Working environment of nurses in public referral hospitals of West Amhara, Ethiopia, 2021.

BACKGROUND: Healthy working environment for nurses is a foundation for promoting patients' and nurses' safety in hospitals. However, in Ethiopia, there is scarcity of data on this issue. Therefore, the objective of this study was to assess the working environment of nurses in Public Referral Hospitals in Public Referral Hospitals of West Amhara Regional State, Ethiopia, 2021. METHODS: An institution based cross-sectional study was conducted among 423 nurses from January to February 2021. Systematic random sampling was used to select nurses from each hospital. Structured, self-administered questionnaires were used to collect the data. EPI- DATA and SPSS were used for data entry and analysis respectively. Frequency, percentages, and means were calculated. Practice Environment Scale of the Nursing Work Index tool was used to measure the outcome variable. Binary and multivariable logistic regression analyses were computed to identify associated factors. Finally, texts, tables and graphs were used to report findings. RESULTS: The response rate for the study was 96.2%. Around 210 (51.6%) of the study participants were male. One hundred eighty eight (46.2%) nurses reported that their working environment was healthy, while 219 (53.8%,) reported it as not healthy. Nurses who were working in pediatrics wards (AOR = 0.13, 0.02, 0.1) and nurses who gave care for 7-12 patients per day (AOR = 0.21, 0.05, 0.98) were less likely to have a healthy working environment, respectively. Nurses who reported the Ministry of Health to give focus to the nursing profession were 73% more likely to have a healthy work environment (AOR = 0.27; 0.09, .82). CONCLUSION: and recommendations. More than half of nurses reported that their working environment was not healthy to appropriate practice. Hence, introducing systems to improve participation of nurses in hospital affairs and patient care is essential. It is also important to give attention to nurses who are working at pediatrics wards, and for nurses who give care more than the standards.

Incidence and Associated Factors of Failed First Peripheral Intravenous Catheters among Adult Patients at Medical Surgical Wards in Public Referral Hospitals of West Amhara, Ethiopia, 2021.

BACKGROUND: Complications of peripheral intravenous catheters cause problems in clinical practice and bring high costs in terms of morbidity and mortality of patients. Therefore, this study aimed to assess the incidence and associated factors of failed first peripheral intravenous catheters among adult patients in selected Public Referral Hospitals of West Amhara Regional State, Ethiopia, 2021. MATERIALS AND METHODS: An institution-based prospective observational study was conducted among 423 adult patients from January to February 2021. Patients were selected using systematic random sampling techniques. The data were collected using interviewer-based, structured questionnaires and observational checklists. EPI-DATA 3.1 and SPSS version-23 were used for data entry and analysis, respectively. Frequency, percentages, and means were calculated. The outcome variable was determined and graded based on phlebitis and infiltration scales. Binary and multivariable logistics regressions were computed. RESULTS: Four hundred and seventeen first peripheral cannula sites from 418 patients were followed for 2,565 peripheral catheter hours. A failed first peripheral intravenous catheter was observed in 124 (29.7%, CI: 25.6-34) adult patients. Patients who were female (AOR = 0.4, 95% CI: 0.22-0.74) had cannula duration of 49-72 hours (AOR = 0.31, 95% CI: 0.14-0.7) and 73-96 hours (AOR = 0.39, 95% CI: 0.17-0.9), and patients who had been given electrolytes (AOR = 0.31, 95% CI: 0.11-0.86) were more likely to have failed first peripheral intravenous cannula. CONCLUSIONS: Failed first peripheral intravenous cannula is much higher as compared to the acceptable rate of ≤5% by the Infusion Nurses Society. Hence, all patients with peripheral intravenous catheters are screened for catheter failure at least once a day. Providing appropriate nursing care and patient education is also required to reduce the risks.

Knowledge, Attitude, and Practice towards Labor Pain Management and Associated Factors among Skilled Birth Attendants Working at Hospitals Found in Central, West, and North Gondar Zones, Northwest Ethiopia, 2019: A Multicenter Cross-Sectional Study.

