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Assessment of Strategies on Patient Safety Practices Among Healthcare Providers at Nakuru County Referral Hospital, Kenya
No full textQuality care is achieved through integrating all components within the healthcare delivery
system. Patient safety involves increasing awareness about errors made due to human
factors in the process of delivering healthcare services that may lead to harm and adverse
effects. This study was on Assessment of strategies on patient safety practices among
healthcare providers at Nakuru County Referral Hospital, Kenya. The study objectives
were to: Examine the organizational processes on patient safety practices, determine the
communication strategies on patient safety practices, assess monitoring strategies on
patient safety practices, and determine patient advocacy strategies on patient safety
practices among healthcare providers at Nakuru County Referral Hospital, Kenya. The
study was anchored on General Service Readiness Theory, Anderson Model of Health
Services Utilization and Donabedian Model for Assessment of Quality of Care. The study
adopted descriptive cross-sectional study design. The sampling technique was purposive,
stratified random sampling and proportionate with a sample size of 310 healthcare
providers drawn from various cadres. Data collection tools were questionnaire, interview
schedule and observational checklist. Quantitative data was analyzed using descriptive
statistics and inferential statistics. Spearman’s correlation analysis was used for
inferential statistics to determine the association between organizational processes,
communication strategy, monitoring strategy, patient advocacy on patient safety practices
using 20th version of Statistical Package for the Social Sciences (SPSS) with 0.05 level
of significance. Data was presented in tables, pie charts and graphs forms. A Permit was
obtained from National Commission for Science, Technology and Innovation, through an
introductory letter provided by Mount Kenya University Research Ethical Committee and
authority from health directorate of Nakuru County. The study findings established that
Nakuru County Referral Hospital had effective organizational processes on patient safety
practices indicated by mean of 3.6 and standard deviation of 1.2 with need for
implementation of quality improvement programmes having strongest correlation with
patient safety practices (R = 0.922 and P + 0.028). There were effective communication
strategies on patient safety practices with early clarification of information and efficient
dissemination of information facilitating timely service delivery. There was complete
handover of information, access to electronic records, prescribing systems and
coordination of patient flow, mitigating delayed diagnosis, treatment and adverse events
( mean = 3.6, standard deviation = 1.0, R value = 0.893 and P value = 0.021).However,
patients were found not to be adequately compensated in cases of erroneous medical
procedures (mean = 2.8, standard deviation = 1.2, R value = 0.945 and P value = 0.014),
indicating strong correlation with patient safety practices. The study recommends the
need for implementation of quality improvement programmes to patient safety practices.
The hospital administration should ensure there is coordination in ensuring patient flow
which enhances mitigation of delayed diagnosis, treatment and adverse events. There is
need for meetings to review and share ideas on patient safety thus achievement oforganizational culture in relation to safety. The hospital should also improve on patient
involvement in decision making while receiving healthcare services and clear guidance
that ensures patients are adequately compensated in-case of medical errors
A Palm Vein Authentication Implementation Model for Enhanced Access of Biometric Systems: A Case of Mount Kenya University Main Campus
No full textOne of the crucial components that contributes to the efficacy and efficiency of information systems is system integrity. One security method used to increase system integrity is biometrics. The existing fingerprint system is prone to spoofing attacks, high FRR and FAR, tear and wear of the sensor scanner. The goal of this study was to look at the integrity issues that affect the security of biometric technologies in Kenyan higher education institutions, IT security factors, implementing a new model and validating it. The implemented contactless security model sought to solve the current security problems facing the current biometric system. The study's particular goals were to look into the IT security factors that influenced biometric system integrity, review the success and failures of present biometric systems in boosting learning institution integrity, and design and validate the model. The research was guided by the extended integrated system theory which consisted of contingency and management theory. Since the contactless model had been approved by security system specialists, the researcher used an experimental and descriptive research approach. The research subject was Mount Kenya University's faculty and employees. Stratified sampling provided a true depiction of the varied population. 