RP-School of Nursing

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Browsing RP-School of Nursing by Author "Githemo, Grace"

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    Determinants of Abcde Bundle Implementation by Healthcare Providers at Coast General Teaching and Referral Hospital Critical Care Unit, Mombasa County Kenya
    (Kenyan Journal of Nursing and Midwifery, 2024) Kahindi, Thomas Mwalimu; Githemo, Grace; Mbuthia, Nickcy
    Background. The Awakening, Breathing, Choice of analgesic and sedation, Delirium management and prevention and early Exercise/mobility (ABCDE) is evidenced based protocol associated with improved outcome of the critically ill patients. Fully implementation of this protocol optimizes the outcome of the mechanically ventilated patients. Objective. The study explored the determinants of ABCDE bundle implementation by healthcare providers Coast general teaching and referral hospital critical care unit. Methods. The study used descriptive design to explore the determinants that influence the ABCDE bundle implementation. Data collection was done through structured questionnaires in form of Likert scale. Study participants were selected using census sampling method. A total of (N=60) participants were involved in the study. Data was analysed using statistical package of social sciences (SPSS) version 25. Results. A total of 60 questionnaires were collected from the participants. The results showed that female were the majority of the participants with 68.3% (n=41). Majority of the participants were between 30-39 age group with 38.3% (n=23). The results further revealed that nursing profession contributed the majority of the participants with 75% (n=45). The results also showed that most of the participants had diploma as their level of education with 65% (n=39). Furthermore, the results revealed that majority of the participants had experience of 1-2 years. Additionally, the results revealed that implementation of the bundle varied with 71.7% (n=43) implementing SAT, 66.7% (n=40) SBT, 63.3% (n=38) pain, 75% (n=45) sedation, 75% (n=45) delirium and 76% (n=46) early exercise/mobility. Bivariate analysis of healthcare providers’ factors showed that both knowledge and experience has relationship with ABCDE bundle implementation. Similarly bivariate analysis of the healthcare system factors revealed that workload, staffing, protocol availability and training are both significantly related to the implementation of the bundle. Multivariate analysis using logistic regression revealed that knowledge predicts bundle implementation with p=0.009, experience with p=0.049, workload with p=0.021, protocol with p=0.029, training with p=0.035 and staffing with p=0.007. Conclusion. ABCDE bundle implementation is influenced by both healthcare provider factors and healthcare system factors as revealed by this study.
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    Determinants of Quality of Hemodialysis Services in Selected County Dialysis Centers in Nyanza Region, Kenya
    (IJSMR, 2024-09) Nyabaro, Doreen; Githemo, Grace; Onsongo, Lister
    Background: Hemodialysis is a common management intervention in chronic kidney and End-Stage Renal Disease patients. Despite the increase in utilization of maintenance hemodialysis in low and medium-income countries, there needs to be more efforts to assess the quality of hemodialysis services. Objective: To evaluate the quality of hemodialysis services at selected county dialysis centres. Methodology: A cross-sectional descriptive study was used. Proportionate sampling was used with a sample size of 118 patients on hemodialysis. Chi squares test was used to determine the association between variables while binary logistic regression analysis was used to determine predictors of quality hemodialysis services. Results: Fifty-six percent of the participants perceived the quality of hemodialysis services as good. Gender, education level, co-morbidities, admission due to side effects, social support, waiting time, education before dialysis session, and satisfaction with care were associated with the quality of hemodialysis services. Moreover, being male (AOR =3.75, 95%CI: 1.11 – 12.64, p =0.033), having secondary level education (AOR =2.31, 95%CI: 1.41 – 4.97, p =0.046), having been admitted due to side effects since the beginning of hemodialysis sessions (AOR =0.22, 95%CI:0.15 – 0.86, p<0.001), having received social support from family and friends (AOR =11.49, 95%CI: 1.79 -73.95, p =0.010) and not waiting longer to be allocated a H.D. (AOR = 0.21, 95%CI: 0.05 – 0.93, p =0.041) as predictors of quality of hemodialysis services: Conclusion and recommendation: The quality of hemodialysis services in selected centres is slightly above average. Increased health education, training more staff on the needs of patients, and reviewing appointment period based on the number of machines available is essential to improve the quality of hemodialysis services.