Incidence of critical events in the post-anesthesia care unit at a resource-limited setting in Debre Markos, Northwest Ethiopia

by Abebaw Misganaw, Alaye Debas Ayenew, Netsanet Temesgen Ayenew, Enyew Fenta Mengistu, Baye Ashenef, Samrawit Nega Shiferaw, Getamesay Demelash Simegn

Surgery and anesthesia can disrupt normal physiological function through surgical stress and residual anesthetic effects, increasing the risk of post-anesthetic complications, known as critical incidents. This study aimed to determine the incidence of critical events in the post-anesthesia care unit at Debre Markos Comprehensive Specialized Hospital, Ethiopia.

An institution-based prospective cross-sectional study was conducted from June 1, 2024, to September 30, 2024. The sample size was determined by a single proportion formula using a prevalence of 50% and a 5% margin of error at the 95% confidence interval. The data was analyzed using SPSS version 22 for windows. Analysis was conducted using bivariable and multivariable logistic regression as needed.

Of the 422 patients, 160 (37.9%) experienced one or more critical events, with a total of 214 complications recorded. The most common critical events that occurred in the PACU were cardiovascular-related events (42%) and respiratory & airway related incidents (20%). BMI, duration of anesthesia, intraoperative complications, patient handover, PACU staff training, and ASA physical status were significantly associated with the occurrence of critical events. The odds of critical events were higher among underweight (AOR = 3.71; 95% CI: 1.27–10.79) and overweight patients (AOR = 3.05; 95% CI: 1.28–7.24). Anesthesia duration of 1–2 hours (AOR = 2.01; 95% CI: 1.06–3.81) and >2 hours (AOR = 4.11; 95% CI: 1.59–10.66) also increased the risk. Patients with intraoperative complications had higher odds of critical events (AOR = 3.52; 95% CI: 1.88–6.58), as did those without proper handover (AOR = 3.92; 95% CI: 2.11–7.25). Increasing ASA class was associated with higher risk ASA II (AOR = 2.59; 95% CI: 1.11–6.07), ASA III (AOR = 2.86; 95% CI: 1.20–6.86), and ASA IV (AOR = 11.75; 95% CI: 2.76–50.03). Additionally, patients cared for by PACU nurses without prior PACU training were more likely to develop complications (AOR = 3.15; 95% CI: 1.73–5.72).

Approximately 38% of patients experienced ≥1 critical event, mainly cardiovascular and respiratory complications. Patients who had intraoperative complications, ASA 2 to ASA 4 status, under/overweight, and those who received anesthesia for a prolonged duration were relatively at higher risk of developing critical events. There was a long time to stay in the PACU for those patients who experienced critical events.

Nursing students’ knowledge and skills on children’s environmental health in Ethiopia: A cross-sectional Study

by Werku Etafa, Wandimu Muche, Dereje Temesgen, Dawit Tesfaye

Children’s environmental health encompasses a wide range of factors that impact the well-being of children, including physical, chemical, biological, and social elements in their immediate environment. Safeguarding children from harmful substances is the crucial role of nursing students. Nursing students play a vital role as valuable resources for individuals, families, communities, and policymakers. This study aimed to assess the knowledge and skills of nursing students concerning children’s environmental health at academic institutions delivering nursing programs in Nekemte town, Ethiopia.

An institutional-based cross-sectional study was conducted in Nekemte town from 1^st to 30^th August, 2023, among 634 randomly selected nursing students using standardized questionnaires: Children’s Environmental Health Knowledge and Skills Questionnaire (ChEHK-Q and ChEHS-Q). Data were entered into Epi Data 3.1 and analyzed in SPSS 25, with linear regression applied to identify predictors of knowledge and skills at 95%CI and p-value Results

Most nursing students had insufficient and poor knowledge (79%) of children’s environmental health, and over a third (34%) showed insufficient skills. The study also found a reciprocal relationship: students’ skills (β = 0.03, CI: 1.01–1.04, p = 0.01) and age (β = 0.06, CI: 1.02–1.10, p = 0.001) predicted their knowledge, while knowledge (β = 0.06, CI: 1.01–1.11, p = 0.01) and age (β = 0.05, CI: 1.02–1.09, p = 0.002) predicted their skills.

The study concludes that nursing students possess limited knowledge and skills in children’s environmental health. It is suggested to integrate children’s environmental health into nursing curricula, strengthening pediatric and neonatal education, and conduct further research to address the gap.

Incidence, progression and predictors of chronic kidney disease among adult HIV/AIDS patients on antiretroviral treatment in comprehensive specialised hospitals in the Amhara Region, Ethiopia, 2022: a multi-centre retrospective follow-up study