Browsing by Author "Gachuiri, Grace"

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    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.
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    Utilization of Reflective Practice by Nurses Working in the Critical Care Units at a Level Six Hospital in Kenya
    (eviewed International Jour-nal of Medicine, Nursing & Public Health, 2024-07) Samoita, Lillian Nyanduko; Bett, Sarah; Meng’anyi, lucy Wankuru; Gachuiri, Grace
    This study aimed to investigate the Utilization of Reflective practice among nurses in the critical care units (CCUs) at Kenyatta National Hospital (KNH). The specific objectives of the study weredetermining the practice of reflection,the perception towards utilization of reflective practice,the relationshipbetween nurse characteristics, and facility associatedfactorsand utilization of reflective practice.Across sectional quantitative study was conducted with 154 sampled respondents. A structured self-administered questionnairewas used for data collection. Statistical Package for Social Sciences (SPSS) version 25.0 was utilized for data analysis, incorporating Logisticregression and Chi-square tests to evaluate relationships.Formal training in reflective practice was strongly associated with increased utilization, as those who received training had a utilization rate of (92.6%), while those without training had a utilization rate of (47%). Nurses who indicated that their nursing practice had been altered by engaging in reflection demonstrated a greater utilization rate (68.2%) in comparison to those who did not report any such modification. Majority (88.2%) of the respondents reported they did not have a designated space for reflective practice, (76.3%) lacked supportive institutional policies,(80.8%) missed opportunities for training, and (68.7%) experienced workload related obstacles.The study underscores the importance of promoting formal training in reflective practice, establishing supportiveinstitutionalpolicies, and providing dedicated spaces for reflection among CCN