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    EFFECT OF AN EDUCATIONAL PROGRAMME ON NURSES’ KNOWLEDGE AND PRACTICE OF PRESSURE ULCER PREVENTION STRATEGIES IN SELECTED TEACHING HOSPITALS IN SOUTH-WESTERN NIGERIA
    (2014-01) ILESANMI, R.E
    Prevention of Pressure Ulcer (PU) is a nursing responsibility and reflects the quality of nursing care. The role of evidence-based Educational Intervention Programme (EIP) among nurses towards its prevention has been differently reported in the literature. However, the possible effects of EIP on PU prevention among nurses in Nigeria have not been adequately explored. This study was aimed at evaluating the effects of an EIP on knowledge and practice of PU prevention among nurses in selected teaching hospitals in Nigeria. A quasi-experimental study was conducted in three of the six teaching hospitals in south-western Nigeria: Lagos State University Teaching Hospital (LASUTH), University College Hospital (UCH) and Obafemi Awolowo Teaching Hospital Complex (OAUTHC). These hospitals were selected through balloting and labeled as Intervention Group (IG)-LASUTH and UCH; and Control (OAUTHC). All 193 nurses (127 in IG and 66 in control group) from the purposively selected wards in neurological, orthopedics and medical units in each hospital were recruited. Participants received a 5-day EIP of five modules focusing on PU risk assessment and preventive interventions with hands-on training. Baseline, immediate post-EIP and 3-month post-EIP knowledge of PU prevention strategies were evaluated using a standardised Pressure Ulcer Knowledge Test (PUKT). Practice was assessed using a validated observational checklist (Risk-based Prevention Intervention Checklist) at baseline and 3-month post-EIP. During the 3-month period, consumables for skin care and prevention of friction were also provided for use on the skin of patients at risk for PU in the IG and control group. Paired t, Mann-Whitney U and Wilcoxon Sign tests were used for data analyses. There were no significant differences in the mean ages of participants [IG: 36.3±10.4 years; control: 35.2±11.9 years] p<0.05, and mean years of experience [IG: 14.5 ±13.7 years; control: 12.6 ±12.0 years] p<0.05. The mean knowledge scores increased significantly among IG from 32.5 ±4.2 at baseline to 40.7 ±3.4 (p<0.05) at immediate post- EIP while in the control group it increased from 30.8± 5.0 to 31.2 ±5.2. At 3-month post-EIP, the mean score increased significantly in both groups; from 40.7±3.4 to 42.0 ± 4.0 in the IG and 31.2±5.2 to 37.8 ± 5.6 in the control group. The increased mean knowledge scores from baseline to immediate post-EIP among IG (8.2 ±5.4) was significantly higher than that of the control group (0.4 ±2.2); (p < 0.05). The increased mean knowledge scores from immediate post-EIP to 3-month post-EIP among IG (2.0 ±5.5) was not significantly different from the control (6.2 ±7.2). The median rank for practice in both IG and control groups were equal (97.0) at baseline and it increased to 105.0 only in the IG at 3months (p<0.05). However, in the control group the median rank decreased to 87.5 at 3-month post-EIP (p<0.05). Educational Intervention Programme improved nurses’ knowledge of pressure ulcer prevention and practice. There is the need to improve on existing nursing continuing education programmes on evidence-based educational intervention for pressure ulcer prevention.
