Oral care practices of nurses on ventilated patients in Kigali Intensive Care Unit

Background: Oral care in the Intensive Care Unit (ICU) is an essential intervention proven to prevent Ventilator Associated Pneumonia (VAP). VAP results in increased morbidity and mortality, with excess hospital stay and cost. Oral care is a critical intervention that controls the accumulation of oral pathogens; however, it is viewed as a comfort measure and not a critical life-saving intervention.Objective: To assess the oral care provided to ICU ventilated patients by nurses at a referral hospital in Kigali.Methods: This cross-sectional design used a convenience sample of 47 nurses at a referral hospital in Kigali. Descriptive statistics were used for data analysis.Results: The majority of nurses (89.4%) used normal saline for comprehensive mouth care on ICU patients. The majority reported they never used a toothbrush (53.2%) toothpaste (63.8%), or Chlorhexidine solution (89.4%), which are the recommendation. One third (34%) do not perform the oral assessment on admission. There is no ICU oral care protocol, and oral hygiene supplies are limited.Conclusion: Oral care is critical care in VAP prevention. ICU nurses reported a low level of oral care practice. We recommend an oral care protocol and in-service training to improve the quality of oral care to ICU ventilated patients.Keywords: Oral care, ICU, nurses, ventilated patients, ventilator-associated pneumoni

Diabetes health education: nurses’ knowledge of essential components at a Rwandan hospital

Background: Diabetes mellitus type 2 (T2DM) is the most prevalent form of diabetes that has continued to increase worldwide over the past decades. The cornerstone of T2DM management is education on self-management. Evidence shows that nurses have insufficient knowledge of the content of T2DM patient education.Objective: To assess nurses’ knowledge of health education content for T2DM patients, and to establish the relationship between their education and knowledge level of T2DM health education.Methods: A descriptive cross-sectional design and total population sampling strategy were used to recruit nursing staff at a medical/surgical unit. Fifty-one nurses at the referral hospital of Rwanda completed the self-administered questionnaire. Descriptive statistics were used for data analysis.Results: Nurses exhibited poor knowledge of diabetes health education. There was no significant relationship between the nurses’ level of education and diabetes health education knowledge (p=0.102).Conclusion: Nurses had good general knowledge of diabetes, though a low level of knowledge of diabetes health education in this low-resource setting. Hospitals equipped with a T2DM protocol and appropriate staff training would likely improve the nurses’ knowledge and patient care outcomes.Keywords: Type 2 diabetes mellitus, nurses, knowledge, patients’ self management educatio

Perceived effects of burnout on patients and its management among nurses in the Intensive Care Unit and Emergency Department of a Rwandan University Teaching Hospital

Background: The level of burnout among nurses working in the Intensive Care Unit (ICU) and Emergency Department (ED) is high, which adversely affects health and work-related outcomes for both nurses and patients. Little is known about burnout among ICU and ED nurses in Rwanda.Objective: To explore the perceived effects of burnout among nurses and its management at a referral hospital in Rwanda.Methods: A qualitative study design was carried out using focus groups. A purposive sample of six ICU and six ED nurses were recruited from the referral hospital in the capital city of Kigali. The discussions were audio-recorded in Kinyarwanda, transcribed verbatim into English and analysed inductively using thematic analysis.Results: Burnout among the 12 nurses was high and the five main themes namely, high burnout, the Variability of care, Incomplete care, Erratic care and Improving situation to prevent burnout.Conclusion: The results of this study indicated that burnout is high between the ICU and ED study population and nurses need to be taken care of too. A good working environment addressing adequate staffing, specialty training, operational materials, and social activities are needed to improve unit functioning, and patient satisfaction and safety.Keywords: Burnout, nurses, Intensive Care Unit, emergency department, patient car

Organ donation and transplantation within the Zulu culture

M.Cur. (Intensive General Nursing)Knowledge and technological advancement in the field of transplantation has increased the demand for organ donation. However, the supply of organs does not meet this demand, especially, among the black communities. Literature reviewed associate this imbalance with the few sources of organs, the technique of organ retrieval, discrepancies in the allocation of organs and sociocultural factors. The aim of this study was to investigate the extent to which the Zulu cultural norms and social structural dimensions influence an individual's decision to donate an organ or to undergo a transplantation, based on the theoretical assumptions of Leininger and Chrisman. A qualitative approach using an ethno- nursing method was selected, semi-structured interviews were conducted with the transplant co-ordinator representing the professional sector, the religious leaders and traditional healers representing the folk sector and the general public representing the popular sector of the health care system. The respondents were extracted from both the urban and rural settings. The conclusions arrived at were that there is lack of knowledge among the Zulu speaking people on organ donation and transplantation, related mainly to misconceptions associated with their life patterns, beliefs about death, burial and life hereafter, values and social structural dimensions. The recommendations with regard to the promotion of organ donation and transplantation among the Zulu speaking people were made based on culture sensitive and culture congruent principles, namely: • Cultural care preservative or maintenance such as ancestor worship, extended families etc. • Cultural care accommodation or negotiation such as their knowledge of anatomy and physiology of the human body especially the transplantable organs and their fear to discuss death, etc. • Cultural care repatterning and restructuring such as culture sensitive educational campaigns to dispel the fears and correct misconceptions