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Background: Enteral tube feeding is recommended as a route for nutrient delivery in critically ill patients. The practice of enteral tube feeding by nurses significantly influences patient treatment outcomes. Therefore, this study aimed to identify the practices of enteral tube feeding and the associated factors among nurses working in South Wollo Zone Specialized and General Hospitals, Wollo, Ethiopia, 2022. Methods: A hospital-based cross-sectional study design was conducted on 420 nurses from 1st August to 1st September 2022. Simple random sampling methods were used to select study participants. Data were collected using self-administered questionnaires and an observational checklist. The data were entered into Epi Data version 4.6 and analyzed using SPSS version 26. Variables with a p-value <0.05, a 95% confidence interval, and an adjusted odd ratio were considered to be significantly associated with enteral tube feeding practice. Result: A total of 400 nurses participated in the study, yielding a 95.2% response rate. The overall good practice of enteral tube feeding among nurses was 114 (28.5%) with a 95% CI of 23.8-33. Enteral tube feeding practice was significantly associated with a lack of adequate resources (AOR = 0.359, 95% CI: 0.192-0.673), unfamiliarity with current guidelines (AOR = 0.346, 95% CI: 0.203-0.586), lack of awareness (AOR = 0.511, 95% CI: 0.306-0.673) and the thermal effect of food (AOR = 0.56, 95% CI: 0.348-0.889). Conclusion: The enteral tube feeding practice among nurses was found to be 28.5%. Significant determinants of enteral tube feeding practice included a lack of awareness, inadequate resources in the institution, and unfamiliarity with the current guidelines for enteral feeding. To improve enteral feeding practices, it is recommended that sufficient resources be provided, guidelines be made readily available, and training programs be conducted for the nursing staff.
RESUMO
INTRODUCTION: Globally, tuberculosis takes the first rank for the ill-health of people living with HIV/AIDS. Despite the favorable outcome of antiretroviral therapy, the risk of tuberculosis remains higher among HIV patients. This obliges to identify factors for its occurrence and further prevention of drug-resistant tuberculosis. There is a contradiction between different studies and studies conducted in Ethiopia studied poorly the association between adherence to antiretroviral therapy and viral load with tuberculosis. Studies conducted in the study area were limited to cross-sectional study design. Therefore, this study claimed to identify factors determining the occurrence of tuberculosis after initiation of antiretroviral therapy. METHODS: This study was conducted at Dessie Referral Hospital by using a case-control study design on a sample of 565 with a control: case ratio of 3:1. Participants from controls were selected by systematic random sampling and from cases by consecutive random sampling. The data were collected by interviewing through structured questionnaires and from the medical record. The data were entered into Epi data version 3.1. In the multivariable analysis, variables with a P-value of ≤0.05 were anticipated as independent determinant factors. RESULT: Patients without separate kitchen (AOR: 3.547, 95% CI: 2.137, 5.888), having opportunistic infection (AOR: 3.728, 95% CI: 2.058, 6.753), CD4 count of <350 cells/mm3 (AOR: 3.383, 95% CI: 1.520, 7.528), baseline WHO stage III (AOR: 3.321, 95% CI: 1.688, 6.534) or IV (AOR: 2.900, 95% CI: 1.251, 6.722), don't taking IPT (AOR: 3.701, 95% CI: 2.228, 6.147) and those who were poorly adherent (AOR: 2.626, 95% CI: 1.272, 5.423) or moderately adherent (AOR: 3.455, 95% CI: 1.885, 6.335) to anti-retroviral therapy were more likely to develop tuberculosis after anti-retroviral therapy initiation. CONCLUSION: Poor housing conditions, having an opportunistic infection, low CD4 count, starting ART at the advanced HIV stage, don't take IPT, and being poorly adherent to antiretroviral therapy were associated with the occurrence of TB after initiation of ART. The institution should screen for TB as early as possible and strictly follow their drug adherence.