Nurses' Supplemental Oxygen Therapy Knowledge and Practice in Debre Tabor General Hospital: A Cross-Sectional Study

Knowledge, attitude, practice and associated factors of oxygen therapy among health professionals in Ethiopia: A systematic review and meta-analysis

BACKGROUND

Oxygen therapy is a life-saving intervention used in various healthcare settings to maintain adequate tissue oxygenation while minimizing cardiopulmonary work. Its effective and safe administration depends largely on the knowledge, attitudes, and practices of health professionals. However, there are no pooled studies that examined these skills in the context of Ethiopia. Therefore, this study aimed to assess the pooled prevalence of health professionals' knowledge, attitude, practice, and determinant factors about oxygen therapy in Ethiopia.

METHODS

The databases PubMed, Web of Science, Scopus, Hinari, Science Direct, African Journal of Online, and Google Scholar were used to search for published studies; Direct Google searches and institutional repositories were used to search for unpublished studies. Duplicate studies were eliminated with Endnote X8 and reported according to PRISMA guidelines. The quality of the included studies was assessed using the Joanna Briggs Institute critical appraisal checklist. A random-effects model was used to estimate the pooled prevalence of KAP among health professionals. Heterogeneity was assessed using Cochran's Q test and I2 statistics. Publication bias was checked by visual inspection of a funnel plot and Egger's regression test. STATA version 11 software was used for statistical analysis.

RESULTS

A total of 14 studies with 2,960 participants for knowledge and practice and 9 studies with 1,991 participants for attitude were used to estimate the pooled prevalence of KAP among health professionals. The pooled prevalence of good knowledge, positive attitude, and good practice regarding oxygen therapy were 52.13% (95% CI: 43.88, 60.39), 55.08% (95% CI: 50.80, 59.35%), and 48.94% (95% CI: 41.14, 56.74) respectively. Both good knowledge and positive attitude were affected by the availability of oxygen therapy guidelines, with adjusted odds ratios (AOR) of 6.11 (95% CI: 2.45, 15.22) and 2.17 (95% CI: 1.39, 3.39) respectively. Additionally, good knowledge (AOR: 4.31, 95% CI: 1.53, 12.11), training (AOR: 4.09, 95% CI: 2.04-8.20), and having an adequate oxygen supply and delivery system (AOR: 3.12, 95% CI: 1.92-5.07) were statistically associated with good practice.

CONCLUSION AND RECOMMENDATIONS

The national pooled prevalence of good knowledge, positive attitude, and good practice among health professionals was low. Therefore, thorough monitoring, supervision, and evaluation of their oxygen therapy is highly recommended for all stakeholders. Yet again, we strongly advise that the identified factors be improved by organizing training sessions, making oxygen therapy guidelines available, and maintaining an adequate oxygen supply system.

TRIAL REGISTRATION

The review protocol was registered in the international prospective register of systematic reviews with registration number PROSPERO: CRD42023486036.

Oxygen therapy practice and associated factors among nurses working at an Ethiopian Referral Hospital

Objective

Supplemental oxygen therapy is suppling oxygen at quantities higher than those found in the atmosphere (>21 %) and is mostly prescribed for hypoxic patients. To avoid hypoxemia, hypercapnia, and oxygen poisoning, nurses closely monitor patients receiving oxygen therapy. There are considerable gaps in nurses' practice of oxygen therapy. Patients who receive inappropriate oxygen therapy may have negative effects, and it has financial repercussions for both individuals and nations. The aim of this study was to assess oxygen therapy practices and associated factors influencing oxygen administration among nurses in an Ethiopian Regional Hospital.

Method

From March 1 to March 30, 2019, a cross-sectional institutional study using quantitative methods was performed amongst nurses working at a referral hospital in northwestern Ethiopia. Data was gathered using structured self-administered questionnaires.

Result

In this study, 147 participants (91.3 %) were found to have inadequate practice with oxygen therapy. Nurses' lack of knowledge about carbon monoxide, adult patients' typical breathing rates, cardiopulmonary function, and devices (face mask, nasal cannula, oxygen concentrators, pulse oximeter and others) that are difficult for patients to accept were found to be factors associated with oxygen administration practice.

Conclusion

The findings of this study showed that nurses' use of oxygen administration was subpar. The institutional factors, knowledge gaps, and attitudes of nurses were identified as the determinants affecting oxygen administration practice. Nurses would do better to read up on oxygen administration, interact with one another and undertake further training.

