Patient safety incident reporting behavior and its associated factors among healthcare professionals in Hadiya zone, Ethiopia: A facility based cross-sectional study.

Background: Incidents affecting patient safety can cause unnecessary injury to a patient. It is generally accepted that incident reporting can improve patient safety. In Ethiopian public hospitals, especially in the Hadiya zone, patient safety-related incidents are commonly witnessed, but there is no evidence of reporting behavior among healthcare professionals. Purpose: This study aimed to assess patient safety incident reporting behavior and its associated factors among healthcare professionals working in public hospitals in the Hadiya zone, South Nation's, Nationalities, and Peoples' Region, Ethiopia, in 2021. Method: A cross-sectional study design was employed, among 345 healthcare professionals working in public hospitals in the Hadiya zone from August 1-30, 2021. A simple random sampling technique was used to select study participants, and a structured self-administered questionnaire which is adapted from a Hospital survey on patient safety survey and literature was used to collect the data. The data were entered into a data attraction template prepared using the Epi data software and then exported to the SPSS version 25 software for analysis. Descriptive analyses were conducted to determine the general characteristics and distributions of the data collected. An inferential statistical analysis was conducted using the logistic regression model to identify associations between outcome and predictor variables. The odds ratio with the 95 % confidence interval was used to test the associations between the outcome variable and predictor variables. Finally, statistical significance was set at p-value < 0.05. Results: From the total of 354 healthcare professionals expected, 334 participants, which gave a response rate of 94.4 %, had completed and returned the questionnaire. The result shows that overall patient safety incident reporting behavior among healthcare professionals was 28.7 % (95 % Confidence Interval (CI): (24.6, 33.2). Being a nurse professional [Adjusted Odd Ratio (AOR): 5.48, 95 % CI: (1.67, 17.80)], having job training [AOR: 2.87, 95 % CI: (1.46, 6.28)], having a team within the units [AOR=2.79, 95 %CI: (1.23, 6.28)], communication openness [AOR=2.78, 95 %CI: (1.44, 5.37)], and management support [AOR=2.8, 95 %CI; (1.40, 5.60)] were found to factor significantly associated with patient safety incident reporting behaviour. Conclusion: This study revealed that the incident-reporting behavior among healthcare professionals was low compared to previous studies. Being a nurse professional, having an on -job training, having a team within the unit, communication openness, perception of the time reporting takes, fear of administration sanction and management support were factors associated with their patient safety incident reporting behavior. Managers should focus on patient safety incidents, prepare continuous training programs, and provide open communication to improve patient safety incident reporting.

Intention to Leave Nursing Profession and Its Associated Factors Among Nurses: A Facility Based Cross-Sectional Study.

Nurses' intention of leaving their profession is the main challenge for healthcare and hospital administrators in many countries. It has significant impact on the performance, stability and productivity of health facilities. However, there is limited evidence on the nurses' intention to leave their profession and associated factors among nurses in developing countries including Ethiopia. This study was aimed to assess intention to leave nursing profession and its associated factors among nurses working in West Shoa Zone public Hospitals, Oromia region, Central Ethiopia, 2020. Institution based cross-sectional study was conducted among 393 nurses working in West Shoa zone public hospitals, Ethiopia from May 1 to 30, 2020. Simple random sampling technique was used to select the study participants. Structured self- administered questionnaire was used to collect data. Data were cleaned and entered into Epi-data version 3.1 then exported to SPSS version 25 for analysis. Descriptive statistics such as frequency mean and standard deviation was computed to describe variables of the study. All covariates that were significant at P value <0.25 in bivariate logistic regression analysis were considered for further multivariable logistic regression analysis. Backward stepwise logistic regression model was fitted, crude ratio and odds ratio were calculated for factors at 95% confidence interval (CI). Level of statistical significance was declared at P value <0.05. In this study, the overall nurses' intention to leave nursing profession was 61.3% [95% CI (56.5%, 66.2%)]. Nurses' educational status, age, working experience, working position, professional commitment, job stress, job satisfaction and organizational factor were significantly associated with nurses' intention to leave their profession. The overall nurses' intention to leave their profession was high. Reducing this level of leaving intention needs collaborative intervention related to factors like safety of working environment, job related stress, job satisfaction, professional commitment and education opportunities which are a big homework for managers on health sectors of West Shoa zone public Hospitals and higher level health sector managers.

