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- ItemA Criterion - based audit of Postnatal services given to Mothers and newborns within 24 hours of birth in the general hospital in western Uganda(2023-09-12) AGWANG AGNESAbstract Background: Postnatal care is a key global intervention and a major safe motherhood initiative recommended for reducing maternal and neonatal mortality globally. Criterion-based audit helps measure the quality of postnatal care reliably and checks adherence to World Health Organization criteria and standards. This study assessed the quality of postnatal care services offered to mothers and their babies within 24 hours using a baseline Criterion-based audit at the general hospital. Methods: Mixed methods used on a facility Criterion-based audit with descriptive cross-sectional and explorative study design. Study population comprised of quarterly recorded and reviewed maternal postnatal files. A questionnaire and key informant interview guide were used. A systematic sampling technique was used for selecting files while key informants were selected purposively. Data was analyzed using SPSS version 20. Qualitative data was transcribed using related concepts to form themes and sub themes. Results: 248 files reviewed. Assessment of the mothers and their babies within one hour after birth almost met the WHO standards in all the parameters except after birth pains and incision site for cesarean mothers. Within 6 hours, assessments fell far below the WHO criteria and standards, including records of potentially life-threatening conditions and information shared upon discharge. No mental health information was shared upon discharge. Immediate care of the newborn almost met the WHO criteria and standards except for stimulation of the baby, use of ambu bag and mask, and use of resuscitation drugs. Six hours and subsequently the standards were not met (head circumference, temperature, bladder and bowel function, color of the eyes, cord checked and skin color), including records of potentially life-threatening conditions. Information on discharge was shared except delayed bath and continuity of prescribed treatment. Factors associated with quality of postnatal care included lack of guidelines, understaffing, inadequate sundries and equipment. Conclusion and recommendations: Assessment of the mothers and their babies after six hours of birth did not meet the WHO criteria and standards. Criterion-Based Audit of postnatal services in this study revealed that attention was given in improving the quality of postnatal care than it did before through, adopting WHO guidelines for postnatal care, improving the staffing levels and their general welfare. Criterion-based Audits can be used in other maternity departments like antenatal clinic and labour ward to assess quality of care.
- ItemEffect of an Orientation Activity on the Perception and Attitude on First Year Direct Bachelors Nursing Students towards the Nursing Profession, A Study Done in Four Universities in Central Uganda.(2023-09-15) NAKAWUNDE AISABackground and Objective: The roles that nurses play in health care are numerous but not well known to the public nor to the students who join nursing. The students instead join with various misperceptions of the profession and they have limited awareness of the different opportunities in nursing. Without any intervention to correct the misperceptions, the students’ attitude towards their chosen nursing course remains questionable and this can affect their performance in school and the quality of nurses they make after school. Orientation programs have been proven to clear misperceptions and promote a positive attitude towards nursing, but their effect has not been studied in Uganda. The purpose of this study was therefore, to determine how an orientation activity affects the perception and attitude of first year nursing students towards the Nursing profession. Method: It was a descriptive quantitative study with a pre-post interventional design (quasi experimental). It was carried out in four universities in central Uganda and 64 students participated. Pre-test data was collected, followed by a one-hour orientation presentation about nursing professionalism, roles and specialties among others in each institution. Then, Post- data was collected two weeks later using self-administered questionnaires. Data was analyzed using stata version 16, and descriptive statistics included: mean, standard deviation, and frequencies. The relationship between variables was examined using a paired T-test with a P value of < 0.05 to measure significance. Results: Students had favorable perceptions in some aspects before the presentation, for example like; the need of knowledge and skills to practice(M=2.1, SD=.9), professional autonomy(M=2.1, SD=.9), gender(M=2.1, SD=.9), nurses’ contribution to research(M=2.1, SD=.9), etc. However, their ideas about nursing were found to be limited and unfavorable in some other aspects before the presentation for example on: nurses pay (M=2.1, SD=.9), marriage (M=2.8, SD=.9), advanced roles (M=2.9, SD= .8), males make good nurses (M=3, SD=.9). Following the presentation, students became more aware of the roles and opportunities in nursing like professionalism, advanced roles, marriage and specialties. Therefore, the presentation had a significant effect on the students perception as shown by the paired T-test (Pr(|T| > |t|)= 0.033 & Pr(T > t)= 0.016 > 0.05) at 5% level. Although some aspects of attitude obtained favorable mean scores, students had an unfavorable score on their comfort in attending to the hygiene needs of others (M=2.7, SD: .9) and this was one of the lowest mean scores before and after the presentation. There was little but no change in their attitude except increment in their intention to remain in nursing following the presentation. Conclusion: These findings reveal that students have some favorable perception of nursing at the beginning of the course. However, their ideas are limited and unfavorable in some other aspects of nursing. Also, unfavorable attitude towards nursing was noted before and after the presentation in very important profession aspects. An orientation activity can improve students’ perceptions and attitude towards nursing, but more effort is needed to change the students’ attitude towards caring for the hygiene needs of others. Educators should pick interest in knowing the students’ perception at the beginning of their course and create intentional positive professional experiences to correct any misperception and influence students’ attitude towards nursing.
- ItemThe Effects of Integrating a Pain Assessment Scale on the Surgical Ward Nurse’s Knowledge, Attitude, and Practice regarding Post-Operative Pain Management in Mengo Hospital Kampala, Uganda.(2023-09-08) Nabiwande Betty MusisiAbstract Background Post operative pain remains one of the greatest concerns for patients following surgery. Pain is an unpleasant sensory and emotional experience accompanied by actual and potential tissue damage. Failure to promptly assess and manage pain may upshot into postoperative complications like hypertension, depression, lengthened hospital stays, and overall patients’ poor health outcomes. Objective The purpose of this study was to describe the effect of integrating the pain assessment scale on the nurse’s knowledge, attitude, and practice toward post-operative pain management in the surgical ward in Mengo hospital, Kampala. Methods At the surgical wards (obstetrics/gynecology & other general surgical procedures), nurses participated in a descriptive quantitative cross-sectional, quasi-experimental study. A total of 60 nurses participated in the study by applying the educational intervention of integrating the PAS into postoperative pain management using a 4-point Likert scale. The practice was observed using a checklist. Data were analyzed using SPSS version 20. A chi-square test was done, and significantly associated factors were acknowledged. Results In the pretest and posttest, the mean total knowledge scores about post-operative pain treatment were (M= 62.83, SD= 9.583), t = -59, P=0.01, respectively. The results raise concerns about the respondents' intolerable lack of understanding regarding how to manage patients' post-operative pain. Conclusion Nurses’ low level of knowledge, unacceptable attitude, and practice were acknowledged. Nursing curricula both at Under-Graduate and master’s should be undertaken to ensure relevant, appropriate information equips nurses to effectively manage pain.