Assessment of knowledge, attitude and practice for oxygen therapy among medical staff at the Colonial War Memorial Hospital in Fiji

BACKGROUND

Oxygen therapy (OT) is a commonly prescribed essential medicine for people of all ages in the management of hypoxia. The adverse effects of inappropriate OT supplementation may be underestimated by health professionals and lead to poor health outcomes among hospitalised patients. Knowledge, attitude and practice (KAP) assessments of medical staff members to OT guidelines are essential to ensure optimal patient care.

AIMS

To perform a KAP assessment of OT administration among doctors and nurses employed at the national hospital of Fiji in 2021.

METHODS

Prospective cross-sectional study design. KAP assessment was performed with an online questionnaire and clinical observation.

RESULTS

The study population (N = 116) consisted of doctors (20.7%) and nurses (79.3%) representing the acute medical, burns, cardiac care, intensive care, surgical and postanaesthetic recovery units. Overall, the proportion of participants who obtained a good score (>70%) was 87% for knowledge, 87.93% for attitudes and 84% for practice. Best knowledge scores were obtained for general OT indications (71%) and scenarios where immediate oxygen application is required (70%). Lowest knowledge scores were for OT contraindications (14%) and oxygen saturation for acute myocardial infarction (32%), asthma (36%) and healthy newborns (43%). The most positive attitudes were in response to the statement that OT guidelines are essential (96%). A total of 78 (80.4%) patients were being cared for with good OT practice.

CONCLUSIONS

Good KAP scores were obtained for medical staff in Fiji regarding OT administration. Ongoing professional education activities should include updated training of OT contraindications and optimal oxygen saturation levels for special patient groups.

Knowledge, Practice, and Associated Factors Towards Supplemental Oxygen Therapy Among Nurses Working in Neonatal Intensive Care Units in Public Hospitals of Addis Ababa, Ethiopia, 2022: A Cross-Sectional Study

Purpose

Proper administration of oxygen therapy for hospitalized newborns is undoubtedly essential. World Health Organization estimates that approximately 1.4 million deaths worldwide each year are due to inappropriate administration of oxygen, but its administration in clinical practice is usually inappropriate due to lack of knowledge and practice. Therefore, the aim of this study was to determine the level of knowledge, practice and associated factors related to supplemental oxygen therapy among nurses working in neonatal intensive care units.

Methods

An institutional cross-sectional study was conducted with 166 randomly selected respondents using a self-administered questionnaire for data collection. Bivariate and multivariable analyses were performed using SPSS version 26. Variables with a p-value of <0.25 in the bivariate analysis were included in the multivariable logistic regression, and statistical significance was ensured by a p-value <0.05 with 95% CI.

Results

One hundred and sixty-six nurses took part in this study, with a response rate of 96%. Of these, 60.8% had good knowledge and 54.2% had good practice in supplemental oxygen therapy. In the multivariable logistic regression analysis, work experience was significantly associated with knowledge (AOR: 5.40; 95% CI: 2.12-13.73)) and practice (AOR = 3.69, 95% CI: 1.30-10.44)) of supplemental oxygen therapy. Level of knowledge (AOR=2.92, 95% CI: (1.24-6.86)) and educational status (AOR=6.51, 95% CI (1.34-31.55)) were also significantly associated with the practice of supplemental oxygen therapy with a p < 0.05.

Conclusion

Approximately 40% and 46% of nurses in this study had poor knowledge and practice of supplemental oxygen therapy. This figure is shocking and shows a large gap in the knowledge and practice of supplemental oxygen therapy that requires urgent action. Educational status, professional experience and level of knowledge were found to be associated with good knowledge and professional experience with good practice in relation to supplemental oxygen therapy.

Barriers to Safe Oxygen Therapy and the Effect of the Training on the Knowledge and Performance of ICU Nurses

Introduction

Proper oxygen therapy is crucial in hospitals, particularly intensive care units, to ensure safety and accuracy. The role of nurses during oxygen therapy is vital, as their knowledge and correct performance significantly impact patients' clinical conditions. A study was carried out to examine the knowledge and performance of nurses regarding safe oxygen therapy. The study aimed to identify the obstacles hindering safe oxygen therapy and assess the impact of training on the knowledge and performance of intensive care nurses.

Methods

This study was conducted among the ICU nurses at Shahid Rahnemoun Teaching Hospital in Yazd, Iran. The study method is a sequential combination of descriptive, qualitative, and educational phases. The first stage involved examining the knowledge and performance of 80 ICU nurses in oxygen therapy. The study employed content analysis to elaborate on participants' perspectives on safe oxygen therapy challenges and potential solutions. The third phase involved a two-group study with pre- and post-tests to examine the effect of training on ICU nurses' knowledge and performance in oxygen therapy.

