Stigma towards People Living on HIV/AIDS and Associated Factors among Nurses’ Working in Amhara Region Referral Hospitals, Northwest Ethiopia: A Cross-Sectional Study

Introduction. HIV/AIDS-related stigma occurs in the world towards people living with HIV/AIDS in a different form. Stigma among nurses in health care setting is one of the main challenges towards the prevention and management of HIV/AIDS in developing countries. It is one of the main reasons keeping patients from seeking health care service. Therefore assessing the magnitude of stigma and associated factors towards people living on HIV/AIDS among nurses is of paramount importance for the quality of nursing care as well as service utilization. Methods. An institutional based cross-sectional study was conducted in March 2013. Pretested and structured questionnaire via self-administration was used in the tool of HIV/AIDS Stigma Instrument-Nurse (HASI-N). Data were entered using EPI info version 3.5.3 and transferred to SPSS version 20 for further analysis. Descriptive statistics were conducted to summarize the sample characteristics. A backward stepwise logistic regression model was fitted and adjusted odds ratio with 95% confidence interval was calculated to identify associated factors. Results. A total of 386 nurses participated yielding a response rate of 97.2%. Nearly two-thirds (64.5%) of them have shown stigma towards people living with HIV/AIDS in the health institution. Qualification level of diploma or certificate, lack of training, experiences of <06 years, low HIV patient caseload seen in the last six months, and the absence of guidelines/protocols about HIV/AIDS in their health institution were associated factors for stigma. Conclusions. The findings of this research showed high magnitude of stigma towards people living with HIV/AIDS among nurses. For stigma to be decreased nurses need to update their knowledge through training and experience sharing with senior staff. And it is crucial that the Ethiopian Ministry of Health, Amhara Regional Health Bureau, and the two hospitals work for decreasing stigma by creating educational development, ensuring accessibility of guidelines about HIV/AIDS, and providing access to training.

Adult Patients’ Satisfaction with Inpatient Nursing Care and Associated Factors in an Ethiopian Referral Hospital, Northeast, Ethiopia

Introduction. Patient satisfaction with nursing care is considered as an important factor in explaining patients’ perceptions of service quality. Care assessed to be high quality according to clinical, economic, or other provider-defined criteria is far from ideal if as a result of that care the patient is unhappy or dissatisfied. Objective. The aim of this study was to assess adult patients’ satisfaction with inpatient nursing care and associated factors in Dessie Referral Hospital, Northeast Ethiopia. Methods. Institution based quantitative cross-sectional study was conducted among patients admitted in medical, surgical, orthopedics, gynecology, and ophthalmology wards of the hospital from March 24 to April 30, 2013. All admitted patients who stayed in the study wards for at least two days during the data collection time were interviewed. Newcastle Satisfaction with Nursing Scale questionnaire was used to collect the data and was analyzed using SPSS version 20. Odds ratios with their 95% confidence intervals and p values in a multiple logistic regression were used to identify factors associated with patient satisfaction with nursing care. Result. The overall patient satisfaction was 52.5%. Respondents’ sex, age, admission ward, self-reported health status, and class of admission were the variables significantly associated with patient satisfaction with nursing care. Conclusion and Recommendation. The rate of patient satisfaction with nursing care was found to be low in this study. Being female, younger age group (18–30 years), good self-reported current health status, being admitted in ophthalmology ward, and first class of admission were significantly associated with better patient satisfaction with nursing care. In-service training programs for nurses, with special emphasis on communication skills, are recommended.

Perceived Clinical Competence among Undergraduate Nursing Students in the University of Gondar and Bahir Dar University, Northwest Ethiopia: A Cross-Sectional Institution Based Study

Introduction. To produce competent, confident, critical thinker with the ability to lead, to question, and to be questioned is needed in nursing education. This study aimed to assess perceived clinical competence among nursing students. Methods. This cross-sectional study was conducted in two nursing schools in Ethiopia. Data were collected using pretested, semistructured questionnaire. Clinical competence was measured by Short Nursing Competence Questionnaires. Binary logistic regression model was fitted to identify associated factors. An adjusted odds ratio with 95% confidence interval was computed. Results. Overall, 48.7 % of the participants perceived themselves as clinically competent. Social support [moderate (AOR = 5.87, CI: 1.346, 9.586), high (AOR = 6.27, CI: 1.741, 7.608)], type of institution [(AOR = 3.20, CI: 1.331, 7.694)], year of study [(AOR = 1.89 (4.760, 18.510)], attending theoretical classes [(AOR = 0.83 CI: 0.017, 0.412)], and clinical environment [poor (AOR = 5.65, CI: 1.837, 13.453), fair (AOR = 7.31, CI: 2.790, 15.356), good (AOR = 9.31, CI: 3.260, 19.967)] were associated with clinical competence. Conclusion. More than half of the study participants perceived themselves as incompetent. Social support, type of institution, year of study, attending theory classes, and clinical environment were associated with perceived clinical competence. Authors suggested that nursing students attend their theoretical class and utilize the available resource.

