, PRACTICE AND ASSOCIATED FACTORS TOWARDS DISASTER PREPARDNESS AMONG NURSES WORKING IN THE EMERGENCY DEPARTMENT OF PUBLIC HOSPITALS IN SIDAMA REGION, ETHIOPIA,2023.
    (hawassa universty, 2023-11) YUNUKA MARUFA TUNUSHE
    Introduction: According to recent researches, nurses in health-care settings who lack sufficient knowledge and practice in disaster preparedness can lose resources, delay treatments, cause patient unhappiness, and have other negative effects. Little is known regarding nurses’ knowledge, practice, and associated factors towards disaster preparedness in Ethiopia, particularly in this study area. Objective: The aim of this study was to assess the knowledge, practice and associated factors toward disaster preparedness among nurses working in emergency department at Public Hospitals in Sidama region, Ethiopia, 2023. Methods: A facility-based cross-sectional study design was conducted among randomly selected 175 nurses working in the emergency department (ED) from June 15 to July 15, 2023. The collected data was entered into Epi Data Version 4.6 and exported to Statistical Package for Social Science (SPSS) Version 25 for analysis. A logistic regression model was used to assess the strength of the association between the dependent and independent variables. Variables with a p-value <0.05 in the multivariable analysis were considered statistically significant. Results: A total of 175 nurses working in emergency departments participated in the study. The mean age of the respondents was 29 ± 4 years. From all study participants, around 95 (53%) and 114 (65%) of nurses working in the ED had poor knowledge levels and insufficient practice towards disaster preparedness respectively.In multivariate logistic regression, being male(AOR=2.6(CI 95%1.19-5.76 p=0.017), receiving training on subject (AOR=6.42, CI 95% 2.2-15.8, P=0.000), and having experience in disaster management(AOR=2.43, CI 95% 1.02 5.62, p=0.043) were factors significantly associated with the good knowledge of participants, while having disaster guideline(AOR=3.96, CI 95% 1.6-9.5, p=0.002, direct personal or professional exposure to disaster events, receiving training(AOR=4.4, CI 95% 1.7-11.8, p=0.003), and having good knowledge (AOR=3.32, CI 95% 1.7-11.8, p=0.01) were significantly associated with sufficient practices. Conclusion and recommendation: The current study revealed that more than half of the study participants have poor knowledge and insufficient practice in disaster preparedness. It’s advisable to hospitals have to have and distribute disaster guideline in emergency departments, and ongoing professional development training for nurses has to be given to improve the knowledge and practice of nurses working in the emergency department.
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    Knowledge and Practice towards Initial Management of Acute Poisoning Among Nurses Working at Emergency Department of Sidama Region Hospitals
    (hawassa universty, 2023-11) Tamire Adamu
    Introduction: Acute poisoning remains a common medical emergency worldwide. It is an important health problem, which cause both morbidity and mortality globally.Even though acutely poisoned patients have been visited emergency department and got emergency care, so many people died from poisoning worldwide.Emergency department nurses’ knowledge and practice can affect the early management of poisoning. However, limited information is available regarding the level and factors associated with nurses’ knowledge and practice on initial management of acute poisoning. Objective: To assess knowledge, practice and its associated factors of initial management of acute poisoning among nurses at emergency department of hospitals in Sidama Region, Ethiopia. Methods and Materials:Institutional based cross sectional study was conducted at emergency departments at 10 selected Hospitals found in Sidama Region from April to May 2023 on 182 nurses. Structured and self-administered questionnaire was used for data collection. Collected data were entered in to Epi-data version 3.1 and transported to SPSS version 20 for analysis. Bi variate and multivariable logistic regression were performed to identify factors. Statistical significances were set at p-value less than 0.25 and less than 0.05 during bi-variate and multivariable logistic regression respectively. Results:The study was conducted among 182 nurses, with a response rate of 98.4%. From total 99 (54.4%) (Mean =6.6, SD±2.5) and 69 (37.9%) (Mean =6.5, SD±2.3) of nurses had good knowledge and good practice on acute poisoning management respectively.Nurses; 30-39 and ≥40 years old were 93% (AOR=0.066, 95% CI (0.012-0.355)) and 98% (AOR=0.023, 95% CI (0.002-0.247)) less likely knowledgeable compared to nurses 20-29 years old respectively. Trained nurses on acute poisoning management were three times (AOR=3.186, 95% CI (1.553 6.538)to have good knowledgethan those they are not trained. Nurses trained on acute poison management were 5.4 times more likely to have good practice compared with not trained (AOR=5.377, 95% CI (2.595-11.143).
