THE PRACTICE OF ASSESSING INTENSIVE CARE UNIT ACQUIRED WEAKNESS BY NURSES AT KENYATTA NATIONAL HOSPITAL, KENYA
THE PRACTICE OF ASSESSING INTENSIVE CARE UNIT ACQUIRED WEAKNESS BY NURSES AT KENYATTA NATIONAL HOSPITAL, KENYA
Dorcas Mbaika Mbua (Bsc. Nursing) - Kenyatta University School of Health Science, Kenya
Dr. Nickcy Mbuthia, BScN, PhD - Lecturer & Researcher, Kenyatta University School of Health Sciences, Nursing Department, Kenya
Dr. Joseph K. Musau, PhD - Lecturer, Kenyatta University School of Health Sciences, Department of Pharmacology and Clinical Pharmacy, Kenya
ABSTRACT
Intensive care unit-acquired weakness (ICUAW) is an acute dysfunction of the neuromuscular system in acutely ill patients admitted in intensive care unit. Best assessment practices initiated and maintained from time of admission leads to positive patient care outcomes. Nurses are the primary caregivers for critically ill patients and ICUAW clinical assessments by nurses mainly follows their clinical experiences. The research findings contribute in policy and guidelines development for all other Critical Care Units(CCU) in assessment of ICUAW practices. The main objective of this study was to evaluate the practices and influencing factors for ICUAW assessment by nurses working in the CCU in Kenyatta National Hospital. Research employed correlational research design. Multistage proportionate random sampling method used.193 nurses were recruited. Informed consent obtained before the study. Self-administered questionnaire used. Multivariate analysis employed. Results presented by use of frequency tables. Descriptive statistics utilized to make summaries of the research data. Permission obtained from Kenyatta University Graduate School, Kenyatta University Ethical and Research committee, National Council for Science and Technology through commission of university education, Kenyatta National Hospital/University of Nairobi Ethical and Research Committee, the Kenyatta National Hospital(KNH) administration and the relevant KNH CCUs nurse managers. Majority of the participants were female (n = 149, 77.2%) while male respondents accounted for 22.8% (n = 44), most participants aged between 36–45 years (n = 83, 43.0%). A statistically significant association was found between nurses' experience in the critical care unit (CCU) and ICU-AW assessment (χ² = 8.558, p = 0.032). Perception-related variables like severity of patients’ illness (χ² = 13.749, p = 0.001), patient’s age (χ² = 8.671, p = 0.013), patients with multiple conditions (χ² = 18.218, p < 0.001), physically inactive patients (χ² = 5.696, p = 0.045) showed significant associations with the assessment practice. The findings indicate that routine assessment of ICU-acquired muscle weakness (ICU-AW) is not yet widely institutionalized among nurses in the critical care units. Only 20.7% of the respondents reported that ICU-AW assessment is routinely performed on patients in their unit, whereas a significant majority (77.2%) stated it is not. A conclusion made that ICUAW assessment practice is majorly determined by nurses’ attitude and perceptions whereas the attitude and perceptions were influenced by knowledge and skills. Recommendations made for all healthcare facilities with a CCU to invest in modern methods of ICUAW assessment providing appropriate tools for assessing ICUAW and the nursing education policy be made on higher nursing education on ICUAW assessment training.