300 randomly chosen employees from particular departments made up the study's target population, and 169 individuals were picked for the sample using simple random sampling. The Zetech University served as the site of the pilot study. In the study area, questionnaires were used to collect the data. The researchers employed an equation for multivariate regression. Analysis of Variance (ANOVA) was used to examine the model's fitness, with a 95 percent confidence level test of significance. From the findings a strong correlation coefficient of 0.792 was obtained on objective one. This showed that the model fitted well and their statistical relationship between the variables. The correlation coefficient between the variables was at 0.792, indicating that the constructed model was more efficient in terms of data integrity. One objective two the R2 of 73.4% indicated the data fitted the model well on the assessment the IT security metrics that influenced the integrity of biometric systems in higher learning institutions since it was greater than 50%. The experiment consisted of a control group having 15 participants. From the experiment the palm vein had an FRR of 93.33% while fingerprint had 60% which demonstrated superiority in authentication accuracy. On objective three a F value of 0.714 was produced regarding the integrity of the new security model. This value is lower than the table value at (1.70) degree of freedom (10,59), which showed that there was statistical significance. 87.5% of the experts concurred that the security system satisfied the requirement for a system that can improve the integrity of the data. The researcher added feature extraction component that represented infrastructure variable in the conceptual framework. The institution should consider changing its present fingerprint security system, which failed to verify legitimate users and was therefore inconsistent with data integrity. Learning institutions should implement the contactless system that does not require physical touch to verify people, which was more useful in the current COVID 19 epidemic, which has rendered the existing fingerprint security system useless. Organizations should consider implementing live detection systems or employ cancellable biometric systems that helps overcome spoofing attacks. More research needs to be carried out on palm vein template protection in deep learning since little research has been done in the field and also new decision authentication algorithms
Factors Influencing The Prevalence of Khat Chewing Among The Youth in Eastleigh, Nairobi, Kenya
No full textThe consumption of khat has a significant health and financial impact to the nation, as well
as an increasing public health hazard. khat usage reduces users' effectiveness, makes them
more sensitive to health issues, and increases their chance of committing crimes. In this
sense, they pose a risk to society and place a strain on the health system. As such, the
current study examined factors attributing to the prevalence of khat effects of Khat chewing
on well-being among the youth in Eastleigh, Nairobi, Kenya. The following objectives
guided the study; to find out factors that contribute to Khat chewing to determine the
prevalence of khat chewing, to assess the effects of khat consumption awareness on health,
and to assess the effects awareness of khat consumption on social-economic life among
youth in Eastleigh, Nairobi County, Kenya. The research was led by Social Learning and
Reference Group theories, which were critical in understanding why individuals engage in
Khat intake and other Khat-related behaviour. The study used a survey research approach in
which a questionnaire was used to collect information from a sample of participants. The
research focused on 200 teenagers from Section I, 150 from Section II, and 100 from
Section III, which has a smaller population than the other sections. The research also
targeted (2) two people from each Division who were above the age of 35. As a result, the
study's target population was 456 people. The research sample included 384 youth and six
Key Informants, totaling 390 individuals. The three Divisions in this research were chosen
on purpose since they represent Eastleigh's three major Divisions. As a result, their findings
most likely mirrored the real situation in the targeted group. A pilot study was conducted
prior to data collection to evaluate the questionnaire utilized in this investigation. To ensure
validity, the researcher sent the questionnaire results to specialists who determined if the
questions were acceptable. In assessing consistency for multi-item measures, a cut-off of
more than 0.7 was considered adequate. Chi-square inferential statistics were employed to
establish a one-to-one link between the independent and dependent variables. This served as
the foundation for either rejecting or accepting the null hypothesis. To examine qualitative
data, the researcher used the content analysis approach. Graphs, tables, and pie charts were
used to present a result. NACOTSI, MKU, and consent from respondents were consulted on
ethical considerations in this sstudy. According to the report, 36.06% of respondents were
introduced to Khat by their neighbours or peers. According to the research, 70% of
youngsters ingest Khat, indicating that khat usage is widespread in EightLeigh. The study
discovered that 66.67% were aware of the negative consequences of khat intake on health
yet continued to use it. According to the survey, the rate of khat use is high, and most
youngsters are aware of the effects of khat consumption on health and social-economic life.
