Evaluation of Nurses Awareness and Practice of Hemodialysis Access Care in Khartoum State, Sudan

Introduction: In hemodialysis (HD) wards, nurses play a pivotal role in HD access care. Unfortunately, guideline recommendations for routine preventive care are not always followed. This study was designed to evaluate nurses’ awareness and practice of HD access care in Khartoum state, Sudan.Methods: The study included 50 randomly selected HD nurses. Nurses’ knowledge was evaluated using a participant-filled questionnaire and their practice was evaluated by direct monitoring. Variables were summarized as frequencies and related to nurses’ educational level.Results: Females constituted 72% of study participants and 85% were university graduates. Half the nurses had more than two years experience in HD centers. Structured training on HD machines and HD access care was received by 56% and 54% of respondents respectively. All participants stated that proper HD access care helps prevent access infection but only 54% stated that it helps in preserving access function. Most nurses (98%) stated that hand hygiene in HD centers was necessary to prevent infection but only 70% were adherent to hand hygiene before access manipulation. Most nurses (98%) evaluated HD access function before connection but only 52% evaluated it for signs of infection. Nurses with a bachelor degree tended to be more adherent to hand hygiene (72.5 versus 42.9%, P=0.1) and the use of gloves (100% versus 85.7%, P=0.1) compared to nurses with a diploma degree, but the difference was not statistically significant.Conclusion: HD nurses adherence to the recommended infection control measures in studied HD centers was suboptimal. HD centers are required to organize adequate training on HD access care for their nursing staff.Keywords: Arteriovenous Fistula; Central Venous Catheter; Hand Hygiene; Hemodialysis; Infection Control

The Potential Role of Nursing Students in the Implementation of Community-Based Hypertension Screening Programs in Sudan

Introduction: Hypertension (HTN), diabetes mellitus (DM) and chronic kidney disease (CKD) are important health problems worldwide, and it is possible to reduce their burden through effective HTN screening and treatment programs. It may be feasible to incorporate such programs in the community outreach activities of nursing and medical schools in Sudan. Methods: Village inhabitants in the Northern state of Sudan were invited to attend a free clinic for screening of hypertension as well as for follow up and treatment of persons with previously diagnosed hypertension. Fourth year nursing students from the National Ribat University were asked to record demographic data and blood pressure measurements for the attendants of the clinic. Results: A total of 389 adults were screened, their mean age was 41±15 years and 83.8% of them were females. Family history of HTN, DM and CKD was reported by 52.7%, 40.4% and 12.9% respectively. Personal history of HTN, DM and CKD was reported by 28.5%, 17% and 6.4% respectively. The overall prevalence of HTN was 39.6%. Among persons previously diagnosed as hypertensive, 80.2% were on antihypertensive medication but only 48.6% had blood pressure < 140/90 mmHg. Among the 278 persons with no personal history of HTN, 19.1% had blood pressure ≥ 140/90 mmHg. Variables significantly and independently associated with the presence of HTN were family history of HTN (OR: 6.4, P: 0.005), less than 10 years of formal education (OR: 3.5, P: 0.000) and age ≥ 40 years (OR: 2.4, P: 0.005). Conclusion: With proper coordination, nursing and medical students can effectively contribute to the implementation of hypertension screening programs. Keywords: Hypertension; Nursing Students; Screening; Suda

Osteitis of the radius following Bacillus Calmette–Guérin vaccination at birth: a case report

Abstract Background The Bacillus Calmette–Guérin vaccine, which is used for the prevention of tuberculosis, is considered protective against the severe forms of childhood tuberculosis. However, some serious adverse reactions including osteitis of the long bones can occur. Case presentation We report a case of an 18-month-old Sudanese girl who presented at the age of 3 months with swelling of her left forearm following Bacillus Calmette–Guérin vaccination administered at birth. Radiological and histological investigations confirmed tuberculous osteitis of the distal radius. She responded very well to antituberculous treatment with complete healing at follow-up visits. To the best of our knowledge this is the first case report of osteitis of the radius following Bacillus Calmette–Guérin vaccination described from Sudan. Conclusions Bacillus Calmette–Guérin osteitis, although rare, should be considered a possible complication of the Bacillus Calmette–Guérin vaccination, and early diagnosis and treatment are essential