Quality structures and processes in the prevention of secondary traumatic brain injury at accident emergency and critical care unit in Kenyatta national hospital: Nairobi-Kenya

Abstract

The outcome of traumatic brain injury (TBl) patients largely depends on the institution structures and the processes put in place to facilitate care. Good institutional structures lead to improved processes which lead to better patient care. The aim of study was to determine the structures and processes that support quality nursing care for traumatic brain injurv patients. A descriptive cross sectional study was conducted in KNH whereby semi-structured questionnaires and observational checklist were used to collect data. The population was registered nurses working in Critical Care Unit (CCU) and Accident and Emergency (A&E). Descriptive statistics and inferential statistics were used to explain relationships between variables. The data was analyzed using Statistical Package for Social Sciences (SPSS). A total number of 133 participants were recruited in this study from CCU and A&E. There were 60 participants from A & E. More than half 73% (n=44) were females while 27% (n=16) were males. The mean age was 36.37 years and standard deviation of 7.08. CCU had 73 participants whereby 68% (n=48) were females while 32% (n=23) were males. The mean age was 38.9 and standard deviation 6.09. The largest proportion of the participants 46% (n=33) in CCU had higher diploma in Critical Care Nursing. Majority of the participants had more than five years of working experience, thus 67% in A&E and 65% in CCU. The relationship between nurses' knowledge and nursing management of the traumatic brain injured was statistically significant at p=0.001. Challenges identified in the study included; inadequate nursing staff, equipment and lack of guidelines in management of TBI. The study recommends that the KNH management should employ adequate nursing staff and design protocols to enhance the care ofTBI patients.