25 Records out of 22207 Records

Patients' perceptions regarding care in the general surgicals wards at Kenyatta National Hospital

Author: Shawa, Elwin

Awarding University: University of Nairobi, Kenya

Level : MSc

Year: 2012

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Patients/Perceptions/Health services/Nursing/Quality of service/Kenyatta National Hospital, Nairobi, Kenya/Hospital, Nairobi, Kenyas/ ;

Abstract:

Background: Nursing care is a major component of the health services because it is one of the determinants of quality health services. The anecdotal patients' care evaluation and media reports have portrayed negative publicity and image regarding nursing care in certain hospitals . Patients' perceptions regarding nursing care is thought to be the determinant of quality nursing care. Aim of the study: To explore patients' perceptions and experiences regarding nursing care in surgical wards. Methods: A descriptive cross-sectional study was conducted at Kenyatta National Hospital in general surgical wards between April and June, 2012. The study population was adult postoperative patients admitted in the general surgical wards (5A, 5B and 5D). The data collection tool was a structured questionnaire with open and closed questions. Ethical clearance was secured from University of Nairobi and Kenyatta National Hospital Ethics Committee. Participation in the study was voluntary and based on patients' ability to give informed consent. Results: A total of 168 adult patients from general surgical wards were approached and 167 of them participated in the study (non-response rate of 0.6%). Most patients agreed that they expected nurses to be knowledgeable with an average response of 86% and strongly disagreed that nurses should be rude and harsh (44%). The elderly reported that they had a better experience of pain management than the younger patients (m>3.36). Almost all patients reported that nurses were usually responding quickly when they needed pain medication. The elderly were very satisfied with nursing care with mean response (m>4.00). Most patients (52.4%) were satisfied with wound dressing. Generally, (50.2%) with a mean response (m>2.50) were satisfied with nursing care provided though some complained that nurses were not introducing themselves (41%), some nurses were rude (16.7%), their privacy was not respected and nurses were not providing adequate information. Most participants (40.5%) indicated that they had a good perception of the nursing care and 22.6% recommended that nursing staff should be added and 11.3% reported that quality of nursing care was poor. Conclusion and recommendation: Patients' perceptions were influenced by how nurses were conducting themselves towards patients. The need to improve on nurses' interpersonal skills and relationship, and behaviour towards patients was recommended.

Feasibility of task shifting in nursing practice : a case study of two level five public hospitals in Kenya

Author: Koome, Domisiano Impwii

Awarding University: University of Nairobi, Kenya

Level : MSc

Year: 2012

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Nurse practitioners/Nursing/Delegation/Hospitals/Nyeri Provincial General Hospital, Kenya/Embu Provincial General Hospital, Kenya ;

Abstract:

Task shifting denotes a process of delegation whereby tasks are delegated, where appropriate to less specialized health workers who in most cases have lower qualifications and shorter training (WHO, 2008). According to WHO (2006) only six out of forty six countries meet health worker density of 2.5 Doctors, Nurses and Midwives per 1000 population required to achieve health outcomes. Kenya has a health worker density of 1.98 per 1000 population (NCP AD, 2005).Nurses and midwives density stood at 0.4111000 population by 2010(WHO, 2010). To help bridge this gap of health worker density population ratio, countries have been asked to embrace task shifting. This study was therefore designed to explore task shifting knowledge, attitude and practices among nurses at two level five public hospitals in Kenya. Materials and methods A cross sectional survey was conducted in two level Spublic hospitals in a period of two months from 23rd April, 2012 to ISthJune, 2012. Stratified random sampling method was used to select the respondents for the study A structured self administered questionnaire developed by the investigator was used to gather data on socio-demographics, task shifting knowledge, attitudes, practices and barriers from nurse practitioners. Part two of the study explored attitudes towards task shifting among nurse supervisors, nurse representatives and regulators of nursing through key informant interviews. An indepth guide was used to guide the interviews. Data cleaning and entry was done using EPI info. Quantitative data analysis was done using Statistical Package for Social Sciences (SPSS) version 17.0. Chi square and Fishers exact tests were used to test relationships at 0.05significance level. Qualitative data was transcribed and analyzed using Nvivo version 9.0. Results The results showed that majority of the nurses (70%, n=162) understood the concept of task shifting. Majority of the nurses (70%) supported task shifting. Support increased with increase in years of practice (p=0.02S). There was also a strong correlation between knowledge and support for task shifting (p=<O.OOl). There was no significant association between facility and support for task shifting (p=O.3). Results further show that support staff performed most of the shifted task (73.4%, n=118) and that there was a positive correlation between perceived benefits and self report task shifting practice (p=O.Ol) There was a positive correlation between facility and preferred task for shifting with nurses in Nyeri PGH more likely to delegate collection of drugs and other supplies compared to those in Embu PGH(p=O.004) Asked about what conditions are required for effective task shifting 68% (n=157) mentioned regular support supervision, while 65% mentioned training (n=151). Finally, Insufficient number of trained personnel to which tasks can be shifted was considered the greatest obstacle to task shifting by 78.9% (n=165) of the respondents. Conclusion and Recommendations Nurses have adequate knowledge, are supportive of task shifting and task shifting is rife in nursing practice with support staffs performing most of the shifted tasks. Nurses considered supportive supervision and training as a prerequisite to effective task shifting. As a way forward, stakeholders including the Nursing council, NNAK and MOH need to explore task shifting as a strategy for improving the quality of patient care.

