Browsing by Author "Abate Ananya"

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    Assessment of Knowledge, Attitude and Practice of Anesthesia Providers towards Post Operative Nausea and Vomiting at Tikur Anbessa Specialized Hospital.
    (Addis Abeba University, 2020-11) Getiye Awoke; Abate Ananya; Tilahun Rahel
    Background: Evidence based knowledge, attitude and practice of anesthesia providers towards postoperative nausea and vomiting management is essential to improve hospital service as well as patient care. Objective: the objective of this study was to assess the knowledge, attitude and practice of anesthesia providers working at Tikur Anbessa Specialized Hospital towards postoperative nausea and vomiting. Method: Institutional based cross-sectional study was employed among anesthesia providers at TASH from September to October 2020. Single population proportion formula was utilized to calculate sample size of the study participants and the final sample size was 111. The study participants were selected after proportional allocation was done among the different anaesthesia providers based on their educational level. Thedata was collected by self-administered questionnaire and entered into Epi-data and exported to SPSS version 26 for analysis. Descriptive statistics, bi-variable and multivariable logistic regression analysis were done to identify factors associated with the knowledge, attitude and practice level of study participants. Result: A total of 111 study subjects were participated in the study of which 65.5 % (n=73) were male with male to female ratio of 1.921:1. The result showed that 58.6% (n=65), 61.3% (n = 68) and 39.6% ( n = 44) of study participants had good knowledge,positive attitude and good practice towards PONV management respectively.Educational level of anesthesia providers was a factor significantly associated with knowledge, attitude and practice of anesthesia providers towards management of PONV. Conclusion and recommendation: Over all educational level of anesthesia providers was a factor significantly affecting the knowledge, attitude and practice of anesthesia providers towards management of PONV. Even though majority of anesthesia providers had good knowledge and positive attitude towards management of PONV practice was lacking. Anesthesiologists were having good knowledge, positive attitude and good practicethan other level of anesthesia providers at TASH . We recommend department of anesthesia, critical care and pain medicine to prepare training, protocols and guidelines for effective management of PONV in the future.
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    Assessment of Knowledge, Attitude and Practice towards Pediatric Pain Management among Nurses Working in Pediatrics Unit at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
    (Addis Abeba University, 2020-11) Taddess Roza; Abate Ananya; Idris Semira
    Background the world is facing unprecedented health crisis with the pandemic caused by novel coronavirus SARS COVID191 .The pathogen is spread by human to human transmission through droplet exposure and contact surface causing minor symptom in majority but critical illness ,bilateral pneumonia and ARDS in minority 2The burden of escalating the case number of covid19 is presenting a challenge to management of patients in the intensive care unit. The number of patients with covid19 admitted to ICU is escalating in Ethiopia. Identifying the risk factors among patients in the intensive care unit between the survivors and non survivors, and predicting mortality will have significant impact to determine prognosis and direct resource management. Objective: to identify associated risk factors and mortality of patients with covid19 admitted to ekakotebe intensive care unit. Method: a 7 month retrospective cohort study was employed at ICU of eka kotebe general hospital. . Review of records of all the patients admitted during the period was carried out. Information on socio-demographic characters, characteristic of patient, comorbidities and lab investigations on admission, and outcomes was collected through trained data collectors and the principal investigator by using prepared questioner. Data compiled and analyzed using computer software and presented using tables, graphs and figure Result: During the period of the study 163 critical patients were admitted to covid19 ICU with laboratory confirmed covid19.Most patients were male (68.1%; 95% CI, 61.3%-76.1%]), with a median age of 60 (95% CI, 58-65; IQR, 50-67) years. One hundred fourteen (69.9%; 95% CI, 63.8%-77.8%) had at least 1 comorbidity. Median time from symptom onset to ICU admission was 7 (95% CI, 6.1-8; IQR, 5-11) days. A total of 73 patients were intubated during the study period, 32 (43.8%) were during admission and the others (41(56.1%)) patients were intubated after mean length of stay of 4.47 (95% CI 3.5-5.5) days at ICU. Median duration on mechanical ventilator was 6 (IQR 3-12 95% CI 5-8, range 1-30) days. The median length hospital stay was 16 (IQR 10-23 range 2-48) days. The median length of ICU stay was 7 (IQR 4-12 95% CI 5-8) days. At the time of censoring, a total of 77 patients (49.1% 95% CI 41.7-56.4) transferred from ICU only 3 patients were still in ICU. And a total of 83(50.9%; CI 43.6-59.5) patients has died in ICU. Among comorbidities CLD was significantly associated with mortality with (HR: 4 (95%CI 1.28-12). Elevated liver function (HR: 1.83 95 CI (1.08-3.13 p -0.02) and PH<7.35(HR:1.8(95% CI 1.05-3)), p value-0.03) during admission were also had significantly associated with mortality. The invasive mechanical ventilator was also significantly associated with mortality (HR: 2.27(2.27 (1.12-4), p <0.02). Conclusion and recommendation: SARS –covid19 has a serious challenge to our health care system in our country Ethiopia and the world. Despite our hospital had lower number of admission during the study period to our ICU, the mortality rate is high 3. Patients who require IMV had significant association and absolute high mortality rate. We recommend that a prospective study should be undertaken, with higher number of patients, to strengthen the findings of this study