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    BREAST CANCER SCREENING PRACTICE AND ASSOCIATED FACTORS AMONG FEMALE NURSES WORKING AT SOUTH OMO ZONE PUBLIC HEALTH FACILITIES, SOUTHERN ETHIOPIA, 2023
    (hawassa universty, 2023-11) TADELE DAMENA (BSc)
    Background: Globally, breast cancer is one of the most prevalent cancers and the leading cause of mortality for women due to not receiving screening. Therefore, early detection of breast cancer could potentially reduce morbidity and mortality from breast cancer among women. Hence, female nurses play a vital role in promoting breast cancer screening, although there is scarce data regarding the screening practices among female nurses in the research area. Objective: To assess breast cancer screening practice and associated factors among female nurses working at South Omo Zone public health facilities in Southern Ethiopia in 2023. Methods: An institutional-based cross-sectional study was conducted from May 15 to June 15, 2023, among female nurses employed in public health facilities in the South Omo Zone. Simple random sampling was used to select the study participants. Data was collected using a pre tested, structured, and self-administered questionnaire. The collected data were entered and cleaned using Epi Data version 3.1 and exported to SPSS version 22 for analysis. Binary logistic regression analyses were used. Variables with a p-value <0.05 in the multivariable logistic regression analysis were considered statistically significant. Result: In the current study, the prevalence of breast cancer screening practice was 21% (95% CI: 16.0, 26.5) based on recommendations. The mean age of respondents is 33 ±7 SD. Being age ≥40 years (AOR = 0.18; 95% CI: 0.04–0.70), having good knowledge about breast cancer signs and symptoms (AOR =2.94; 95% CI: 1.18–7.35), good knowledge of risk factors (AOR =8.60; 95% CI: 3.72–19.87), high perceived susceptibility (AOR = 2.55; 95% CI: 1.11–5.88), and a high perceived benefit of breast cancer screening (AOR = 2.30; 95% CI: 1.02–5.18) were significantly associated. Conclusion and recommendation: The practice of breast cancer screening among female nurses in the study area was low as compared to previous studies. Being age ≥40 years, knowledge of signs and symptoms, risk factors of breast cancer, susceptibility to breast cancer, and benefits from breast cancer screening were associated with the practice of breast cancer screening. It is better to provide mammography and training to improve breast cancer screening.
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    MAGNITUDE AND ASSOCIATED FACTORS OF EARLY MORTALITY AMONG DEATHS IN ADULT EMERGENCY DEPARTMENT, AT PUBLIC HOSPITALS, HAWASSA, SIDAMA, ETHIOPIA,2023.
