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Assessment of knowledge, attitude and practice of post exposure prophylaxis for HIV among nurses at Jigme Dorji Wanghuck National Referral Hospital, Bhutan.

ABSTRACT: Nurses are managing huge number of patients infected with human immunodeficiency virus (HIV), which made them highly vulnerable to HIV infection through occupational exposure such as needle stick injuries and splashing of blood/bodily fluids on mucosal surface. This made the practice of post exposure prophylaxis (PEP) for HIV crucial among nurses. Therefore, our study aimed to assess knowledge, attitude and practice of PEP for HIV among nurses in Bhutan. A cross-sectional study was conducted among 221 registered nurses working at Jigme Dorji Wangchuck National Referral Hospital, Bhutan between April and June 2017. A structured self-administered questionnaire was used to collect data and analysed using SPSS version 21. Majority (80.1%) of our participants had poor knowledge regarding PEP for HIV. Although half (51.1%) of our participants had heard about PEP, only 3 (1.4%) attended a formal training on PEP for HIV. However, a significant proportion of nurses (92.3%) had positive attitude towards PEP for HIV. Out of 221 respondents, 95(43%) had been exposed to needle stick injuries and splashing of blood/bodily fluids while managing patients. Despite significant number of exposures, only 2 (2.1%) of them took PEP and completed 28 days of prophylaxis. Lack of protective barriers at work place (56.8%) and poor knowledge on personal protective equipment (14.7%) were major perceived causes of exposure among study participants. No PEP service (30.2%) and lack of support to report incidents (22.6%) were two major reasons leading to failure of PEP practice among exposed individuals. Despite positive attitude exhibited by majority of our respondents, the level of knowledge and practice of PEP for HIV among nurses was very low. Therefore, a formal training on PEP and 24 hours accessible PEP service with proper guidelines are recommended to improve the overall knowledge and practice of PEP against HIV among nurses.

SUBMITTER: Tshering K

PROVIDER: S-EPMC7454947 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Assessment of knowledge, attitude and practice of post exposure prophylaxis for HIV among nurses at Jigme Dorji Wanghuck National Referral Hospital, Bhutan.

Tshering Kezang K Wangchuk Kinzang K Letho Zimba Z

PloS one 20200828 8

Nurses are managing huge number of patients infected with human immunodeficiency virus (HIV), which made them highly vulnerable to HIV infection through occupational exposure such as needle stick injuries and splashing of blood/bodily fluids on mucosal surface. This made the practice of post exposure prophylaxis (PEP) for HIV crucial among nurses. Therefore, our study aimed to assess knowledge, attitude and practice of PEP for HIV among nurses in Bhutan. A cross-sectional study was conducted amo ...[more]

PMID: 32857804

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Project description:BackgroundPatient safety has been identified as a global priority area. It is one of the most health care challenges. There is a rising number of patients' mortality in hospitals each year because of lapses in patient safety practice. Therefore, the purpose of the present study was to assess knowledge, attitude, practice, and associated factors towards patient safety among nurses working at Asella Referral and Teaching Hospital.MethodsInstitution based cross-sectional study was conducted on 172 nurses working at Asella Referral and Teaching Hospital, Arsi Zone, Oromia Regional State, Ethiopia. The data were collected from nurses from December 28, 2020 to January 05, 2021 by using a pretested questionnaire. The data were entered into Epi-Data version 4.2.0.0 and analyzed using the SPSS version 23.0 software.ResultsA total of 172 nurses were enrolled in to the study, resulting a response rate of 99.4%. The mean age of the nurses was 32.53 years. More than half 94(54.7%) of them were female. The majority 133(77.3%) of them were qualified for degrees and above. The majority 155(90.1%) of them had working experience of ≤13years. The nurse's level of good knowledge, positive attitude, and good practice towards patient safety was 58.7% (n = 101, [95% CI; 51.7, 66.7]), 52.9% (n = 91, [95% CI; 43.6, 61.4]), and 50% (n = 86, [95% CI; 43.6, 57%]) respectively. The multivariable logistic regression analysis showed; working in the operation theatre unit [AOR = 5.01, 95% CI; 1.36, 18.46], having information on patient safety during initial education [AOR = 4.99, 95%CI; 1.87, 13.31], and having information on patient safety during continuing education [AOR = 2.85, 95% CI; 1.14, 7.12] were factors significantly associated with knowledge towards patient safety. Being male [AOR = 3.09, 95% CI; 1.38, 6.95], having working experience of >13 years [AOR = 8.37, 95% CI; 1.36, 51.70], having information on patient safety during initial education [AOR = 3.36, 95%CI; 1.11, 10.15], having information on patient safety during continuing education [AOR = 3.33, 95% CI; 1.25, 8.85], and having good Knowledge towards patient safety [AOR = 2.74, 95% CI; 1.21, 6.21] were factors significantly associated with attitude towards patient safety. Having information on patient safety during initial education [AOR = 5.35, 95%CI; 1.77, 16.17] and having a positive attitude towards patient safety [AOR = 3.02, 95% CI; 1.32, 6.91] were factors significantly associated with practice towards patient safety.ConclusionIn the present study, more than half of the nurse's had good knowledge and positive attitude towards patient safety. However, only half of the nurses had good practice towards patient safety. Educational programs and training on patient safety may need to take place for nurses to abate these problems.

