scholarly journals Practice of Regional Anesthesia and Its Associated Factors among Anesthesia Professionals Working in Teaching Referral Hospitals of Ethiopia; A Multi-center Study

2021 ◽  
Vol 14 (1) ◽  
pp. 1-8
Author(s):  
Elias Habtu ◽  
Mamo Nigatu ◽  
Yemane Ayele ◽  
Mebratu Tila ◽  
Wondu R. Demissie

Background: Regional Anesthesia (RA) provides site-specific, complete pain relief, early mobilization, and rehabilitation; and it is preferred than general anesthesia due to associated risks in the later technique. It also ensures prolonged analgesia while reducing the need for systemic drugs with their side effects. Despite these advantages, the techniques have not been embraced as alternatives to general anesthesia in Ethiopia. Objective: The study aimed to assess the magnitude of regional anesthesia practice and its associated factors among Anesthesia Care Providers (ACPs) working in Ethiopian teaching referral hospitals, 2019. Materials and Methods: Multi-center-based crossectional study was conducted among all ACPs working in three institutions (Jimma Medical Center, Black Lion hospital and Wolaita Sodo teaching referral hospital) which were randomly selected among six government teaching referral hospitals running postgraduate anesthesia programs; from August 1-September 1, 2019. The practice of RA was considered significant if the participants performed >5 types of RA, assuming as minimum representation (30%) of all types of RA. Data were entered into Epidata manager version 4.3 and exported to SPSS version 22 for further analysis. Logistic regression was applied to determine predictors of RA practice. Adjusted odds ratio and 95% CI interval were used to measure the association and P-value <0.05 was declared as statistically significant. Results: Out of 143 participants, a total of 130 anesthesia professionals participated in the study, making the response rate of 90% . The mean age was 30.77±7.049 years that ranges from 22-56 years. Majority of the respondents were males, 88(67.7%). About 59.2% of ACPs practiced RA. The most performed types of RA were spinal anesthesia (98.5%), caudal anesthesia (72.3%) and axillary block (69.2%), while sub gluteal sciatic block and IV RA were the least practiced types of RA (8.5% each). Finally, two variables (years of experience (1-5 years) and academic qualification (above MSc)) were identified as the independent predictors of RA practice among ACPs with AOR of 6(1.7-21.6), p-v =0.005 and 10.4(1.9-56.9), p-v =0.007 respectively. Conclusion: In a nutshell, the practice of RA in teaching government hospitals of Ethiopia was relatively low despite some RA types like SA were almost practiced well. Thus, ACPs were expected to practice all types of RA than routinely abusing GA for patient safety and welfare in all dimensions.

2020 ◽  
Vol 1 (1) ◽  
pp. 9-12
Author(s):  
Heru Purnomo ◽  
Mu'awanah Mu'awanah ◽  
Mohammad Nur Mudhofar

ABSTRACTBackground : Early mobilization is some effort to defend autonomy as early as possible by guiding the victim for defending fisiologis function (Carpenito, 2001).  According Smeltzer Bare (2002) in patient with colon inflammation disturbance, explained that change position encourage doing passive and active exercise to depend muscle and prevent tromboembolic.  Activity limitation changed suitable with daily necessary.  General anesthesia can cause decreasing colon movement with stimuli parasympatic obstruction in colon muscle.  Client with local anesthesia will experience same case.  Direction surgery which involved intestinal can cause stopping intestinal while movement. Surgery action with general anesthesia in RS.DR.R.Soeprapto Cepuoften was being done in juny – December 2012 period reported 166 cases.Objective : This study to determine the difference of early mobilization 6 hours and 8 hours toward intestine peristaltic on post operation patient with general anesthesia at RSUD dr. R. Soeprapto Cepu. Methods : Method of this research  used quasi eksperimental design and taking sampling method was stratified random sampling, research was done into 20 respondences.  Collecting data technique using observation technique.  Statistic analysis used Independent t-test exam, organize and data analysis with computer program assist SPSS for windows 16.Result : The result analysis was shown with independent t-test exam was be found t hitung 0,662, t table 2,101, p value 0,641.  Where is t hitung t table (0,662 2,101) and p value alpha (0,641 0,05) above can be conclude Ho was accepted.  Its mean its’nt difference early mobilization 6 hours and 8 hours about peristaltic of intestine for post operation patient with general anesthesia in dr.R.Soeprapto Cepu Hospitals.Conclusion : Advice we recommend early mobilization of patients immediately after surgery with general anesthesia, according to the results of this study was able to mobilize patients early in the post anesthesia 6 hours. Keywords: mobilisation, peristaltic of intestine, post operation, general anesthesia.