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    Assessment of Post-Operative Pain Management in Pediatrics in Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia 2024 G.C
    (Addis Ababa University, 2024-03) Hailemelekot Mahdere; Abate Ananya ; Hulala Faiza
    Background: Understanding the pathophysiology of pain and performing age appropriate pain assessment tools will help create goal oriented pain treatment plans and better pain control in children. Anticipating and effectively treating pain in pediatric patients is an essential component of care. Inadequately treated pain will lead to multiple morbidity and increased mortality. The goal of this study is to assess practice of pain management within the first 24postoperative hours. Objective: Assessment of post-operative pain management in pediatrics patients aged 1-14years at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia 2024 G.C. Method: An institutional-based descriptive cross-sectional study was conducted over 4 months utilizing a semi-structured questionnaire and age appropriate pain assessment tools. The Face,Leg, Activity, Cry and Consolability (FLACC) scale and Visual Analog Scale (VAS) were used to measure pain intensity. Additional data was collected from respective medical chart. A total of 160 patients were included in the study and data was cleaned, coded and entered to SPSS version 27 for analysis. Bivariate and multivariable multinomial logistic regression analysis was done to assess factors affecting severity of pain; P< 0.05 was used to declare significant variable. Result: The prevalence of pain in the study was 70%. The mean pain score was 2.3. Mild, moderate, and severe pain scores were 41.9%, 14%, and 10.6% respectively. The most commonly prescribed medications were non narcotics. There was no use of standard pain assessment tool. Children under 7 years pain (AOR = 0.206, 95% CI: 0.050-0.841), those receiving narcotic analgesics (AOR = 0.094, 95% CI: 0.017-0.504) and on scheduled prescription (AOR = 0.182, 95% CI: 0.039-0.863) had lower odds of experiencing severe pain. Conclusion: There is high prevalence of pain in pediatric post-operative patients. In TASH,there is poor evaluation, documentation, reassessing, and treatment of pain. The study highlights the importance of considering age, medication type, and prescription patterns in managing post-operative pain in the pediatric population.
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    The incidence and Associated Risk Factors of Endotracheal and Tracheostomy Tube Blockage in Intensive Care Unit at Tikur Anbesa Specialized Hospital, Addis Ababa,Ethiopia
    (Addis Ababa University, 2018-10) Mengistie Shimelis; Abate Ananya
    Background: Endotracheal (ETT) and tracheostomy tube (TT) blockage is a common airway accident in Intensive Care Unit (ICU). Although tube blockage is rarely fatal, it has a major impact on the quality of ICU care and the family of the patient12. The present study is aimed to assess the incidence of ETT/TT tube blockage and associated risk factors including the tube size,shift of tube blockage, type of tube blockage, duration of intubation and frequency of suctioning.The causes of tube blockage and outcome of tube blockage. Objective: To assess the incidence and associated risk factors of endotracheal tube and tracheostomy tube blockage in pediatric, adult surgical and medical intensive care units in Addis Ababa University School of health science Tikur Anbesa specialized hospital.Materials and Methods: After the department of Anesthesiology research committee approval,Institutional based prospective cross sectional study was conducted from March to August, 2018to assess the incidence and associated risk factors of endotracheal and tracheostomy tube blockage in pediatric, adult medical and surgical ICUs. Data was collected using formatted questionnaire in ICU patients admitted to pediatric, adult medical and surgical ICU during the study period. All admitted patients in ICU who were intubated with ETT or TT had been included in this study whose consent was taken from the family. The collected data was entered,coded using Epi – info software and analyzed through SPSS software 23 version. Result: A total of 276 patients were admitted in ICU, surgical 129, medical 81 and pediatric 66 ICU from thispatient 122 were intubated, from those tube blocked, medical 5 (25%), surgical 9 (45%) and pediatric ICU 6 (30%) respectively. The Incidence of ETT/TT blocked was 20(16.4%). Fromthose ETT was16 (80%) and TT blocked was 4(20%) (P=0.042), most cause of tube blocked was mucus 11(55%) then debris 4(20%), and 1(5%) kinked from pediatric ICU. Greater than 7 TDS’7(35%) were blocked, so tube blockage higher in number. The degree of ETT/TT blocked was similar between in partial and complete blocked which was 10(50%) vs 10(50%) consecutively(P=0.025), so it is statistical significant. During the night shift tube blockage was 11(55%)slightly high in number, but during day shift, it was 9(45%). Conclusion: The overall incidence of tube blocked was 20(16.4%), so it was higher compare to other studies might been highersetup
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    Knowledge, Attitude and Practice Regarding COVID-19 Transmission among Health Care Workers at TASH Operating Theater
    (Addis Abeba University, 2020-09) Gesesew Tsegay; Girma Mesfin ; Abate Ananya