Incidence and predictors of postoperative severe acute pain within 24 hours after cesarean section performed under spinal anesthesia at public hospitals in West Shoa, Ethiopia, 2022 prospective cohort study.

Background: Acute postoperative pain is common after a caesarean section; the mother suffers severe pain in the first 24 h after the caesarean section compared to spontaneous birth. Failure to discover predictors of pain leads to maternal dissatisfaction, increased expenses, and restricted movement; it increases the risk of deep vein thrombosis, lengthens hospital stays, and decreases social intimacy. Methods and materials: An institution-based prospective cohort study was conducted among 422 women who went to undergo caesarean sections under spinal anaesthesia at public hospitals in West Shoa from 30 July to 30 October. Participants were selected by systematic random sampling. Data were collected by a structured questionnaire, and the collected data were entered into SPSS version 20 and exported into STATA 64 for analysis. The results were presented in tables and figures. Risk factors were assessed by Poisson regression with a robust standard error. Results: The overall incidence of severe postoperative pain after a caesarean section performed under spinal anaesthesia within 24 h of follow-up was 50.4% [95% confidence interval (CI): 40.7, 60.1]. Preoperative anxiety risk ratio 1.7 (95% CI: 1.4-2.0), preoperative pain risk ratio 1.3 (95% CI: 1.0-1.48), type of incision risk ratio 11.3 (95% CI: 1.1-1.6), spinal anaesthesia without adjuvants risk ratio 4.1 (95% CI: 1.5-10.9), and duration of surgery risk ratio 1.5 (95% CI: 1.3-1.8) were found to be predictors for postoperative severe acute pain after caesarean section performed under spinal anaesthesia. Conclusion: In this study, the overall incidence of severe acute pain after a caesarean section under spinal anaesthesia was high. Preoperative fear, duration of the operation, preparatory pain, spinal anaesthesia without the use of adjuvants, and the type of incision were risk factors for severe acute postoperative pain after a caesarean section under spinal anaesthesia.

Predictors of recovery rate among undernourished HIV-positive adults treated with ready-to-use therapeutic food at Debre Markos Comprehensive Specialized Hospital: A retrospective cohort study.

BACKGROUND: Nutritional support is becoming more widely acknowledged as a crucial component of the key package of care for HIV/AIDS patients. This nutritional support is exceptionally important for patients in sub-Saharan Africa, including Ethiopia, where HIV/AIDS is very prevalent. However, there is a lack of evidence on the recovery rate and predictors at the study site and at large in Ethiopia. Therefore, this study will give some insight into the recovery rate and its predictors among under-nourished HIV-positive adults treated with Ready to Use Therapeutic Food (RUTF) attending at Debre Markos referral hospital. Moreover, the findings of this study will be used by both governmental and non-governmental organizations to allocate more resources to mitigate the nutritional problems for people living with HIV. METHODS: An institution-based retrospective cohort study was conducted among 453 under-nourished HIV positive adults treated with RUTF at Debre Markos referral Hospital from the 1st of July, 2015 to the 31st of December, 2017. The study participants were selected using a simple random sampling technique. Data were extracted from patient charts using a standardized data extraction checklist. Data were entered into Epi-Data Version 4.2 and analyzed using Stata Version 14. The Kaplan-Meier survival curve was used to estimate the time to recovery. Log-rank test was used to compare the recovery time between different baseline categorical variables. The bivariable and multivariable Cox-proportional hazard regression models were fitted for potential predictors of recovery time. Adjusted hazard Ratios (AHRs) with 95% CIs were used to measure the strength of association and test statistical significance. RESULTS: A total of 453 undernourished HIV-positive adults were included in the final analysis. About 201, 44.4% (95%CI: 38.9, 49.0%) patients participating in the RUTF program were recovered based on predetermined exit criteria with incidence of 10.65 (95% CI: 9.28, 12.23) per 100 person-month observations. Being moderately undernourished (AHR: 11.0, 95% CI: 5.3, 23.1), WHO clinical stage (I or II) (AHR:1.8, 95% CI: 1.2, 2.6), and working functional status at baseline (AHR = 2.34, 95%CI: 1.01,5.45) were predictors of recovery time. CONCLUSION: This study concluded that the overall nutritional recovery rate was below the acceptable minimum requirement which at least 75% of patients should recovered. Mild to moderate undernutrition at baseline, WHO clinical stage I or II at enrolment, and working functional status were found to be predictors of recovery time in HIV/AIDS patients treated with the RUTF. As a result, special attention should be paid to severely malnourished patients, WHO clinical stages III or higher, and patients who are bedridden or ambulatory during treatment.

