ASSESSING SELF-REPORTED INTRAVENOUS FLUID THERAPY PRACTICES AMONG NURSES AT A DISTRICT HOSPITAL IN MALAWI

Samson W. D. Kaphera*, Shadreck Malingamoyo, Patricia Kamanga and Kassimu Mlakala Haji

ABSTRACT

Introduction: About 80% of hospitalized patients receive intravenous fluid therapy (IVT). IVT is given to prevent or correct problems arising from fluid and electrolyte imbalances. However, there is a large proportion of fluids that are administered inappropriately. Inappropriate fluid administration leads to fluid overload or deficit and can result in serious complications among the patients. However, there is limited evidence about fluid therapy, in particular, the IVT practices, in sub- Saharan Africa, especially in developing countries such as Malawi. The aim of the study: The study aimed to assess self-reported intravenous fluid therapy practices among nurses. Methods: The quantitative descriptive cross-sectional study was carried out at Salima District Hospital in December 2021. 44 nurses were recruited using a simple random sampling technique. Structured questionnaires were used to collect data. The data collection instrument was developed by researchers and validated post-hoc with all subscales giving acceptable values of Cronbach’s alpha (>.6). Descriptive statistical analysis was run with the aid of SPSS (ver. 22). Independent samples T-tests, one sample T-tests and one-way ANOVA statistical procedures were used to compare practices across different groups The study underwent ethical clearance. Results: A total of 44 nurses were recruited representing 73.3% recruitment rate. 72.7% (n=32) were females; 59.1% (n=26) were aged 25 to 35 years; 52.3% (n=23) had work experience of 1 to 5 years. Results show that nurses reported good practices when priming or commencing IVFs with a score of 77.9% slightly above 76% and with 61.4% of nurses reporting good IVF priming practices. On the other hand, the rest of the four IVT practices were rated as acceptable. Fluid balance monitoring (t= -2.34, p<.05), IV drip monitoring practices (t= -3.52, p<.05) and drop-rate calculation (t= -2.1, p<.05) were significantly lower than 76%. The study suggested that staff shortage, difficult quantification/estimation of fluid output, inadequate in-service training, time pressure, and unavailability of resources are factors affecting the IVT practices at the hospital. Conclusion: IVT practices among nurses remain poor. The study suggests that improving resource supply and conducting IVT-specific in-service training and mentorship programs can help to locally lift the problem while centrally, resolving the human capital crisis can improve staff practices.

Keywords: Self-reported, Nurses, Practices, Intravenous fluids, Intravenous therapy.