RP-School of Nursing

Permanent URI for this community

https://repository.ku.ac.ke/handle/123456789/18476

Browse

Browsing RP-School of Nursing by Author "Mbuthia, Nickcy"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    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.
  • Thumbnail Image
    Item
    Integration of Critical Care Nurses in Antimicrobial Stewardship; Opportunities and Barriers at a County Referral Hospital in Kenya
    (IAJHMN, 2024-08) Chege, Joseph Waithanji; Mbuthia, Nickcy; Gachuiri, Grace
    Antimicrobial stewardship optimizes appropriate use of antimicrobials through agent selection, route, dosing, and duration of therapy. It serves to optimize clinical outcomes of patients and limit adverse reactions of antimicrobials. Nurses are frontline implementers of antimicrobial stewardship. However, they face issues on inter-professional jurisdiction, hierarchical power relations within hospitals and limited training on antimicrobial stewardship. The main objective of this study is to explore the integration of nurses into antimicrobial stewardship activities in the critical care unit at Thika Level 5 Hospital, Kenya. The study used exploratory descriptive qualitative research design. Data collection was done through semi-structured interviews and NVIVO 14 software was used for thematic analysis of data. A total of 11 nurses working in the intensive care unit were interviewed. Patient advocacy, communication and collaboration, monitoring and documenting, and patient education and empowerment emerged as important roles that nurses play in antimicrobial stewardship. Participants highlighted continuous medical education, inclusion of antimicrobial stewardship in formal nursing education, team work and organization support as major facilitators of nurses’ roles in antimicrobial stewardship. The study findings revealed that stringent regulatory requirements, heavy workload, poorly regulated systems and limited knowledge on antimicrobial stewardship as the major barriers that limit nurses’ role in antimicrobial stewardship. Nurses’ inputs in decision making process on treatment plans and antimicrobial use is invaluable in promoting judicious use of antimicrobials. Future research should focus on redefining the nature, scope and influence of perceived nurses’ role in antimicrobial stewardship.