27 Records out of 22207 Records

Perception of patients and student nurses of nursing care at Kenyatta National Hospital Medical wards

Author: Muhoro, Susan N

Awarding University: University of Nairobi, Kenya

Level : MSc

Year: 2012

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Nurses ; Nurse patient relationships ; Patients ; Perceptions ;

Abstract:

Recovery or alleviating the suffering of patients is through delivery of nursing care. The patients' perception of nursing care is dependent on various factors, one being the professional behaviours. The objective of this study was to explore the patients' and the students nurses' perception towards nursing care behaviours. In the methodology, a cross section, descriptive and comparative study was done and the population included patients in eight (8) medical wards, in Kenyatta National Hospital, and student nurses from University of Nairobi. Purposive sampling was employed to select participants, after which proportionate allocation was done to get samples of patients (134 participants) and students ( 68 participants). The patients were those with at least 4 days of stay in the ward, of sound mind, who were in stable health status and not in pain. The nursing students were those with more than two years in training. Data was collected by eight (8) research assistants using the Care-Quality instrument, (CARE-Q), which was developed by Larson, (1981), after undergoing a two day training on how to handle the tool. The tool was pretested at Mbagathi Hospital for reliability. Data was cleaned and SPSS database used for analysis. To compare patients and student nurses' perception scores on CARE-Q scales paired t-test was used. The study results showed that students rated highly the subscales of Aticipates (ANT), Explains and Facilitates (E&F) and Monitors and Follows through (M&F). More students than patient rated highly ANT with a mean difference of 6.029 .. The patients rated highly the subscales of Anticipates, Accessible (ACC), and Comforts. More patients (mean 4.8) rated Comforts highly than students (mean 3.08). Both the patient and students picked trusting relationship for almost a ratio of one to one, (t=31.5 vs t=32.6; P=<O.OOI). One recommendation is that similar studies should be done to find out factors that affect perceptions of patients and nurses on nursing care behaviours in Kenya.

Factors influencing use of the nursing process in Naivasha District Hospital

Author: Mangare, Linet Nyatichi

Awarding University: University of Nairobi, Kenya

Level : MSc

Year: 2012

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Nurses ; Nursing ; Naivasha District Hospital, Kenya ;

Abstract:

Introduction: Nurses make up 51.5% of all health workers in' Kenyan public hospitals (NHRH, 2010). This implies that nursing services' contribute a large percentage towards overall healthcare, The nursing process (NP) is a framework of care that is applicable in all clinical care settings to provide quality nursing care (QNC). Fortunately training curricula for all cadres of nurses in Kenya have incorporated the NP as a framework for using care. However, nurses find it difficult to implement nursing care using this framework. This contributes to poor quality health care (QHC) in public hospitals in Kenya (KIPPRA' 20M). This study was therefore aimed at determining factors influencing use ofthe NP in Naivasha District Hospital (NDH). Methodology: This was a cross sectional study conducted between May and June 2012 on &3 nurses. A structured questionnaire and an observation checklist were used to collect data on factors influencing use ofthe NP in NDH. The data was entered in Microsoft excel computer software and analyzed using the statistical package fur social sciences (SPSS) version 20.0. Pearson's Correlation Coefficient was used to establish correlation. between variables. Ethical approval was obtained from Keuyatta National Hospital/ UON Ethics and Research Committee. Results: Mniority of the participants (51.8%,11=43, mean=4.2, SD= 1.124) strongly agreed that the NP facilitates total patient care. The proportion of the participants who carried out the various components of the nursing process appropriately ranged between 15.7% and 30.1%. The study showed a statistically significantly 1 correlation between. demographic characteristics and nursing factors that could promote use of the NP as follows: qualification of participants & training on NP (F -0.228, p=O.038), gender & drive to appear professional (1= 0.234, p~O.034), age & drive to appear professional (r= 0.24, p=0.029) and years of clinical experience & drive to appear professional (r=O.28:5, p=<tO(9).. There was also a ~51atisticaHy significant correlation between demographic characteristics and nursing factors hindering use of the NP as follows: gender & lack ofexperienee on using the NP (r= -0.218, p= 0.047) and age & inadequate knowledge on the NP (r= 0.245, p= 0.026).