Incidence and Predictors of Tuberculosis among Adult Diabetic Patients, Debre Markos Referral Hospital, Northwest Ethiopia, 2018: A Retrospective Cohort Study.

BACKGROUND: Tuberculosis remains a serious global public health problem. It mainly affects the lungs, and occurs in every part of the world. The link between tuberculosis and diabetes mellitus is essential to inform programs and policies, yet there is a scarcity of information in our study area. Therefore, this study aimed to investigate the incidence and predictors of tuberculosis among diabetic patients at Debre Markos Referral Hospital, northwest Ethiopia. METHODS: This institutionally based retrospective cohort study was undertaken among 433 diabetic patients of Debre Markos Referral Hospital between January 2013 and December 2017. All eligible diabetic patients who met the inclusion criteria were included in the study. Data were entered using EpiData version 3.1 and analyzed using Stata version 14. The survival time of diabetic patients was estimated using Kaplan-Meier survival curves, and survival time among different categorical variables compared using the log-rank test. Both bivariate and multivariate Coxproportional-hazard regression models were fitted to identify independent predictors of tuberculosis among diabetic patients. RESULTS: Among the cohort of 43326 (6%) developed tuberculosis during follow-up. The overall tuberculosis-incidence rate was 2.4 per 100 with 95% CI. The total time allotted to follow up the study participants was 1,101.5 person-years. Using multivariate Cox regression analysis, history of alcohol consumption (adjusted incidence ratio 4, 95% CI 1.2-13; P=0.02) and history of tuberculosis (12, 95% CI 3-39; P=0.01) significantly increased the risk of tuberculosis, but normal body-mass index and above (≥18.5 kg/m2) was associated with a rate reduction (0.34, 95% CI 0.14; P=0.80; 0.03) forincidence of tuberculosis. CONCLUSION: In this study, we found a high rate of tuberculosis among diabetic patients. Factors significantly linked with increased risk of tuberculosis included history of alcohol consumption, history of tuberculosis, and low body-mass index. Early screening and treatment for tuberculosis is highly recommended at diabetes mellitus follow-up for patients with these risk factors.

Determinants of neonatal sepsis among neonates in the northwest part of Ethiopia: case-control study.

BACKGROUND: Neonatal sepsis is one of the leading causes of neonatal morbidity and mortality. Despite implementing of different preventive interventions, the burden of neonatal sepsis is reporting in different areas of Ethiopia. For further interventions, identifying its determinants is found to be crucial. OBJECTIVE: This study aimed to identify determinants of neonatal sepsis in the Northwest part of Ethiopia. METHODS: Unmatched case-control study was conducted among 246 neonates admitted in neonatal intensive care unit, Northwest Ethiopia. Study participants were selected from February 1st to March 30th 2018. Data was collected through face to face interview and review of neonates' medical records using pretested structured questionnaire. Data was entered into Epi Data version 4.2.0.0 and further transferred to SPSS statistical software version 25 for analysis. All independent variables with p-value < 0.25 in Bivariable analysis were entered into multivariable logistic regression analysis. Finally, variables with p-value < 0.05 were considered as determinants of neonatal sepsis. RESULTS: A total of 82 cases and 164 controls were included in this study. Neonates with gestational age < 37 weeks [AOR = 6.90; 95% CI (2.76, 17.28)], premature rupture of membrane [AOR = 2.81; 95% CI (1.01, 7.79)], not crying immediately at birth and have received resuscitation at birth [AOR = 2.85; 95% CI (1.09, 7.47)] were found to be predictors of neonatal sepsis. CONCLUSIONS AND RECOMMENDATIONS: Premature rupture of membrane was found to be obstetric-related determinant of neonatal sepsis. Gestational age < 37 weeks, not crying immediately at birth, and have received resuscitation at birth were found to be neonatal-related risk factors of neonatal sepsis. Infection prevention strategies need to be strengthening and/or implementing by providing especial attention for the specified determinants.

Utilization of institutional delivery and associated factors among mothers in rural community of Pawe Woreda northwest Ethiopia, 2018.

