Assessment of knowledge regarding care of patients with stroke among registered nurses at Muhimbili National Hospitals, Dar es Salaam Tanzania

Abstract

ABSTRACT Background Stroke is a major public health problem causing both mortality and morbidity worldwide inclusive of Africa regions. Low and middle-income countries have a high mortality rate compare to high-income countries. World Health Organisation reports that 15 million people suffer stroke worldwide annually. In Tanzania, the burden of stroke on health services appears to have increased rapidly. Nurses as leading health care professional team members play a pivotal role in all phases of care of stroke patients. For optimal neurological outcomes, nurses have to develop measures to quickly, easily identify and assess stroke patients and implement appropriate interventions. However, there are few studies in Tanzania undertaken to assess the knowledge of health staff caring for patients with stroke. Aims of the study: This study aimed to assess nurses' knowledge regarding care of stroke patients at Muhimbili National Hospitals ( Upanga and Merge campus). Method: The study was cross-section study design employed a quantitative approach, conducted at Muhimbili National Hospitals. A convenience sampling was used to select a sample size of 122 nurses working in medical wards and Intensive Care Units. Data was collected by using a self-administered questionnaire, analysed by using Statistical Package for the Social Sciences (SPSS) version 23, and represented into frequencies tables. Results A total of 122 nurses working in a medical ward and intensive care unit were recruited for the study. This study has shown that the majority of nurses 99(81.1%) successfully defined stroke. However, a considerable number of nurses 43(35.2%) incorrectly indicated that hemiplegia is one of the types of stroke. The majority of nurses 113(92.6%) identified high blood pressure as a risk factor for stroke. However, the majority of nurses were not able to identify family history of stroke 86(70.5%), previous intracranial haemorrhage 101(82.8%), lack of physical activity 83(68.0%), previous atrial fibrillation 71(58.2%), and previous Transient Ischemic Attack 87(71.3%) as risk factors for stroke. On the other hand, about 94% were knowledgeable about early warning signs of stroke which are sudden numbness or weakness of the face, arm, or leg, especially on one side of the body. The study also found that nurses had general knowledge on key nursing interventions for stroke patients. However, many were not knowledgeable on other important interventions that are recommended for stroke patients such as treatment of hyperglycaemia to keep blood glucose levels between 140-180 mg/dL and treatment of hypoglycaemia (blood glucose < 60 mg/dL) per hospital xii protocol, and use of antiplatelet agent in the place of oral anticoagulation in a non-embolic stroke to reduce the risk of recurrent stroke. Conclusion The results of the present study showed that participants were knowledgeable about care of patient with stroke in general. However, with regard to specific areas that were assessed in the study, the majority of participants were not knowledgeable. It is recommended that the management organizes on-job training enhance nurses‘ knowledge about stroke care at Muhimbili national Hospitals Keyword: Nurses, knowledge, stroke, care, Muhimbil