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    EDUCATIONAL INTERVENTION ON NURSES’ USE OF CLINICAL GUIDELINE INDICATORS IN TRACHEOSTOMY CARE IN FEDERAL TEACHING HOSPITALS IN SOUTH-WEST NIGERIA
    (2018-10) KOROYIN, M.O
    Quality nursing decisions in tracheostomy care are guided by clinical indicators and research evidence. Application of these clinical indicators lessen noisy respirations, excessive coughing, skin maceration and infection. Studies showed that tracheostomy care decisions in some clinical settings are not guided by evidence-based clinical indicators. Research findings suggest poor knowledge and utilisation of recommended clinical indicators in tracheostomy care in Nigeria. This study was designed to examine nurses’ knowledge and determine effect of use of clinical guideline indicators in evidence-based tracheostomy care decisions. This Quasi-experimental study was conducted in three Federal Teaching Hospitals in South-West Nigeria: University College Hospital (UCH), Lagos University Teaching Hospital (LUTH), Obafemi Awolowo University Teaching Hospital Complex (OAUTHC). Specific units included were Intensive Care, Neurology, and Ear, Nose and Throat. Due to limited number of nurses, LUTH and OAUTHC were purposely labelled control group (CG), and UCH intervention group (IG). All the 121 nurses in the units were recruited. Data were collected using validated structured decision-making and documentation checklists (inter-observer reliability 0.75-1.0 and 0.76-1.0), and questionnaire (Cronbach’s Alpha Coefficient 0.8 and 0.83). Stage 1 involved participant observation of nurses’ utilisation of clinical indicators for 10 evidence-based tracheostomy assessment, care, and documentation practices per participant in each of; suctioning, airway maintenance, dressing, and tie change decisions in both groups. In stage 2, pre intervention knowledge was assessed in both groups. Educational intervention of five modules on clinical guideline indicators, assessment, care, and documentation of evidence-based tracheostomy care decisions was conducted only in the IG. Knowledge was assessed immediately post intervention in both groups. At 3 months post intervention (stage 3), only participant observation of 10 evidence-based care decisions per participant was conducted as in stage 1 in both groups. Data were analysed using Chi-square, Independent t-test and Mann-Whitney U at α0.05. Sixty-seven of 121 nurses completed the three stages (IG=32; CG=35). There was significant difference in mean knowledge of evidence-based tracheostomy care at pre-test (IG:20.3±3.1; CG:22.0±4.6); which increased in both groups at post-test (IG:31.3±3.3; CG:22.9±3.9). The mean knowledge of decision-making was comparable at pre-test (IG:5.6±1.7; CG:5.5±2.0); but increased at post-test (IG:6.7±1.3; CG:5.9±1.1) in both groups. The mean knowledge of use of clinical guidelines was similar at pre-test (IG:3.0±0.9; CG:3.1±1.1) and post-test (IG:3.2±0.9; CG:3.1±0.91). There was no significant difference in nurses’ performance of evidence-based tracheostomy suctioning assessment decisions: medianpre (IG:5.0; CG:45.0); medianpost (IG:0.0; CG:20.0), suctioning care decisions: medianpre (IG:4.0; CG:32.0); medianpost (IG:0.0; CG:20.0), and airway maintenance care decisions: medianpre (IG:86.6; CG:0.0); medianpost (IG:63.6; CG:50.0). Nurses’ performance of documentation of evidence-based decision-making practices in tracheostomy assessment and care decisions for suctioning, airway maintenance, dressing, and tie change were also not significant in IG and CG, pre and post intervention. Despite the educational intervention there is poor application of clinical guideline indicators to direct evidence-based tracheostomy care decisions and documentation amongst nurses. There is need for regular audit and continuous monitoring of nurses’ decision-making, and periodic research-based continuing education in practice to improve nurses’ clinical competence of evidence-based decision-making, in tracheostomy care.