    (hawassa universty, 2023-11) GELANE GELETO (BSc)
    Background: early mortality defined as death with 72 hours of emergency department presentation. In low-income countries with limited resources, adult emergency department mortality remains high. The majority (59.8%) of those deaths occur within the first three days of admission to the emergency department in Ethiopia. Previously, only single-center studies at tertiary hospitals were conducted in Ethiopia. Objective: to assess the magnitude and associated factors of early mortality among deaths in adult emergency departments at selected public hospitals in Hawassa, Sidama, Ethiopia, from January 2021 to December 2022. Methods: An institutional-based cross-sectional study design was applied. A systematic random sampling technique was used to select 369 charts of patients who died in adult emergency departments of selected public hospitals in two years. The data was collected using a pre-tested data abstraction tool entered into the Kobo toolbox, then entered into EpiData version 4.6.0 and exported to SPSS version 27 for analysis. By using binary logistic regression Bivariate and multivariate analyses were run. Finally, statistical significance was declared at p-value <0.05, and an adjusted odds ratio with a 95% confidence interval was used to report the strength of the association Result: This study result shows that 50.2% of the participants were between the ages of 25-54 with mean average 40.6 ± 17.5 and 67.7% were male. 288 (78%) died within 72 hours. Lack of prehospital care [(AOR = 4.2; 95% CI: 2.23, 7.87), P = 0.007], road traffic accidents [(AOR = 4.1; 95% CI: 1.403, 12.076), P = 0.013], red triage categories [(AOR = 3.9; 95% CI: 1.6, 9.4), P = 0.003], had lack of investigation[(AOR = 3.4; 95% CI: 1.2, 9.4), comorbid illness [(AOR = 3.2; 95% CI: 1.558, 6.49), P = 0.001] and delayed initial intervention [(AOR = 2.338; 95% CI: 1.259, 4.339), P = 0.007] were significantly associated with early mortality. Conclusion: In this study, a greater early mortality rate was detected. Early morality was increased by a lack of prehospital treatment, road traffic accidents, a red warning score, a lack of investigation, comorbidity, and a delay in the first intervention.
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    PATTERN OF INJURY, OUTCOME AND ASSOCIATED FACTORS AMONG PATIENTS VISITING THE EMERGENCY DEPARTMENT IN SIDAMA REGIONAL GENERAL HOSPITALS, ETHIOPIA; 2023.
    (hawassa universty, 2023-11) DREREJE BUCHE
    Background: Injury has a significant impact on societal health and well-being, taking the lives of more than 15,000 people daily and more than 4.4 million people annually. Low- and middle income countries have a disproportionately high injury burden, account for almost 90% of injury-related fatalities. Despite government health agencies and hospitals should have a detailed picture of injuries, little is known about injury statistics and outcomes in this region and across the country. Objectives: To assess pattern of injury, outcome, and associated factors of injury outcome Among patients visited selected general hospitals in Sidama regional state, Ethiopia, 2023. Methodology: An institutional-based cross-sectional study was conducted on Sidama Regional General Hospitals from March 10 to June 10, 2023, after three general hospitals were selected by the lottery method out of five general hospitals. The sample size was calculated by using the single population formula, and it became 342. Data was collected using a structured questionnaire adopted from WHO trauma surveillance, and ethical clearance was obtained from Hawassa University's ethical review board. Data was entered into EpiData version 4.1 and analyzed through SPSS version 27. Result: A total of 342 injured patients participated in this study, and unintentional injuries accounted for 225 (65.2%) of the total injuries, and the age group 24-44 years was the most commonly affected, with 137 (40.1%). 35.6% of injury cases were due to road traffic injuries, and 27.19% of the cases were due to interpersonal violence. Out of the total participants, 96.2% were discharged alive, and 3.8% died. The glaucoma scale, severity of injury , time between injury and care, head injury, triage scale, and operated on have associations with mortality. Conclusion and recommendation: Male patients and those aged 25–44 had a higher proportion of injury victims. The primary cause of injury was RTA, followed by interpersonal violence and fall injuries. The glaucoma scale, severity of injury, triage scale, head injury, and those patients who operated were more associated with mortality. More efforts are needed to raise awareness of RTA, improve road safety, and impose severe regulations on pedestrians and drivers.