A comparative study between government and faith based services in the caring for the elderly persons : a case study of Mombasa County, Kenya

Author: Osongo, Sophine Atieno

Awarding University: University of Nairobi, Kenya

Level : MA

Year: 2012

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Older people ; Nursing homes ; Social services ; Religious organizations ; Elder care ; Mombasa County ;

Abstract:

The purpose of this study was to understand the services offered in both the Government and faith based eldercare institutions in relation to the needs of the elderly persons in Kenya. The target population included the elderly persons residing in both the Government home for the elderly (Nyumba ya Wazee) and the faith based home for the elderly (Little Sisters) in Mombasa county, Coast Province, Kenya. The study adopted descriptive research study design. Snowballing sampling technique was used in selection of study respondents. Five key informants were used to supplement the study findings. To complement each other, schedule-structured interviews, focus group discussion guide, observation checklist and in-depth interviews were used as key data collection instruments. The raw data from the field was analyzed using Statistical Package for Social Sciences (SPSS) and MS excel. Descriptive statistics were used in interpretation of findings. Here the main descriptive tools were; frequencies and percentages. The study revealed that majority of the elderly persons understood the concept 'old age'. They used their age as an indicator and considered themselves aged. The study also observed that a higher proportion (50% and 31 %) of the elderly persons had been in the Government and faith based homes respectively for 4-6 years. This was followed by 19% and 23% who had been in the homes for 1-3 years. This was due to low admission into the homes as the homes are already overwhelmed by the big numbers of the aged. Finally, 6% and 12% of the elderly persons had been in the homes for 16 years and above. Findings showed that an overwhelming majority (94% and 77%) of the elderly from the Government and faith based homes respectively were taken to the homes by 'others'. Here 'others' included; municipal askaris (53%), hospital staffs (27%), nuns (60%), priests (40%), self (13%) and finally chiefs (7%). It was evident that a smaller percentage of the elderly were taken to the homes by their children and relatives and this was because of the social distance that led to social isolation. It was evident that poverty, illness, disability, lack of caregiver and lack of a place to call home for the refugees were the main reasons as to why the elderly were taken to the homes. The study established that the aging have social, economic and physiological needs which they are unable to meet on their own unless through outside intervention. On the level of satisfaction with the services offered in the homes in trying to meet their needs, 43% and 77% of the elderly from the Government and faith based homes registered satisfaction, 44% and 19% registered dissatisfaction while the rest were not sure whether they were satisfied orsnot. It was evident that the elderly persons residing in the faith based home were more comfortable than those residing in the Government home. When asked whether they would wish to go back home given a chance, an overwhelming majority (85%) from the faith based home said no while majority (63%) from the government home were more than willing to go back home. Findings revealed that there were various challenges that were facing both the elderly persons as well as the homes administration while in their respective homes. The elderly person's challenges included; adjusting to life in the home for the elderly, lack of right for decision, participation, and freedom of choice, disability, chronic illness, ageism, pain of losing their friends through death and lack of finances. On the other hand the homes administration was challenged by lack of finances, caregiver burnout, getting and admitting genuine elderly person. In conclusion, both the homes are doing their level best to deliver the best services to the elderly persons. Despite these efforts, the services in the faith based home were better than those in the Govenunent home and this has led to more satisfaction in the faith based home as compared to the Government home.

