Browsing by Author "Odhiambo Roselyne Akinyi"

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Evaluation of continuous professional development effectiveness in clinical practice among nurses and midwives in Meru county - Kenya
(Chuka University, 2024-10) Odhiambo Roselyne Akinyi
Continuous Professional Development, refers to the process through which professionals maintain and expand their knowledge and skills. Globally, the top five causes of maternal mortality in women of all ages include haemorrhage, hypertensive disorders, embolism, abortions and sepsis, accounting for over 75% of all maternal fatalities. In Sub-Saharan Africa, the need for nurses and midwives is increasing due to the heavy disease burden and increased workloads. In Meru County, the Maternal Mortality Rate (MMR) burden remains a concern. The Nursing Council of Kenya requires nurses and midwives to complete 20 hours of CPD annually. The International Confederation of Midwives’ (ICM) has emphasized on strengthening continuing midwifery education programs. The justification of the study is evidenced by high MMR and Neonatal Mortality Rates (NMR), which exceeds the Sustainable Development Goals (SDG) target. Additionally, due to the poorly structured CPD programs that has led to its poor uptake. The objective of this study was to evaluate the effectiveness of Continuous Professional Development in Clinical practice among nurses and midwives in Meru County, Kenya. This was an evaluation study that utilized both qualitative and quantitative techniques and adopted the randomized controlled trial design. The study participants included nurses and midwives from Kanyakine, Muthara, Githongo and Nyambene Sub-County Hospitals. The study was three phased. Purposive and stratified random sampling methods were used to select the four facilities and the 78 sampled participants respectively. Participants were then allocated into the control and intervention groups using systematic random sampling. Pretesting was done in Isiolo Sub-County Hospital. Permission to conduct the study was sought from Chuka University Ethics Review Committee, National Commission for Science and Technology, from the facility heads and consent taken from the participants. Data was collected using questionnaires, structured interviews and case study follow-up. Quantitative data was analysed using SPSS version 26 while qualitative data was analysed using the themes that emerged. Pearson’s chi square was used to test the association between the nurses and midwives knowledge and CPD effectiveness in clinical practice. Paired t-test was used to compare means within the two groups (control and intervention). Phase two involved training the participants belonging to the intervention, based on the results for phase one. Phase three involved evaluation of the training intervention, which was done in two levels, immediately after training and during clinical practice using the post-test structured interviews. Data was analysed and compared with those of phase one. The mean differences in performance was done between phase one and phase three using paired t-test. Phase one results revealed poor participation in CPD activities and gaps in knowledge and skills on midwifery clinical competencies, indicating an association between CPD effectiveness and knowledge (p<0.00). Phase two results revealed marked improvement in skills after the training. The results improved from a pre-test mean of 54.19% to a post-test mean of 90%, indicating a 35.81% improvement. Phase three results showed great improvements in knowledge and skills in all areas of antenatal, normal labour, immediate newborn care, postpartum and skills in management of complications. Results from the structured interviews, as compared to phase one performance improved from a mean of 79.30% to a post-test mean of 91.34%. Further, the findings were subjected to paired sample tests which were significant with a df = 24 and (p < 0.001) at 95%CI. In conclusion, there was great improvement in the participant’s knowledge and skills after the training. The study recommended that the Hospital’s management to develop strategies on how to provide continuous education forums for nurses and midwives, in liaison with the relevant stakeholders. A CPD Model was developed from the study’s findings.
Evaluation of Effectiveness of Continuous Professional Development in Clinical Practice among Nurses and Midwives in Meru County, Kenya
(International Journal of Professional Practice, 2024-12-16) Odhiambo Roselyne Akinyi; Gitonga Lucy Kawira; Marwa Immaculate Nyaseba
The global Maternal Mortality Rate (MMR) is 223 per 100,000 live births, with hemorrhage being the leading cause of death. In Sub-Saharan Africa, the need for nurses and midwives is increasing. Incidentally, only 3.5% of the world's health staff are accountable for 27% of the disease burden. The depicted heavy workloads have largely contributed to poor participation in Continuous Professional Development activities among nurses and midwives. Meru County’s MMR burden, which exceeds the global MMR, remains a concern. However, the Nursing Council of Kenya stipulates a total of 20 CPD hours to be met annually for all nurses. The aim of the study was to evaluate the effectiveness of CPD in clinical practice among nurses and midwives in Meru County. This study seeks to inform the public on the gaps in the uptake and implementation of CPD, and provide recommendations to improve its effectiveness. The study utilized both the qualitative and the quantitative techniques, and adopted Randomized Clinical Trial design. A sample of 78 nurses and midwives was obtained from a target population of 98. Quantitative data was collected using questionnaires and case studies, and analyzed using SPSS version 26, to derive descriptive statistics, while qualitative data was collected through interview schedule checklists and observation, and was analyzed thematically. Pearson’s chi square tested the relationship between knowledge and CPD uptake in clinical practice (p=0.00) at 95%CI. Paired t-test compared means within the control and intervention groups (t=1.000). Despite the provision and use of BEmONC guidelines, major gaps were observed in Active Management of Third stage of labour (17.9%) and also in completion of the patograph (mean=1.7). Despite the efforts to maintain competence levels in clinical practice, gaps pertaining to standardization still exist. The study recommended continuous training to bridge quality gaps and need in clinical practice among nurses and midwives