http://ir.library.ui.edu.ng/handle/123456789/524 scholarly 2025-09-27T08:17:22Z http://ir.library.ui.edu.ng/handle/123456789/9188 Title: EFFECT OF AN EDUCATIONAL PROGRAMME ON NURSES’ KNOWLEDGE AND PRACTICE OF PRESSURE ULCER PREVENTION STRATEGIES IN SELECTED TEACHING HOSPITALS IN SOUTH-WESTERN NIGERIA Authors: ILESANMI, R.E Abstract: Prevention of Pressure Ulcer (PU) is a nursing responsibility and reflects the quality of nursing care. The role of evidence-based Educational Intervention Programme (EIP) among nurses towards its prevention has been differently reported in the literature. However, the possible effects of EIP on PU prevention among nurses in Nigeria have not been adequately explored. This study was aimed at evaluating the effects of an EIP on knowledge and practice of PU prevention among nurses in selected teaching hospitals in Nigeria. A quasi-experimental study was conducted in three of the six teaching hospitals in south-western Nigeria: Lagos State University Teaching Hospital (LASUTH), University College Hospital (UCH) and Obafemi Awolowo Teaching Hospital Complex (OAUTHC). These hospitals were selected through balloting and labeled as Intervention Group (IG)-LASUTH and UCH; and Control (OAUTHC). All 193 nurses (127 in IG and 66 in control group) from the purposively selected wards in neurological, orthopedics and medical units in each hospital were recruited. Participants received a 5-day EIP of five modules focusing on PU risk assessment and preventive interventions with hands-on training. Baseline, immediate post-EIP and 3-month post-EIP knowledge of PU prevention strategies were evaluated using a standardised Pressure Ulcer Knowledge Test (PUKT). Practice was assessed using a validated observational checklist (Risk-based Prevention Intervention Checklist) at baseline and 3-month post-EIP. During the 3-month period, consumables for skin care and prevention of friction were also provided for use on the skin of patients at risk for PU in the IG and control group. Paired t, Mann-Whitney U and Wilcoxon Sign tests were used for data analyses. There were no significant differences in the mean ages of participants [IG: 36.3±10.4 years; control: 35.2±11.9 years] p<0.05, and mean years of experience [IG: 14.5 ±13.7 years; control: 12.6 ±12.0 years] p<0.05. The mean knowledge scores increased significantly among IG from 32.5 ±4.2 at baseline to 40.7 ±3.4 (p<0.05) at immediate post- EIP while in the control group it increased from 30.8± 5.0 to 31.2 ±5.2. At 3-month post-EIP, the mean score increased significantly in both groups; from 40.7±3.4 to 42.0 ± 4.0 in the IG and 31.2±5.2 to 37.8 ± 5.6 in the control group. The increased mean knowledge scores from baseline to immediate post-EIP among IG (8.2 ±5.4) was significantly higher than that of the control group (0.4 ±2.2); (p < 0.05). The increased mean knowledge scores from immediate post-EIP to 3-month post-EIP among IG (2.0 ±5.5) was not significantly different from the control (6.2 ±7.2). The median rank for practice in both IG and control groups were equal (97.0) at baseline and it increased to 105.0 only in the IG at 3months (p<0.05). However, in the control group the median rank decreased to 87.5 at 3-month post-EIP (p<0.05). Educational Intervention Programme improved nurses’ knowledge of pressure ulcer prevention and practice. There is the need to improve on existing nursing continuing education programmes on evidence-based educational intervention for pressure ulcer prevention. Description: A Thesis in the Department of Nursing, submitted to the Faculty of Clinical Sciences in Partial Fulfilment of the Requirement for Degree of DOCTOR OF PHILOSOPHY of the UNIVERSITY OF IBADAN 2014-01-01T00:00:00Z http://ir.library.ui.edu.ng/handle/123456789/9186 Title: EDUCATIONAL INTERVENTION ON NURSES’ USE OF CLINICAL GUIDELINE INDICATORS IN TRACHEOSTOMY CARE IN FEDERAL TEACHING HOSPITALS IN SOUTH-WEST NIGERIA Authors: KOROYIN, M.O Abstract: Quality nursing decisions in tracheostomy care are guided by clinical indicators and research evidence. Application of these clinical indicators lessen noisy respirations, excessive coughing, skin maceration and infection. Studies showed that tracheostomy care decisions in some clinical settings are not guided by evidence-based clinical indicators. Research findings suggest poor knowledge and utilisation of recommended clinical indicators in tracheostomy care in Nigeria. This study was designed to examine nurses’ knowledge and determine effect of use of clinical guideline indicators in evidence-based tracheostomy care decisions. This Quasi-experimental study was conducted in three Federal Teaching Hospitals in South-West Nigeria: University College Hospital (UCH), Lagos University Teaching Hospital (LUTH), Obafemi Awolowo University Teaching Hospital Complex (OAUTHC). Specific units included were Intensive Care, Neurology, and Ear, Nose and Throat. Due to limited number of nurses, LUTH and OAUTHC were purposely labelled control group (CG), and UCH intervention group (IG). All the 121 nurses in the units were recruited. Data were collected using validated structured decision-making and