Browsing by Author "Mika, Elizabeth Z."

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    Nursing practice on post-operative wound care in surgical wards at Muhimbili National Hospital, Dar-es-Salaam, Tanzania
    (Open Journal of Nursing, 2019) Mwakanyamale, Adela A.; Mukaja, Anna-Mary; Ndomondo, Mathew D.; Zenas, Joan, P.; Stephen, Ambroce M.; Mika, Elizabeth Z.
    Background: Postoperative wound healing has been a problem which causes high mortality in the developing world; postoperative wound has been reported to cause devastating consequences and a measurable mortality. There is a limited number of published studies in Tanzania investigating Nursing practice on post-operative wound care in surgical wards at Muhimbili National Hospital, Dar-es-Salaam, Tanzania. This study assesses nursing practice on postoperative wound care by nurses in surgical wards at Muhimbili National Hospital. Methods: A cross-sectional study of surgical nurses was carried out through the use of randomly selected surgical wards at Muhimbili National Hospital in Tanzania from September 2011 to July 2013. A multistage cluster sampling technique was used to obtain a suitable number of study participants. Data collection was done using a checklist from a convenient sample of 71 nurses in selected surgical wards. Results: The result indicates that a big number of the participants were female (76.5%) and those of the age group 25 to 34 years were 40.8%. Participants exceeding a half of the selected sample reported to have poor post-operative wound care practice (57.7%). In comparison, male participants scored higher, and had better practice than their female counterparts, however, there was no considerable difference in the scores (P = 0.803). During set-up and preparation phase, the washing of hands before starting and after the completion of procedure was taken into consideration by less than half of the participants (49.3%). All participants did not ensure the environment is clean and take into account the patient’s privacy through the use of screen or even closing the room. The report shows that nurses take into consideration putting on clean gloves during the removal of the old dressing (99%), the use of sterile gloves during wound dressing was taken into consideration by most of the nurses (63%). Good practice was noted in applying dressing solution as recommended (85%), dry sterile dressing was applied by (90%), arrangement and setting up of dressing forceps and other items that may be needed in order of their application using forceps (20%), usage of forceps to dip gauze into antiseptic solution (35%) and cleaning of the wound cleaning from least contaminated to most contaminated area was only adhered to by (34%). Post-operative counseling and giving to the patient not to temper with the wound was done by a representation of only 15% of nurses. All the nurses did not do the documentation of the changes observed on the wound nor did they report on the patients comfort and the date and time after the procedure wound changes, reported patient comfort, and recorded date or time after the procedure. Conclusion: Majority of the nurses in surgical wards do not follow the postoperative wound care checklist provided by MNH although they know its importance. Assessment of the wound and documentation continues to be a problem in the nursing profession in Tanzania. Nurses are reasonably knowledgeable about the principal of wound dressing; however, lack of knowledge on some of the key principles of wound dressing is worth noting. Almost half of the nurses do not wash hands before and after the procedures, they don’t use single gauze in one direction only, not cleaning from least contaminated to most contaminated area, which can lead to wound contamination.
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    Surgical Site Infection among Patients Undergone Orthopaedic Surgery at Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania.
    (East and Central African Journal of Surgery, 2017) Protas, Joyce; Semiono, Avelina; Mika, Elizabeth Z.; Sariah, Adellah
    Background: The aim of this study was to determine prevalence and factors associated with surgical site infection at Muhimbili Orthopedic Institute. Method: This was a cross-sectional study conducted at Muhimbili Orthopaedic Institute (MOI) in Dar es Salaam, from August, 2015 to October 2015. Convenience sampling technique was used to recruit postoperative patients for this study. Standardized questionnaires were used to obtain demographic, social, and clinical information from respondents. Determination of the relationship between outcome and exposure variables was done using chi square test. Multivariate logistic regression was used to measure the association after controlling for confounders. Odds ratio corresponding to 95% confidence interval with a p value of ≤ 0.05 was considered significant. Results: Out of 300 study participants 75(25.0%) had surgical site infection. This was highly determined by more than 2 hours length of surgical procedure (AOR= 1.4; 95%CI 1.14-6.69; P value=0.05), none prophylactic use of antibiotics (AOR= 3.4; 95%CI 1.6-7.78; P value=0.03), more than one week stay before surgery (AOR=3.3; 95%CI 2.24-3.34; P value =0.00). Conclusion: The overall prevalence of surgical site infection at Muhimbili Orthopedic Institute was high. This was associated with more than 2 hours length of surgery, lack of prophylaxis use, and pre-operative hospital stay.