OBJECTIVE: In most of sub-Saharan African countries the significance of delivering in health institution and threats of death is still little known. This study is to assess utilization of institutional delivery and associated factors among mothers who gave birth in the last 12 months prior to the study in rural community of Pawe Woreda, Benishangul-Gumuz, northwest Ethiopia, 2018. A community-based cross-sectional study was conducted on 623 mothers. RESULTS: Overall deliveries 60.5% were assisted at health facilities. Multivariable logistic regression showed that Mothers educational status, Antenatal Care visit during their recent pregnancy, delivery plan of recent pregnancy, maternal knowledge on benefit of institutional, decision power about place of delivery and distance to reach the nearby facility on were significantly associated with utilization of institutional delivery. The utilization of institutional delivery services among rural women in Pawe Woreda had improvements but still low. Intensifying women education, up taking Antenatal Care potential services, address health education for mothers about benefit of institutional birth and counseling danger sign of labor and delivery, involving couples decision power of facility birth and expanding health facilities in the community are recommended interventions.

Preoperative anxiety and associated factors among adult surgical patients in Debre Markos and Felege Hiwot referral hospitals, Northwest Ethiopia.

BACKGROUND: Anxiety during the preoperative period is the most common problem with a number of postoperative complications such as an increase in postoperative pain, delay of healing and prolong the hospital stay. Further, patients with a high level of preoperative anxiety require higher doses of anesthetic agents and recover poorly. Despite its serious health complications, its magnitude and associated factors have been poorly explored in Ethiopia particularly in the selected study areas. OBJECTIVE: To assess preoperative anxiety and associated factors among adult surgical patients in Debre Markos and Felege Hiwot Referral Hospitals, Northwest Ethiopia. METHOD: An institution based cross-sectional study was conducted on 353 patients scheduled for surgery using a systematic random sampling technique. The data were collected using the state version of the state-trait anxiety inventory scale. All collected data were entered into Epi-Data version 3.1 and analysis was done by using SPSS version 20 software. Binary logistic regression was performed to assess the effect of independent variables on the dependent variable. A p-value < 0.05 was considered as statistically significant. RESULTS: Overall, 61% (95%CI (55.5-65.7)) patients had significant high level of preoperative anxiety. The most common reported factor responsible for preoperative anxiety was fear of complications 187(52.4%). There was a statistically significant high level of pre-operative anxiety among female patients [AOR 2.19 (95%CI (1.29-3.71))] and patients who lack preoperative information [AOR 2.03(95%CI (1.22-3.39))]. CONCLUSION: The prevalence of preoperative anxiety was high. The level of preoperative anxiety significantly associated with sex, preoperative information provision, and previous surgical experience. Preoperative psychosocial assessment should be incorporated into a routine nursing practice and every patient should be provided with preoperative information before surgery.

Dietary diversity and associated factors among children of Orthodox Christian mothers/caregivers during the fasting season in Dejen District, North West Ethiopia.

BACKGROUND: Proper feeding practices during early childhood is fundamental for optimal child growth and development. However, scientific evidences on the determinants of dietary diversity are scanty. Particularly, the impact of fasting on children`s dietary diversity is not explored in Ethiopia. The aim of this study was to assess dietary diversity and associated factors among children aged 6-23 months, whose mothers/care-givers were Orthodox Christians during the fasting season (Lent), in Dejen District, North West Ethiopia, 2016. METHODS: A community based cross-sectional study was conducted during the fasting season from March to April, 2016. The study sample were children aged 6-23 months, whose mothers/care-givers were Orthodox Christians. A systematic random sampling technique was used to select a sample of 967 children proportionally from all selected kebeles. Data was entered using Epi data and statistical analysis were done using logistic regression. P-value < 0.05 at 95% confidence interval was taken as statistically significant. RESULTS: Only 13.6% of children surveyed met the minimum requirement for dietary diversity. Unsatisfactory exposure to media [AOR = 5.22] and low household monthly income [AOR = 2.20] were negatively associated with dietary diversity. As compared to economic related reasons, mothers/caregivers who do not feed diet of animal origin to their children due to fear of utensil contamination for family food preparation were 1.5 times [AOR=1.5; 95% CI (1.05 - 2.53)] less likely to feed the recommended dietary diversity. CONCLUSIONS: The findings of this study revealed that the diet of children in the study area lacked diversity. Promoting mass media and socioeconomic empowerment of women have positive contribution to optimal child feeding practice. Sustained nutrition education to mothers regarding proper infant and young child feeding practice in collaboration with the respective religious leaders is highly recommended.

Determinants of severe acute malnutrition among under five children in rural Enebsie Sarmidr District, East Gojjam Zone, North West Ethiopia, 2016.

