Incidence and predictors of acute kidney injury among adults admitted to the medical intensive care unit of a Comprehensive Specialized Hospital in Central Ethiopia.

BACKGROUND: Acute kidney injury is a prevalent complication in the Intensive Care Unit (ICU) and a significant global public health concern. It affects approximately 13 million individuals and contributes to nearly two million deaths worldwide. Acute kidney injury among Intensive Care Unit patients is closely associated with higher rates of morbidity and mortality. This study aims to assess the incidence of acute kidney injury and identify predictors among adult patients admitted to the medical Intensive Care Unit. METHOD: A retrospective follow-up study was conducted by reviewing charts of 317 systematically selected patients admitted to the Intensive Care Unit from September 1, 2018, to August 30, 2022, in Wachemo University Nigist Ellen Mohammed Memorial Comprehensive Specialized Hospital. The extraction tool was used for the data collection, Epi-data version 4.6.0 for data entry, and STATA version 14 for data cleaning and analysis. The Kaplan-Meier, log-rank test, and life table were used to describe the data. The Cox proportional hazard regression model was used for analysis. RESULTS: Among the total study participants, 128 (40.4%) developed Acute Kidney Injury (AKI). The incidence rate of Acute Kidney Injury was 30.1 (95% CI: 25.33, 35.8) per 1000 person-days of observation, with a median survival time of 23 days. It was found that patients with invasive mechanical ventilation (AHR = 2.64; 95% CI: 1.46-4.78), negative fluid balance (AHR = 2.00; 95% CI: 1.30-3.03), hypertension (AHR = 1.6; 95% CI: 1.05-2.38), and a vasopressor (AHR = 1.72; 95% CI: 1.10-2.63) were independent predictors of acute kidney injury. CONCLUSION: The incidence of Acute Kidney Injury was a major concern in the ICU of the study area. In the intensive care unit (ICU), it was found that patients with vasopressors, invasive mechanical ventilation, negative fluid balance, and chronic hypertension were independent predictors of developing AKI. It would be better if clinicians in the ICU provided targeted interventions through close monitoring and evaluation of those patients with invasive ventilation, chronic hypertension, negative fluid balance, and vasopressors.

Professional quality of life and job satisfaction among nurses working at tertiary hospitals in central Ethiopia.

BACKGROUND: Professional quality of life is a crucial aspect of healthcare professionals' well-being and job satisfaction. Job satisfaction, on the other hand, encompasses fulfillment of desired needs within the work environment, happiness or gratifying emotional response towards working conditions, and job values or equity. Existing literature tends to address job satisfaction and professional quality of life separately, overlooking their interconnectedness, especially within the unique context of Ethiopia. This study aimed to assess nurses' professional quality of life and job satisfaction. METHODS: A descriptive cross-sectional study was conducted from September 1-30 2023 among 420 nurses using a structured questionnaire. The study participants were recruited by simple random sampling. Multiple linear regressions were used to identify factors associated with outcome variables. RESULTS: The study involved 420 nurses, with 407 completing the questionnaire, yielding a 96.68% response rate. The findings revealed varying levels of professional quality of life. Specifically, 258 participants (63.4%) exhibited low compassion satisfaction, while 271 (66.6%) and 266 (65.4%) experienced average levels of burnout and secondary traumatic stress, respectively. Job satisfaction was moderate to high for 55% of the participants. As the finding of this study indicates, there is a positive correlation between compassion satisfaction and job satisfaction in nursing. The study also identified predictors for job satisfaction, compassion satisfaction, and compassion fatigue, such as marital status, education, and experience. CONCLUSION: The majority of participants reported a medium level of compassion satisfaction, with a significant proportion experiencing moderate to high levels of compassion fatigue. Although more than half of the participants had moderate to high job satisfaction, there were still low levels of satisfaction. The study recommends developing targeted training programs, implementing workplace policies, and designing initiatives to enhance education, experience, and compassion satisfaction.

Incidence and Predictors of Cardiac Arrest Among Patients Admitted to the Intensive Care Units of a Comprehensive Specialized Hospital in Central Ethiopia.

Background: Cardiac arrest (CA) is a common public health problem. Worldwide, cardiac arrest ranks highly among hospitalised patients' public health concerns, particularly in low-income nations. Data on cardiac arrest in intensive care units in low-income countries are relatively scarce. Determining the incidence and predictors of cardiac arrest among ICU patients will be a very crucial and fruitful clinical practice in resource-limited areas like Ethiopia. Methods: A retrospective cohort study was conducted by reviewing charts of 422 systematically selected patients admitted to the ICU from 2018 to 2022 in Wachemo University Comprehensive Specialized Hospital. The extraction tool was used for the data collection, Epi-data version 4.6.0 for data entry, and STATA version 14 for data cleaning and analysis. Kaplan-Meier, log rank test, and life table were used to describe the data. The Cox proportional hazard regression model was used for analysis. Results: The findings of this study revealed that the overall occurrence of cardiac arrest among critically ill ICU patients was 27% (95% CI: 23, 32). The incidence density rate of cardiac arrest among intensive care unit patients was 19.6 per 1000 person-days of observation. In a multivariable analysis, patients with chronic kidney disease, oxygen saturation <90%, delirium, intubation, and patients admitted to the ICU with cardiovascular disease were found to be independent predictors of cardiac arrest in the Intensive Care Unit. Conclusion: The incidence density rate of cardiac arrest among intensive care unit patients was high. This study also revealed that chronic kidney disease, delirium, intubation, oxygen saturation level below 90% and patients admitted with cardiovascular disease were independent predictors of the occurrence of cardiac arrest among intensive care unit patients. Finally, we recommend that clinician pays attention to those identified as preventable risk factors for early interventions to improve the recovery process of patients in the ICU.