Assessment of Nurses’ Knowledge of the Management of Pre-Eclampsia in a Hospital Setting: The Case of the Van Norman Clinic. Bujumbura-Burundi

Background: Pre-eclampsia is one of the pathologies of pregnancy that causes serious maternal and fetal complications. Good nursing management of pre-eclampsia could stabilize and limit possible maternal and fetal complication. Aim: This study aims to assess nurses’ knowledge of the management of pre-eclampsia. This is a descriptive prospective study conducted at the Van Norman Clinic over three-month period from November 1st, 2020 to January 31st, 2021 to assess the knowledge of nurses assigned to the Patient reception service, Emergency service, Gynecological-Obstetrics service and Community Medicine department on the management of pre-eclampsia. Data were treated using Microsoft Word and analyzed by Statistical Package for Social Scientists version 16 (SPSS). During the period of our study, we collected 40 nurses out of 44 nurses, which represents 90.9% (n = 40) of the nurses assigned to the Patient reception service, Emergency service, Gynecological-Obstetrics service and Community Medicine department. Among the 40 cases collected, 30% respondents did not give the true definition of pre-eclampsia. Our study also showed that 70% of nurses had not been trained on the management of pre-eclampsia and 90% had not used nursing theories in their practice while the Inquiry-Based Practice (IBP) and Evidence-Based Practice (EBP) applications were known in 7.5% of cases. With regard to the nursing management of pre-eclampsia, 62.5% of cases knew the first gestures of management while 90% of cases did not know the overall nursing management of pre-eclampsia. Last of continuing education, use of nursing theories and lack of resuscitation were the main obstacles observed in the nursing management of pre-eclampsia. For better nursing management of pre-eclampsia, emphasis should be placed on building staff capacity and executing the care plan by applying nursing theories.

Nurses’ Knowledge, Attitudes and Practice regarding Pressure Ulcers Prevention and Treatment

Pressure ulcers (PU) are one of the most common hospital-acquired problems that occur in patients with mobility limitations. Such wounds can produce pain and deterioration of the underlying condition. Sometimes, they can be life-threatening, and their treatment can impose a financial burden on both the patient’s family and society. Nurses’ knowledge, attitude, and practice are the most important weapons to fight this preventable burden of PU among patients with impaired mobility. The purpose of this study was to assess nurses’ knowledge, attitude, and practice regarding PU prevention and treatment at Clinique Prince Louis Rwagasore (CPLR) in Bujumbura, Burundi. A cross-sectional study design was used. Convenience sampling was used to invite all 28 qualified nurses and nurses’ aids who work in the services where critically ill patients are admitted to participate. A questionnaire was created, and underwent evaluation of face validity before using it to collect data which was analysed using SPSS 21.0. Results revealed that nurses’ knowledge and practice scores were low as participants scored less than 50% on the six knowledge items and the six practice items. However, the attitude scores were greater than 65% on the five items used to evaluate attitude. A strong negative correlation was found between nurses’ knowledge and their attitude scores (r = ?0.479, p = 0.015). Education level was negatively associated with nurses’ knowledge and practice scores of PU prevention and treatment. A high attitude score did not correlate with a higher practice score which might be explained by low knowledge scores (less than 50% on knowledge items). Continuous professional development (CPD) was recommended to improve nurses’ knowledge scores and implementation of PU preventive practices at CPLR.

Emergy Evaluation of Treatment Methods for Solid Medical Waste in Bujumbura-Burundi

Introduction: Treatment of solid medical waste (SMW) is a complex task requiring the proper practices with specific treatment methods corresponding to each type of SMW during pretreatment and final treatment. This study targeted three treatment methods identified as the main used by the majority of health care facilities (HCFs) and treating a large amount of SMW. It aimed: 1) to evaluate the current practices by calculating the emergy investment and emergy costs that are required to treat one ton of SMW through the three treatment methods and 2) to evaluate and compare better technologies and provide policy suggestions for the final treatment of SMW in Burundi. Materials and Methods: This study used the emergy methodology to evaluate the relative efficiencies of three treatment methods used for to treat SMW in twelve HCFs in Bujumbura. Results and Conclusion: The total emergy input was 1.36E+20 seJ/yr, 3.54E+17 seJ/yr, and 1.681E+18 seJ/yr for low temperature incinerator, landfill and organic pit, respectively. Conclusion: Rapid improvement of organic pit by ensuring its maintenance, the gradual replacement of low temperature incinerator by high temperature incinerator with air control pollution and landfill by sanitary landfill are highly recommended by respecting its maintenance (fence, roof and monitoring evaluation) for reducing the risk.