Preterm Birth and Associated Factors among Mothers Who Gave Birth in Gondar Town Health Institutions

Background. The birth of a preterm infant has a greater risk of developmental disabilities, health, and growth problems than infants born at full term. The main aim of this study was to assess the prevalence and associated factors of preterm birth Northwest Ethiopia, Gondar town health institutions. Methods. Facility based cross section study was undertaken. Systematic sampling was used to select 540 study participants. Both bivariate and multiple logistic regression were fitted. Variables with p value < 0.05 and 95% CI in multivariate were considered statistically significant. Result. This study showed that 4.4% from the total 540 mothers gave a preterm birth. The covariates of pregnancy induced hypertension (AOR 5.36 (95% CI 1.8, 15.96)) and being HIV positive (AOR 3.4 (95% CI 1.25, 9.2)) were found to be significantly associated with preterm birth. Conclusion. The main factors for preterm birth were pregnancy induced hypertension and being HIV positive. Therefore, still efforts have to be made to decrease the prevalence of preterm birth and for timely management of pregnancy induced hypertension and identifying pregnant women at the risk of preterm delivery like HIV positive women and proving quality of healthcare may decrease the rate of preterm birth and its consequences.

Preceptorship versus Clinical Teaching Partnership: Literature Review and Recommendations for Implementation in Ghana

Clinical education is an essential component of the education of nursing students. However clinical nursing education in Ghana is currently facing challenges of poor working relations between hospitals and health training institutions, inadequate preceptor preparations, and inadequate faculty supervisions. Although the dominant clinical education model used in Ghana is the preceptorship model, health service and education industries are faced with challenges of lack of qualified staff, inadequately prepared preceptors, and inadequate supervision from faculty. These challenges undermine the effectiveness of the clinical learning environment and the use of the preceptorship model. The purpose of this paper was to review preceptorship and clinical teaching partnership (CTP) and make recommendations for improving clinical nursing education in Ghana. A literature review was undertaken through a search of databases that included Google Scholar, EBSCOhost, CINAHL, and HINARI. A literature review identified advantages for using clinical teaching partnership (CTP) in clinical nursing education in Ghana. Recommendations were made for the use of CTP in Ghana.

Adherence and Associated Factors towards Antidiabetic Medication among Type II Diabetic Patients on Follow-Up at University of Gondar Hospital, Northwest Ethiopia

Background. The prevalence of diabetes mellitus (DM) is rising worldwide and is more in the developing countries which unfortunately are already suffering from communicable diseases. The aim of this study was to assess adherence and associated factors towards antidiabetic medication among type II diabetic patients in University of Gondar Hospital, Diabetic Clinic, Gondar, Northwest Ethiopia. Methods. Institutional based cross-sectional study was conducted. Systematic sampling technique was used. Morisky Medication Adherence Scale (MMAS) scores were used for labeling patients as adherent or nonadherent. Data were entered and analyzed using SPSS version 20. To see the association of variables logistic regression with OR and 95% CI was done. Results. A total of 288 study participants were interviewed with response rate of 100%. The level of adherence was found to be 85.1%. Factors found to be significantly associated with antidiabetic medication adherence were level of education (AOR = 14.27, 95% CI = 3.0, 67.82), duration of diabetes (AOR = 6.10, 95% CI = 2.03, 18.34), and knowledge about DM and its medications (AOR = 28.05, 95% CI = 8.96, 87.8). Conclusions and Recommendations. Large proportion of respondents in this study were found to be adherent to their antidiabetic medications. Level of education, duration of diabetes, and knowledge about DM and its medication were significantly associated with antidiabetic medication adherence of patients. Health education including adherence counseling to create awareness towards DM and its medications is mandatory.

Is There Significant Difference between Digital and Glass Mercury Thermometer?