As a result, the research advised that the government and stakeholders educate the people about the health risks associated with Kha
Factors Influencing Choice of Place for Child Delivery among Child Bearing-Aged Women in Balambala Sub-County, Garissa County, Kenya
No full textBackground: There has been little progress made in Sub-Saharan Africa in achieving Sustainable Development Goal of reducing maternal deaths. Maternal mortality can be reduced significantly by skilled delivery. Women in low-income countries choose home deliveries despite the risks. In Kenya, maternity services are offered free-of-charge in all public health facilities. Mothers receive non-cash incentives after delivery. Investigated independent variables were health care related factors, gynecological factors and socio-cultural factors. The dependent variable was the proportions of hospital and, home deliveries. Maternal mortality rate in Balambala was found to be 587/100,000 while the national and county averages were 223 and 530/100,000 respectively. The study investigated factors influencing choice of place of child delivery.
Methods: Cross-sectional study was used and participants recruited through randomization. A sample size of 384 mothers, who had 1-year-old child, registered for ante-natal care services in latest pregnancy in Balambala were interviewed at the households. Quantitative data collected using structured questionnaires and analyzed using Statistical Package for Social Sciences version 25. P-value of .05 was set as statistical significance. Descriptive and inferential statistics were calculated, nature and magnitude of association between dependent and independent variables investigated.
Results: The independent variables recorded the following; p-value of 0.042 for socio-cultural factors, p-value of 0.039 for obstetric factors and p-value of 0.035 for health care related factors
Determinants of Non-Compliance to Hepatitis B Vaccination among Students of Kenya Medical Training College in Machakos Sub County, Kenya
Full text linkIn Sub-Saharan Africa, the prevalence of Hepatitis B Virus (HBV) is high, with an estimated 70 to 90% of the population becoming infected before the age of 40. Healthcare workers (HCWs), including healthcare students (HCSs), face an increased risk of HBV infection due to their occupational exposure. HCSs, in particular, are vulnerable to the disease due to their limited experience with infection control measures and insufficient knowledge about the risks associated with treating patients. This study aimed to assess the level of awareness of HBV vaccination among students in KMTC in Machakos Sub County, determine the compliance with the Hepatitis B vaccination schedule among students in Kenya Medical Training Colleges in Machakos County, evaluate attitudes towards Hepatitis B immunization among students in KMTC in Machakos Sub County, and establish the existence of institutional measures to ensure the implementation of HBV vaccination policies for students in KMTC in Machakos County. The research utilized a cross-sectional descriptive study design, employing a mixed approach with both quantitative and qualitative data collection among KMTC students to identify the factors influencing noncompliance with the HBV vaccine. The study was conducted at the Kenya Medical Training Colleges in Machakos County, specifically at the Machakos and Manza campuses. The majority of the respondents in the study reported being aware of Hepatitis B virus infection, with 301 (76.1%) indicating they had heard about it, while 93 (23.6%) had not. Among the KMTC students, the primary mode of Hepatitis B virus transmission identified was contact with the blood of an infected person, as reported by 98 (24.9%) respondents. Contact with body fluids contaminated by the blood of an infected person and sexual transmission were also recognized as significant modes of transmission, with frequencies of 74 (18.8%) and 71 (18.0%) respectively. The findings indicate a high level of awareness of HBV vaccination among students in KMTC in Machakos Sub County, with the majority of students possessing sufficient knowledge on the subject. Needle stick injuries were identified as the most likely route of disease transmission, highlighting the risk that medical students face when attending to patients in hospitals. Therefore, it is crucial for medical students to diligently adhere to the Hepatitis B vaccination schedule. Encouraging a culture of mutual support among medical students to get vaccinated as a preventive measure against acquiring the disease is recommended. Furthermore, KMTC should establish standardized guidelines and policies to ensure the implementation of HBV vaccination measures
Knowledge and Risk Factors of Hepatitis B Disease Among Women Attending Antenatal Care at Arua Regional Referral Hospital, Arua, Uganda
