Nursing Education to Prevent Resident Falls in Long-Term Care

Residents in nursing facilities are more prone to falls than those living in the community. Injuries resulting from falls impact residents, their families, and healthcare costs. The gap in nursing practice was the lack of a comprehensive fall-prevention program in a long-term care facility that had experienced high fall rates among residents. This project addressed whether an educational program using the American Medical Directors Association\u27s clinical practice guideline and the Centers for Disease Control and Prevention\u27s STEADI (Stopping Elderly Accidents, Deaths, & Injuries) toolkit for fall- prevention improved the self-efficacy of direct-care staff in preventing falls among residents in a long-term care facility. The practice-focused question focused on whether education on the use of an integrated multifactorial fall-prevention guideline would increase confidence of long-term care staff in reducing falls in long-term care residents. The evaluation used the 11-item Self-Efficacy for Preventing Falls-Nurse scale for 5 licensed nursing staff and the 8-item Self-Efficacy for Preventing Falls-Assistant scale for 21 nursing assistants. The positive change in self-efficacy scores of nurses and nursing assistants after the education program was greatest for face-to-face team communication regarding fall risk and individual resident prevention plans. The use of best-practice guidelines that improve fall risk-assessment and use of fall precautions to decrease the number of falls and falls with injury has the potential to bring about positive social change by improving the nursing care of nursing home residents, resulting in improved resident safety and quality of life

Sensitivity and Responsiveness of Health Utility Indices (HUI2 and HUI3) Among Type 2 Diabetes Patients

Purpose: To assess the sensitivity and responsiveness of HUI2 and HUI3 among Type 2 diabetes patients.Methods: This cross-sectional study was conducted in two purposively selected Nigerian tertiary hospitals. Six hundred and thirty-eight (638) adult patients were surveyed following their consent using the HUI2 and HUI3 (HUI23S4En.40Q) questionnaire. Patients’ clinical characteristics such as age, comorbidity, severity of disease, and utilization of hospital resources were postulated a priori to be associated significantly with utility scores of HUI2 and HUI3. Student’s t-test and bivariate analyses were conducted to determine the diabetes-severity discriminatory ability of HUI2 and HUI3. The analyses were conducted with SPSS 14.0. A two-tailed significance level of 0.05 was used.Results: Older patients had lower quality of life than younger patients. The overall health deficit of increasing age for HU13 was -0.2950 and that of overall HUI2 was -0.1553. The respondents without eye problem had higher quality of life than those with eye problem, in both HUI3 and HUI2 utility scores. Stroke was the most important patients’ characteristic that negatively affected HRQOL. Patients with duration of diabetes > 4 years had lower quality of life scores than their counterparts (≤ 4years).Conclusion: Health Utility Index Mark 2 and Mark 3 were sufficiently sensitive and responsive to diabetes severity among Type 2 diabetes patients.Keywords: Health utility index, HUI2, HUI3, Quality of life, Diabetes

Burnout and psychological distress among nurses in a Nigerian tertiary health institution

Background: The role of nurses in the health care delivery system cannot be overemphasized. Nurses are needed at all levels of healthcare and the profession requires a lot of dedication, time and energy with regards to patient management and service delivery. This time investment and dedication to duty is likely to lead to burnout and psychological distress among the nurses. Objective: This study assesses the prevalence of burnout and psychological distress among nurses working in Nigerian tertiary health institution. Method: The Maslach Burnout Inventory (MBI) and the General Health Questionnaire (GHQ-12) were used to assess 210 nurses working in this health institution for symptoms of burnout and psychological distress. Results: High levels of burnout were identified in 42.9% of the respondents in the area of emotional exhaustion, 47.6% in the area of depersonalization and 53.8% in the area of reduced personal accomplishment, while 44.1% scored positive in the GHQ-12 indicating presence of psychological distress. Conclusion: Prevalence of burnout and psychological distress is high among nurses.Keywords: Burnout, psychological distress, stress managementAfrican Health sciences Vol 14 No. 1 March 201

Oral health knowledge, perceptions and behaviour among nursing students in a Nigerian tertiary hospital