Results

The study found that intervention and control groups had low average scores in knowledge, performance, and total score of oxygen therapy before the study, with no significant difference. There was a significant difference between intervention and control groups one and three months after the intervention in the areas of knowledge (after-1 month 24.41 vs. 20.29, 95% CI [3.144-5.098], after-3 month 22.13 vs. 20.24, 95% CI [0.729-3.053]), performance (after-1 month 21.54 vs. 18.05, 95% CI [2.898-4.073], after-3 month 19.74 vs. 18.63, 95% CI [0.400-1.824]), and total score of oxygen therapy (after-1 month 45.95 vs. 38.34, 95% CI [6.288-8.925], after-3 month 41.87 vs. 38.87, 95% CI [1.394-4.613]).

Conclusion

The study's findings revealed that nurses in ICUs lack the appropriate knowledge and performance in oxygen therapy. A lack of knowledge and correct practice, insufficient monitoring of oxygen therapy, and defects in hospital equipment are contributing factors. The training was found to improve the knowledge and performance of nurses significantly. Consistent training at shorter intervals is suggested for nurses to keep their knowledge current.

Development and evaluation of an e-learning course in oxygen therapy

BACKGROUND

Respiratory problems are among the most challenging situations in emergency care services. Different oxygen therapy methods are usually used to deal with these problems. In recent years, oxygen therapy has been recognized as one of the most widely used therapeutic processes in emergency departments (ED) mainly due to the Covid-19 pandemic. The aim of this study was to develop and evaluate an e-learning course in oxygen therapy for the ED clinicians.

METHODS

This was a pre-post study conducted in three phases in 2021. Initially, the educational requirements of clinicians (n = 181) were investigated using a questionnaire, and in the second phase, an interactive e-learning course was developed. In the third phase, the course was assessed in terms of maintaining the principles of developing an e-learning course, affecting participants' knowledge, and supporting usability requirements.

RESULTS

The findings revealed that training in oxygen therapy was essential for the ED clinicians. Therefore, an e-learning course was developed. The content production experts and the participants evaluated the content and usability of the online course at a good level. In addition, there was a statistically significant difference between the nurses' (p < 0.001) and general practitioners' (p < 0.002) pre- and post-test scores suggesting that the course improved their knowledge.

CONCLUSION

It seems that the e-learning course developed in the current study can improve health care professionals' knowledge and quality of care. However, more evaluation studies are needed to investigate the effectiveness of the course for other clinicians, such as nurses who work in intensive care units.

Assessment of knowledge, attitude, and factors associated with oxygen therapy for critically ill patients among nurses at the University of Gondar Comprehensive Specialized Hospital Northwest, Ethiopia, 2021

Background

Administering oxygen therapy has an essential role in preventing and managing hypoxemia in both acute and chronic conditions. The aim of this study was to assess knowledge, attitude and factors associated with oxygen therapy for critically ill patients among nurses.

Methods

An institutional-based cross-sectional study was conducted from May 23 to June 07 at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, in 2021. A self-administered, structured and validated questionnaire was used. It has socio-demographic characteristics, multiple choice questions, items that measure the possible associated factors and items that were used to assess the level of knowledge and attitude. Epi Data (“The EpiData Association” Odense, Denmark) version 4.6 was used to enter data, and SPSS (IBM) version 20 was used to analyze it. Both bivariate and multivariate logistic regression analyses were used to identify associated factors. Variables with a p value < 0.05 were considered statistically significant.

Results

The overall proportion of critically ill patients with good knowledge and a positive attitude toward oxygen therapy was 33% (95% CI: 25.8–37.8) and 53.8% (95% CI: 49–59), respectively. Age (AOR; 1.738, 95% CI: 1.034–2.921), level of education (AOR; 7.731, 95% CI: 2.507–23.846) and guideline (AOR; 4.338, 95% CI: 2.233–8.428) and good level of practice (AOR; 1.885, 95% CI: 1.173–3.030) were discovered to be significant factors associated with good knowledge towards oxygen therapy and the reading guideline was found to be a significant factor associated with a positive attitude toward oxygen therapy (AOR; 1.396, 95% CI: 0.830–2.348).

Conclusions

and recommendations: The level of knowledge was low, whereas the attitude of nurses was positive towards oxygen therapy. Reading guidelines, older aged nurses, master holder nurses, and good practice were significant factors associated with good knowledge of oxygen therapy, and reading guidelines was statistically associated with a positive attitude toward oxygen therapy. Thus, nurses need to be aware and skillful regarding the updated oxygen therapy guidelines. They should improve their level of education.