Introduction: Delivery of the infant into the arms of a conscious and pain-free mother is the most exciting and rewarding moment in maternal care services. Physical and mental care of women during delivery requires good knowledge and a positive insight to the needs and rights of the mothers. Little was known regarding skilled birth attendants' knowledge, attitude, and practice towards labor pain management in the study area. Hence, the current study aimed at assessing knowledge, attitude, and practice, and associated factors towards labor pain management among skilled birth attendants working at hospitals found in central, west, and north Gondar zones, northwest Ethiopia, 2019. Method: A multicenter institution-based cross-sectional study was conducted from June 1 to 30, 2019. A census sampling technique was used to include a total of 336 skill birth attendants. A pretested standardized self-administered questionnaire was used to collect the data. The data were then entered into Epi Info 7.1.2 and exported to SPSS version 25 for analysis. Multivariable logistic regression analyses were undertaken to identify factors associated with outcome variables. The level of significance of the study was declared based on adjusted odds ratio with 95% confidence interval at a p value of ≤0.05. Result: The proportion of skill birth attendants having good knowledge, a favorable attitude, and a good practice on labor pain relief methods was 47%, 41.96%, and 57.14%, respectively. Age of ≤30 years (AOR = 5.43; 95% CI: 1.25, 23.53), educational status of 2nd degree and above (AOR = 3.56; 95% CI: 1.32, 9.60), working at a private primary hospital (AOR: = 6.55; 95% CI: 2.15, 19.93), and working at a referral hospital (AOR = 2.24 : 95% CI: 1.01, 4.93) are factors significantly associated with good knowledge while having good knowledge on labor pain relief methods (AOR = 2.26; 95% CI: 1.42, 3.60) and working at private primary hospitals (AOR = 7.01; 95% CI: 1.92, 25.65) had statistically significant association with favorable attitude and good practice on labor pain relief methods, respectively. Conclusion and Recommendations. Poor knowledge, unfavorable attitude, and poor practice towards labor pain management were found in this study. Strengthening the capacity of public health facilities and providing continuous professional development (CPD) training for the skilled birth attendants would be helpful in improving knowledge, attitude, and practice towards labor pain management.

The Effects of Fear and Knowledge of COVID-19 on Preventive Practice Among Pregnant Women Who Attend Antenatal Care in Northwest Ethiopia, 2020: Institution-Based Cross-Sectional Study.

BACKGROUND: The novel coronavirus disease 2019 (COVID-19) pandemic has infected over one million individuals with almost 50,000 deaths worldwide. COVID-19 is currently a global health threat and a public health emergency. Therefore, accurate and up-to-date information regarding prevention and control methods is essential. OBJECTIVE: The aim of the study was to assess the effects of fear and knowledge of COVID-19 on preventive practices among pregnant women who attend antenatal care in northwest Ethiopia, 2020. METHODS: An institution-based cross-sectional study was conducted between July and August 2020. The systematic random sampling technique was used to select 422 participants. Data collected by a face to face interview on pretested and structured questions were entered using Epi-Info version 7 and it was analyzed using SPSS version 22 software. The bivariate and multivariable logistic regression model was used to assess factors associated with COVID-19 preventive practices. Adjusted odds ratio (OR) with a 95% confidence interval (CI) was used to determine the association between covariates and the outcome variable. The p-value less than 0.05 was considered statically significant. RESULTS: According to this study, good preventive practice of COVID-19 among pregnant women was found to be (47.4%). Fear of COVID-19 was (50.9%). The majority (55.0%) of the respondents had good knowledge. Fear [AOR: 2.485, 95% CI: (1.664-3.711)] and having good knowledge [AOR: 2.308, 95% CI: (1.541-3.457)] were significantly associated with good prevention practices among the women. CONCLUSION AND RECOMMENDATION: Only half of the pregnant women had good preventive practice. The findings suggest that healthcare bodies should consider these findings to develop strategies for preventive practice against COVID-19.

Repeat induced abortion and associated factors among women seeking abortion care services at Debre Markos town health institutions, Amhara regional state, Ethiopia, 2017.

OBJECTIVE: The aim of this study was to assess the proportion and determinants of repeat induced abortion among women seeking abortion care services at Debre Markos town health institutions, Amhara regional state, Ethiopia, 2017. RESULT: From the total 567-sample size, 547 women were participated in the study making a response rate of 96.5%. In this study 191 women reported that they had at least one previous abortion, making the proportion of repeat induced abortion 34.9%. In multivariable logistic regression analysis; illiteracy (AOR = 8.45, 95% CI 1.85, 36.49), living in an urban area (AOR = 5.14, 95% CI 2.29, 11.53), having multiple sexual partner (AOR = 6.16, 95% CI 3.25, 11.68), consuming alcohol (AOR = 2.77, 95% CI 1.52, 5.05) and having a history of physical violence by a male partner (AOR = 2.68, 95% CI 1.45, 4.94) were significantly associated with repeat induced abortion at p value less than 0.05.

House-hold contact tuberculosis screening adherence and associated factors among tuberculosis patients attending at health facilities in Gondar town, northwest, Ethiopia.