Aim: The purpose of the study was to investigate oral health knowledge, perceptions and behaviour amongst nursing students in a Nigerian tertiary hospital. Materials and methods: The study was conducted at University of Nigeria Teaching Hospital on 244 respondents aged 17 to 40 years, using self administered structured questionnaire. Result: Respondents showed high level of oral health knowledge. Most of them (68.3%), had never visited a dentist with females accounting for 144 (67.7%) (P > 0.05). About 58.0% of the respondents brushed once a day. Majority, 155 (70.5%), of females perceived their oral health as good as against 14 (58.3%) males. Conclusion: The respondents had good oral health knowledge, but poor oral health behaviour. Importance of regular dental visit, frequent tooth brushing, should be stressed. Keywords: Oral health, knowledge, behaviour, Nursing students, tertiary hospital. Tanzania Dental Journal Vol. 14 (1) 2007: pp. 26-2

A Comparative Study of Quinine and Artemether in the Treatment of Severe Malaria in Nigerian Children

Purpose: Nigeria has adopted quinine as the drug of first choice in the treatment of severe malaria and artemether as an alternative therapy. The purpose of this study was to ascertain whether artemether is a comparable alternative to quinine in the management of severe malaria in Nigerian children. Methods: We conducted a randomized prospective study comparing quinine and artemether therapies in 90 Nigerian children with severe malaria. Results: Mortality was lower in quinine group (13.0 %) than artemether (15.9 %), Odds Ratio (OR) = 0.446 (95 % Confidence Interval (CI), 0.124 to 1.603, p = 0.249 ). The parasitaemia clearance on day 3 by quinine and artemether was 96.8 and 99.0 % (p = 0.422), respectively, while on day 14 it was 100 % for both medicines. Fever clearance by quinine and artemether was 87.7 and 90 % (p = 0.753), respectively, on day 3 but it increased to 100 and 96.42 % (p = 0.072), respectively, on day 14. For the quinine group, 71.74 % of the patients spent less than one week in the hospital versus 61.76 % for the artemether group (p = 0.829, OR = 0.883, 95 %CI = 0.284 to 2.742). Conclusion: Artemether is a comparable alternative to quinine in the treatment of severe paediatric malaria.Key words: Artemether; Nigerian children; Paediatric; Quinine; Severe malaria.

The Construct Validity of an Instrument for Measuring Type 2 Diabetes Self-Care Knowledge in Nigeria

Purpose: To develop an instrument (DSCKQ-30) for measuring type 2 diabetic patients’ knowledge of self-care practices.Methods: A 30-item questionnaire (DSCKQ-30) consisting of close ended questions was developed for this study. DSCKQ-30 was self administered to a cross-section of randomly selected 400 ambulatory adult diabetic patients (≥ 18 years), who were attending endocrinology clinics at the hospitals included in this study. The sex distribution for female and male was 56.7 and 43.3% respectively. Factor analysis and item analysis were performed to test the construct validity and reliability of the instrument. Item performance was measured by item discrimination (item-to-total correlation) and percent correctness (%C).Results: The response rate was 78.5%. Factor analysis identified three scales of knowledge of self-care management. Chronbach’s alpha of the 30 questionnaire items was found to be 0.89. The item-to-total correlation coefficients and ranges for component 1 - 3 were 0.36 (0.25 - 0.48), 0.28 (0.23 - 0.35), and 0.34 (0.23 - 0.41), respectively, with overall average of 0.33 (0.23 - 0.48). Items percent correctness (% C) ranged from 16.7 to 86.7 % with an overall average of 55.6 %. Item factor loadings averaged 0.62 for the total items; averages of the three scales ranged from 0.59 to 0.68.Conclusion: The DSCKQ-30 provided a quantitative measure of patient's knowledge of self-care practices.Keywords: Diabetes self-care knowledge, DSCKQ-30, Knowledge instrument, Nigeria

REFRACTIVE ERRORS AMONG NIGERIAN YOUTHS

Genetic, cultural, and environmental factors play key roles in the prevalence and distribution of refractive errors. More youths in Nigeria today use medicated glasses to enhance vision than we had in the past decades. This study is aimed at revealing the prevalence of refractive errors among students of Madonna University Nigeria, Elele campus, Rivers state. One thousand questionnaires were randomly distributed to the 3rd year undergraduate students in various departments in the College of Medicine, including anatomy, physiology, medical laboratory science, optometry, public health, and pharmacy. Eight hundred and fifty-two (85.2%) out of the 1000 of the questionnaires shared were retrieved and analyzed using simple percentages. Data collected included information on age, sex, state of origin, place of residence, and presence of refractive errors. Our results reveal that the incidence of refractive errors was highest in the North-west region of the country having (93.55%). This was followed by South-west (50.51%), South-south (32.88%), South-east (27.67%), North-central (18.03%), and North-east (15.79%). The highest occurring refractive error among the six geopolitical regions of Nigeria is myopia (54%), followed by hyperopia (21.01%), astigmatism (15.30%), and presbyopia (9.46%). This work represents the first attempt at having a comprehensive outlook at the statistics of refractive errors among Nigerian youths from across the country

