Nurse’s knowledge, attitude and practice on the initial management of acute poisoning among adult casualties: Study at Kenyatta National Hospital, Kenya
ABSTRACT
The purpose of this study was to determine nurse’s knowledge, attitude and practice on the initial management of acute poisoning among adult casualties seen at Accident and Emergency Department (AED), Kenyatta National Hospital (KNH). The study was cross sectional. Both qualitative and quantitative methods of data collection were employed. The target population were all nurses working at AED, KNH. Purposive sampling was used to select study subjects. Sample size included all Accident and Emergency (A&E) nurses who met subject’s inclusion criteria. Structured questionnaires, observation checklist and interview were used to collect the data. Sixty eight (82%) of A&E nurses participated in this study. The study found out that with higher nursing qualification and training on courses related to emergency care, knowledge and skills of A&E nurses on the initial management of acute poisoning is enhanced. A&E nurses with lower education level had a higher mean score of positive attitude compared with nurses with higher nursing qualification. Majority 60 (88.2%) of the A&E nurses indicated that, they required more training on the initial management of acute poisoning. Study recommends that A&E nurses should be trained on various types of poisoning including; assessment, clinical presentations and management to include gut decontaminations. In addition, refresher courses should be organised for those already trained. Flowcharts that will enhance easy identification and management of poisoned casualties should be put in place and utilized accordingly.
The purpose of this study was to determine nurse’s knowledge, attitude and practice on the initial management of acute poisoning among adult casualties seen at Accident and Emergency Department (AED), Kenyatta National Hospital (KNH). The study was cross sectional. Both qualitative and quantitative methods of data collection were employed. The target population were all nurses working at AED, KNH. Purposive sampling was used to select study subjects. Sample size included all Accident and Emergency (A&E) nurses who met subject’s inclusion criteria. Structured questionnaires, observation checklist and interview were used to collect the data. Sixty eight (82%) of A&E nurses participated in this study. The study found out that with higher nursing qualification and training on courses related to emergency care, knowledge and skills of A&E nurses on the initial management of acute poisoning is enhanced. A&E nurses with lower education level had a higher mean score of positive attitude compared with nurses with higher nursing qualification. Majority 60 (88.2%) of the A&E nurses indicated that, they required more training on the initial management of acute poisoning. Study recommends that A&E nurses should be trained on various types of poisoning including; assessment, clinical presentations and management to include gut decontaminations. In addition, refresher courses should be organised for those already trained. Flowcharts that will enhance easy identification and management of poisoned casualties should be put in place and utilized accordingly.
Cite this paper
Rutto, J. , Mwaura, J. , Chepchirchir, A. and Odero, T. (2012) Nurse’s knowledge, attitude and practice on the initial management of acute poisoning among adult casualties: Study at Kenyatta National Hospital, Kenya. Open Journal of Nursing, 2, 149-156. doi: 10.4236/ojn.2012.23023.
Rutto, J. , Mwaura, J. , Chepchirchir, A. and Odero, T. (2012) Nurse’s knowledge, attitude and practice on the initial management of acute poisoning among adult casualties: Study at Kenyatta National Hospital, Kenya. Open Journal of Nursing, 2, 149-156. doi: 10.4236/ojn.2012.23023.
References
[1] Hodgson, E. (2010) A textbook of modern toxicology. 4th Edition, John Wiley & Sons Publication, New Jersey. [2] Malangu, N. and Ogunbanjo G.A. (2009) A profile of acute poisoning at selected hospitals in South Africa. South African Journal of Epidemiology and Infection, 24, 14-16. [3] Fernando, R. (2007) Management of Poisoning. 3rd Edition, The National Poisons Information Centre, National Hospital of Sri Lanka, Colombo. [4] Greene S.L., Wood, D.M., Gawarammana, I.B., Warren-Gash, C., Drakes, N., Jones, A.L. and Dargan, P.I. (2008) Improvement in the management of acutely poisoned patients using an electronic database: Prospective audit and targeted educational intervention. Postgraduate Medical Journal, 84, 603-608. doi:10.1136/pgmj.2007.066043 [5] Senarathna, L., Jon, A., Dhammika D.S., Buckley, N. and Dawson, A. (2008) Personal and professional challenges in the management of deliberate self-poisoning patients in rural Sri Lanka: A qualitative study of rural hospital doctors’ experiences and perceptions. British Medical Journal of Public Health, 8, 373. [6] Oslon, R.K. (2004) Poisoning and drug overdose. 