Background. Children’s decisions concerning investigation and treatment may be based on the results of temperature alone. Although the accuracy of axillary temperature measurement is affected by a number of factors, device dwell time and device type are common. Objective. Compare body temperature between glass mercury thermometer (GMT) and digital thermometer (DT). Method. Comparative descriptive study was used. A total of 101 samples were taken with convenient sampling technique, but 98 were analyzed. Statistical significance (p<0.01) and clinical significance (MD≥0.2°C) were used in the analyses. Correlations and Bland-Altman plots were used to observe agreements of the recording. Results. Mean difference (MD) of 10 min GMT and DT was 0.13±0.11. Statistically significant differences were noted in 10 min GMT and DT (p<0.00). But the correlations were strong positive (r>0.75) and all MD were at the limit of agreement in Bland-Altman plot. Clinically, it is not significant (MD<0.2°C). Conclusion and Recommendations. Even though statistical significant differences (p<0.001) were noted between 10 min GMT and DT, the strong correlation, good agreements, and clinical insignificances make DT good alternative to the traditional GMT. Their variation in temperature is not likely to change any clinical decision. So, health professionals should use DT for measuring body temperature in under-5 febrile illnesses.

Assessment of Nurses’ Knowledge, Attitude, and Perceived Barriers to Expressed Pressure Ulcer Prevention Practice in Addis Ababa Government Hospitals, Addis Ababa, Ethiopia, 2015

Background. Although pressure ulcer development is now generally considered as an indicator for quality of nursing care, questions and concerns about situations in which they are unavoidable remain. Awareness about the significance of the problem, positive attitude towards prevention, and an adequate level of knowledge are cornerstones to effectively prevent pressure ulcers. Objective. To assess nurses’ knowledge, attitudes, and perceived barriers to expressed pressure ulcer prevention practice in Addis Ababa government hospitals. Methods and Materials. This is a cross-sectional study by design. A total of 217 eligible nurses participated in the study and data were collected through pretested self-administered questionnaire. Results. When queried, 61.2% of the respondents had adequate knowledge on pressure ulcer prevention practices, while 68.4% had favorable attitudes towards prevention practices. Moreover, 67.3% of participants had good pressure ulcer prevention practices. Conclusion and Recommendation. More than half of the nurses were found to have adequate knowledge about pressure ulcer prevention and their attitude towards it was overall favorable. Expressed pressure ulcer prevention practice was affected by the participant’s level of knowledge, attitude, and barriers of care. To provide effective prevention of pressure ulcer, nurses’ level of knowledge and attitude should be enhanced besides resolving these barriers.

Registered Nurses’ Experiences with the Medication Administration Process

Background. Registered nurses (RNs) have a role in the medication administration process (MAP) multiple times per day in a hectic hospital environment. This requires a great deal from the RNs in order to accomplish the demanding task of avoiding adverse drug events. However, the process has not been widely studied from the nurses’ perspective. Aim. The aim of this study was to describe the different stages of MAP from the RNs’ perspective. Methods. A qualitative descriptive research design, with a purposive sample involving thematic interviews of 20 RNs and questions to them in a paper form, was conducted in two medical units. Data was analyzed by using deductive content analysis. Results. The results revealed that RNs confront numerous problems such as equivocal prescriptions, problems with information technology (IT), unavailability or incompatibility of the medicines, a substantial amount of generic substitutions, and changing medicine brands. Disruptions and distraction run through each stage of the MAP, excluding prescribing. The RNs desire support in all stages of the MAP. Conclusion. There are areas to improve in each stage of the MAP from the RNs perspective. Real-time and ubiquitous documentation, along with software including the data and knowledge required in medication management, is needed.

The Effects of Nonpharmacological Treatment on Uremic Pruritus Patients: A Systematic Review

Background. Around 50–90% of hemodialysis patients develop pruritus. Although studies examining nonpharmacological treatments for itchy skin have been conducted, the conclusions have not been decisive. Purpose. Through a systematic review of the literature, this study aimed to understand nonpharmacological interventions carried out in clinical trials for uremic pruritus and to evaluate and consolidate the information regarding these improvements and their effectiveness. Methods. A literature search focusing on studies published between January 2004 and December 2013 was conducted from 5 electronic databases. After screening based on inclusion criteria and excluding duplicates, nonpharmacological treatments examined in randomized clinical trials were selected for further analysis and synthesis. A modified Jadad scale was used to evaluate the quality of the identified articles. Results. Seven nonpharmacological studies met the inclusion criteria. The interventions to improve uremic pruritus included using emollients, phototherapy, acupuncture, and thermal therapy. Research showed that using emollients, phototherapy, and acupuncture significantly reduces uremic pruritus. Conclusion. Nonpharmacological interventions are effective for hemodialysis patients with pruritus. Emollients were found to provide the most relief compared to the other methods and constitute a readily available and cost-effective intervention to improve pruritus symptoms.