BACKGROUND: Severe acute malnutrition is one of the major public health problems in developing countries having a devastating effect on the lives of many children under 5 years of age. In Ethiopia, there has been isolated studies conducted on malnutrition with no study attempting to identify the determinants of severe acute malnutrition in the rural district of Enebsie Sarmidr.This study intends to identify the determinants of severe acute malnutrition in rural district located in North West Ethiopia. METHODS: A Community based un matched case -control study was carried on 311 (64 cases and 247 controls) children aged between birth-59 months with their respective mothers or care takers from March 1-30/ 2016. Odds Ratio along with 95% confidence interval was estimated to identify determinants of severe acute malnutrition using the multivariable logistic regression. RESULTS: The response rate was 97.8%. Severe acute malnutrition was significantly associated with age groups birth-24 months (AOR = 2.64, 95% CI 1.17-5.95), late initiation of breast feeding greater than an hour after birth (AOR = 4.26, 95% CI 1.74-10.42), nonexclusive breast feeding (AOR =5.81, 95% CI 1.80-18.79), diarrheal disease in the preceding 2 weeks before SAM (AOR = 7.98, 95% CI 2.57-24.74), febrile illnesses preceding 2 weeks before SAM (AOR = 2.87 95% CI 1.13-7.63), decreased or maintained mealing of the mother compared to the regular during pregnancy or lactation (AOR = 8.15, 95% CI 3.70-17.98) and birth interval less than 2 years (AOR = 3.34, 95% CI 1.55-7.20) after controlling other variables effect. CONCLUSION: A child's age, late initiation of breast feeding, nonexclusive breast feeding, diarrheal diseases and febrile illnesses preceding 2 weeks before SAM, decreased or maintained mealing compared to the regular during pregnancy and lactating of the mother and narrow birth interval were identified as determinants of SAM. Therefore, collaborative efforts are needed to improve promotion of better child caring practices specifically, child and maternal feeding practices and prevention and treatment of acute illnesses.

Knowledge of direct obstetric causes of maternal mortality and associated factors among reproductive age women in Aneded woreda, Northwest Ethiopia; a cross-sectional study.

INTRODUCTION: in Ethiopia, 20,000 women die each year from complications related to pregnancy and childbirth with much more maternal morbidity occurring for each maternal death. Good knowledge of women related with direct causes of maternal mortality is important in reducing maternal morbidity and mortality. Therefore, the aim of this study was to assess knowledge of direct obstetric causes of maternal mortality and associated factors among reproductive age of women in Aneded woreda, Northwest Ethiopia. METHODS: A community-based cross-sectional study was conducted using multi-stage sampling followed by simple random sampling technique. The study was conducted in Aneded woreda, Northwest Ethiopia. A total of 844 reproductive age women were included in the study. Pre-tested semi-structured questionnaire was used to collect the data. Data was collected through face-to-face interviews by 12 data collectors. Data was cleaned, coded and entered into Epi-data, then exported and analyzed using SPSS software. Bivariate and multivariable logistic regression analysis were computed to identify factors related to knowledge of obstetric causes of maternal mortality. The crude and adjusted odds ratios together with their corresponding 95% confidence intervals (CI) were computed. A P-value less than 0.05 was used to declare statistical significance. RESULTS: This study found that almost half (49.6%) of respondents have good knowledge level towards obstetric causes of maternal mortality. Significant variables associated with knowledge towards obstetric causes of maternal mortality were; being government employee (AOR=3.6, 95% CI=1.4-8.9), respondents who had additional monthly income from family members (AOR=1.54, 95% CI=1.04-2.27), respondents who attended primary school and above (AOR=1.6, 95% CI=1.13-2.25), distance of health facility in which the time it took less than 20 minutes (AOR=2.25, 95% CI(1.24-4.09), 20-39minutes (AOR=3.06, 95% CI=1.66-5.64), 40-60 minutes (AOR=2.38, 95% CI=1.52-5.26), and previous history of prolonged labor (AOR=1.4, 95% CI=1.04 -2.03) were the significant variables. CONCLUSION: This study indicated that the reproductive age women in the study area had poor knowledge towards about obstetric causes of maternal mortality. Therefore, to improve maternal knowledge and thereby reduce maternal death, the identified significant factors should be addressed through maternal and child health services. Designing appropriate strategies including the provision of targeted information, education, and communication is important.