Full text linkHepatitis B is a highly infectious disease with a prevalence of 4.3% among people aged 15-64 years, with a prevalence of 5.6% in men compared to 3.1% in women in Uganda. Mother-to-child transmission accounts for nearly 50% of new cases per year, and infants who acquire hepatitis B disease before 5 years have a 90% chance of progressing to chronic hepatitis B infection. The study assessed the knowledge and risk factors of hepatitis B disease among women attending antenatal care (ANC) at Arua Regional Referral Hospital (ARRH), Uganda. A cross-sectional study was carried out at Antenatal care unit of Arua Regional Referral Hospital. Convenience sampling was used, and a sample size of 384 was calculated. Each participant was screened for HBsAg using commercial rapid test kits and evaluated using a structured questionnaire and. A hepatitis B basic knowledge summary score was used to assess the of knowledge of the participants on hepatitis B. Data analysis was carried out using MICROSOFT EXCEL-2013 and STATA version 14 packages. Poor knowledge levels of hepatitis B disease stood at 17.9%, while 82.1% of the pregnant women had adequate knowledge. A prevalence of 2.05% was obtained from the participants in the study. None of the assessed risk factors was significantly associated with HBsAg positivity. The study participants were knowledgeable to a great extent about hepatitis B disease, with 82.1% exhibiting good knowledge of hepatitis B disease. There are gaps in knowledge, especially among the low educated groups, which need to be addressed to improve knowledge levels of hepatitis B disease among these categories in the community. The results show a relatively healthy population given the low prevalence of 2.05% seen in the participants of the study. The absence of a risk factor associated with hepatitis B disease in this study does not imply that there are no risk factors in the community around Arua Regional Referral Hospital. Further studies are recommended to assess more risk factors for hepatitis B disease in the communit
Assessing Preparedness of Health Care Facilities in the Implementation of Universal Health Care in Nakuru West Sub-County, Kenya
No full textUniversal health care (UHC), all Kenyans are able to access essential quality health
services without suffering financial hardship which depends on availability and
competence of health care providers whose intent is to deliver health services to the
Country’s population. The study aimed to examine the preparedness on the health care
facilitieson the implementation of UHC in Nakuru West Sub-County in tier 1, 2 and 3 at
public health facilities, private health facilities and faith-based health facilities. The
study applied cross sectional design. Data collection was through administration of
structured questionnaire to various staff at Sub-County hospital, health centres and
dispensaries. Interviews were conducted on health key informants; a checklist was used
on the availability of health facilities and Focus Group Discussion (FGDs) with
community members who visited the health facilities. The stratified sampling was used
to select facilities from six different wards which were grouped into hospitals,
dispensary and community clinics, while stratified sampling was used on the health care
providers, purposive sampling on the key informants and focused group discussion on
the community members seeking health services in health facilities. The data was
analyzed descriptively through determination of means and frequencies as well as
inferentially through Spearman’s correlation analysis to determine to determine the
relationship between the perception on the healthcare facilities readiness, the perception
on the role played by CHVs and the perception on the satisfaction level of the CHVs
with the successful implementation of the UHC. All the test was performed at 95%
(P=0.05) level of significance. Data analysis was done by Statistical Package for Social
Sciences (SPSS) 23rd version computer software. The study results indicated that the
health care providersreceived somegeneral training as wellas supervision. However,
some health care providershad not acquired adequate training on UHC, inadequate
number of HCP, inadequate efforts to motivate them, inadequate funding making the
healthcare facilitieslack essential commodities and also theCHVswere fundamental in
the implementation of UHC;howeverthey received inadequate facilitationby county
government. Most of theamenities necessary for the implementation of the UHC were
still at inadequate state. It was only the level of electricity connection and labeling of
the rooms within the health facilities which showed strongest and statistically
significant positive Spearman’s correlation with readiness for UHC implementation
(R=0.944 and P=0.045 & R= 0.922 and P=0.038 respectively). In conclusion, CHVs
had significant contribution to the implementation of UHC(High R values and P values
of <0.05). There satisfaction had significant contribution on the implementation of UHC
(high R values and P values of <0.05). For effective UHC implementation, there is need
for the national and county governments to avail adequate funds to all facilities for