BACKGROUND: Contacting patients with tuberculosis have a substantial risk of developing the disease. Household contact screening has recently been recommended as a strategy to enhance case detection in high-burden countries. But there is no enough information in Gondar town regarding household contact screening practice among TB patients. METHODS: An institution-based cross-sectional study was conducted from March 1 to 30, 2019 on 404 tuberculosis patients attending at health facilities in Gondar Town. Epi-Info version 7 for data entry and SPSS version 20 for data analysis were used. Descriptive statistics were carried out to illustrate the means, standard deviations, and frequencies. Bivariable and multivariable logistic regression analyses were used to identify significantly associated variables with the dependent variable. RESULTS: From 412 study populations, 404 were completed the study with 98.06% response rate. The overall household contact TB screening adherence was 47.5% (95% CI: 43.1, 52.5). In the multivariable analysis, having certificate and above educational level (AOR = 2.83, 95% CI:1.40,5.67), having sufficient knowledge about TB (AOR = 8.26, 95% CI:4.34,15.71), being satisfied with health care service (AOR = 3.26, 95% CI:1.58,6.76), health education given by health care workers (AOR = 2.60, 95% CI:1.54,4.40),and having HIV/AIDS co-infection (AOR = 3.54, 95% CI:1.70,7.39), were factors associated with household contact TB screening adherence. CONCLUSION: Compared to other previous studies, the current finding was high but it was low as compared with WHO and Ethiopian Ministry of Health recommendations (all persons having TB contact should be screened). Educational status, knowledge on TB, satisfaction with delivered health care service, health education given by HCWs about TB and HIV/AIDS co-infection were factors associated with household contact TB screening practice. Thus, strengthening household TB contact screening and educational programs regarding the risk of getting TB infection from household contacts is crucial.

Surgical Management Outcome of Intestinal Obstruction and Its Associated Factors at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2018.

BACKGROUND: Intestinal obstruction (IO) is one of the most common acute abdominal disorders that often requires emergency surgical management in the hospital setting. However, the surgical management sometimes ends with unfavorable outcomes characterized by fatal and nonfatal postoperative complications. AIM: The aim of this study was to analyze the surgical management outcome of IO and its associated factors among surgically treated patients for intestinal obstruction at the University of Gondar Comprehensive Specialized Hospital (UGCSH), Ethiopia, 2018. METHODS: An institution-based cross-sectional study was conducted among patients who were surgically treated for IO during the last 3 years at the UGCSH. The patient participants were selected using a systematic random sampling technique. A structured research tool was used to collect all the necessary data from the patients' medical records. The data were analyzed by using SPSS version 21. Frequencies with percentages were used to describe the surgical management outcome of IO. The binary logistic regression model was used to explore the determinant factors associated with the surgical management outcome of IO. Factors at P < 0.05 were declared statically significant. RESULTS: 227 patient participants were included and finally analyzed in this study. From these, 83.3% patients have favorable surgical management outcomes of IO, whereas the rest 16.7% patients have unfavorable outcomes. Of 38 patients with unfavorable outcome, the most common postoperative complication occurred was surgical site infection (36.8%), followed by pneumonia (23.6%) and septic shock (21.0%) among other complications. A total of 10 postoperative deaths were also documented as unfavorable surgical management outcomes of IO. Of the determinant factors analyzed in this study, only three factors, duration of illness before surgery, length of hospital stay after surgery, and comorbidity, were independently significantly associated with the surgical management outcome of IO. CONCLUSIONS: In this study, the majority of patients had favorable surgical management outcomes of IO, and the proportion of patients with unfavorable outcomes was however considerable. Thus, designing a strategy addressing the significantly associated determining factors could be helpful to further increase the likelihood of favorable surgical management outcomes of IO.

Knowledge, attitude and associated factors towards end of life care among nurses' working in Amhara Referral Hospitals, Northwest Ethiopia: a cross-sectional study.

OBJECTIVE: The aim of this study was to assess nurses' Knowledge, Attitude and Associated Factors towards end of life care in Amhara Referral Hospitals, Northwest Ethiopia, 2017. RESULTS: A total of 331 participants were included with a response rate of 93.2%. From these, 129 (39.0%) of them had good knowledge and 234 (70.7%) had favorable attitude towards end of life care. Being Bachelor of Science holder and above in nursing (AOR = 4.261, 95% CI 1.524-11.912), working in Emergency department (AOR = 4.911, 95% CI 1.796-13.426), having daily experience of caring for chronically ill patients (AOR = 2.764, 95% CI 1.366-5.591) and taking training on end of life care (AOR = 10.269, 95% CI 4.730-22.296) were significantly associated with good knowledge of nurses towards end of life care. On the other hand, having 6-10 years of working experience in nursing (AOR = 2.199, 95% CI 1.147-4.215), being trained in end of life care (AOR = 3.027, 95% CI 1.285-7.13), Bachelor of Science holder and above in nursing (AOR = 4.414, 95% CI 2.230-8.738) were found to be statistically significant with more positive attitude of nurses towards end of life care.

