Clinical Knowledge And Attitude On The Usage Of Pulse Oximeter In Managing Sick Children

Abstract

Background: Pulse oximetry is a widely used technology in developed countries and is also becoming popular in developing countries. It allows non- invasive, reliable and continuous measuring of oxygen saturation. Rapid, accurate detection of hypoxemia is critical in preventing serious complications, however oxygenation is difficult to assess on the basis of physical examination alone. Appropriate utilization of this important tool is often hampered by health workers’ knowledge and attitudes towards the technology Objective: This study sought to determine, the knowledge and attitude regarding pulse oxymetry among staff taking care of sick children. Design: A hospital based cross-sectional survey was carried out over a period of three months-August to October, 2011. Methodology: A twenty item questionnaire was administered to clinicians working in pediatric departments at Kenyatta National Hospital (K.N.H.). The questionnaire contained questions on: demography, work place, the usage of pulse oximeter, the years of training, assessment on the knowledge and interpretation of pulse oximeter readings. Study population: The study population consisted of clinicians referring to medical officers, clinical officers and nurses, who work in, pediatric wards, in pediatric emergency units (P.E.U), and in new born unit (N.B.U.), at Kenyatta National Hospital. Sample size: Using Fishers’ formula the calculated sample size is 154 clinicians. Sampling procedure: All clinicians working in pediatric units were approached and consent obtained from them. A standard questionnaire was then administered. Management of data: Data was coded and entered into a preformed excel data sheet and analyzed using Statistical package for Social Science version 11.0. Categorical data was summarized using proportions and tabulated using frequency tables. Chi-square was performed to test for associations. Discrete data was summarized using means and Student ttest performed to test for associations. The level of significance is 0.05. Results: A 100% response rate was achieved from staff participating in the study, with 161 respondents. The participants included medical officers (M.O) 25.5%, nurses (N) 68.3% and

clinical officers (C.O) 6.2%. Majority of those interviewed (81.8%), had used a pulse oximeter, however, only 25.2% had been trained on its use. The responses to questions on knowledge revealed poor knowledge with a score of 45.8% among clinicians who had used the oximeter before. Majority of those who had been trained on its use worked in PEU, 59.1% .The knowledge score in these clinicians was 94.7 %. The knowledge of the normal saturation among the newborn and the children was poor. Only 45.8% and 49% of the respondents knew the correct saturation among the newborns and children respectively. The knowledge score of nurses was 52.9% compared to 50% and 26.8% scores among clinical officers and medical officers respectively. Only 8% of the participants could correctly interpret the oximeter readings. On average only 31.9% of the respondents could correctly answer the questions on what the pulse oximeter readings meant. Most of the respondents found the knowledge questions difficult and expressed concern about their poor knowledge of pulse oximeters. Conclusions: Available evidence shows that knowledge on use of pulse oximeter is sub-optimal (32.6%) despite clinicians having the right attitude towards it (87.7%). Refer to tables 4 and 5. Training on the use of pulse oximeter is important to achieve maximal benefit to the patient Recommendations: It is recommended that all staff working in pediatric units at K.N.H should have a basic training on the use of pulse oximeter and how to interpret its results. Retraining of staff is needed to re-enforce the knowledge and interpretation of pulse oximeters.