Assessment of nurses’ early recognition and responses to clinically deteriorating children in pediatric wards at 2 selected referal hospital in Rwanda

Abstract

Background: Clinical deterioration is more prevalent in hospitalized children and nurses working in pediatric ward but also faced with challenges to recognize children who are at a potential risk of clinical deterioration therefore these lapses in recognizing clinically deteriorating children eventually affect their response towards clinical deterioration The purpose of the study: This study was aimed at assessing nurses‘ recognition and responses to clinically deteriorating children admitted in pediatric ward in 2 referral hospital Methods: A descriptive cross sectional design, quantitative approach was used. A convenience sampling strategy was used to select 111 nurses working in pediatric department in two referral hospitals who filled semi structured questionnaire. Ethical principles involving human subjects were observed. Data were analyzed using the statistical package for the social sciences software (SPSS), version 21.0. Descriptive statistics, Pearson chi-square, Fisher test and multiple logistic regressions were used in data analysis. Results: The majority 70(63.06 %) nurses were demonstrated to have difficulties in recognizing early signs of clinically deteriorating children and nearly a half 50(45.05%) nurses had also demonstrated inappropriate responses towards clinically deteriorating children. Advanced level of education and ability to early recognize clinically deteriorating children were the only variables that were shown to be significantly associated with appropriate nurses response to clinically deteriorating children (p= 0.011 and p=0.001 respectively) . Regression analysis showed that nurses with higher level education qualification and nurses who were able to recognize early clinical cues towards clinical deterioration (OR= 2.659, 95%CI=1.023-6.916and OR= 3.490: CI= 1.449-8.406 respectively) were more likely to respond appropriately to clinically deteriorating children than their counterpart nurses. Conclusion: Generally, nurses had limited awareness on early recognition towards clinically deteriorating children and their responses to those children were hampered as well. The associated factors to their appropriate responses, were level of education and ability to early recognize clinically deteriorating children. Therefore, there is need to increase nurses awareness on early recognition of clinically deteriorating children. Moreover, further studies are needed to assess the associated factors to nurses‘ early recognition towards clinically deteriorating children.