Hypertensive Patients' Knowledge of Risk Factors and Warning Signs of Stroke at Felege Hiwot Referral Hospital, Northwest Ethiopia: A Cross-Sectional Study.

BACKGROUND: Stroke is a neurological condition which is a major cause of death and disability in many low- and middle-income countries. However, several modifiable risk factors are becoming significant. Hypertension is the most common stroke risk factor globally as well as in our country, Ethiopia. OBJECTIVE: The aim of this study was to assess hypertensive patients' knowledge of risk factors and warning signs of stroke at Felege Hiwot Referral Hospital, Northwest Ethiopia, 2018. METHOD: An institutional based cross-sectional study design was conducted in May 01-30/2018. A total of 278 hypertensive patients were enrolled and systemic random sampling technique was employed to select the study participants. Data was collected through an interviewer-administered questionnaire. The collected data was entered into Epi info 7 and exported to SPSS version 22 for analysis. Binary and multivariable logistic regressions were used and P value ≤ 0.05 was considered as statistically significant. RESULT: Out of the total 284 selected hypertensive patients, 278 of them responded completely with a response rate of 97.9 %. Of these, more than three fourths, 214 (77%) and 201 (72.3%), of them did not identify any risk factors and warning signs of stroke, respectively, with an overall proportion of only 18.3% of them having good knowledge towards stroke. Risk factor of stroke most commonly known to the respondents was physical inactivity (21.58%), whereas hypertension was the least described risk factor (3.6%). Regarding stroke warning signs, sudden weakness on one side of the body (35.97%) was the most commonly known warning sign of stroke to the respondents. Being able to read and write, being young, urban residence, and having sufficient monthly income were significantly associated with the overall knowledge of hypertensive patients towards stroke. These findings suggest the need for emphasizing on stroke education regarding its risk factors and warning signs through public or social media and health education targeting to low-income high risk subjects.

Reproductive health services utilization and its associated factors among secondary school youths in Woreta town, South Gondar, North West Ethiopia: a cross sectional study.

OBJECTIVE: The aim of this study was to assess reproductive health service utilization and its associated factors among secondary school students in Woreta town, South Gondar, North east Ethiopia 2018. RESULT: Out of the total 376 selected students, 345 were participated in the study with a response rate of 94%. Of these respondents, 85 (24.6%) of them utilized at least one reproductive health services in the past 1 year. Voluntary testing and counseling for HIV/AIDS and Family planning services were utilized by 47 (55.3%) and 43 (50.6%) of youths respectively. Being grade 11-12 (AOR = 5.299, 95% CI 2.019, 13.912, P = 0.001) and closeness of the service facility to their home (AOR = 2.76, 95% CI 1.168, 6.525, P = 0.021) were significantly associated with students' reproductive health service utilization. This low service utilization might make students prone for different reproductive health risks; which in turn can increase school dropout rate, and has impact on individual's future life as well as the country's youth health policy from meeting its goal. Therefore, it needs a great effort and attention of all the concerned bodies including parents, school staffs, and health professionals to improve the service utilization in schools.

Self-care practice and associated factors among Diabetes Mellitus patients on follow up in Benishangul Gumuz Regional State Public Hospitals, Western Ethiopia: a cross-sectional study.

OBJECTIVE: The aim of this study was to assess the self-care practice among patients with diabetes and their associated factors in Benishangul Gumuz Public Hospitals, Western Ethiopia, 2018. RESULT: Out of the total 399 selected patients, 383 were participated in the study with a response rate of 96%. From 383 respondents, 45.7% had poor diabetes self-care practice. Unable to read and write (AOR = 3.63, 95% CI 1.33-9.89, p = 0.011), never had a diabetic health education (AOR = 4.09, 95% CI 1.89, 8.84, p = 0.000), not having glucometer (AOR = 2.66, 95% CI 1.30, 5.46 p = 0.007), poor diabetic knowledge (AOR = 5.01, 95% CI 2.44, 10.28, p = 0.000), poor self-efficacy (AOR = 3.00, 95% CI 1.76, 5.11, p = 0.000) and not having social support (AOR = 1.84, 95% CI 1.08, 3.13, p = 0.023) were significantly associated with poor self-care practice of diabetes patients. These findings request for the need of integrated interventional management approach, which will improve the health and quality of life of the diabetes patients.