The relationship between trade union membership and job commitment among nurses in Vihiga County, Kenya

Author: Lwegado, Kenneth Endende

Awarding University: University of Nairobi, Kenya

Level : MBA

Year: 2012

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Labour unions ; Union membership ; Job satisfaction ; Commitments ; Nurses ; Vihiga County ;

Abstract:

The objective of this study was to determine the relationship between trade union membership and job commitment among nurses in Vihiga County, Kenya. The research design was a descriptive survey. The sample of 120 respondents was selected using stratified random sampling technique. The study used primary data and secondary data. The data collection instrument was a questionnaire which was semi-structured comprising both open and close ended questions. Quantitative data was analyzed using descriptive statistics by using spss and presented in form of percentages means, standard deviations and frequencies. Linear regression technique was used to establish the strength of the relationship between trade union membership and job commitment. Based on the findings, it was found that all nurses know that job commitment affect employee performance. Some of the issues affecting job commitment include poor remunerations, staff shortage, and work environment loyalty of management to nurses. Employees felt that by joining trade unions issues affecting job commitment could be articulated on their behalf by their union leaders as they concentrate on their work .Unions have pushed management of hospitals to a moderate extent improve job security, working conditions, achieve work life balance and to a less extent improved management loyalty to employees. Meaning a lot more need to be done to improve even further. Nurses agree that trade unions playa significant role in bringing harmony, cooperation; peace and understanding whenever the management and employees disputes reach a deadlock . The research reveal that there is a strong positive correlation between trade union membership and job commitment among nurses in Vihiga county Kenya. The respondents however cited shortcomings in the inability by the hospital management to address issues on remuneration, labor turnover, understaffing, work life balance and loyalty of management to employees. The study highly recommends hospital management to involve nurses in formulating mission statement, vision and setting goals to make them feel that they are part of the organization.

Factors influencing staff turnover among the nurses : the case of Compassion International assisted projects of Isiolo and Meru sub clusters, Kenya

Author: Ikunyua, Moses Mwiti

Awarding University: University of Nairobi, Kenya

Level : MA

Year: 2011

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Compassion International/Nurses/Employee turnover/Project management/Isiolo, Kenya/Meru ;

Abstract:

This research establishes factors influencing staff turnover among nurses of Compassion International assisted projects of Isiolo and Meru sub clusters, Kenya. It is noted that turnover among nurses is a major phenomenon around the globe as pointed out in the literature review. This study was guided by the following objectives; to establish the influence of job security on labour turnover, to establish the influence of non financial motivations on labour turnover, to establish the influence of working environment on labour turnover, to establish the influence of age on labour turnover and finally, to establish how training influences labour turnover. Descriptive research design was adapted for this study where structured and semi structured questionnaires were used. Due to scarcity of financial resources and limited time, the study was conducted around Meru Town, Ruiri in Meru, Timau and Isiolo comprising of 12 projects out of the 285 projects located across Kenya. The target population was 87, the estimated sample size was forty comprising of the four nurses in the projects of Isiolo, and Meru who were purposively sampled, 25 other staff members randomly selected from the accessible population and 11 former staff that left in the last three years. Data was edited, coded and then analyzed by use of a computer program called SPSS. The study found that there was a positive relationship between the turnover of nurses and job security, non-financial motivations, working environment, age of the nurse and the training orientation of the nurses. The project nurse had higher turnover than any other staff member had in the projects and was also found to be the most likely staff to seek for other employments when compared with the other staffs. The study recommended that employers and trainers for nurses be alert on what is needed from each of them to have a positive and enabling environment for nurses to be retained at the projects.

Factors influencing application of Evidence Based Practice (EBP) among nurses working in Kenyatta National Hospital (KNH)-Nairobi

Author: Talaso, Dulacha Barako

Awarding University: University of Nairobi, Kenya

Level : MScN

Year: 2011

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Nurses/Nursing administration/Kenyatta National Hospital, Nairobi, Kenya/Evidence-based nursing ;

Abstract:

