Pre-operative pulmonary assessment and risk factors for post-operative pulmonary complications in elective abdominal surgery in Nigeria

Background and Objectives: Post-operative pulmonary complications (PPCs) are recurring causes of rising morbidity and mortality in surgeries. This study sought to evaluate pre-operative risk factors for PPCs in abdominal surgerypatients in Nigeria.Methodology: This was a prospective study in patients booked for surgery in 2014. Biodata, medical his tory, pre-operative respiratory and cardiovascular examination findings, body mass index, serum albumin, serum urea, ventilatory function, chest x-rays and oxygen saturation were obtained. The association between pre-operative variables and PPCs was determined.Results: The pre-operative spirometry was predominantly restrictive (62%). Overall, the prevalence of PPCs was 52%. This included non-productive cough (14%), isolated productive cough (10%), productive cough with abnormal chest finding (16%), pneumonia (8%), pleural effusion (5%), ARDS (2%). Percentage predicted FEV1 and FVC were lower in participants with PPCs. (p= 0.03 and p=0.01respectively). Pre-operative cough, shortness of breath and consolidation were associated with PPCs (p< 0.05). Post-operative respiratory rate and pulse rate in participants with PPCs were higher than the values in those without PPCs (p=0.03 and p=0.05).Conclusion: The prevalence of PPCs was high in this study. Pre-operative cough, shortness of breath, consolidation, abnor- mally low percentage predicted FEV1 and FVC were associated with PPCs.Keywords: Post-operative pulmonary complications, pre-operative assessment, risk factors, cough, shortness of breath, consol- idation, pneumonia, elective abdominal surgeries, Nnewi, Nigeria

Comparative Study of Knowledge on Team Building Between Healthcare Workers in Two Federal Tertiary Health Facilities in Different Geo-political Zones of Nigeria

Introduction: Team building has been found to improve effectiveness and efficiency of workforce in the healthcare system generally.The objective of this study was to compare knowledge of team building between healthcare workers in two federal tertiary health facilities in South-South and South-East geopolitical zones of Nigeria. Materials and Methods: This was a descriptive cross sectional study carried out using multistage sampling technique to select a total of 242 subjects from ten categories of health professionals working in South-East(SE) geopolitical zone (Nnamdi Azikiwe University Teaching Hospital, NAUTH Nnewi) and South-South(SS) geopolitical zone (Federal Medical Centre , FMC Asaba) with 121 subjects in each geopolitical zone. Respondents participated in the study using same self-administered questionnaire for both geopolitical zones. Results: A total of 242 respondents participated, 121 each from the two different geopolitical zones. Majority were in the age group of 41-50 years and 21-30 years for SE and SS zones respectively. Majority were female and had first degree education for SE and SS zones respectively. Seven variables of knowledge of team building were collected and analysed with SPSS version 22 with results for SE and SS zones respectively with statistical significance set at p< 0.01 . This consisted of respondents that heard of team in healthcare 74.4 % and 91.0% (p<0.01), those that heard of inter-professional team composition in healthcare 65.9% and 78.7% (p>0.01), those that defined correctly team building 75.6% and 91.0% (p< 0.01), those that defined correctly inter-professional team building to involve different professionals 73.5% and 81.4% (p>0.01), those with sources of information on team building in health healthcare 57.3%(mainly health publication) 65.1% (mainly lectures/conferences) (p <0.01), those that defined correctly a team 70.4% and 88.4% (p< 0.01), those that had good knowledge of competencies to possess to be an effective team member 65.9% and 69.6% (p>0.01). Conclusion and recommendations: Proportion of respondents for the seven variables were higher for the South-South geopolitical zone tertiary health facility than the South-East geopolitical zone tertiary health facility though with no statistical significant difference across all seven variables. It is ,therefore, recommended that needs assessment for team building knowledge be done for healthcare workers in health facilities located in different geopolitical zones before team building training and re-training institutionalization building in order to persistently improve their knowledge of team building as a mechanism to reduce inter-professional conflicts and ultimately improve health outcomes in line with the National Health Policy 2016 of the Federal Government of Nigeria. More research is needful to assess intra- and inter-departmental/ and -professional level of knowledge on team building among healthcare workers  in any health facility in a geopolitical zone. Keywords: Team building, Knowledge, Health facilities, Healthcare workers, Geo-political zones, Nigeri

Pre-operative pulmonary assessment and risk factors for post-operative pulmonary complications in elective abdominal surgery in Nigeria

Background and Objectives: Post-operative pulmonary complications (PPCs) are recurring causes of rising morbidity and mortality in surgeries. This study sought to evaluate pre-operative risk factors for PPCs in abdominal surgerypatients in Nigeria. Methodology: This was a prospective study in patients booked for surgery in 2014. Biodata, medical his tory, pre-operative respiratory and cardiovascular examination findings, body mass index, serum albumin, serum urea, ventilatory function, chest x-rays and oxygen saturation were obtained. The association between pre-operative variables and PPCs was determined. Results: The pre-operative spirometry was predominantly restrictive (62%). Overall, the prevalence of PPCs was 52%. This included non-productive cough (14%), isolated productive cough (10%), productive cough with abnormal chest finding (16%), pneumonia (8%), pleural effusion (5%), ARDS (2%). Percentage predicted FEV1 and FVC were lower in participants with PPCs. (p= 0.03 and p=0.01respectively). Pre-operative cough, shortness of breath and consolidation were associated with PPCs (p<0.05). Post-operative respiratory rate and pulse rate in participants with PPCs were higher than the values in those without PPCs (p=0.03 and p=0.05). Conclusion: The prevalence of PPCs was high in this study. Pre-operative cough, shortness of breath, consolidation, abnormally low percentage predicted FEV1 and FVC were associated with PPCs. DOI: https://dx.doi.org/10.4314/ahs.v19i1.51 Cite as: Ufoaroh CU, Ele PU, Anyabolu AE, Enemuo EH, Emegoakor CD, Okoli CC, et al. Pre-operative pulmonary assessment and risk factors for post-operative pulmonary complications in elective abdominal surgery in Nigeria. Afri Health Sci. 2019;19(1). 1745-1756. https:// dx.doi. org/10.4314/ ahs. v19i1.5