Project description:BackgroundKnowing the pattern and presentation of the diseases is critical for management strategies. To inform eye-care policy we quantified the pattern of vitreo-retinal (VR) diseases presenting at the national referral hospital in Bhutan.MethodsWe reviewed all new patients over three years from the retinal clinic of the Jigme Dorji Wangchuck National Referral Hospital. Demographic data, presenting complaints and duration, treatment history, associated systemic diseases, diagnostic procedures performed, and final diagnoses were quantified. Comparisons of the expected and observed frequency of gender used Chi-squared tests. We applied a sampling with replacement based bootstrap analysis (10,000?cycles) to estimate the population means and the standard errors of the means and standard error of the 10th, 25th, 50th, 75th and 90th percentiles of the ages of the males and females within 20-year cohorts. We then applied t-tests employing the estimated means and standard errors. The 2913 subjects insured that the bootstrap estimates were statistically conservative.ResultsThe 2913 new cases were aged 47.2?±?21.8?years. 1544 (53.0%) were males. Housewives (953, 32.7%) and farmers (648, 22.2%) were the commonest occupations. Poor vision (41.9%), screening for diabetic and hypertensive retinopathy (13.1%), referral (9.7%), sudden vision loss (9.3%), and trauma (8.0%) were the commonest presenting symptoms. Coexistent diabetes and hypertension were the most common associated systemic diseases. Haematological tests (blood sugar, HbA1c and lipid profile, 31.8%), OCT (27.4%), refraction (9.9%), B-scan (8.7%), fundus photography (8.0%) were the most commonly performed diagnostic tests. Hypertensive retinopathy (18.9%) was the commonest VR disease, followed by refractive errors referred for retinal evaluation (16.7%), diabetic retinopathy with macular oedema (15.8%), and AMD (11.0%). Retinal detachment was more prevalent in females (83 vs. 41, p?=?0.007). Rare vision-threatening diseases like seasonal hyper-acute pan-uveitis also presented.ConclusionsThe developing VR service in Bhutan is challenged by the spectrum of diseases, limited human resources (e.g. one retinal surgeon during the study), and accessibility to tertiary eye-care services, all amidst difficult terrain. Sustained effort and robust coordination among the eye-care professionals, government and non-governmental organisations are critical for optimising VR services, especially as rates of diseases such as diabetes and hypertension grow.