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    ADMISSION OUTCOMES AND ASSOCIATED FACTORS OF ADULTS ADMITTED TO INTENSIVE CARE UNITS OF SELECTED GOVERNMENTAL HOSPITALS IN SIDAMA REGION, ETHIOPIA, 2023
    (hawassa universty, 2023-11) BIRHANU MULETA BAYECHA
    Background: Intensive care ismultidisciplinary and inter-professional specialty dedicated to the total management of patients with acute life-threatening conditions. Patientsadmitted to the intensive care unit need frequent assessments of their vital signs, invasive hemodynamic monitoring, intravenous drugs and fluid management, ventilatory assistance, and dietary support. The overall goal is to increase the patient chance of survival.In resource-limited settings, mortality is still higher due to various reasons. Objective:To assess admissionoutcomes, andassociated factors of adults admitted to intensive care units of selected governmental hospitals in theSidama region, Ethiopia, 2023. Materials and methods: After obtaining ethical clearance,a cross-sectional study was conducted on 401adult patients admitted to ICUfromMarch 2020 to February 2023. Patient‘s chart was selected by systematic randomsampling; needed information was retrieved by a pretested data abstraction tool and analyzed with SPSS version 26.Furthermore,to support this study ICU director and/or chief nurse were surveyed regarding ICU characteristics.A binary and multivariable logistic regression was conducted to see if variables were associated with outcomes. Results: The emergency department was a common source of admission (65.4%) to the ICUs. Cardiovascular diseases107(27.4%) were common causes of ICU admission.The mortality rate was 39.5%.Patients who were within the 56-65(AOR=3.6, CI,1.130-11.408), and >65 (AOR=4.3,CI,1.125-16.625) age category, mechanically ventilated(AOR=4.3, CI,2.117-8.837), high serum creatinine (AOR=2.4, CI,1.186-4.668), lowsodium(AOR=2.6, CI,1.344-5.188), lowpotassium (AOR=2.1, CI, 1.038-4.097),anemicat admission (AOR= 3.6, CI,1.908-6.636), and supported with a vasopressor (AOR= 6.2, CI, 3.212-12.131)were at higher risk of mortality whereasthose treated in general hospitals (AOR=0.5, CI,0.239 0.950)were at lower risk of mortality. Conclusion and Recommendation: The overall mortality observed in this study was high. ICU to hospital bed ratio should be improved and clinicians should give due attention to patients who had these associated factors of mortality at admission.Overall there is a need to strengthen action to improve critical care services in the region.
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    PALLIATIVE CARE PRACTICE, PERCEIVED BARRIERS, AND ASSOCIATED FACTORS AMONG NURSES WORKING IN SELECTED PUBLIC HOSPITALS IN HAWASSA CITY, SIDAMA ETHIOPIA
    (hawassa universty, 2023-11) BEYENE FELEKE ASHAGRE (BSc)
    Background: Palliative care is a comprehensive approach that enhances the quality of life of patients and their families facing problems related to life-threatening illnesses. Since nurses play an active role in managing patients' disease diagnosis and treatment in clinical palliative care practice, identifying their practice level is critical. However, there is a lack of data regarding palliative care practice, barriers, and associated factors among nurses in the study area. Objective: To assess the palliative care practice, perceived barriers, and associated factors among nurses working in selected public hospitals in Hawassa, Sidama, Ethiopia. Methods: An institutional-based cross-sectional study design using quantitative supplemented by qualitative data collection methods was employed among 319 nurses and 8 key informants, respectively, at a selected public hospital in Hawassa City, Sidama, Ethiopia, from March 15 to July 30, 2023.Simple random sampling techniques and purposive sampling techniques were used to collect data. Data were collected using pretested, self-administered questionnaires and an in-depth interview. Epi-Data and Statistical Program for Social Sciences software were used for data entry and analysis. Descriptive, bivariate, and multivariable logistic regression analyses were utilized. A p-value of <0.05 on multivariate logistic regression was declaredfor the associated variable. For qualitative data, thematic analysis was used. Results:The response rate among the 313 nurses who completed the questionnaire was 98%. Around three-fourths,76.6% [95% CI, 72–81] of participants had poor palliative care practices. Type of hospital, age, education level, experiences, and training were significantly associated with overall palliative care practices. This study explored four main themes in qualitative findings: knowledge deficit, negative patient attitudes, spiritual care, and modern medicine clash, issues with healthcare providers, and inadequate hospital facilities. Conclusion and recommendations: Overall, nurses had poor palliative care practices. Type of hospital, age, education level, experiences, and training were factors associated with practice towards palliative care, anda sub-category of themes emerged from a qualitative study. Therefore, it is necessary to provide basic education and continue on-the-job training for nurses to bridge the gap of poor practice.