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    COMPARISON OF OBJECTIVE STRUCTURED CLINICAL EXAMINATION WITH TRADITIONAL PRACTICAL EXAMINATION IN ASSESSMENT OF NURSING STUDENTS’ CLINICAL COMPETENCIES IN SOUTHWESTERN NIGERIA
    (2017-08) EDWARD, M.I
    Clinical examination is crucial to assess competencies of nursing students in the delivery of quality nursing care. Globally, Traditional Practical Examination (TPE) and Objective Structured Clinical Examination (OSCE) are the methods of clinical assessments in Nursing. The Nursing and Midwifery Council of Nigeria (NMCN) had always used TPE for clinical examinations. The NMCN adopted OSCE for midwifery two decades ago while the examination in general nursing remains TPE. There is dearth of information on the effectiveness of OSCE and TPE in assessing students in general nursing. The goal of this study was to compare the effectiveness of OSCE and TPE in the assessment of clinical competencies of nursing students in Southwestern Nigeria. The study utilised quasi-experimental design among nursing students. Using a ballot system, two out of the sixteen hospital-based and two out of the five university-based nursing programmes were selected. The four schools participated in OSCE and TPE. The two programmes have similar curricula for nursing clinical procedures. Out of the 186 nursing students selected, 100 were second year hospital-based (51 students in Wesley Guild School of Nursing, Ilesa and 49 students in School of Nursing, Akure) while 86 were 300 level university-based (36 students in the Department of Nursing, University of Ibadan and 50 students in the Department of Nursing, Ladoke Akintola University of Technology, Osogbo). Data were obtained using adapted and validated instruments: Traditional Practical Examination Instrument (TPEI), Objective Structured Clinical Examination Instruments (OSCEIs) and Students’ Demographic and Perception Questionnaires (SDPQ). Pre-test was administered to the students to obtain the baseline data after which clinical teaching of selected nursing procedures were taught to all students for four weeks. The TPE (post-test I) was conducted at fifth week while OSCE (post-test II) was conducted at sixth week. The means of the performance scores in OSCE and TPE were computed while competency data were obtained by grouping performance scores into two levels of competencies: fairly competent (50.0%-59.9%) and very competent (60.0% and above). The SDPQ was used to collect data on students’ preference and perception of the two examination formats. Data were analysed using descriptive statistics, Students t-test, Chi-square test and ANOVA at α0.05. Age of respondents was 21.5±3.8 years. At baseline, the mean of students’ performance score was 53.3±3.7. There was a significant difference between the mean scores obtained at baseline and the two practical examination formats: pre-test 53.3±3.7, OSCE(post-test II) 64.6±5.2, TPE (post-test I) 59.3±2.9. More respondents were very competent in OSCE (80.1%) compared to TPE (45.7%). Perception of Objective Structured Clinical Examination and Traditional Practical Examination revealed: consumed less time (53.0% versus 48.0%); more objective (52.1% versus 47.9%); assessed wider range of learned materials (54.4% versus 45.6%); less destabilizing during practical sessions (53.5% versus 46.5%) less stressful (56.1% versus 44.0%). Lastly, 56.8% of respondents preferred OSCE while 43.2% preferred TPE. Objective Structured Clinical Examination was more effective in assessing competency of nursing students.
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    PROSTATE CANCER EDUCATIONAL INTERVENTION AS A STRATEGY FOR ENHANCING KNOWLEDGE AND SCREENING UPTAKE OF MEN IN SELECTED HOSPITALS IN CROSS RIVER STATE, NIGERIA
    (2019-05) INGWU, J.A