improvement of the amenities provide proper facilitation on UHC, adequate
appreciation of HCP.Recommendation, recruiting adequate numbers of HCP, more
funds on policy facilitation, upgrade of health facilities amenities and adequate funds to
support CHVs. There is need for further study to be conductedto establish the
community members’ uptake of UHC
Measuring implementation outcomes in the context of scaling up possible serious bacterial infection guidelines: Implications for measurement and programs
No full textBackground
Reducing the burden of neonatal sepsis requires timely identification and initiation of suitable antibiotic treatment in primary health care (PHC) settings. Countries are encouraged to adopt simplified antibiotic regimens at the PHC level for treating sick young infants (SYI) with signs of possible serious bacterial infection (PSBI). As countries implement PSBI guidelines, more lessons on effective implementation strategies and outcome measurements are needed. We document pragmatic approaches used to design, measure and report implementation strategies and outcomes while adopting PSBI guidelines in Kenya.
Methods
We designed implementation research using longitudinal mixed methods embedded in a continuous regular systematic learning and adoption of evidence in the PHC context. We synthesized formative data to co-create with stakeholders, implementation strategies to incorporate PSBI guidelines into routine service delivery for SYIs. This was followed by quarterly monitoring for learning and feedback on the effect of implementation strategies, documented lessons learned and tracked implementation outcomes. We collected endline data to measure the overall effect on service level outcomes.
Results
Our findings show that characterizing implementation strategies and linking them with implementation outcomes, helps illustrate the pathway between the implementation process and outcomes. Although we have demonstrated that it is feasible to implement PSBI in PHC, effective investment in continuous capacity strengthening of providers through blended approaches, efficient use of available human resources, and improving the efficiency of service areas for managing SYIs optimizes timely identification and management of SYI. Sustained provision of commodities for management of SYI facilitates increased uptake of services. Strengthening facility-community linkages supports adherence to scheduled visits. Enhancing the caregiver’s preparedness during postnatal contacts in the community or facility will facilitate the effective completion of treatment.
Conclusion
Careful design, and definition of terms related to the measurement of implementation outcomes and strategies enable ease of interpretation of findings. Using the taxonomy of implementation outcomes help frame the measurement process and provides empirical evidence in a structured way to demonstrate causal relationships between implementation strategies and outcomes. Using this approach, we have illustrated that the implementation of simplified antibiotic regimens for treating SYIs with PSBI in PHC settings is feasible in Kenya.CW- Awarded Grant Full name of Funder; United States Agency for International Development (USAID) Grant Number: AID-OAA-A-17-00031. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
Influence of Students’ Associations on Educational Socialization Outcomes Among Students in Selected Universities in Nairobi County Kenya
No full textThis research conducted a study on; Influence of Students’ Associations on Educational
Socialization Outcomes among Students in Selected Universities in Nairobi County
Kenya. The researcher settled for Nairobi County as a suitable site for the study since
apart from being the capital city, it is home to many universities as well as constituent
colleges. The objectives entailed; to investigate influence of regional-based students’
associations, to examine influence of religious-based students’ associations and to
investigate influence of career-based students’ associations on the educational
socialization outcomes among students in selected universities in Nairobi County Kenya.
The study also intended; to assess influence of welfare-based students’ associations, to
determine influence of talent-based students’ associations on educational socialization
outcomes among students in selected universities in Nairobi County Kenya. The two
theories that guided the study are the Structural Functionalist Theory and the Social
Learning Theory. The study used Mixed Methodology whereby qualitative and
quantitative methods were concurrently triangulated. Qualitative data was presented
thematically while the quantitative data was presented using tables and charts. The target
population of the study was the 105,917 students in ten chartered universities in Nairobi
County. The universities were categorised into public and private. The reason for
choosing universities was that the associations are well defined and have clear objectives.