Evidence based practices (EBP) is application of care that is based on scientific evidence in order to obtain quality patient care. This concept was first introduced in the late 1970s' by Florence Nightingale who linked environment, disease occurrence and patient care. Modern Nursing care has evolved from this concept. However, documentary evidence on these evolutions and standardization of nursing practice was limited to the developing world. This study was designed to establish factors that influence application of EBP by nurses at Kenyatta National Hospital. The cross sectional study which was conducted over a four weeks period, 144 eligible nurses consented and enrolled in the study. Questionnaires was used to collect data on sociodemographics, evidence based practices and challenges encountered during the implementation process. Part two of the study involved an in-depth interview with nurse managers regarding knowledge, role and audit processes on evidence based practices. Quantitative data was analyzed using Statistical Package for Social Science (SPSS) version 17, while INVIVO 9 was used to analyze qualitative data. Association between independent and dependent variables was determined using Chi square (P<0.05). The result was presented in form of tables, pie charts and graphs. The result of the study has revealed that EBP application was influenced by personal factors like nurse education, nurses' attitudes towards research, and ability to critically review literature among other factors. In conclusion the study recommends that KNH Management design and develop staff work model that takes into consideration factors, such as, patient to nurse ratio, balance between routine duties and time for research and training. There is need to develop a guideline on EBP application as most of the informants stated that their practices were based more on ward routine and hospital guideline than on research evidence.

Stigmatization of Mathare Mental Hospital nursing staff caring for the mentally ill

Author: Kamunge, Georgina Wangui

Awarding University: University of Nairobi, Kenya

Level : MMED

Year: 2011

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Mathare Hospital, Nairobi, Kenya/Nurses/Stigma (Social psychology) ;

Abstract:

BACKGROUND: Over the years, mental illness has been associated with stigma and negative attitudes. Most research has been on stigma of mentally ill and few on their relatives. Staff members caring for the mentally ill are at risk of stigma by association due to regular interaction with mentally ill. In the local setting, majority of the staff members working for the mentally ill patients in the hospital institutions are the nurses. In view of this the current study aimed to establish the prevalence of stigmatization of Mathare mental hospital nursing staff caring for the mentally ill. OBJECTIVES: To determine the prevalence of stigmatization of Mathare mental hospital nursing staff caring for the mentally ill patients and their social demographic characteristics. DESIGN: Cross-Sectional descriptive study involving nursing staff members caring for the mentally ill at Mathare Mental Hospital who fulfilled the inclusion criteria. STUDY SITE: Mathare Mental Hospital situated along Thika Road, 4km North of Nairobi City. METHOD: Participants were interviewed using a researcher designed social demographic questionnaire and Adopted Researcher designed stigma questionnaire assessing discrimination, disclosure and positive attitude. Statistical analysis included descriptive analysis of nurse's demographic characteristics and associations between stigma and demographics using chi square tests conducted using SPSS version 17. RESULTS: One hundred and twenty (n = 120) nurses met the inclusion criteria and were recruited in the study. The age of nurses in the study ranged from18 years to 60 years with a mean age of 42 (SD 7.7) years. There were 108 (90 %) female nurses and 12 (10%) male nurses. Married participants constituted 80 % (n=96) of the population while 12.5% (n=15) were single. Majority of the nurses, 97.5 %( n= 117) were Christians. Approximately 56% nurses had worked in the nursing field for 15 years, while 26.7% (n=32) nurses and 15% (n=18) nurses had worked for 10 -15 and 5 -10 years respectively. Only 1.7% (n = 2) of nurses had worked for less than five years. Enrolled community psychiatric nurses accounted for 45% (n=53), followed by Kenya registered community psychiatric nurses with 24%(, n=28) and registered community health nurses with 18%( n=21) while enrolled community nurses accounted for 14%.Most nurses lived in rented premises(54%), while 46% (n = 55) lived in their own houses. The main significance of the study found a moderate level of stigma among the nursing staff caring for the mentally ill at a mean overall score of 35.2(SD=14.4) with a range of 4 to 56.The mean stigma score for the 9 discrimination items was 22(SD=8.3), 11.7(SD=5.9) mean score for 5 items on disclosure items while mean score for the 2 positive attitude items was 1.5(SD=1.5). The multivariate analysis showed significant association with nursing experience where a longer working experience was associated with lower stigma score. CONCLUSION: There is a moderate level of stigma at among nursing staff caring for the mentally ill in Mathare Mental Hospital. Nurses with longer exposure to mental health practice reported lower level of stigma related caring for the mentally ill. RECOMMENDATIONS: Mental health education needs to be introduced early at various levels in the education curriculum to help reduce level of stigma associated with mentally ill patients.