    Prostate Cancer (PC) is a common cause of cancer-related death among men. In developing countries, available evidence indicates that factors responsible for high PC-related mortality rate include poor knowledge and low uptake of screening practices. In Nigeria, there is paucity of literature on PC-specific health promotion package that emphasise knowledge and screening uptake of men. This study, therefore, was designed to evaluate prostate cancer educational intervention as a strategy for enhancing knowledge and screening uptake of men in selected hospitals in Cross River State, Nigeria. A mixed method research comprising of focus group discussion and a quasi-experimental pretest-posttest research design was used. The study was conducted in four randomly selected General hospitals in three senatorial districts in Cross River State. The hospitals in Ogoja and Ugep were purposively designated Intervention Group (IG) while Akamkpa and Calabar constituted the Control Group (CG). A sample of 420 men out of 980 regular Out Patient Department attendees was proportionately distributed 210 to IG and CG respectively. An educational training package on knowledge and screening uptake of PC with four teaching sessions of 60 minutes each was administered weekly to participants in IG while CG received the traditional health education on wide range of health promotion and disease prevention activities. A validated structured questionnaire (r = 0.89) was used to assess knowledge and PC screening uptake of men at baseline (PT1), immediate post intervention (PT2), at three months (PT3) and six months post intervention (PT4) periods. The participants’ knowledge was scored on a scale of 1-100 and then categorised into good (60 - 100%), fair (40 -59%) and poor (0 - 39%). The PC screening uptake was assessed using questionnaire and authenticated by Prostate Specific Antigen assay and Digital Rectal Examination. The participants were then categorised as users and non-users. Data were analysed using descriptive statistics, student t-test, and Cochran Q test at α 0.05. Mean age of IG and CG was (51.4 ± 8.9) and (54.1 ± 8.2) years respectively. At baseline, there was a significant difference between knowledge scores of IG (10.1 ±3.0) and CG (9.1 ± 4.8). In the IG, there was an increase in knowledge scores to 19.4 ± 2.0 at PT2, 16.6 ± 2.7 at PT3 and 17 ±2.7 at PT4. Similarly, the knowledge scores increased slightly in CG to 9.8 ± 3.6 at PT2, 11.3 ± 2.1 at PT3 and decreased to 10.7 ± 2.3 at PT4. The observed increment in knowledge scores was significantly higher among IG than CG. At baseline only 2.4% of participants had utilized PC screening uptake, 5.2% at PT2, 10.5% at PT3 and 45.2% at PT4 among IG. Likewise among the CG, only 2.9% of participants had utilized PC screening uptake at baseline and at PT2, 5.4% at PT3 and at 8.1% at PT4. The observed increment in utilisation of PC screening uptake was significantly higher among IG than CG. The Prostate cancer specific educational intervention improved the knowledge of men about prostate cancer and enhanced uptake of prostate cancer screening. It is therefore recommended for routine use in susceptible men.
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    Knowledge and practice of pain management among nurses In labour wards in Ibadan, Nigeria
    (2016-09) EZE-Ojerinde, O.; Onibokun, A.; Akpa, O. M.
    Background: It is not clear whether awareness of pain management has influenced the management of labour pain by nurse/midwives in Ibadan, Nigeria. Many women in labour do not get optimal pain relief, despite awareness of the importance of pain management. Aims: This study aimed to assess knowledge and practice of labour pain management among nurse/midwives in Ibadan. Methods: This cross-sectional study included 87 nurse/midwives on duty in labour rooms of three hospitals in Ibadan, Nigeria. Data were collected using semi-structured questionnaires. Descriptive statistics, and Pearson's and Kendall's correlation coefficients were used for data analysis. All analyses were performed using IBM SPSS version 20.0 at a 5% level of significance. Findings: Two thirds of respondents (66.7%) had a moderate level of knowledge, and 34.5% managed labour pain through back massage/psychotherapy. Knowledge of pain management was associated with level of education (τ = 0.82; P < 0.001) while good practice of pain management was associated with good knowledge (r = 0.49; P < 0.001). The association between good practice and years of working experience just failed to be statistically significant (P = 0.06). Conclusions: Nurse/midwives in Ibadan have moderate knowledge of labour pain management. Participants in this study primarily used back massage and psychotherapy. There is need for improvement in knowledge of labour pain management through continuing education for nurse/midwives in Ibadan
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    Nurses’ knowledge and reported practice of palliative and end- of-life care nursing at the university college hospital, Ibadan, Nigeria
    (TextLinks Publishers, Ibadan, 2014-06) Onibokun, A. C.