2021 ◽  
Author(s):  
Belete Fenta Kebede ◽  
Tsegaw Biazin Tesfaye ◽  
Aynalem Yetwale Hiwot

Abstract Introduction: The practice of informed consent before any surgical procedure should form the fundamental element that serves to protect both patient and surgeon from prosecution. Several factors can affect the process of surgical informed consent. Knowledge towards surgical informed consent is one important factor. It is worth mentioning that patients’ understanding of the information provided in the consent form is a prerequisite for obtaining valid informed consent, otherwise, it will be only symbolic. The study aimed to assess knowledge of surgical informed consent and associated factors among patients who undergone obstetric and gynecologic surgery at Jimma Medical Center, Jimma, Oromia Region, EthiopiaMethodology: Institutional based crossectional study was conducted among systematically selected women undergo obstetrics and gynecologic surgery in Jimmy medical center from April 1 to May 30, 2020. The collected data were coded, entered into Epi data version 3.1, and analyzed using SPSS version 25. Bivariate and multivariate regression was carried out to determine the association between an outcome variable and an independent variable. Tables, pie -charts, and texts were used to report the result.Results: This study revealed that the mean age of the respondents was 29.5 ±3.5 years and the majority of them (83.3%) were married. The respondents had significantly poor overall knowledge of surgical informed consent 77.2 %( 95%CI: 72.8-81.2).Patient educational status (AOR: 1.22 (95%CI: 1.1-2.47), satisfaction level (AOR: 1.823(95%CI: 1.061-3.134).and patient- provider relation-ship (AOR: 0.472(95%CI: 0.271-0.822) were associated with knowledge of surgical informed consent.Conclusion: in this study, the overall level of knowledge regarding surgical informed consent was significantly poor than the other national and international figures. Patient Education, satisfaction, and patient-provider relation-ship were associated with knowledge of surgical informed consent. Health care providers should provide adequate information before surgery to improve patients’ knowledge regarding surgical informed consent and provide adequate input on ways to improve the consent process to make it better suited to fit the needs of all patients.


2019 ◽  
Author(s):  
Tigist Demssew Adane ◽  
Birhan Gebresillassie Gebregiorgis ◽  
Elda Mekonnen Nigussie ◽  
Abate Dargie Wubetu

Abstract Background These days, engaging at sufficient regular physical activity strongly recommended for good health and physical functioning. Physical activity can increase the self-confidence of the health professionals and they would become fit for daily activities with patients. Knowing the level of physical activity can help health care professionals to plan for physical activity programs. This study aimed to measure the level of physical activity and associated factors among adult health professionals at Tirunesh Beijing general hospital.Objective The aim of this study was to assess the level of physical activity and associated factors among health care workers in Ethiopia, 2019.Methods Institution based cross-sectional study conducted level of physical activity and associated factors among health care workers in Ethiopia, 2019. Two hundred nighty seven adult health professionals were participated, which was a 97.4% response rate. The global physical activity questionnaire used to measure the level of physical activity. Descriptive statistics and binary logistic regression analyses was done to affirm the variables characteristics. A predictor variable with a p-value of less than 0.2 exported to multivariate analysis. During multivariate analysis, statistical significance declared at a p-value of < 0.05.Results In general, the majority of the study participants, 89.2% (95% CI: 85.9-92.6) were achieved recommended levels of physical activity. Regarding the intensity of the physical activity, the overall mean time score was 518.4 mints per week or 2352.6 MET/week. For moderate-intensity physical activity, 83.5% of the study participants were physically active, (≥150 minutes/week). In the case of vigorous activity, about 32.7% of the study participants were physically active and engaged in vigorous physical activity (≥75 minutes /week). The study participants, who had self-motivation for physical activity, had a BMI of less than 25 kg/m2 and aged < 40 years were physically active.Conclusions Health care providers’ habit of physical activity improved as compared with the previous studies. However, the current level of physical activity of health professionals is not adequate. Health care providers’ age, body mass index and self-motivation attribute to physical activity. The level of physical activity can increase by enhancing staff motivation towards physical activity.


