Evaluation of Effectiveness of Continuous Professional Development in Clinical Practice among Nurses and Midwives in Meru County, Kenya

Abstract

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