    Background: The COVID 19 was announced to be a worldwide pandemic by the WHO on March eleven, 2020. It introduced serious work-related health risks to the HCPs owing to their frequent exposure to infected persons. Protection of HCPs and prevention of intra-hospital transmission ofinfection are important aspects in epidemic response and this requires that HCPs must have updated knowledge regarding the source, transmission, symptoms, and prevention of COVID-19. Having poor knowledge, poor practice and negative attitude toward the disease among HCPs could result in a negative impact in the supportive treatment and, worsen the spread of the pandemic OBJECTIVE: The main purpose of this study was to assess Knowledge, Attitude, and Practice Regarding Covid-19 Transmission among Health Care Workers who work in TASH Operating Theater. Methods: Cross-sectional study was conducted on September 2020 among 261 HCW who were selected by a stratified sampling technique. Pretested structured questionnaire was used to collect data. Data were entered and analyzed using SPSS version 26. Variables with a p-value < 0.05 were used as significantly associated with the dependent variable. Result: A total of 261 HCW had participated in the study with a 100% response rate. The majority of the respondents were male (69.7%) with a median age of 30 (range 23-63) years. The mean knowledge score was 81.11 % (i.e. 11.3554 out of 14 with SD=1.52). The mean attitude score was 68 %( i.e. 6.8 out of 10 with SD=1.32) with sixty-five percent point five (65.5%) of the respondents have an overall positive attitude. the occupation was the only variable significantly associated with knowledge and attitude. The total mean practice score is 45.36% (i.e. 4.08 out of 9 SD= 1.6); with no statistically significant heterogeneity across socio-demographic, IP training status, knowledge, and practice. Most (54.8 %) of the respondents scored below the mean (45.36 %) Conclusion: In this study, around half of HCWs have good knowledge and two-third of HCWs have a positive attitude score towards COVID-19 transmission. The total mean practice score and those who scored above the mean are both below 50% which shows having poor practice. The occupation was the only independent variable with a significant association with knowledge and attitude.
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    Patient Satisfaction with Postoperative Pain Management and its Associated Factors in Adult Patients Undergoing Elective Surgery at Tikur Anbessa Specialized Hospital Addis Ababa Ethiopia
    (Addis Ababa University, 2021-11) Kedir Nura; Abate Ananya; Endris Semira
    Background: Patient satisfaction with postoperative pain management is a relevant but difficult measure of quality of care. It is a complex concept which highly depends on subjective judgment and is influenced by emotional feelings, sociocultural values and expectations.However, data regarding this issue is limited in the study area. Therefore, generating data in terms of patients’ satisfaction will reduce this limitation. It will also have a significant input in the formulation of appropriate strategy to modify and transform the overall post-operative pain management in to one that is patient centered. Objective: Assess level of patients` satisfaction and its associated factors in adult patients who underwent elective surgery at Tikur Anbessa Specialized Hospital from June 1 to September 15, 2021 GC Methods: An institution-based cross-sectional study was conducted from June 1 to September 15 2021 at Addis Ababa University, TASH using the APS-POQ-R tool. Trained data collectors approached participants within 24-72 hours of surgery for interview. Data was entered, cleaned and analyzed using SPSS version 25 software. Level of satisfaction was dichotomized in to high and low satisfaction using the median split technique. Bivariate and Multivariate Binary logistic regression and Pearson`s correlation tests were done to identify factors associated with level of patient satisfaction. One way ANOVA and Mann Whitney- U tests were done to reveal differences in pain intensity and satisfaction across different groups of independent variables.P values less than 0.05 were considered significant throughout the analysis. Results were presented using texts, tables, charts and graphs. Results: Reliability test showed, the APS-POQ-R tool had good internal consistency (Cronbach’s α= 0.84). A total of 335 individuals participated in the study (98.5% response rate). Only 19% of the participants had information about their pain management. The mean satisfaction score was 7.13 (SD±2.23) respectively. The proportion of patients with high satisfaction was 57.3%. Satisfaction scores were higher in Obstetrics, Gynecology and Urology patients than Orthopedic patients (ANOVA, p<0.05). Female sex, increased degree of pain relief and use of non-pharmacological pain relief methods were significantly associated with high level of satisfaction (p<0.05). Higher preoperative and postoperative pain level, longer duration of surgery, increased levels of affective behaviors and adverse effects had inverse relation with patients` satisfaction (P<0.05). Conclusion: Compared to similar studies, satisfaction of patients with postoperative pain management was substantially low in this study. Presence of high intensity of pain was an important factor for this finding. A huge gap in information provision regarding patients’ pain management was also observed. In order to alleviate these problems, we recommend for nurses and physicians to provide the necessary information on the available pain treatment modalities and conduct a thorough evaluation and management of preoperative and postoperative pain.