documentation checklists (inter-observer reliability 0.75-1.0 and 0.76-1.0), and questionnaire (Cronbach’s Alpha Coefficient 0.8 and 0.83). Stage 1 involved participant observation of nurses’ utilisation of clinical indicators for 10 evidence-based tracheostomy assessment, care, and documentation practices per participant in each of; suctioning, airway maintenance, dressing, and tie change decisions in both groups. In stage 2, pre intervention knowledge was assessed in both groups. Educational intervention of five modules on clinical guideline indicators, assessment, care, and documentation of evidence-based tracheostomy care decisions was conducted only in the IG. Knowledge was assessed immediately post intervention in both groups. At 3 months post intervention (stage 3), only participant observation of 10 evidence-based care decisions per participant was conducted as in stage 1 in both groups. Data were analysed using Chi-square, Independent t-test and Mann-Whitney U at α0.05. Sixty-seven of 121 nurses completed the three stages (IG=32; CG=35). There was significant difference in mean knowledge of evidence-based tracheostomy care at pre-test (IG:20.3±3.1; CG:22.0±4.6); which increased in both groups at post-test (IG:31.3±3.3; CG:22.9±3.9). The mean knowledge of decision-making was comparable at pre-test (IG:5.6±1.7; CG:5.5±2.0); but increased at post-test (IG:6.7±1.3; CG:5.9±1.1) in both groups. The mean knowledge of use of clinical guidelines was similar at pre-test (IG:3.0±0.9; CG:3.1±1.1) and post-test (IG:3.2±0.9; CG:3.1±0.91). There was no significant difference in nurses’ performance of evidence-based tracheostomy suctioning assessment decisions: medianpre (IG:5.0; CG:45.0); medianpost (IG:0.0; CG:20.0), suctioning care decisions: medianpre (IG:4.0; CG:32.0); medianpost (IG:0.0; CG:20.0), and airway maintenance care decisions: medianpre (IG:86.6; CG:0.0); medianpost (IG:63.6; CG:50.0). Nurses’ performance of documentation of evidence-based decision-making practices in tracheostomy assessment and care decisions for suctioning, airway maintenance, dressing, and tie change were also not significant in IG and CG, pre and post intervention. Despite the educational intervention there is poor application of clinical guideline indicators to direct evidence-based tracheostomy care decisions and documentation amongst nurses. There is need for regular audit and continuous monitoring of nurses’ decision-making, and periodic research-based continuing education in practice to improve nurses’ clinical competence of evidence-based decision-making, in tracheostomy care. Description: A Thesis in the Department of Nursing, Submitted to the Faculty of Clinical Sciences, College of Medicine in partial fulfilment of the requirements for the award of the Degree of DOCTOR OF PHILOSOPHY of the UNIVERSITY OF IBADAN 2018-10-01T00:00:00Z http://ir.library.ui.edu.ng/handle/123456789/9183 Title: COMPARISON OF OBJECTIVE STRUCTURED CLINICAL EXAMINATION WITH TRADITIONAL PRACTICAL EXAMINATION IN ASSESSMENT OF NURSING STUDENTS’ CLINICAL COMPETENCIES IN SOUTHWESTERN NIGERIA Authors: EDWARD, M.I Abstract: Clinical examination is crucial to assess competencies of nursing students in the delivery of quality nursing care. Globally, Traditional Practical Examination (TPE) and Objective Structured Clinical Examination (OSCE) are the methods of clinical assessments in Nursing. The Nursing and Midwifery Council of Nigeria (NMCN) had always used TPE for clinical examinations. The NMCN adopted OSCE for midwifery two decades ago while the examination in general nursing remains TPE. There is dearth of information on the effectiveness of OSCE and TPE in assessing students in general nursing. The goal of this study was to compare the effectiveness of OSCE and TPE in the assessment of clinical competencies of nursing students in Southwestern Nigeria. The study utilised quasi-experimental design among nursing students. Using a ballot system, two out of the sixteen hospital-based and two out of the five university-based nursing programmes were selected. The four schools participated in OSCE and TPE. The two programmes have similar curricula for nursing clinical procedures. Out of the 186 nursing students selected, 100 were second year hospital-based (51 students in Wesley Guild School of Nursing, Ilesa and 49 students in School of Nursing, Akure) while 86 were 300 level university-based (36 students in the Department of Nursing, University of Ibadan and 50 students in the Department of Nursing, Ladoke Akintola University of Technology, Osogbo). Data were obtained using adapted and validated instruments: Traditional Practical Examination Instrument (TPEI), Objective Structured Clinical Examination Instruments (OSCEIs) and Students’ Demographic and Perception Questionnaires (SDPQ). Pre-test was administered to the students to obtain the baseline data after which clinical teaching of selected nursing procedures were taught to all students for four weeks. The TPE (post-test I) was conducted at fifth week while OSCE (post-test II) was conducted at sixth week. The means of the performance scores in OSCE and TPE were computed