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    KNOWLEDGE AND PRACTICE TOWARDS BASIC LIFE SUPPORT AMONG NURSES WORKING AT PUBLIC HOSPITALS, IN HAWASSA CITY, SIDAMA, ETHIOPIA, 2023
    (hawassa universty, 2023-11) BETELHEM DEMEKE ALEMU (BSc)
    Introduction: Basic Life Support (BLS) is the foundation for saving lives after cardiac arrest, respiratory arrest, and choking in adults, children, and infants. In hospital cardiac arrest situations as well as community emergency calls, nurses are frequently the initial responders; as a result, their proficiency in basic life support is crucial for enhancing patient outcomes. However, little is known about the knowledge and practice of basic life support in Ethiopia. Objective: To assess knowledge, practice, and their associated factors toward basic life support among nurses working at public hospitals in Hawassa City, Sidama, Ethiopia, in 2023. Methodology: An institution-based cross-sectional study was conducted from April 1 to 15, 2023, in Hawassa City public hospitals with a sample size of 410 study participants selected using simple random sampling techniques. Data were collected using a self-administered, structured questionnaire. Logistic regression was applied to control the effects of some variables on the outcome variables, and odd ratios were calculated to determine the strength of the association. Results were interpreted as an association if the p-value was < 0.05 at 95% CI. Descriptions of data were made using tables, percentages, and graphs. Results: A total of 375 participants took part in the study, with a response rate of 91.5%. About one-fourth of 102 (27.2%) [95% CI (22.7–31.7)] and 106 (28.3%) [95% CI (23.7–32.9)] were found to be knowledgeable and have good practices towards basic life support, respectively. Being female, age and work experience were found to be significantly associated with knowledge of BLS. Being male, Nurses’ who had taken training and good knowledge level nurses towards basic life support were found to be significantly associated with practice of BLS. Conclusion: The results of this study showed that nurses working at public hospitals in Hawassa City's overall knowledge and practice of basic life support were poor. Therefore, more work needs to be done to increase nurses’ knowledge and practice in order to reduce avoidable deaths caused by unexpected emergencies such as choking, drowning, or sudden cardiac arrest. Thus, subsequent training and education on basic life support are mandatory to achieve the desired outcome.
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    KNOWLEDGE, PRACTICE AND ASSOCIATED FACTORS TOWARDS DISASTER PREPAREDNESS AMONG NURSES WORKING IN THE EMERGENCY DEPARTMENT OF PUBLIC HOSPITALS IN SIDAMA REGION, ETHIOPIA,2023.