Background: Type of anesthesia during elective cesarean is very important and is chosen according to the decision of the specialist as well as the mother’s desire. This study aimed to determine the rate and associated factors of choosing general or regional (spinal and epidural) anesthesia among pregnant women who underwent elective cesarean in hospitals of Northern Iran in 2017. Methods: This descriptive-analytic study included the pregnant women referred to the hospitals in Sari with indications for both kinds of anesthesia. The reasons for choosing the type of anesthesia were asked and collected in a researcher-made checklist. The collected data were described and analyzed using SPSS software (version 24) through the Chi-square or Fisher's exact tests and Logistic regression. A p-value less than 0.05 was considered statistically significant. Results: Out of 384 pregnant women who participated in the study, 60% and 40% of the cases chose general and regional anesthesia, respectively. Fear of spinal cord damage (64.3%) and fear of observing and hearing in the operation room (53.3%) were the most reasons for the rejection of the regional methods of anesthesia. However, the fear of not waking up (54.3%) and being interested in seeing the baby during childbirth (40.7%) were the main reasons for choosing spinal anesthesia. Most of the women who had experienced regional anesthesia selected this procedure in the current operation (53%), while general anesthesia was chosen by women without previous history of regional anesthesia (62%). Conclusion: Although most of the pregnant women selected general anesthesia, the reasons for rejecting the spinal method were mainly non-scientific and could be managed with maternal education.


Author(s):  
Cherish Paul ◽  
John Paul

Background: Shivering is a common problem faced by anaesthesiologists in the intraoperative as well as post-operative period. It occurs during both general anesthesia and regional anesthesia, but is more frequent and troublesome during regional anesthesia. There are many pharmacological and other methods to tackle this issue. Not many studies have compared between pharmacological agents that control shivering.Methods: This randomized, prospective study conducted in 80 adult patients, was designed to explore the efficacy and potency of Tramadol in comparison to Pethidine for control of shivering under regional anesthesia. Patients received Tramadol or Pethidine in a dose of 0.5 mg/kg intravenously after the appearance of shivering. Disappearance and recurrence of shivering, sedation as well as haemodynamics were observed at scheduled intervalsResults: The complete disappearance of shivering took a mean 4.5 minutes in Tramadol group while 8 minutes in pethidine group (p value<=0.05). Tramadol was more potent than Pethidine with respect to control of shivering and its recurrence.Conclusions: Intravenous Tramadol is qualitatively superior to Pethidine for control of shivering after regional anesthesia.


2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Tadese Tamire ◽  
Habtamu Demelash ◽  
Tikuneh Yetneberk ◽  
Simegnew Kibret

Introduction. Awareness with recall of intraoperative events is an infrequent but potentially devastating complication of general anesthesia, with a reported incidence of 0.1-0.2% in low-risk patients. Higher incidence is expected in resource-limited operation room setups and in high-risk patients. Awareness can result in significant distress to patients and long-term psychological consequences, including symptoms associated with posttraumatic stress disorder, anxiety, night mares, night terror, dissatisfaction with surgical service, and sometimes even suicide. Objective. To assess the magnitude and associated factors of awareness with recall under general anesthesia in Amhara regional state referral hospitals. Method. An institution-based cross-sectional study was conducted on 1065 patients who underwent surgery under general anesthesia from January 1 to June 30, 2018. The study participants were selected by systematic random sampling from 4 referral hospitals. The modified Brice questionnaire was used to detect awareness under general anesthesia. Interviewer-administered structured questionnaire and chart review were employed. Data with complete information were entered in to SPSS version 20 computer software. Descriptive statics and bivariate and multivariable analysis were computed. A P-value less than 0.2 was used to select candidate variables for multivariable logistic regression. A P-value less than 0.05 was used to declare statistical significance. Result. 1065 patients were included in the study which makes the response rate of 90.7%. The magnitude of awareness with recall under general anesthesia was found to be 8.2% of which 4.9%, 2.6%, and 0.7% of patients reported hearing voice, pain, and sensation of breathing tube, respectively. Lack of premedication was the only significantly associated factor for awareness with recall under general anesthesia (AOR = 3.014, 95% CI (1.201 to 7.565)). Conclusion and Recommendation. Our study showed higher magnitude of awareness with recall under general anesthesia. Lack of premedication was the only associated factor with awareness with recall under general anesthesia. Anesthetists should give emphasis to prevent the possibility of awareness under general anesthesia by providing premedication. Cohort studies should be done including the consequences of awareness with recall under general anesthesia.