Health education alone and health education plus advance provision of emergency contraceptive pills on knowledge and attitudes among university female students in Enugu, Nigeria

This was an intervention study to compare the effects of health education alone and health education plus advance provision of emergency contraception (EC) pills on the knowledge and attitudes to EC by female students of University of Nigeria in South‑East Nigeria.Materials and Methods: Astructured questionnaire was used to collect data in February, 2009 from 290 female students of a tertiary educational institution (140 in the study group and 150 from the control group) who were selected by multistage sampling. Subsequently, health education was conducted among all the students. In addition, a pack containing 2 tablets of EC pills (Postinor) was given only to the students in the study group. Three months after this intervention, its effects were assessed through a survey using the same structured questionnaire employed in the baseline survey.Results: knowledge of EC was significantly higher among the study group than the controls at post‑intervention, P < 0.05. Attitudes to EC were also more favorable at post‑intervention survey among the study group, P< 0.05 in most of the variables.Conclusion/Recommendation: Health education plus advance provision of EC pills effectively improved knowledge and attitudes to EC among female students of tertiary institutions more than health education alone and this should be promoted.Key words: Advance provision, attitudes, emergency contraception, female students, health education, knowledge, tertiary institution

Study of the strength characteristics of protein-based lightweight foamed concrete with cement partially replaced with Rice husk ash

Compressive strength test was carried out on the protein-based lightweight foamed concrete produced with cement partially replaced by rice husk ash to ascertain its strength characteristics. Standard concrete cubes of 150 x 150 x 150 mm were produced using ordinary Portland cement (OPC), fine aggregate, aqueous protein-based foaming agent and rice husk ash (RHA). The RHA was used to replace cement at 5 %, 10 %, 15 %, 20 %, 25 %, 30 %, 35%, 40 %, 45 % and 50 % by weight of cement. Control cubes with no cement replacement (0 %), were also produced and used as reference points for comparing the compressive strength of the lightweight foamed concrete at 28 days and 56 days respectively. The mix proportion of 1:1.5 was used as binder/fine aggregate proportions with the foam occupying 20 % of the volume of the concrete and the other constituents occupying the remaining 80 %. The compressive strengths of the lightweight foamed concrete at both 28 days and 56 days, increased for cement replacement levels of 5 – 30 % and gradually decreased for cement replacement levels of 35 – 50 % respectively for the mix proportion of 1:1.5 and for the water/binder ratio of 0.4. The minimum 28 days compressive strength for the mix proportion of 1:1.5 at cement replacement level of 30 % and water/binder ratio of 0.4 was          15.52 N/mm2 while that at 56 days was 18.51 N/mm2. The rice husk ash is a pozzolanic material with a capability of contributing up to 80 % and above to the compressive strength of lightweight foamed concrete, if the percentage replacement does not exceed 30 %. The mix proportion of 1:1.5 at water/binder ratio of 0.4 produces a structural lightweight concrete at 28 days. http://dx.doi.org/10.4314/njt.v35i4.

Impact of pharmaceutical care interventions on the occurrence and resolution of side/adverse drug effects associated with antiretroviral drug therapy

Pharmaceutical care (PC) has been shown to improve the outcome of drug therapy in many disease conditions. HIV/AIDS is one of the disease conditions that are fraught with many problems that can benefit from this new emphasis of pharmacy practice also known as ‘pharmacists care’. Adverse drug reactions or effects are unintended and undesirable effects of drugs other than their known and expected actions which can be unpleasant and sometimes fatal. This study is designed to evaluate the impact of pharmaceutical care activities on the occurrence of side/adverse drug reactions in HIV/AIDS patients receiving antiretroviral drugs. The components of the American society of health-system pharmacists (ASHP) guidelines on ‘standardized method for pharmaceutical care’ was used as a data collection instrument to evaluate, document and intervene in the antiretroviral therapy of about one thousand four hundred and seventy three (1,473) patients. The study identified about sixty (60) different types of side/adverse effects occurring among these patients through observation and patient complaints. The study also showed significant reduction in the incidence of side/adverse drug effects following the Pharmacist’s intervention activities, p ≥ 0.5. The study showed that pharmacists’ interventions in antiretroviral drug therapy through Pharmaceutical care can significantly reduce the incidence of side/adverse drug effects in HIV/AIDS patients receiving antiretroviral drugs