Inquiry Based on Evidence and its Practices in Two Healthcare Facilities of Bujumbura

Background: Inquiry evidence-based practice (IBP) improves healthcare quality, reliability, and patient outcomes as well as reduces variations in care and costs. IBP and its practice in health care promote also many advantages, such as improvements of practices based on the attitudes and cognitive ideas. This study aims to assess the inquiry based on evidence (IBP) and its practices in two Health Care Facilities (HCFs) of Bujumbura to help the practitioners to understand its importance. Methods: A cross-sectional study design was used to analyze the importance of IBP and its practice in these two hospitals. The probability-sampling technique was used also to select 104 nurses from the Military Hospital of Kamenge and 55 nurses from the Van Norman Clinic. A questionnaire was used to collect data with two mains components, demographic data and knowledge and attitudes addressing the following parameters: evidence practice during inquiry, nursing theory, current analysis in nursing care oriented the evidence, prioritization of care, rational diagnostic, monitoring and assessment. Results: The findings from this study revealed a poor knowledge and attitude among participants towards Inquiry Based Practice. In all variables, participants were scoring less than 10%. However, majority of participants (76.5%) know the indicators of patients’ satisfaction with nursing interventions through survey-based practice and 74.1% argued to analyze their information collected. Conclusion: This study revealed a weak awareness on IBP and its importance during nursing practice among participants as for almost all variables, participants were scoring less than 10%, except for the indicators of patients’ satisfaction with nursing interventions through survey-based practice (76.5%). Therefore, in-service training and curriculum revision had been highlighted and recommended another to provide the best rational diagnosis and achieve the patient’s outcomes.

Women’s Attitudes and Knowledge towards the Use of Contraceptive Methods

Background: Contraceptive use reduces the need for abortion by preventing unwanted pregnancies, and the causes of maternal death worldwide. Contraceptive use helps women to plan their pregnancies and contributes for population growth. This study aims to analyze the attitudes and knowledge of the women attending Van Norma Clinic for the use of contraceptive methods. Methods: A cross-sectional study was used to analyze the information. A convenience sampling method has been used to select the 100 women who attended Van Norman Clinic in Family planning service in the period of the study of four months (April to July, 2020). A self-administered questionnaire with four parameters addressing importance of using contraceptive methods, the factors affecting the women’s attitudes for not using contraceptive methods, types of contraceptive methods currently used, advantages and disadvantages of using contraceptive methods was used to collect data. Results: Research findings show that the majority of respondents knew the importance of using contraceptive methods like preventing unwanted pregnancies (97%), spacing pregnancies (96%), planning pregnancies (92%), and getting well (70%). Two factors affecting women for not using contraceptive methods had been identified such as religion (73%) and fear (70%). In addition, the women attending Van Norman Clinic prefer using implants (99%) and injectable (99%). It is clear that women do not know the consequences related to the nonuse of contraceptive methods. Some recommendations have been made to the health care facilities, parents, women themselves, churches’ leaders and government in general. Conclusion: Factors which influence women’s attitudes for not using contraceptive methods were notified in our study such as religion (73.0%) and fear (70.0%) which was explained by the fact that in Burundi most people are catholic which is the most religion prohibiting the use of contraceptive methods. However, the participants’ knowledge was significantly good as their score was more than 50% for all variables.

Infection Control Measures among Healthcare Workers: Knowledge, Attitude and Practice

Background: Nosocomial infections are some of public health problems globally and continue to be increased regardless of the hospital’s efforts on infection control measures and are contributing significantly to morbidity, mortality and cost. The absence of infection control policies, guidelines and trained professionals also contributes to the magnitude of the problem. The aim of this study was to assess the Knowledge, attitude and practices towards infection control measures among healthcare workers at Old Mutare Hospital. Methods: A cross-sectional survey design was used to acquire information. A purposive sampling method was used to select 22 nurses, 15 nurse Aids and 2 laboratory technicians (Lab Tech). A self-administered questionnaire with four components addressing demographic data, knowledge, attitudes and practices was used to collect data that was completed by a checklist. Results: The study findings revealed a poor knowledge of infection control measures among the nurse’s aide. The attitude and practices among participants were impartially good in all variables. The participants had scored over 50% towards their attitude and their practices on infection control. A significant statistical difference was found between the professional status of the participants and the ability to explain how one can get Hospital Acquired Infections (HAIs) and awareness of infection control programs in their hospital (rs = 0.640, 0.645) with P < 0.05 (0.01, 0.01) respectively. Conclusion: Despite of having a fair attitude and practice towards infection control, the participants had presented poor knowledge;therefore, it had been recommended that in service training and workshop should be planned by the administration to update their knowledge and attain full compliance towards their practice.

