School of Medicine and Health Sciences
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Item Factors Influencing Evidence-Based Decision-Making Among Specialized Nurses Working in Selected Health Facilities in Nairobi, Kenya(KeMU, 2025-10) Agure, SafariEvidence-based decision-making (EBDM) and practice among nurses in Kenya, is largely unexplored. The study was designed to determine the factors influencing the utilization of evidence by nurses for decision-making and practice. In 2024, a concurrent, triangulation mixed methods study was designed, targeting nurses working in maternal and child (Reproductive) wards in selected facilities in Nairobi County with the sites being all public facilities of levels 4 and 5. A 5-point Likert scale questionnaire was administered to all nurses found working on the day the researcher visited the facility. Key informant interviews were also conducted on the same day. Ethical approval was sought from Kenya Methodist University and individual respondents completed Informed consent forms prior to participation in the study. All other ethical considerations required were adhered to. Quantitative data analysis was carried out using SPSS version 22 statistical software. Exploratory data analysis (EDA) was employed at the initial stage of analysis. Bivariate level analysis was used to assess the association of independent variables with EBDM utilization using Chi-square test and/ or Fisher’s Exact Test. All variables with a P-value < 0.25 in the bivariate analysis were subjected to multivariate analysis. Adjusted Odds Ratios (AOR) with 95% Confidence Intervals (CIs), were used to evaluate the strength of statistical association between dependent and independent variables. Qualitative data was managed using thematic analysis. Results show intuition is the most applied thought paradigm among nurses for decision making alluding to the importance of tacit knowledge in nursing. Factors that emerged as significantly associated with EBDM among reproductive nurses were individual in nature. The findings of this study are expected to inform policy and management efforts to enhance nurses’ decision making. As without nurses’ engagement with evidence and learning, EBDM contributions will continue to be negligible, it is recommend that more research be done to enhance institutional factors and the use of intuition to support EBDM. As well, strategies for harvesting tacit knowledge should be enriched.Item The Influence of Continuous Professional Development on Reproductive Health to Service Delivered to Women by Nurses at Mbagathi County Hospital, Nairobi-Kenya(KeMU, 2022-10) Tuya, Scolastica WabwireContinuous Professional Development (CPD) is based on the traditions of lifelong learning in the medical profession, for development of qualities and competencies in the working lives of health care providers. CPD in Nursing enhances competencies, which cannot be achieved without scientific knowledge, clinical skills and humanistic values. Reproductive health is important in every stage of life, it is about access to the safest, effective, affordable method of family planning or safe pregnancy, safe delivery for healthy mother and baby. Therefore, there is need for continuous professional development in reproductive health for all Health care providers. This study sought to evaluate the influence of CPD on reproductive health care service delivery by nurses at Mbagathi County Hospital. The objectives of this study were to establish how CPD on focused antenatal care (FANC) influenced services delivered to women attending antenatal care clinic, determine how CPD on Emergency maternal obstetric and new- born care influenced services delivered to women and new-born in emergency condition and establish how CPD on long lasting reversible contraception (LARC) influenced services delivered to women seeking contraception and identify challenges that Health Care Providers experience during service delivery. This was a cross sectional study. Study population were nurses working in units offering reproductive health services. Sampling method was census. Sixty one nurses who met the study criteria, filled semi structured questionnaires, 58 questionnaires were analysed. Data were analysed using MS Excel where cleaning, coding and tabulation of percentages, were conducted. Stata and Epi Info version 7 where tabulation of percentages and inferential analysis were conducted. The findings were presented by descriptive and inferential statistics. Results obtained indicated that 44 (76%) Nurses were trained on Focused antenatal care, 39 (67%) on EmONC and 31 (53%) on LARC. There was no influence of CPD to provision of Focused Antenatal care services at 95%CL: CI; 0.47- 5.52, P Value= 0.449 and EmONC: CI; 0.47-4.49, P- Value = 0.514. There was influence of CPD in provision of LARC services: CI; 1.82-30.65, P value =0.003. Inadequate staffing and inadequate commodities and supplies were the major challenges in provision of reproductive health services. Therefore, it is recommended that the hospital management explores other methods of training alongside workshops that have been found to be effective in transfer of skills for FANC, EmONC and LARC. Examples are online interactive sessions and on job training that are being used to deliver contents virtually in other platforms. It should be able to provide scheduled updates on long-acting reversible contraception to health care providers. Effective documented monitoring and evaluation of best practice and outcomes will greatly improve service provision. It should also recruit and train more health care providers to strengthen service delivery and ensure provision of adequate commodities and supplies for reproductive health services delivery.Item Influence of Emotional Intelligence on Work Performance among Nurses in Health Facilities in Nakuru County(KeMU, 2022-10) Ondari, Enock OrinaThe numerous occupational risks that nurses in particular routinely face have an unavoidable effect on their capacity to complete their assigned jobs. This is because of the extraordinarily difficult and demanding circumstances in which they work, which have a tendency to disturb their emotional balance and result in pervasive feelings of powerlessness and rage. Therefore, emotional intelligence could potentially be having a significant and potentially negative bearing on nurses’ work performance. The outcomes of past research examining how emotional intelligence affects nurses' effectiveness at work, nevertheless, have been inconsistent. This research was keen on emphatically examining if emotional intelligence determined the nurses’ performance working in sub-county public hospitals in Nakuru County, Kenya. The specific objectives were to ascertain how interpersonal skills, intrapersonal skills, adaptability and stress management impacted on the performance of nurses in sub-county public hospitals in Nakuru County. The logic model of medical health authored by Donabedian was adopted to guide the study. The study's participants were 345 nurses and 21 ward-in-charges from medical facilities in 11 sub-county public hospitals in Nakuru County. The public hospitals were clustered according to the 11 administrative sub counties of Nakuru County. In order to identify the study participants, with a total of 187 nurses, purposive sampling was employed to choose the nurses at sub-county public hospitals in Nakuru County. Data were gathered using closed-ended questionnaire with 5-point likert categories on Likert scales. Data was collected after approval from the Ethics Committee and the national council of technology. Pretesting of the questionnaires was done in the burns unity which is a department with the highest number of nurses. Consultation with the supervisors helped to ensure the validity of the research tool. Descriptive and inferential statistics were employed to evaluate quantitative data using the Statistical Package for Social Sciences (SPSS) version 25. The study established that interpersonal skills, intrapersonal skills, adaptability and stress management accounted for the total variance in the work performance of nurses in sub-county public hospitals in Nakuru County. It was concluded that only stress management significantly predicted the nurses’ performance. Nurses who managed stress were 15.333 times more likely to perform better than nurses who were not able to managed stress. Intrapersonal, interpersonal and adaptability had little influence on the nurses' ability to do their jobs. However, where nurses had intrapersonal skills they were 2.159 times better than those without intrapersonal skills. Where nurses had interpersonal skills, they were 2.083 times more likely to perform their work than those who did not have interpersonal skills. The study recommended that the hospital management should support nurses in discharging their duties by creating an enabling environment that allows nurses to work under flexible conditions.