School of Nursing and Public Health

Permanent URI for this communityhttps://repository.chuka.ac.ke/handle/chuka/236

Browse

Browsing School of Nursing and Public Health by Issue Date

Filter results by year or month
Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Evaluation of continuous professional development effectiveness in clinical practice among nurses and midwives in Meru county - Kenya
    (Chuka University, 2024) 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.
  • Thumbnail Image
    Item
    Effect of diabetes foot care education on preventive practices among patients attending Embu and Kerugoya level five hospitals, Kenya
    (Chuka University, 2025) Mbisi Annastacia Munzi
    Diabetic foot disease, often known as ulceration (DFU) is a common complication among patients with Diabetes Mellitus(DM). An estimated 2 million amputations occur each year due to diabetic foot complications. In Kenya, the incidence of diabetic foot illness was 9.04% in 2020. Diabetic foot care (DFC) practice has the potential of reducing DFUs by 75%. Effective DFC practice requires that the patients have the requisite knowledge. Therefore, the purpose of this study was to determine the effect of diabetic foot care education on preventive practices among diabetes patients attending Embu and Kerugoya level five Hospitals-Diabetes clinics. The two facilities were purposely selected based on the previous data supporting poor foot care practices. A Randomized Controlled Trial (RCT) design involving three phases: Baseline survey, intervention and evaluation phase was adopted. Systematic random sampling strategy was used to select 230 participants for the study. A research administered questionnaire was used to collect quantitative data while focus group discussion (FGD) guide to collect qualitative data. Pre-testing of these instrument was done at Chuka level five hospital. During the baseline survey quantitative and qualitative data was collected using questionnaire and four (4) FGD-each with 10 participants respectively. In the intervention phase, the study population was divided into an intervention and control group. Structured foot care education was provided to patients in the intervention group in groups of 25 patients after every one month for a period of three months. The patients in the control group received normal services. In the evaluation phase, data was collected using the same tool as was used in the baseline survey for both the control and the intervention group. Statistical package for social sciences(SPSS) version 29.0 was utilized for the analysis of quantitative data while a thematic analysis of the qualitative data will be conducted with NVIVO version 14 software. Ethical approval was obtained from Chuka University and the National Commission for Science, Technology and Innovation (NACOSTI), with additional permissions from relevant hospitals. Informed consent was obtained from all participants, with confidentiality and anonymity strictly maintained. Data was securely stored and used solely for research purposes. Baseline results in both group generally revealed majority had inadequate foot care knowledge (n=111, 48%), poor foot care behavior (n=172, 75%) and low self-efficacy (n=132, 58%). FGD findings highlighted key barriers to diabetic foot care, including limited education, high healthcare costs, and staff shortages, while also identifying peer support, flexible clinic schedules, and friendly staff as key enablers. Following the educational program, only slight changes were observed in the control group; however, the intervention group showed marked improvements, with statistically significant differences in mean scores between the two groups in knowledge (Δ = 2.21; 95% CI: 1.27–1.14; p < 0.001), behavior (Δ = 1.02; 95% CI: 1.09–0.96; p < 0.001), and selfefficacy (Δ = 1.63; 95% CI: 1.76–1.50). Thus, the structured diabetic foot care (DFC) education intervention significantly enhanced knowledge, behavior, and self-efficacy among participants in the intervention group. These results confirm that a structured, culturally appropriate, and interactive educational approach is an effective strategy to empower patients, encourage preventive practices, and lower the risk of diabetic foot complications. Consequently, the study recommends that nurses incorporate structured foot care education sessions into routine diabetes clinic visits. Future research should explore its long-term impact on foot ulcers, hospitalizations, and amputations