Perceptions of nurses and family relatives towards family witnessed resuscitation in critical care units of Kenyatta National Hospital and Aga Khan University Hospital

Author: Omoding, Teresa

Awarding University: University of Nairobi, Kenya

Level : MScN

Year: 2011

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Nurses ; Critical care ; Families and family life ; Perceptions ; Kenyatta National Hospital, Nairobi, Kenya ; Aga Khan University Hospital, Nairobi, Kenya ;

Abstract:

Background: Resuscitation is the restoration of vital signs by mechanical, physiological and pharmacological means in the event of an abrupt cessation of cardiac activity. Witnessed resuscitation is the process of active resuscitation in the presence of family relatives. However, should a patient require resuscitation, the family relatives are requested to wait in the visitors' waiting room as the resuscitation team attends to the patient. The family relatives therefore are sometimes left unaware of the sudden illness of their loved one and can be left in isolation in the event of their death. Main Objective: This was to describe the factors that determined the perceptions of nurses and family relatives towards family witnessed resuscitation. Methodology: This was a cross-sectional descriptive study carried out between May 2010 and April 2011. The study involved nurses and family relatives of patients admitted within the critical care units of Kenyatta National Hospital and Agakhan University Hospital. The respondents were selected via proportionate simple random sampling. The study involved 190 respondents, 109 of whom were critical care nurses while 81 were family relatives. Data collection was done via a semi- structured questionnaire; cleaning and analysis was done using Statistical Package of Social Sciences (SPSS) computer software program. Results: The study revealed that the relatives 67.90% (n=55) were more receptive to family witnessed resuscitation in comparison to 59.63% (n=65) of the nurses. There were varied perceptions towards implementation of the practice; however both groups of respondents; (83.49% (n=91) of nurses and 70.37% (n=64) of relatives) stated they would support it more strongly if a support staff would be present with the relatives during the process. Religion, specialization, years of experience and marital status were the factors that determined the nurses' perception towards family witnessed resuscitation; religion and specialization elicited a positive perception while marital status and years of experience elicited a negative perception. Age and occupation determined the relatives' perception and both elicited a positive perception. Conclusion: The relatives were found to be more in favor of witnessed resuscitation as opposed to the, nurses. There were no policy guidelines available regarding how to handle family relatives present during resuscitation. Recommendations: Further research is needed on the opinion of the patient regarding their families' presence during resuscitation. The perception of nurses in other areas of resuscitation for example in the Accident and Emergency departments needs to be explored as well as those of physicians working in these departments. There is also need to develop policy guidelines by the Ministry of Health, Professional Bodies and Organizations which are specific to the hospital setting.

Factors influencing quality management of medication by nurses at Kenyatta National Hospital Paediatric wards

Author: Ndambuki, James Mutua

Awarding University: University of Nairobi, Kenya

Level : MScN

Year: 2011

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Kenyatta National Hospital, Nairobi, Kenya. Paediatric Ward ; Nurses ; Children and youth ; Babies ; Health care delivery ; Drug therapy ;

Abstract:

Background: Quality administration of medications is more than a mechanical task done in compliance with a prescription. Nurses must have basic knowledge of indications, dosages and side effects of medications to accurately interpret prescription orders. Safe drug administration ensures patients' drug safety, cost containment and reduced length of patient hospitalization. Pediatric nurses at KNH have been shown not to adhere to laid down procedures while administering oral medication to children. This could be attributed to several factors probably associated with the nurses' knowledge and practice, caretakers' contribution, care environment, hospital policy and availability of material and human resources. Our literature search did not find any study done on factors influencing quality management of medications by pediatric nurses in Kenya. Objective: The study sought to determine factors influencing quality management of medication by nurses at KNH paediatric medical wards. Methods: A descriptive cross-sectional survey involving 80 nurses, 180 caretakers and four nurse managers was done. Two sets of semi-structured researcher-administered questionnaires were issued. The first set was administered to nurses while the second one was employed on caretakers who had children in the wards. A written guide was used to conduct in-depth interviews with the nurse managers. , An observation tool was further used to collect data as nurses were administering medication. These tools collected both quantitative and qualitative data. Data analysis was done using SPSS software (version 16) while qualitative data was analyzed manually. Findings of the study were presented in bar graphs, pie charts and frequency tables. Results: High workload (90%), language barrier (56%), absence of paediatric formulations (55%), multiple tasks (21 %), lack of support (20%) and limited physical space (19%) were the main challenges that nurses encountered during drug administration. There was only one nurse (1.25%) trained in pediatric nursing. Our analysis revealed an association between quality drug administration and number of years worked in paediatric wards (fisher's exact p < 0.05) and the attendance of continuing medical education (CME) (Fishers exact p < 0.05). Conclusion: The findings in this study indicate a need for concerted efforts and partnerships among the pediatric care stakeholders (nurses, patients/caregivers, hospital management and ministry of health) in enhancing quality medication administration in the pediatric wards. This will boost the nurses' professional confidence in delivery of care and minimize errors in drug administration thus ensuring patient safety and quick recovery. The challenges faced by paediatric nurses should be addressed by the hospital administration if quality administration of medication is to be achieved. The study duration and budget: The study took eleven months to complete at an estimated cost of Kshs.l05 060. Funding was provided for by KNH, the researchers' employer.

