Nurses' knowledge and attitude towards children pain management: a multi-site survey study.

Background: Adequate children's pain management is universally considered an ethical obligation. In evaluating and treating children's pain, nurses invest more time and take a leading role. This study aims to evaluate the knowledge and attitudes of nurses towards the treatment of pediatric pain. Materials and Methods: A total of 292 nurses working at four South Gondar Zone hospitals of Ethiopia was surveyed. To gather information from study participants, the Pediatric Nurses' -Knowledge and Attitudes- Survey Regarding Pain (PNKAS) was employed. Frequency, percentage, mean, and standard deviation of the data were used for descriptive analysis, while Pearson correlation, one-way between-groups analysis of variance, and independent-samples t-test were used for inferential analysis. Results: A large percentage of nurses (74.7%) lacked adequate knowledge and attitudes (PNKAS score <50%) for pediatric pain treatment. The mean ± SD accurate response score of 43.1% ± 8.6% was achieved by nurses. An increase in pediatrics nursing experience was significantly correlated with nurses' PNKAS score (p < 0.001). The mean PNKAS scores of nurses who had official pain management training differed in a statistically significant way as compared to its counterpart (p < 0.001). Conclusion: Nurses who are working South Gondar Zone of Ethiopia have insufficient knowledge and attitudes towards treatment of pediatric pain. Therefore, pediatric pain treatment in-service training is urgently needed.

The effects of intravenous tramadol vs. intravenous ketamine in the prevention of shivering during spinal anesthesia: A meta-analysis of randomized controlled trials.

Background: Shivering is a common complication after subarachnoid administration of local anesthetics. Intravenous ketamine and tramadol are widely available anti-shivering drugs, especially in developing settings. This meta-analysis aimed to compare the effects of intravenous ketamine vs. tramadol for post-spinal anesthesia shivering. Materials and methods: PubMed/MEDLINE, Web of Science, Cochrane Library, Embase, and Google Scholar databases were used to search for relevant articles for this study. Mean difference (MD) with 95% confidence interval (CI) was used to analyze continuous outcomes, and risk ratio (RR) with 95% CI to analyze categorical results. The heterogeneity of the included studies was assessed using the I2 test. We utilized Review Manager 5.4.1 to perform statistical analysis. Results: Thirteen studies involving 1,532 patients were included in this meta-analysis. Ketamine had comparable effects in preventing post-spinal anesthetics shivering [RR = 1.06; 95% CI (0.94, 1.20), P = 0.33, I 2 = 77], and onset of shivering [MD = -0.10; 95%CI (- 2.68, 2.48), P = 0.94, I 2 = 0%], lower incidences of nausea and vomiting [RR = 0.51; 95%CI (0.26, 0.99), P = 0.05, I 2 = 67%], and lower incidences of bradycardia [RR = 0.16; 95%CI (0.05, 0.47), P = 0.001, I 2 = 33%], higher incidence of hallucinations [RR = 12; 95%CI (1.58, 91.40), P = 0.02, I 2 = 0%], and comparable effects regarding the incidences of hypotension [RR = 0.60; 95%CI (0.30, 1.21), P = 0.15, I 2 = 54%] as compared to tramadol. Conclusions: Intravenous ketamine and tramadol are comparable in the prevention of post-spinal anesthetic shivering. Ketamine had a better outcome with less occurrences of nausea, vomiting, and bradycardia. However, ketamine was associated with higher incidences of hallucinations than tramadol.

Parental satisfaction and its associated factors towards neonatal intensive care unit service: a cross-sectional study.

BACKGROUND: Parental satisfaction is a well-established outcome indicator and tool for assessing a healthcare system's quality, as well as input for developing strategies for providing acceptable patient care. This study aimed to assess parental satisfaction with neonatal intensive care unit service and its associated factors. METHOD: A cross-sectional study design was conducted on parents whose neonates were admitted to the neonatal intensive care unit at Debre Tabor Comprehensive Specialized Hospital, in North Central Ethiopia. Data were collected by adopting an EMPATHIC-N instrument during the day of neonatal discharge, after translating the English version of the instrument to the local language (Amharic). Both Bivariable and multivariable logistic analyses were done to identify factors associated with parental satisfaction with neonatal intensive care unit service. P < 0.05 with 95% CI was considered statistically significant. RESULTS: The data analysis was done on 385 parents with a response rate of 95.06%. The overall average satisfaction of parents with neonatal intensive care unit service was 47.8% [95% CI= (43.1-52.5)]. The average parental satisfaction of neonatal intensive care unit service in the information dimension was 50.40%; in the care and treatment dimension was 36.9%, in the parental participation dimension was 50.1%, in the organization dimension was 59.0% and the professional attitude dimension was 48.6%. Gender of parents, residency, parental hospital stay, birth weight, and gestational age were factors associated with parental satisfaction. CONCLUSION: There was a low level of parental satisfaction with neonatal intensive care unit service. Among the dimensions of EMPATHIC-N, the lowest parental satisfaction score was in the care and treatment while the highest parental satisfaction score was in the organization dimension.

Patterns of presentation, prevalence and associated factors of mortality in ICU among adult patients during the pandemic of COVID 19: A retrospective cross-sectional study.

Background: There is concern that patients admitted to the intensive care unit (ICU) with Corona Virus Disease 2019 (COVID-19) have variable prevalence reports of mortality. The survival rates are also inconsistently reported due to varying follow-up periods. Even if data on outcomes and baseline characteristics of ICU patients with COVID-19 is essential for action planning to manage complications, it is still left undisclosed in our study setting. Materials and method: This cross-sectional study was conducted on 402 samples using a retrospective chart review of patient's data who were admitted in the past 2 years of the adult ICUs. All the data were entered and analyzed with SPSS version 21. A multivariable Logistic regression analysis was used to identify the association between outcome variables with independent factors and a p-value of less than 0.05 was taken as statistically significant with a 95% confidence interval. We used text, tables, and figures for the result. Result: The overall prevalence of mortality among adult patients admitted to ICU during COVID-19 pandemics was 67.4%. From the multivariable logistic regression analysis, factors that were shown to have an association with an increase in ICU patient mortality were; lack of Vasopressor support, patients who had confirmed COVID 19 infection, core body temperature at admission greater than 37.5 °c, SPO2 at admission less than 90%, patients who had diagnosed ischemic heart disease (IHD), patients with acute respiratory distress syndrome (ARDS), patients who were intubated and mechanically ventilated (MV), and patient's ICU length of stay longer than two weeks. Conclusion: The prevalence of ICU mortality in adult patients was higher in Debre Tabor Comprehensive specialized hospital. Therefore, clinicians need to minimize factors that maximize patient mortalities like ARDS, hyperthermia, Desaturation, Covid infection, IHD, intubation and MV, lack of Vasopressor use, and prolonged ICU stay.