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).

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.

Nurses' and patients' perception on the importance of nurse-caring behaviours : a study at surgical wards of Kenyatta National Hospital, Nairobi

Author: Ogugu, Everlyne G

Awarding University: University of Nairobi, Kenya

Level : MScN

Year: 2011

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Nursing ; Nurse patient relationships ; Inpatient care ;

Abstract:

Although the importance of caring in nursing and its influence on patients' satisfaction with healthcare services has been demonstrated, there is minimal study on caring in surgical settings in developing countries. A cross-sectional descriptive study was carried out at surgical wards of Kenyatta National Hospital to compare nurses' and patients' perceptions on importance of nursecaring behaviours. A questionnaire based on carative factors of Watson's theory of human caring, developed by Cronin and Harrison in 1988, was used to collect data from 182 adult patients and 127 nurses selected by quota sampling that involved convenience sampling from the created strata of the 10 surgical wards. Analysis of data was done using univariate and bivariate statistics. Results showed the most important nurse-caring behaviour as ranked by patients to be 'give me treatments and medications on time' while for nurses it was 'treat patient as an individual'. Subscales 'Human needs assistance' and 'Humanism! faith-hopei sensitivity' and were rated most important by patients and nurses respectively. Of the ten most important nurse-caring behaviours as ranked by the study participants only three items were common to both groups, namely, 'give patient treatments and medications on time', 'treat patient with respect' and 'know when it is necessary to call the doctor' The results demonstrated a degree of incongruence between nurses' and patients' perception on the importance of various dimensions of caring. It is recommended that this incongruence be addressed by nurses in clinical practice, education and administration levels to enhance patients' satisfaction with nursing services. Researches in various healthcare settings to gain insight into the impact of caring on patient outcomes andhealthcare costs are recommended.

An investigation into the pathways of older people into Gerontological institution : the case of Kariobangi Chesire home, Kasarani-Nairobi

Author: Mutea, Rukwaru

Awarding University: University of Nairobi, Kenya

Level : MA

Year: 2011

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Older people ; Nursing homes ; Kariobangi Cheshire Home for the Aged, Kasarani, Nairobi, Kenya ; Low income groups ;

Abstract:

The study was on investigation into the pathways of older people into gerontological institution, a case of Kariobangi Chesire Home for the Aged, Kasarani, Nairobi. The objective of the study was to find out factors contributing to institutionalization of older persons and to establish the quality of care older persons get in such institutions. The study was conducted using a mixed methods approach. Methods of data collection included questionnaire, key informant interviews and case studies in order to get rich information. Secondary data was also obtained through the internet, government publications, international journals and publications and also existing records in Kariobangi Chesire Home for the Aged. Descriptive statistics were used to analyze the data and to generate percentages and frequencies. The key findings were that poverty, poor access to health care, weakened social networks and abandonment contributed to the institutionalization of older persons. The study also found that with an increase population of older people, high quality institutional care was necessary. The study concluded that the government should while also addressing critique issues with poverty should also establish more gerontological institutions in both urban and rural areas.

Influence of Safaricom foundation funded water projects on health service provision. a case of Assisi nursing home in Machakos District, Kenya

Author: Ndung'u, Rosalyn Wamuyu

Awarding University: University of Nairobi, Kenya

Level : MA

Year: 2010

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Assisi Nursing Home, Machakos District ; Water supply ; Safaricom ; Social responsibility ; Corporate responsibility ; Health care delivery ;

Abstract:

