Determinants of in-Hospital Cardiac Arrest Survival Rates of Adults in Selected Counties in Kenya

Abstract

In-hospital cardiac arrests are a significant reason for illnesses and deaths in hospitals worldwide. Roughly 1-5 patients in a group of 1000 people admitted, experience in hospital cardiac arrest around the world. This contributes to eighty percent of deaths occurring in hospitals hence low survival rates. The purpose of this study was to evaluate the determinants of in-hospital cardiac arrest for survival rates of adults in selected counties in Kenya. The specific objectives were to: Determine the influence of healthcare provider training, area of deployment within the hospital, skill mix (health care cadre), and availability of medical equipment on the survival rate of cardiac arrest among adults in Kenya. The study was guided by two theories which were cardiac pump theory and five-star theory of quality of medical services. A cross-sectional design was used on collecting data from 2,037 doctors and nurses in Machakos Level 5 Hospital, Muranga Level 5 Hospital and the Aga Khan University Hospital, Nairobi. The medical doctors were selected using inclusion and exclusion criteria resulting to 72 doctors. The study used 30% to get a sample size of 402 nurses. Nurses answered questionnaires while the doctors were interviewed and secondary data was gathered from general medical reports on CPR operations from 2022- 2023. Pilot test was done in Nairobi and Kenyatta hospitals whereby the results enabled examine reliability and as well as validity. Descriptive and inferential statistics were examined and the findings presented through tables, figures and explanations. Participants were guaranteed anonymity and confidentiality such that the interview guides and questionnaires did not require them to give personal details. The regression results indicated that the Pearson correlation coefficient of ‘healthcare provider training’ r was 0.495** at α < 0.002; area of deployment of the healthcare provider within the hospital r was 0.117** at α < 0.000; skill mix (health care cadre) r was 0.309** at α < 0.000; availability of medical equipment’ r was=0.412** at α < 0.000. Therefore, the study rejected all the null hypotheses. It was noted that the effectiveness of healthcare providers was greatly affected due to low number of staff assigned tasks at night in different units. Additionally, there was low team work effort hence resulting to work related divisions and sidelining each other during critical scenarios like assessment of the chest compressions. Further, the hospitals lacked advanced medical equipment to ensure that the IHCAs were amicably monitored and treated on time. The recommendations are that, the hospital management should enact learning and development policies that make it mandatory for various staff in different units to attend CPR training. Additionally, the hospital board should push and seek more funding from various sources so as to recruit more staff. Further on, the hospital management should provide more department bonding activities such as retreats, and office meetings, for the staff to create a working connection. Also, the hospital management should come up with unique fund-raising programs that would enable the hospitals purchase the much-required medical equipment.