An investigation into the relationship between job satisfaction and retention of nurses : a case of Nairobi City Council

Author: Njongoro, Mercy

Awarding University: St. Paul's University, Kenya

Level : MA

Year: 2011

Holding Libraries: St. Paul's University Bishop Okullu Memorial Library ;

Subject Terms: Nurses ; Employees ; Job satisfaction ; Nairobi City Council ;

Abstract:

The interest for this study was drawn from an issue that the researcher noted among Nairobi City Council workers. The issue was that despite many problems including delayed salaries, poor systems and procedures, and a highly bureaucratic organizational structure (especially evident in the public health department), very low turnover (0.98%) has been noted among NCC nurses. This dissertation was a survey that aimed at establishing the relationship between employee level of job satisfaction and retention on the job. The focus was particularly on establishing the said relationship among nurses working in Nairobi City Council health centers. The objectives that guided this study were; (I) to establish how NCC nurses rated their job satisfaction levels, (II) to examine the factors that facilitated nurses? stay on the job, (III) to investigate the levels of the various job satisfaction facets among NCC nurses and how they influence nurses desire to stay on the job. Objective (IV) was to establish the demographic population of nurses that were willing to quit the job. There were six hypotheses drawn from five job satisfaction facets (JDI) and the JIG (overall feelings about the job). The data was generated quantitatively using two standardized tools namely; JDI and JIG scales, well validated and used internationally. The analysis of the data was carried out quantitatively too, giving a general view of low levels of job satisfaction among NCC nurses despite them being retained. Highlighting the limitations of the research, the researcher made recommendations to NCC, and gave suggestions on possible areas for further research.

A comparative study of student academic performance under face-to-face and distance learning mode of instructional delivery : a case of the Registered Community Health Nurse Upgrading Programme, Kenya

Author: Mutonga, Joan Wairimu

Awarding University: University of Nairobi, Kenya

Level : MDEd

Year: 2011

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Registered Community Health Nurse Upgrading Programme (Kenya) ; Nurses ; Academic achievement ; Distance learning ;

Abstract:

The purpose of this study was to compare the academic performance of students under face-toface (F2F) and distance learning modes of instructional delivery. The study also sought to determine whether a relationship existed between performance and student demographic factors of age, entry qualifications and work experience. The population under study was Kenya Enrolled Community Health Nurses who completed their study and sat for the Nursing Council of Kenya (NCK) licensing examination between 2008 and 2010. A total of 1,363 cases were included in the statistical analysis, and of these, 943 were DE students and 420 residential or face-to-face students. The study applied a quantitative causal comparative research design to determine whether differences existed between the academic performance of the two groups and also whether there was any relationships between performance and student characteristics of age, entry qualifications and work experience. The study used secondary data obtained from NCK 's electronic database. Quantitative data was analysed using correlation techniques to find out if there was as statistically significant relationship between the dependent and independent variables. The study found that there was a statistically significant difference (P=O.OOO; P<0.05) between the performance of DE and Face-to-face students in the NCK examination. Face-to-face students performed significantly better than DE students. The study also found that there was a significant relationship between students' performance and their entry qualifications and years of work experience in both groups. The higher the O-level grade attained the higher the mean score at the licensing exam and the lower the years of experience the higher the mean score attained in the NCK examination. Further, age was found to predict performance only among DE students, whereby younger students with less than or equal to 30 years achieved higher mean scores (60.57) than students older than 45 years of age. Evidence from this study rejected the null hypothesis that there was no significant difference between the performance of students under face-to-face and DE modes of instructional delivery. The study recommended the use of these findings to develop strategies to improve the performance of DE students, and also to re-evaluate the DE curriculum to establish whether it meets cognitive learning styles of mature students.