    (Hawassa University, 2023-11) YUNUKA MARUFA TUNUSHE
    Introduction: According to recent researches, nurses in health-care settings who lack sufficient knowledge and practice in disaster preparedness can lose resources, delay treatments, cause patient unhappiness, and have other negative effects. Little is known regarding nurses’ knowledge, practice, and associated factors towards disaster preparedness in Ethiopia, particularly in this study area. Objective: The aim of this study was to assess the knowledge, practice and associated factors toward disaster preparedness among nurses working in emergency department at Public Hospitals in Sidama region, Ethiopia, 2023. Methods: A facility-based cross-sectional study design was conducted among randomly selected 175 nurses working in the emergency department (ED) from June 15 to July 15, 2023. The collected data was entered into Epi Data Version 4.6 and exported to Statistical Package for Social Science (SPSS) Version 25 for analysis. A logistic regression model was used to assess the strength of the association between the dependent and independent variables. Variables with a p-value <0.05 in the multivariable analysis were considered statistically significant. Results: A total of 175 nurses working in emergency departments participated in the study. The mean age of the respondents was 29 ± 4 years. From all study participants, around 95 (53%) and 114 (65%) of nurses working in the ED had poor knowledge levels and insufficient practice towards disaster preparedness respectively.In multivariate logistic regression, being male(AOR=2.6(CI 95%1.19-5.76 p=0.017), receiving training on subject (AOR=6.42, CI 95% 2.2-15.8, P=0.000), and having experience in disaster management(AOR=2.43, CI 95% 1.02 5.62, p=0.043) were factors significantly associated with the good knowledge of participants, while having disaster guideline(AOR=3.96, CI 95% 1.6-9.5, p=0.002, direct personal or professional exposure to disaster events, receiving training(AOR=4.4, CI 95% 1.7-11.8, p=0.003), and having good knowledge (AOR=3.32, CI 95% 1.7-11.8, p=0.01) were significantly associated with sufficient practices. Conclusion and recommendation: The current study revealed that more than half of the study participants have poor knowledge and insufficient practice in disaster preparedness. It’s advisable to hospitals have to have and distribute disaster guideline in emergency departments, and ongoing professional development training for nurses has to be given to improve the knowledge and practice of nurses working in the emergency department.
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    MAGNITUDE AND ASSOCIATED FACTORS OF EARLY MORTALITY AMONG DEATHS IN ADULT EMERGENCY DEPARTMENT, AT PUBLIC HOSPITALS, HAWASSA, SIDAMA, ETHIOPIA,2023.
    (Hawassa University, 2023-11) GELANE GELETO
    Background: early mortality defined as death with 72 hours of emergency department presentation. In low-income countries with limited resources, adult emergency department mortality remains high. The majority (59.8%) of those deaths occur within the first three days of admission to the emergency department in Ethiopia. Previously, only single-center studies at tertiary hospitals were conducted in Ethiopia. Objective: to assess the magnitude and associated factors of early mortality among deaths in adult emergency departments at selected public hospitals in Hawassa, Sidama, Ethiopia, from January 2021 to December 2022. Methods: An institutional-based cross-sectional study design was applied. A systematic random sampling technique was used to select 369 charts of patients who died in adult emergency departments of selected public hospitals in two years. The data was collected using a pre-tested data abstraction tool entered into the Kobo toolbox, then entered into EpiData version 4.6.0 and exported to SPSS version 27 for analysis. By using binary logistic regression Bivariate and multivariate analyses were run. Finally, statistical significance was declared at p-value <0.05, and an adjusted odds ratio with a 95% confidence interval was used to report the strength of the association Result: This study result shows that 50.2% of the participants were between the ages of 25-54 with mean average 40.6 ± 17.5 and 67.7% were male. 288 (78%) died within 72 hours. Lack of prehospital care [(AOR = 4.2; 95% CI: 2.23, 7.87), P = 0.007], road traffic accidents [(AOR = 4.1; 95% CI: 1.403, 12.076), P = 0.013], red triage categories [(AOR = 3.9; 95% CI: 1.6, 9.4), P = 0.003], had lack of investigation[(AOR = 3.4; 95% CI: 1.2, 9.4), comorbid illness [(AOR = 3.2; 95% CI: 1.558, 6.49), P = 0.001] and delayed initial intervention [(AOR = 2.338; 95% CI: 1.259, 4.339), P = 0.007] were significantly associated with early mortality. Conclusion: In this study, a greater early mortality rate was detected. Early morality was increased by a lack of prehospital treatment, road traffic accidents, a red warning score, a lack of investigation, comorbidity, and a delay in the first intervention.