The students are mature and have already made career choicest. The researcher used
stratified random sampling technique to come up with a sample representing both public
and private universities, purposive sampling technique to come up with a sample of deans
of students and simple random sampling technique to come with a sample of individual
associations’ members as respondents. Data was gathered from respondents using
observation checklist, questionnaire for students and interview schedule for deans of
students. The researcher piloted the research instruments in Nazarene University that was
not among the main study sites. Reliability and validity of the instruments was checked
using the split half technique and critically assessing the consistency of the responses on
the pilot questionnaires. The data collected was then analysed using Statistical Package
for Social Sciences (SPSS) version 24. The researcher sought the relevant authorization
documents as well as informed consent from the participants. One of the major findings
was that participation in students’ association’s activities influenced educational
socialization outcomes. The study concluded that students’ associations have an
influence on educational socialization outcomes which had implications to academic
performance. Based on the findings the study recommends that university authorities
need to set up or enhance their systems as far as students’ associations are concerned.
Students in universities have a lot of energy and freedom. They engage in many activities
some which are illegal and clandestine and therefore there is need for such groups to be
identified, studied and be guided positively
Assessing the Influence of Community Health Workers on Uptake of Maternal Health Services in Musanze District, Northern Province, Rwanda
No full textBackground: Community-based initiatives are a worldwide policy that guarantees that key health services are available and accessible closer to the community. CHWs are an important element of healthcare services in Rwanda. Community health workers integrate individuals of their communities to provide preventive, habitual, and emergency maternity healthcare requirements. The aim of this research was to assess the influence of community health workers ' on the uptake of maternal health services in Musanze District. Methods: The study design used was an analytical cross-sectional study design utilizing both quantitative and qualitative methods. This research was cross-sectional because it examined the exposure and outcome at a time. In this study, a simple random sample approach was employed to choose 208 CHWs and 16 CHWs’ supervisors were interviewed for qualitative data (KII). The statistical tool for social sciences (SPSS) Version 26, was used to examine the data. Categorical variables were summarized with descriptive statistics for frequencies and percentages. Bivariate analysis with the Chi-square test of independence was used to check the association between both dependent and independent variables. Ordinal logistic regression was used as the most suitable inferential statistic because the predictor variables and the dependent were ordinal variables. Qualitative data were analyzed by NVIVO version 10. CHWs 208 participated in the study and all were female. Results: This study found that the uptake of maternal health services was regarded as very high. Among those services, deliveries at the Health Facility were at 73.6%, Antenatal care at 65.9%, Family planning at 54.3%, and the rate of Postnatal care was at 45.7%. The results also showed that Sending red Alert SMS by CHWs for pregnant mothers’ emergencies by CHWs towards maternal health services with chi-square test result p* =.001. CHWs' enrolment of girls and ladies of reproductive were significant with p* =.011. CHWs' follow-up to the pregnant has improved maternal health services with chi-square p* =.001). Health education has improved maternal health services where chi-square test was significant with p* =.014. This study assessed the influence of sociodemographic factors on uptake of maternal health services, level of education with p* <.001 , and working experience p* = .005 were associated with uptake of maternal health services. 85.1% of CHWs were knowledgeable on the warning signs of an emergency among pregnant mothers, and 89.4% reported that they would act based on these warning signs. CHWs had necessary training to provide care to pregnant mothers with p* =.001.Skills that CHWs have on administration of misoprostol to prevent post-partum hemorrhage was significant with p* <.001. Factors that influenced uptake of maternal health services were CHW’s regular supervision with p*=.001, provision of transportation p*=.001, regular refresher training p* =.002, and motivation/incentives p*=.001, as they were associated with the performance of CHWs towards uptake of Maternal Health care services. The research recommends improvement of maternal health services through access to contraception, antenatal care, and postnatal care, with particularly scale-up key motherly health services, regular training and supervision for CHWs, governmental support in terms of motivations of CHW