•

To assess the level of knowledge and attitude of nurses on oxygen therapy in critically ill patients.

•

An institutional-based cross-sectional survey study was conducted.

•

The overall proportions of good knowledge and a positive attitude toward oxygen therapy were 33% and 53.8%, respectively.

•

The level of knowledge was low, whereas the attitude of nurses was positive towards oxygen therapy.

Nurses' Knowledge Regarding Oxygen Therapy; a Cross-Sectional Study

Introduction

Oxygen therapy, if done correctly, can save patients' life promptly. However, improper use will be just as dangerous. The present study aimed to investigate the level of nurses' knowledge on properly using oxygen.

Method

This was a cross-sectional study with a minimum sample size of 72 nurses who were randomly selected from various wards of Masih Daneshvari Hospital, Tehran, Iran. To determine the level of knowledge about oxygen therapy, a questionnaire was used to collect data. This questionnaire consists of seven items, each of which is designed to determine the level of the individual's knowledge about the various details of oxygen therapy.

Results

Seventy-eight nurses with the mean age of 35.80±7.42 years participated in the study (87% female). The mean knowledge score of nurses regarding oxygen therapy was 8.89 ± 2.79 out of 16 points. 84.6% of the nurses were able to differentiate various types of oxygen masks. Accordingly, 94.9% of nurses had good knowledge on oxygen humidification. Also, 50% of the nurses had sufficient knowledge about the amount of oxygen flow produced by different masks. 10.3% of the nurses could choose the most appropriate mask for different clinical conditions. 6.4% of the nurses had knowledge of working with flowmeters, and 15.4% of the nurses had sufficient information about the maximum level of oxygen required for the patient. 17.9% of the nurses were familiar with measuring the appropriate amount of oxygen for patients. There was no statistically significant relationship between age (p = 0.57), gender (p = 0.09), employment status (p = 0.38), workplace (p = 0.86), current position (p = 0.11), degree (p = 0.27), and graduation time (p = 0.58) of nurses with good knowledge of using oxygen. However, a statistically significant relationship was reported between nurses' related work experience and their knowledge of the proper use of oxygen (p = 0.03).

Conclusion

In general, the nurses' knowledge at Masih Daneshvari Hospital on how to properly use oxygen is at a moderate level. Nurses' knowledge in some areas, such as working with the flowmeter, choosing the suitable mask for specific clinical conditions, and the maximum oxygen required for patients, is meager and requires training intervention.

Knowledge, attitude, and practice of health professionals for oxygen therapy working in South Gondar zone hospitals, 2021: multicenter cross-sectional study

INTRODUCTION

Therapeutic oxygen should be administered by competent healthcare providers who possess the required competencies of knowledge, skill, and judgment/abilities to make clinical decisions regarding the administration of oxygen. Therefore, this study aimed to assess the knowledge, attitude, and practice of health professionals towards oxygen therapy.

METHODS

A multicenter institutional-based cross-sectional study was conducted among 218 health professionals. The assessment was done with a total of 31 questions. After data cleanup analysis was done with SPSS software. Descriptive, chi-square test, bivariable and multivariable analysis were done accordingly. A p-value of ≤0.05 was considered to have a significant association with the outcome variables.

RESULTS

Among 218 participants, most of the participants (92.7%) were in the age range of less than 40 years old. Nurses were the most responding professions followed by physicians and midwifes. From the participants, around 54.6, 54.6, and 65.1% of respondents answered above the means score of knowledge, attitude and practice questions respectively. Getting training (AOR- 4.15, CI- 1.15-14.6), work experiences of less than 4 years (AOR- 2.54, 95%CI- (1.28-5.05), and availability of guidelines (AOR- 11.5, CI- 3.35-39.6) were significantly associated with knowledge level. Also work experience of fewer than 4 years (AOR- 3.41, 95%CI- (1.58-7.35) and presence of periodic maintenance and supply of oxygen therapy devices (AOR- 4.32, 95% CI- (1.44-12.9) were associated with practice level. Similarly, work experiences < 4 years (AOR- 8.6, 95%CI- (2.6-29) and getting training (AOR- 21.4, 95%CI-(2.7- 27.3) has a positive (direct) association with the level of attitude, and poor level of knowledge (AOR- 12.1, 95%CI (3.42-42.9) was contributed for negative attitude.

CONCLUSION

This study concluded that 54.6, 54.6, and 65.1% of participants have a good level of knowledge, positive attitude, and good level of practice towards oxygen therapy respectively.