while competency data were obtained by grouping performance scores into two levels of competencies: fairly competent (50.0%-59.9%) and very competent (60.0% and above). The SDPQ was used to collect data on students’ preference and perception of the two examination formats. Data were analysed using descriptive statistics, Students t-test, Chi-square test and ANOVA at α0.05. Age of respondents was 21.5±3.8 years. At baseline, the mean of students’ performance score was 53.3±3.7. There was a significant difference between the mean scores obtained at baseline and the two practical examination formats: pre-test 53.3±3.7, OSCE(post-test II) 64.6±5.2, TPE (post-test I) 59.3±2.9. More respondents were very competent in OSCE (80.1%) compared to TPE (45.7%). Perception of Objective Structured Clinical Examination and Traditional Practical Examination revealed: consumed less time (53.0% versus 48.0%); more objective (52.1% versus 47.9%); assessed wider range of learned materials (54.4% versus 45.6%); less destabilizing during practical sessions (53.5% versus 46.5%) less stressful (56.1% versus 44.0%). Lastly, 56.8% of respondents preferred OSCE while 43.2% preferred TPE. Objective Structured Clinical Examination was more effective in assessing competency of nursing students. Description: A Thesis in the Department of Nursing submitted to the Faculty of Clinical Sciences in partial fulfilment of the requirements for the Degree of DOCTOR OF PHILOSOPHY of the UNIVERSITY OF IBADAN 2017-08-01T00:00:00Z http://ir.library.ui.edu.ng/handle/123456789/9178 Title: PROSTATE CANCER EDUCATIONAL INTERVENTION AS A STRATEGY FOR ENHANCING KNOWLEDGE AND SCREENING UPTAKE OF MEN IN SELECTED HOSPITALS IN CROSS RIVER STATE, NIGERIA Authors: INGWU, J.A Abstract: Prostate Cancer (PC) is a common cause of cancer-related death among men. In developing countries, available evidence indicates that factors responsible for high PC-related mortality rate include poor knowledge and low uptake of screening practices. In Nigeria, there is paucity of literature on PC-specific health promotion package that emphasise knowledge and screening uptake of men. This study, therefore, was designed to evaluate prostate cancer educational intervention as a strategy for enhancing knowledge and screening uptake of men in selected hospitals in Cross River State, Nigeria. A mixed method research comprising of focus group discussion and a quasi-experimental pretest-posttest research design was used. The study was conducted in four randomly selected General hospitals in three senatorial districts in Cross River State. The hospitals in Ogoja and Ugep were purposively designated Intervention Group (IG) while Akamkpa and Calabar constituted the Control Group (CG). A sample of 420 men out of 980 regular Out Patient Department attendees was proportionately distributed 210 to IG and CG respectively. An educational training package on knowledge and screening uptake of PC with four teaching sessions of 60 minutes each was administered weekly to participants in IG while CG received the traditional health education on wide range of health promotion and disease prevention activities. A validated structured questionnaire (r = 0.89) was used to assess knowledge and PC screening uptake of men at baseline (PT1), immediate post intervention (PT2), at three months (PT3) and six months post intervention (PT4) periods. The participants’ knowledge was scored on a scale of 1-100 and then categorised into good (60 - 100%), fair (40 -59%) and poor (0 - 39%). The PC screening uptake was assessed using questionnaire and authenticated by Prostate Specific Antigen assay and Digital Rectal Examination. The participants were then categorised as users and non-users. Data were analysed using descriptive statistics, student t-test, and Cochran Q test at α 0.05. Mean age of IG and CG was (51.4 ± 8.9) and (54.1 ± 8.2) years respectively. At baseline, there was a significant difference between knowledge scores of IG (10.1 ±3.0) and CG (9.1 ± 4.8). In the IG, there was an increase in knowledge scores to 19.4 ± 2.0 at PT2, 16.6 ± 2.7 at PT3 and 17 ±2.7 at PT4. Similarly, the knowledge scores increased slightly in CG to 9.8 ± 3.6 at PT2, 11.3 ± 2.1 at PT3 and decreased to 10.7 ± 2.3 at PT4. The observed increment in knowledge scores was significantly higher among IG than CG. At baseline only 2.4% of participants had utilized PC screening uptake, 5.2% at PT2, 10.5% at PT3 and 45.2% at PT4 among IG. Likewise among the CG, only 2.9% of participants had utilized PC screening uptake at baseline and at PT2, 5.4% at PT3 and at 8.1% at PT4. The observed increment in utilisation of PC screening uptake was significantly higher among IG than CG. The Prostate cancer specific educational intervention improved the knowledge of men about prostate cancer and enhanced uptake of prostate cancer screening. It is therefore recommended for routine use in susceptible men. Description: A Thesis in the Department of Nursing submitted to the Faculty of Clinical Sciences in partial fulfilment of the requirements for the Degree of DOCTOR OF PHILOSOPHYof the UNIVERSITY OF IBADAN 2019-05-01T00:00:00Z