Pediatric Nursing Care and Its Practices in Three Health Care Facilities

Introduction: Pediatric nursing cares are among the most important care needed referring to the category of patients. A gap of the best practice in Pediatric Nursing Care (PNC) had been publically a major problem of health and raises the rate of morbidity and mortality. The lack of nursing guidelines, low level of studies, experience at work and low economic status of Health Care Facilities (HCFs) were the main problems assessed in these three HCFs (HUCK, VNC and MHK) in this study. The purpose of this study is to assess the knowledge of nurses during their practices in Pediatric Wards of HCFs and to provide a better contribution. Method: A descriptive study design was used in this study during the period of one month. 43, 25 and 30 nurses were selected among 98 nurses by using Dilman formula. A questionnaire with 5 parameters was distributed. Data were typed using Microsoft ward and analyzed using Statistical Package for Social Scientists version 16 software (SPSS). Results: The current study found that the majority of nurses don’t know to make the best nursing diagnosis neither the factors related to the implementation of EBP in PNC. The nurses have shown different barriers often met during their practices. The all process of nursing diagnosis was not recognized with the average of 97.6% of nurses. Conclusion: Even if the nurses have some experience at work they express their weakness based on low level of study, lack of knowledge and trained professionals on work and the pediatric nursing guidelines.

Clinical Preceptor’s Role in the Development of Nursing Training Based on Professional and Competency Frameworks in Two Health Care Facilities of Bujumbura

Background: The aim of clinical preceptors is to support the development of expertise related to the preceptorship of groups of trainees among nurses in clinical settings by the acquisition and use of theoretical knowledge, know-how and know-that. The support of students remains a major problem in hospitals, because the requirements of the preceptors according to the standards are not considered. The lack of guidelines on nursing preceptorships, theoretical application based on the professional curriculum, and professional expertise were the main problems assessed in the two Health Care (HUCK, VNC) in this study. The purpose of this study is to assess the knowledge of nurses and learners during their preceptorship practices and to contribute to the direction of evidence-based preceptorship. Method: A descriptive cross-sectional study design was used in this study during the 3-month period. A sample of 121 nurses as well as 56 learners were selected from 381 nurses and 80 learners using Alain Bouchard’s formula. A questionnaire developed according to the guidelines of Ernestine Wiedenbach’s theory of care, was distributed. The data were analyzed using the Microsoft Excel and the software program version 16 (SPSS-16). Results: The current study found that the majority of nurses do not know the importance of the clinical tutor. The results state that students experience clinical practice problems, thus clinical preceptorship is required. Nurses showed that there are different barriers often encountered during their practices. The overall nurse preceptorship process is not optimal and the average of 97.6% of nurses does not have expertise in coaching interns in clinical settings. Conclusion: Although that nurses have some experience at work, they express their weakness based on a low level of education, a lack of knowledge and trained professionals on the job, and clinical preceptorship guidelines.

Nursing Theory and Its Practices in Two Health Care Facilities of Bujumbura

Introduction: Nursing theory provides a systematic explanation and description of nursing phenomena. It is very important during nursing practice in healthcare facilities (HCFs) because it guides nurses on how to collect data, which data to collect, decide how to interpret the data through the perspective of the theorist, how to plan and implement care, how to make a change and how to evaluate the patient’s outcomes. This study aims to illustrate how nursing theory can be applied during the implementation of nursing care in HCFs of Burundi by orienting the nurses to understand its application during practice. Methods: A cross-sectional study design was used to assess the use of nursing theories in healthcare facilities. A purposive sampling method was used also to select 81 nurses working full and part by applying Alain Bouchard’s formula and the questionnaire was used as the data collection instrument. Results: The current study had revealed a poor knowledge among the participants on the use of nursing theory in these two HCFs as for all variables, their average scores were almost 24.1% whilst those who had no notion related to nursing theory reach a percentage of 75.9%. Conclusion: The study findings were slightly poor as for all variables, they scored less than 40%. Therefore, the use of theories to guide their practice was highly recommended to enhance the patients’ outcomes based on the use of scientific-based experts which could result from continuous education.