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    Preference of Spinal Versus General Anesthesia and Associated Factors among Pregnant Women Undergoing Elective c/s at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2021.
    (Addis Ababa University, 2021-11) Bayisa Lemi; Birhanu Tseganesh; Abate Ananya
    Background: Cesarean section is mainly done under SA or GA. When used appropriately spinal anesthesia has many benefits. Client preference determine the mode of anesthesia to be given for cesarean section. In Ethiopia, the rate of spinal anesthesia for cesarean section is less than that of developed world. There was no study that reported the womens’ preferences of anesthesia mode and factors affecting their preferences in Tikur Anbessa Specialized Hospital. Objective: To assess factors associated with womens’ preferences of anesthesia type for elective C/S at TASH Method: Institutional based prospective Cross-sectional study design was conducted on 200 clients who were scheduled for elective C/S at TASH, in Addis Ababa. This study was conducted from April 1 to September 30, 2021. Systematic random sampling technique was used to select the clients. Structured questionnaire was used to collect the data. Data was checked for completeness and entered into Epi-data version 4.6 then imported to SPSS 25 software for analysis. Descriptive analysis was done for Socio demographic and clinical characteristics of the participants. Bi-variate logistic regression was done for each predictor variable and outcom variable. Multivariate logistic regression was done and statistical significance p-value less than 0.05 was taken as a determinant factor. Results: Overall spinal anesthesia preference rate is about 90 %, while general anesthesia preference rate is 10 %. Clients with no previous anesthesia exposure are high likely to prefer spinal anesthesia as compared to those who previously took anesthesia (p = 0.028 AOR 4.94(1.19, 20.54). Multivariate logistic regression showed that literate women are high likely to prefer spinal anesthesia as compared to illiterate women (p < 0.001 AOR 19.9(4.58, 87.27). There is no association found with age, parity, previous mode of delivery, previous information about anesthesia, employment status, partners preference and feared anesthesia related complications. Conclusion: Majority of clients (90%) who were scheduled for elective c/s prefer spinal anesthesia in TASH. Educational level and lack of previous anesthesia exposure are found to be ssociated with anesthesia mode preference.
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    Prevalence of Postoperative Hypothermia and its Factors in Post Anesthesia Care Unit among Adults Patients Who Underwent Elective Surgery at Tikur Anbesa Specialized Hospital, 2023/4
    (Addis Ababa University, 2024-05) Gebrie Amare; Abate Ananya
    Background: Post-operative hypothermia is defined as a body temperature of <36°C and may be classified as mild, moderate, and severe. It is a frequent occurrence that affects more than 70% of patients undergoing surgery and anesthesia. In the postoperative period, patients might be hypothermic due to different reasons. It continues to be a significant challenge despite previous efforts, which may affect patient outcomes and healthcare costs. Objective: This study aimed to assess the prevalence of postoperative hypothermia and its associated factors among adult patients in PACU who underwent elective surgery. Methods: Institutional-based cross-sectional study design was conducted among adult patients who underwent elective surgery. Systemic random sampling was used to select patients. Patient chart review and temperature measurement were utilized for data collection. Analysis was done by using SPSS 27. Logistic regression was used to identify associated factors and a p-value < 0.05 at 95% confidence intervals was considered as statistical significance. Result: The finding of the study revealed that 39%(n=145) of patients had at least one record of hypothermia. Among them, 22.3% of cases at arrival and 9.1% at the 15-minute had a moderate level, and there were no cases of hypothermia of any severity recorded. Ageabove 60years,medicalcomorbidity, preoperative hypothermia, spinal anesthesia, spinal with epidural anesthesia,unwarmed crystalloid fluid administration, blood transfusion, and duration of surgery were significantly associated with postoperative hypothermia. Sex, ASA, BMI, duration of anesthesia,type of surgery and amount of crystalloid administered have no association with postoperative hypothermia Conclusion and recommendations: The prevalence of postoperative hypothermia was significant. Proactive warming strategies, including warming intravenous fluids to body temperature and implementing continuous warming measures for longer surgeries, are crucial.Close monitoring and adjustment of warming interventions based on surgical complexity and patient needs are essential to prevent postoperative hypothermia effectively.