Safaricom Foundation is a programme that spearheads the corporate social responsibility of Safaricom Limited. It is through this programme that various development projects are funded. The Assisi Nursing Home water project is a beneficiary of the Safaricom Foundation funding. The purpose of this study was to investigate the influence of Safaricom Foundation funded water projects on health service provision. The objectives of the study were to investigate how the Safaricom Foundation funded water project has improved patient management, medication and environment management at Assisi Nursing Home. It also sought to investigate the effect of the project on cost of service provision, the challenges encountered by the facility staff as a result of the water project and the efforts in overcoming these challenges by the facility staff. This study employed a qualitative research design. It targeted all the 11 staff of Assisi Nursing Home. The major research instruments were a focus group discussion for the staff in two groups who were sampled purposively. Interviews were carried out with the 2 administrators and observation was also employed in the study. Questionnaires were administered to 21 customers who were sampled conveniently. Data was analyzed qualitatively. It involved narration that was put into patterns that followed themes developed from the research questions. This data was supported by quantitative data derived from the customers of Assisi. This study found that the SFFWP was providing an adequate water supply to ANH which had improved patient management at the facility leading to less referrals to other hospitals, expansion of the facility's capacity, reduced operational costs and safe administration of treatment to patients. The study also found that the availability of adequate water had improved the hygiene at the facility and improved the livelihood of the neighboring community. Recommendations for policy action specific to the SFFWP at Assisi Nursing Home were given. It was therefore recommended that the staff at this health facility should be trained on water resource management for efficiency in water use and to reduce wastage. Community involvement was also recommended to the management for other projects targeting the whole community.

Evaluation of clinical training and performance of nursing graduates in nursing practice : a case of three universities in Kenya

Author: Nyangena, Elijah Nyabuti

Awarding University: Moi University, Kenya

Level : DPhil

Year: 2010

Holding Libraries: Moi University Margaret Thatcher Library ;

Subject Terms: Nursing ; University education ; Quality of education ; Educational evaluation ;

Abstract:

ABSTRACT NOT AVAILABLE

Trainees and trainers perspectives on effectiveness of clinical training for nursing students in Kenya

Author: Osotsi, Boibanda Franklin

Awarding University: Moi University, Kenya

Level : DPhil

Year: 2009

Holding Libraries: Moi University Margaret Thatcher Library ;

Subject Terms: Nursing ; Students ; Training ; Quality of education ;

Abstract:

The'effectiveness of Clinical Training of Nursing Students in Kenya' and the critical factorsthat influence its effectiveness are not known by different stakeholder including thetrainersand trainees. The purpose of the study was to determine students and trainers perspectives on effectivenessin clinical training of nurses in Kenya. The specific objectives were to: (i) determinethe trainee/trainer perspectives on effectiveness of clinical training in the three specialty areas of nursing; (ii) determine trainer/trainee perspectives on factors that influenceclinical training for nursing students in Kenya and; (iii) determine if there is a significant correlation in students/trainers perspective on effectiveness of clinical training.This was a descriptive survey design and the target population was third year KenyaRegistered Community Health Nursing (KRCHN) students in KMTCs and the clinicalsupervisors in the clinical placement sites used by KMTC for clinical training. Thestudy setting was in fourteen KMTCs and institutions where students are placed for the purpose of clinical training. The students, clinical supervisors and teachers were subjectedto a questionnaire. Additional questionnaire for clinical supervisors solicited responseregarding factors. An additional questionnaire for teachers sought perspectives on factors influencing effectiveness in clinical training. Both probability and nonprobability sampling were used and the data collection technique included self administered questionnaires. Quantitative data was analyzed using non parametric statistics to identify differences that exist in rating within the students, clinical supervisors and teachers. Data analysis was by use of SPSS version 12.0. Data was analysedusing both quantitative and qualitative techniques. The study used student t-test to compare trainee/trainer perspectives on effectiveness of clinical training. Tables, pie chartsand bar-graphs were used in data presentation. The study will provide data for policy on development and sustenance of clinical placementsites for effective clinical training. Ethical approval was sought from IREC beforecommencement of the study. Itwasfound out that clinical training of nurses is effective across the three specialty areas ofnursing according to students, clinical supervisors and teachers but at varying levels of performance as demonstrated by highest rating by clinical supervisors followed by students and then teachers. There are several factors that positively influence clinical training of nurses, though at varying levels as there are shortcomings that require addressingto make clinical training more effective. Thereis a need for further research to determine why there is a significant variation in perspectives of students/teachers, students/clinical supervisors and teachers/clinical supervisorsin addressing clinical training of nurses with aim of improving the quality of theclinical sites and a policy to that direction will be necessary. Variousfactors influence clinical training of nurses at KMTC and constituent colleges at varyinglevels and a further research will help harmonize clinical training to address the issueof quality in patient/client care for benefit to all the stakeholders