Project description:BackgroundTuberculosis (TB) is a major public health problem in Bhutan despite the implementation of directly observed treatment short-course since 1997. This study aimed to assess the knowledge, attitude and practice on TB among the teacher trainees of Samtse College of Education.MethodologyA cross-sectional study was conducted among the teacher trainees of Samtse College of Education. A standardized pretested questionnaire was distributed and self-administered. The participants were selected randomly using randomization. The data was entered in Epi-data 4.4.2.1 and analysed using STATA version 13. A score of 1 point for a correct answer and 0 for wrong/don't know answer was given. The knowledge, attitude and practice score were divided into good and poor based on 50% cut off. Logistic regression was used for the analysis to identify the significant covariates.ResultsA total of 420 trainees responded to the survey questionnaire. The average knowledge score on TB was 10.7 (Range = 0-21). Two hundred and forty respondents (58.6%) had low knowledge (mean score 7.8±2.5) on TB. Cough, chest pain and weight loss were correctly reported as the symptoms of TB by 306 (72.9%), 187(44.5%) and 187 (44.5%) participants. Eighty-nine-point five percent (376) of participants reported coughing as the main route of TB transmission and 85% (357) of the participants said that it could be prevented by covering the mouth while coughing. In multivariable analysis; the trainees in the junior years of college had good knowledge of TB compared with the senior years (adjusted odds ratio [AOR] 2.02; 95% confidence interval [CI] 1.18-3.5; p-value 0.011). Respondents previously treated for TB were more likely to have good knowledge on TB compared to those who never had TB in the past (AOR 2.39; 95% CI 1.07-5.31; p-value 0.033). The majority (93%) of respondents had a good attitude towards TB cases. Female trainees were 2.4 (95% CI 1.02-5.62; p-value 0.045) times more likely than male trainees to have a positive attitude towards TB. Eighty-eight percent of the respondents reported that they would visit the hospital if they had TB symptoms. The mean score for the practice on TB was 1.33±0.59 (Range:0-2).ConclusionIn this study, the majority of the trainees had poor knowledge on TB, especially among the trainees in senior years of college and those who had never suffered from TB. The attitude towards TB was good especially among the female trainees. However, the overall practice was poor among the participants. Therefore, the Ministry of Health should collaborate with relevant stakeholders especially the Ministry of Education to incorporate topics on TB in the syllabus of students and colleges to create awareness on it.

Project description:BackgroundEffective and routine mouth care is necessary for hospitalized patients as it helps to maintain the health of oral cavity and overall health. However, oral care is often overlooked and not prioritized in daily activity plan of nurses even when oral problems are apparent. Therefore, the aim of this study was to assess nurses' attitude towards oral care and their practicing level for hospitalized patients.MethodsA cross-sectional study design was conducted in adult medical-surgical department of Orotta hospital from December 2017 to January 2018. Data was collected from all (N = 73) diploma and associate nurses through face to face interview using a pretested and structured questionnaire. Kruskal-Wallis, Mann-Whitney U tests and spearman rank correlation coefficient tools were performed to analyze the data using SPSS (Version 22).ResultsOut of the 79 participants, 73 completed the interview successfully with a response rate of 92.4%. Of the total, 56.2% were diploma nurses and 43.9% were associate nurses. The median attitude score was 68.89/100 (IQR = 48.89). The majority (94.5%) of the nurses agreed that oral cavity assessment is nurse's responsibility and 94.5% reported adequate training is needed to provide quality oral care. On the other hand, the median practice score was 50.00/100 (IQR = 17.86). Majority of the participants (76.7%) did not perform routine oral health assessment. Almost all (98.4%) used gauze and normal saline for oral care. Practice score was significantly different across the various wards (p < 0.001), however, it was not significantly correlated with attitude (p = 0.646).ConclusionsThe participants had poor level of oral care practice to hospitalized patients, nevertheless, they had favourable attitude. Therefore, Orotta National Referral Hospital needs to give further effort to train the nursing staff, ensure the availability of adequate oral care equipment and provide clear guidelines regarding oral care of hospitalized patients.

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Assessment of knowledge, attitude and practice of post exposure prophylaxis for HIV among nurses at Jigme Dorji Wanghuck National Referral Hospital, Bhutan.

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Assessment of knowledge, attitude and practice of post exposure prophylaxis for HIV among nurses at Jigme Dorji Wanghuck National Referral Hospital, Bhutan.

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