    Background: Palliative and End-of-Life (EoL) care nursing is the active total care of patients with advanced illness. The goal of this approach to care is the achievement of the best quality of life for patients and their families. No member of the interdisciplinary team is more central to making these discoveries possible than the nurse. Care of patients with life-limiting diseases and dealing with death and dying is an integral part of oncology musing. In environments of best practice, nurses routinely identify and suggest patients to physicians for possible referral to palliative care and discuss potential referrals with families. Though studies from other parts of the globe had reported levels of knowledge and practice of palliative and EoL care amongst nurses; there is dearth of literature emanating from Nigeria, specifically on the knowledge and practice of palliative and EoL care nursing by professional nurses. To the best of the authors’ knowledge, the few that have been published in Nigeria, focused mainly on knowledge of palliative care among healthcare workers. Objective: The objective of this study was to explore the knowledge and reported practice of palliative and EoL care nursing by nurses working at the University College Hospital (UCH), Ibadan, Nigeria; in a bid to inform where gap in knowledge to practice may exist. Methods: This is a descriptive study utilizing cross-sectional design, 650 nurses in various nursing cadres, who were participating in the monthly continuing education program organized by the In- Service Education (ISE) department of UCH for nurses, over a period of twelve months. With the aid of a validated semi -structured questionnaire, information was elicited from the participants on demographic variables, education and training profile, and contents of nursing education curricula, years of working experience among others. On a 5-point Likert scale, their knowledge and principles of palliative and end-of-life care nursing were assessed. Their reported practice was also assessed. Results: The sample of 650 nurses was made up of 155(23.8%) university graduates and 495(76.2) diploma-prepared nurses. Three hundred and sixty four (32%) of the participants had component of palliative care nursing in their curricula, while 327(50.3%) had components of palliative care nursing and pain management in their curricula. Fifty-four (4.7%) had formal palliative care training post- qualification. Majority (81.2%) of the respondents claimed they apply the knowledge and principles of palliative care in their current practice. A little above fifty-nine percent (59.2%) had good knowledge of palliative care. However, the practice of some was poor (40.0%) and many (29.2%) also had poor attitude towards provision of palliative and EoL care to patients who are approaching EoL; evidenced by their inappropriate responses to the related questions. Conclusion: This study identified gaps in nursing knowledge and reported practice as it relates to palliative and EoL care nursing in the management of life-limiting diseases, such as cancer. It has provided the authors with baseline data that will be used to generate additional studies to further advocate for the need to integrate palliative and EoL care nursing components into nursing education curricula, both at the university and diploma levels. Our findings suggest a need for urgent review of nursing education curricula in Nigeria at both levels, and the input of all stakeholders especially the Nursing & Midwifery Council of Nigeria
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    Knowledge and practice of breast self-examination among nursing and midwifery students in Ibadan, Nigeria
    (TextLinks Publishers, Ibadan, 2014-06) Hammed, S. K.; Aluko, J. O.; Onibokun, A. C.; Adejumo, P. O.
    Background: Breast self-examination (BSE) is a check-up that a woman does by herself at home to look for changes or problems affecting the breast tissue. BSE is still recommended as a general approach to increasing breast health awareness and thus potentially allow for early detection of any anomalies because it is free, painless and easy to practice. This study assessed the knowledge and practice of BSE among Nursing and Midwifery students of School of Nursing and Midwifery, Eleyele Ibadan. Methods: The descriptive study was conducted with the use of structured questionnaires designed by the researchers. The internet resources and previous related studies served as the sources of content of the questionnaire. A simple random technique was used to select the participants for the study; the Nursing and Midwifery Council indexing record for the school being the sample frame. Thus, a total of 142 participants were recruited for the study. Results: The findings show that, majority (84.5%) of the respondents had good knowledge of BSE, while all of them had heard about BSE as at the time of data collection. However, over 90% had been practicing it prior to the period of data collection appropriately. Less than 15% of the respondents, had been able detect breast lumps while performing BSE. This category of the respondents claimed to have informed their parents before any action was taken. Conclusion: Breast cancer is the most severe and serious health problem faced by the public, majorly women. These nursing and midwifery students, most of whom were within the transitive phase from adolescent to adulthood have potential influence on one another, their immediate families and the society at large. This category of the nation’s population has been less studied in previous related researches. Therefore, educating them particularly during their professional training is very important
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    Preparing nurses for the 21st century: re-envisioning nursing education and practice in Nigeria
    (2013-12) Onibokun, A. C.
