TITLE:
Evaluation of the Nursing Management for Patients on Underwater Chest Drainage at Kenyatta National Hospital
AUTHORS:
Anthony Chege, James Mwaura, Angeline Kirui
KEYWORDS:
Underwater Chest Drainage, Management, Knowledge, Adherence, Challenges
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.8 No.12,
October
26,
2018
ABSTRACT: Aim: To evaluate the nursing management for patients undergoing underwater
chest drainage (UWCD) management at Kenyatta National hospital (KNH). Methods: A cross-sectional study conducted at the medical and surgical wards of
KNH. Data were obtained from 101 consenting nurses selected through simple random
sampling using a researcher administered questionnaire. Ten participant
observations were made among nurses who were systematically sampled. Ten key
informant interviews were conducted among nurse managers of these departments
who were purposively sampled. Data were analysed using SPSS version 21. Findings: Most participants (46.5%) had average knowledge while 6.9% were poor.
This means that 46.5% of the participants either had to refer to guidelines on
UWCD management or assisted by a more competent nurse while 6.9% were unable to
manage UWCD patients. Factors affecting the levels of knowledge and competence
included level of nursing education (p =
0.043), length of working experience (p =
0.022) and the attitude of the participants towards UWCD nursing management (p =
0.022). There was low adherence to the Nursing Council of Kenya (NCK) guidelines
(17%). Most nurses used “shortcuts”
in provision of care. Majority (62.6%) faced challenges in provision of care.
The challenges include inadequate knowledge (37.1%), heavy workload (27.4%) and
lack of guidelines (16.9%). Conclusions: There is a knowledge and
competence gap in the nursing management of UWCD patients at KNH. Majority used
“shortcuts” in nursing care with low
adherence to NCK guidelines. There is a need to
improve the knowledge and competence in order to ensure patients safety and
reduce complications.