Nurses’ perceived competence to recognize risk factors associated with acute kidney injury in intensive care unit at centre Hospitalier Universitaire de Kigali (CHUK), Rwanda

Abstract

Background: In intensive care unit patients‘ conditions can rapidly change to guarantee immediate attention. One such situation is the development of acute kidney injury which is a comparatively severe complication of major surgeries that occur among patients admitted in intensive care unit. Nurses' competencies impacts on patient outcomes. There is need to understand how healthcare professionals, and especially nurses perceive themselves competent in identifying patients at risk, and their ability to institute appropriate interventions. Aim: This study explored nurses' perceived competencies to recognize risk factors associated with acute kidney injury among patients admitted in intensive care units at CHUK. Methodology: The study employed a qualitative approach, using an in-depth interview technique to collect data. Data were transcribed verbatim before being analysed thematically. Ethical approval was received and participants provided written informed consent. Results: Three main findings emerged from the data. These included: perceived competences in recognizing acute kidney injury associated risk factors; perceived barriers to nurses‘ competences to recognize acute kidney injury associated risk factors, and perceived motivators to nurses‘ competences in recognizing acute kidney injury associated risk factors. Nurses perceived themselves as being well trained, experienced and competent in managing intensive care unit patients in general. However, they perceived themselves as lacking the competencies related to the recognition of acute kidney injury risk factors. The main barriers to their competency mainly included a lack of specific acute kidney injury training, inability to carry out independent tasks, and inadequate resources. Nurses felt that teamwork and previous experience enhanced their competencies in recognising acute kidney injury risks. Conclusions: To improve nurses‘ competencies in recognising acute kidney injury risk factors, it is important to increase specialised training in acute kidney injury, and to empower nurses to work more independently. Increasing resources is very key in the overall identification and management of patients with risk factors of acute kidney injury. Further research on a larger sample and from diverse settings is required.