Author(s):  
Ferrie Budianto ◽  
Philia Setiawan ◽  
Hamzah Hamzah ◽  
Erikavitri Yulianti

Introduction: An alteration of cognitive function in geriatrics often occurred after a surgery procedure. To do a surgery, patients would go through the process with anesthesia, whether it is  general or regional anesthesia. We aimed to identify the effect of general and regional anesthesia in increasing the risk of alteration in cognitive function from geriatrics who underwent elective surgery followed by other risks. Material and Method: This observational analytic study has a total sample of 60 patients who aged 60 years or more, and half of the total sample underwent an elective surgery with general anesthesia, whereas the other half with regional anesthesia at Gedung Bedah Pusat Terpadu Dr. Soetomo General Hospital in a range of October – November 2016. The cognitive function of patients was assessed with MMSE which is done in approximately 10 – 15 minutes. Result and Discussion: There was a statistically significant correlation between age and both preoperative MMSE score also the alteration of MMSE score after 3 days in patients with regional anesthesia (P-value = 0.032; 0.044). Also, the correlation between educational status and preoperative MMSE score (P-value = 0.001). There was also a statistically significant difference in alteration of the MMSE score after 3 days between patients with general and regional anesthesia which went through the hypotension phase (P-value = 0.022; 0.003). We identified that both general and regional anesthesia could lead to alteration of MMSE score (P-value = 0.001; 0.02) and there was a statistically significant difference between both of them (P-value = 0.001). Conclusion: Both general and regional anesthesia could lower the cognitive function of geriatrics, especially general anesthesia which happened to have a higher risk to occur. Other factors such as age, educational status, and hemodynamic condition during surgery, had their impacts toward lowering cognitive function in geriatrics.


2020 ◽  
Author(s):  
Taye Zeru ◽  
Dehabo Alemirew

Abstract Background: - The Integrated Management of Newborn and Childhood Illness strategy encompasses a range of interventions to prevent and manage the major childhood illness, both in health facilities and in the home. Information on actual compliance of care takers in integrated management of newborn and childhood illness is important for program planners, policy makers, health care providers and care takers to design appropriate local and national intervention plan, to increase community participation and to improve knowledge of care takers. Based on our knowledge there are limited studies regarding to care takers compliance towards integrated management of new born and childhood illness in the study area. Therefore the result of this study used for design appropriate intervention.Objective: - The objective of this study was to assess the care takers compliance and associated factors in integrated management of newborn and childhood illness with respect to antibiotic treatment.Methods:-Community based cross-sectional study was conducted. The study populations were all care takers of under-five children who attended integrated management of newborn and childhood illness clinic at health center. A total of 394 respondents were randomly selected by using systematic random sampling method from the seven health centers. Information on the care takers compliance was collected using structured, pre-tested questionnaire. Data entry and analysis were conducting using Statistical Package for Social Science version 16. Significance of the study was presented by using adjust odd ratio, confidence interval and p value. The result was presented in texts, tables and graphs.Result:-Three hundred seventy three care takers with under-five year children were voluntary to be interviewed, making the response rate 94.7 %. The findings of this study showed that 144(39%) were compliance to antibiotic treatment. Compliance to antibiotic treatment was significantly associated with post-secondary education with (AOR=5.33, 95%CI: 2.557, 11.109), private/NGO employee with (AOR=5.936, 95%CI: 1.632, 21.582), knowledge with (AOR=1.806, 95%CI: 1.096, 2.976) and distance with (AOR=2.366, 95%CI: 1.419, 3.945). Conclusion and recommendation: The finding of this study revealed that the high rates of noncompliance with counseling were identified. Therefore, the implementation of integrated management of childhood illness activities at all levels should be strengthened. There is a great need to improve the social status of care takers in order to reduce child hood morbidity and mortality.