    The paper explores the current situation and future development of nursing education and practice in Nigeria and their influence on health care. This is necessitated due to the significant advances in biomedical science and in the complexity of health care, coupled with observed shortage of nurses and the numerous reports of unsafe and poor quality of patient care, which have served as precursors to the concerns about nursing education and nursing practice in developed parts of the world sincerely twentieth century. This move was initiated and led by American Association of College of Nursing since year 2000. However, stake holders of Nursing profession in Nigeria are yet to take this initiative, which have direct implications for both nursing education and nursing practice in Nigeria, hence the need for this advocacy paper. Major issues and challenges in this regard are discussed with some suggestions on the way forward
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    Breast and cervical cancers awareness and screening practices among rural women in Ona-ara Local government area, Ibadan, Nigeria
    (2013-05) Ajayi, I. O.; Onibokun, A. C.; Soyannwo, O. A.
    The level of awareness and screening practices for breast and cervical cancers among rural women was investigated. Three of the six rural wards in Ona-ara LGA were selected by balloting and the three largest communities in each of the wards were purposively selected for the study.Structured interview was conducted among 276 consenting women aged ≥18 years in the households. Data were analysed using descriptive statistics and Chi-square test. Mean age of respondents was 36.5+12.6 years. Only 52(18.8%) and 11(4.0%) mentioned they knew something about breast and cervical cancers respectively. Knowledge of risk factors, cause and screening methods was poor irrespective of demographics. Only 15/52 (28.8%) and 3/52 (5.8%) who knew something about breast cancer mentioned clinical and Breast Self-Examination (BSE) respectively as screening methods for breast cancer. Half, 28/52 (53.8%) have ever practiced BSE and 9(17.3%) had clinical examination of the breast which was done as part of antenatal care or physical examination. The 24 respondents who did not examine their breasts mentioned they did not know they should (54.2%), don’t have problems with their breasts (54.3%), don’t know how to do it (37.5%) and think health workers should do it (33.3%). Only 4/11(36.4%) of those who knew something about cervical cancer mentioned vaginal examination for cervical cancer screening and only one (0.1%) respondent mentioned Pap smear. The poor level of awareness and screening practices for breast and cervical cancers among women in these rural communities emphasizes the need for community-based educational campaigns and provision of screening facilities in rural areas
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    Breast cancer knowledge and screening practices among women in selected rural communities of Nigeria
    (Acadenic Journals, 2012-11) Olowokere, A. E.; Onibokun, A. C.; Oluwatosin, O. A.
    Globally, the devastation that befalls women diagnosed of breast cancer remains inestimable. Early detection remains a major effective approach that should be employed to combat the disease. The issue of concern, however, is whether women in the rural underserved areas are aware of these early detection methods. This study was designed to assess rural women’s awareness and knowledge of breast cancer and their screening practices. The study was a descriptive cross-sectional study utilizing self developed structured questionnaire. Reliability of the instrument was determined and alpha correlation values range between 0.81 and 0.95 for the different components of the questionnaire. Data was processed using descriptive analysis and associations tested with Chi-square at 5% level of significance. The results of the findings showed that 52.7% of the women had adequate knowledge about breast cancer risk factors and symptoms. Regarding the women’s awareness about breast cancer screening methods, 52.8 and 51.7% of women have heard about Breast Self-Examination (BSE) and Clinical Breast Examination (CBE) respectively. However, few numbers of respondents (3.9%) were aware about mammography and these are people who did it for the purpose of diagnosing breast problem. Majority of the women (72.8%) did not practice BSE which is the most readily available screening method. Considering the lack of sophisticated diagnostic technology such as mammography for breast screening in the rural areas, BSE provided a unique opportunity for the women to be breast aware and to identify breast problems which may constitute danger to their health in the future. Health care professionals, most especially those at the primary health care level, should enhance the women’s skills to use this simple procedure effectively to promote their health