4th Edition, Medical Publishing Division, New York. [7] McAllister, M., Creedy, D., Moyle, W. and Farrugia, C. (2002) Nurses’ attitudes towards clients who self-harm. Journal of Advanced Nursing, 40, 578-586. doi:10.1046/j.1365-2648.2002.02412.x [8] Lau, F.L. (2000) Emergency management of poisoning in Hong Kong. Hong Kong Journal of Emergency Medicine, 6, 288-292. [9] Burns, M.J. and Schwartzstein, R.M. (1999) Decontamination of poisoned patients. http://cmbi.bjmu.edu.cn/uptodate/critical%20care/Intoxications/Decontamination%20of%20poisoned%20patients.htm [10] Clegg, T. and Hope K. (1999) The first line of response for people who self-poison: Exploring the options for gut decontamination. Journal of Advanced Nursing, 30, 1360-1367. doi:10.1046/j.1365-2648.1999.01237.x [11] Sun, F.-K., Long A. and Boore, J. (2007) The attitudes of casualty nurses in Taiwan to patients who have attempted suicide. Journal of Clinical Nursing, 16, 255-263. doi:10.1111/j.1365-2702.2005.01479.x [12] Turnbull, G. and Chalde, T. (1997) Effects of education on attitudes to deliberate self-harm. Psychiatric Bulletin, 21, 334-335. doi:10.1192/pb.21.6.334 [13] Benner, P. (1984) From novice to expert: Excellence and power in clinical nursing practice. Addison-Wesley Publishers, Menlo Park. [14] Anderson, M. (1997) Nurses’ attitude towards suicidal behaviour—A comparative study of Community health nurses and nurses working in an accident and emergency department. Journal of Advanced Nursing, 25, 1283-1291. doi:10.1046/j.1365-2648.1997.19970251283.x [15] McCann, T., Clark, E., McConachie, S. and Harvey, I. (2006) Accident and emergency nurses’ attitudes towards patients who self-harm. Accident and Emergency Nursing, 14, 4-10 doi:10.1016/j.aaen.2005.10.005 [16] McCarthy, L. and Gijbels, H. (2010) An examination of emergency department nurses’ attitudes towards deliberates self-harm in an Irish teaching hospital. International Emergency Nursing, 18, 29-35. doi:10.1016/j.ienj.2009.05.005 [17] Mclaughlin C. (1994) Casualty nurses’ attitudes to attempted suicide. Journal of Advance Nursing, 20, 1111-1118.
[1] Hodgson, E. (2010) A textbook of modern toxicology. 4th Edition, John Wiley & Sons Publication, New Jersey. [2] Malangu, N. and Ogunbanjo G.A. (2009) A profile of acute poisoning at selected hospitals in South Africa. South African Journal of Epidemiology and Infection, 24, 14-16. [3] Fernando, R. (2007) Management of Poisoning. 3rd Edition, The National Poisons Information Centre, National Hospital of Sri Lanka, Colombo. [4] Greene S.L., Wood, D.M., Gawarammana, I.B., Warren-Gash, C., Drakes, N., Jones, A.L. and Dargan, P.I. (2008) Improvement in the management of acutely poisoned patients using an electronic database: Prospective audit and targeted educational intervention. Postgraduate Medical Journal, 84, 603-608. doi:10.1136/pgmj.2007.066043 [5] Senarathna, L., Jon, A., Dhammika D.S., Buckley, N. and Dawson, A. (2008) Personal and professional challenges in the management of deliberate self-poisoning patients in rural Sri Lanka: A qualitative study of rural hospital doctors’ experiences and perceptions. British Medical Journal of Public Health, 8, 373. [6] Oslon, R.K. (2004) Poisoning and drug overdose. 4th Edition, Medical Publishing Division, New York. [7] McAllister, M., Creedy, D., Moyle, W. and Farrugia, C. (2002) Nurses’ attitudes towards clients who self-harm. Journal of Advanced Nursing, 40, 578-586. doi:10.1046/j.1365-2648.2002.02412.x [8] Lau, F.L. (2000) Emergency management of poisoning in Hong Kong. Hong Kong Journal of Emergency Medicine, 6, 288-292. [9] Burns, M.J. and Schwartzstein, R.M. (1999) Decontamination of poisoned patients. http://cmbi.bjmu.edu.cn/uptodate/critical%20care/Intoxications/Decontamination%20of%20poisoned%20patients.htm [10] Clegg, T. and Hope K. (1999) The first line of response for people who self-poison: Exploring the options for gut decontamination. Journal of Advanced Nursing, 30, 1360-1367. doi:10.1046/j.1365-2648.1999.01237.x [11] Sun, F.-K., Long A. and Boore, J. (2007) The attitudes of casualty nurses in Taiwan to patients who have attempted suicide. Journal of Clinical Nursing, 16, 255-263. doi:10.1111/j.1365-2702.2005.01479.x [12] Turnbull, G. and Chalde, T. (1997) Effects of education on attitudes to deliberate self-harm. Psychiatric Bulletin, 21, 334-335. doi:10.1192/pb.21.6.334 [13] Benner, P. (1984) From novice to expert: Excellence and power in clinical nursing practice. Addison-Wesley Publishers, Menlo Park. [14] Anderson, M. (1997) Nurses’ attitude towards suicidal behaviour—A comparative study of Community health nurses and nurses working in an accident and emergency department. Journal of Advanced Nursing, 25, 1283-1291. doi:10.1046/j.1365-2648.1997.19970251283.x [15] McCann, T., Clark, E., McConachie, S. and Harvey, I. (2006) Accident and emergency nurses’ attitudes towards patients who self-harm. Accident and Emergency Nursing, 14, 4-10 doi:10.1016/j.aaen.2005.10.005 [16] McCarthy, L. and Gijbels, H. (2010) An examination of emergency department nurses’ attitudes towards deliberates self-harm in an Irish teaching hospital. International Emergency Nursing, 18, 29-35. doi:10.1016/j.ienj.2009.05.005 [17] Mclaughlin C. (1994) Casualty nurses’ attitudes to attempted suicide. Journal of Advance Nursing, 20, 1111-1118.