2020 ◽  
Author(s):  
dahibo Alemirew ◽  
Taye Zeru

Abstract Background:-The Integrated Management of Newborn and Childhood Illness strategy encompasses a range of interventions to prevent and manage the major childhood illness, both in health facilities and in the home. Information on actual compliance of care takers in integrated management of newborn and childhood illness is important for program planners, policy makers, health care providers and care takers to design appropriate local and national intervention plan, to increase community participation and to improve knowledge of care takers. Based on our knowledge there are limited studies regarding to care takers compliance towards integrated management of new born and childhood illness in the study area. Therefore the result of this study used for design appropriate intervention.Objective: - The objective of this study was to assess the care takers compliance and associated factors in integrated management of newborn and childhood illness with respect to counseling.Methods:-Community based cross-sectional study was conducted. The study populations were all care takers of under-five children who attended integrated management of newborn and childhood illness clinic at health center. A total of 394 respondents were randomly selected by using systematic random sampling method from the seven health centers. Information on the care takers compliance was collected using structured, pre-tested questionnaire. Data entry and analysis were conducting using Statistical Package for Social Science version 16. Significance of the study was presented by using adjust odd ratio, confidence interval and p value. The result was presented in texts, tables and graphs.Result:-Three hundred seventy three care takers with under-five year children were voluntary to be interviewed, making the response rate 94.7 %. The findings of this study showed that 144(39%) were compliance to antibiotic treatment and 102(27.3%) were compliance to counseling. Compliance to counseling was significantly associated with age categories between 25-34 year with (AOR=2.118, 95% CI: 1.042, 4.305), post-secondary education with (AOR=2.959, 95% CI: 1.354, 6.463), knowledge with (AOR= 2.574, 95% CI: 1.482, 4.469), trust on health workers with (AOR= 2.781, 95% CI: 1.344, 5.752) and distance with (AOR= 2.214, 95% CI: 1.254, 3.91).Conclusion: The finding of this study revealed that the high rates of noncompliance with antibiotic treatment were identified. Therefore, implementation of integrated management of childhood illness activities at all levels should be strengthened and need to improve the social status of care takers in order to reduce child hood morbidity and mortality.


PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248834
Author(s):  
Zewdu Bishaw Aynalem ◽  
Kassahun Gebeyehu Yazew ◽  
Mignote Hailu Gebrie

Background Applying evidence-based practice during care provision is essential because it improves the quality of care, reduces health care costs, and increases patient and family satisfaction. However, information on evidence-based nursing practice and associated factors were not well studied and documented in the study area. Hence, this study aimed to assess utilization and associated factors of evidence-based practice among nurses working in Amhara Region Referral Hospitals, Ethiopia. Methods An institution-based cross-sectional study was conducted from March 18 to April 16, 2019, in Amhara Region Referral Hospitals. A simple random sampling technique was used to select 684 respondents. Data were collected using a pretested and self-administered questionnaire. Data were entered into Epi Info version 7.1.2.0 and exported to SPSS version 22.0 for analysis. The bivariable analysis was used primarily and variables with p-value < 0.2 were further examined using a multivariable logistic regression model to control con-founders. Then, variables’ p-value < 0.05 with 95% CI was used to determine associated factors. Results From 684 proposed nurses, 671 of them completed the questionnaire giving 98.1% response rate. Of these, 55% (95% CI: 51.2, 58.9) of them had good evidence-based practice utilization. Variables including single (AOR = 1.662: 95% CI: 1.089–2.536), fewer work experience (AOR = 1.849: 95% CI: 1.049–3.257), good knowledge (AOR = 2.044: 95% CI: 1.406–2.972), effective communication skill (AOR = 2.537: 95% CI: 1.744–3.689), EBP training (AOR = 3.224 95% CI: 1.957–5.311), internet access (AOR = 1.655: 95% CI: 1.119–2.448) and evidence-based guideline availability (AOR = 1.827: 95% CI: 1.249–2.673) were found to be predictors of evidence-based practice utilization. Conclusions The study revealed that evidence-based practice utilization among nurses is low. Availing evidence-based guidelines in the work area, improving facilities’ internet access, and building nurses’ evidence-based practice competencies through either by giving separate training or incorporating as part of the curriculum would improve its utilization.


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