Browsing by Author "Tadele Achamyelesh"

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    Assessment of Availability of Treatment Resource in Emergency Department for the Management of Acute Toxic Exposures and Poisoning Detection in Selected Governmental hospitals, Addis Ababa, Ethiopia
    (Addis Ababa University, 2017-06) Girma Tesfaye; Tadele Achamyelesh
    Background: Poisoning exposures continue to be a significant cause of morbidity and mortality worldwide. The lack of facilities, treatment resources, and antidotes in hospitals may affect the treatments provided and outcomes. Objective: Assessment of availability of treatment resource in emergency department for the management of acute toxic exposures and poisoning detection in selected governmental hospitals, Addis Ababa, Ethiopia. Methodology: Hospital based descriptive cross sectional study was applied to assess availability of treatment resource for the management of acute toxic exposures and poisoning in selected governmental hospitals from December 2016 to June 2017. Data were collected using semi-structured questionnaire and the data obtained was analysed using SPSS and the result was presented using tables Chart and graph. Result: Over the study period, 920 poisoning cases were listed in the selected hospital registries. Among them, Organo phosphate poisoning was the most top leading cause of acute poison (18.8%, 173/920), Followed by Bleach (Sodium hypochlorite) poison (18.6%, 172/920).In all the hospitals all form of Charcoal and Sodium Sulphate were not available. Four of the five hospitals have had Orogastric tube and magnesium Sulphate. Only Nasogastric tube out of the ten decontamination resource had available in all hospitals. None of the studied hospitals have the stock of all either WHO or Ethiopian essential drug list recommended antidotes and none had fomepizole, pralidoxime, charcoal, sorbitol, ipecac, polyethylene glycol, deferoxaminedimercaprol, glucagon, and Protamine sulphate. In surveyed hospitals peritoneal dialysis was not available. Conclusion: For the majority of the surveyed hospitals the resources which are essential for treatment and management of poisoned patient are not sufficient. Furthermore, the available resources and the pattern of causes of poisoning show discrepancy. Recommendation: Based on the pattern of causes of poisoning it is better if the selected anti-dotes, stabilization, decontamination and elimination resource are available. Keywords Decontamination _ Elimination enhancement _ Stabilization resources _Availability_ Hospital _ Ethiopia _Poisoning.
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    Assessment of Clinical Profile and Magnitude of Early Mortality in the Adult Emergency Department of TASH, Addis Ababa City, Ethiopia.
    (Addis Abeba University, 2020-06) Daniel Hanna; Tadele Achamyelesh ; Teklu Sisay
    Background: The classification of ED mortality is important because it identifies a group of patients who can benefit from the treatment that are provided at the department. Early mortality is defined as death within 72 hrs.‟ of ED presentation (7) and 'very early' ED mortality is defined as death within 24 hours (8). This 'very early' mortality group represents the most urgently ill patients likely to benefit from ED care interventions to prevent mortality. Objective: The purpose of this is study to assess clinical profile and magnitude of early emergency department mortality among patients presented to the adult emergency department of Tikur Anbesa Specialized Hospital from March 1,2018-March 1, 2020, Addis Ababa,Ethiopia. Methodology: A cross-sectional study design was used to assess clinical profile and Magnitude of early mortality in the adult emergency department, Tikur Anbesa Specialized Hospital; Addis Ababa, Ethiopia, From March 1, 2018 to March 1, 2020. The data were collected by review of patients‟ medical record cards. Data was entered by Epi data 4.2.1 and analyzed by SPSS Version 23. Binary and multiple logistic regression analysis were used for theassociation. Statically significance was P-value<0.05 at CI 95%. Result: Of analyzed 506 charts, overall early ED mortality rate was 1.68 %, with male tofemale ratio 1.1:1. From multiple logistic regression results, it was found that, patients whowere triaged as Green were 4.2 times more likely to die after 24 hrs of admission.‟ than patientswho triaged as red. (AOR= .235 95% CI .101, .546). Patients who presented with chief compliant of >1 week duration were 2.1 times more likely to die after 24 hrs of admission.‟than who came with chief complaints of 4-24 hrs.‟ duration (AOR = .471, 95% CI: (.256,.866.). From co morbid diseases HIV patients were 2.7 times more likely to die after 24 hrs.‟than Asthmatic patients.‟ (AOR = 2.720, 95% CI: (1.013, 7.300). Conclusion and recommendations: even though important steps were done to boost the emergency care there are still gaps. It has been found triage acuity; comorbid disease and duration of symptoms of patients were associated with Early ED mortality. Therefore it isessential to improve the quality of care of ED, to reduce the magnitude of preventable EDmortalities.
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    Assessment of Knowledge, Attitude, Practice and Associated Factors towards Fluid Balance Monitoring among Nurses working in Adult ICU of Federally Administered Government Hospitals in Addis Ababa, Ethiopia, 2020.
    (Addis Abeba University, 2020-06) Mengest Wondayehu; Worku Tigest; Tadele Achamyelesh
    Background:Fluid Balance is net result of intake and output of fluid to provide metabolic processes to function correctly. In Intensive care unit the patient needs special consideration for Fluid balance monitoring. Fluid balance monitoring is very vital component in intensive care unit for managementand good patient prognosis. Recent studies show negative fluid balance and positive fluid balance adversely affects patient morbidity, mortality and patient length of stay in hospitals. Even if there is some related researches but still little is known regarding fluid balance monitoring. Objectives: To assess knowledge, attitude and practice of nurses working in ICU towards fluid balance monitoring and associated factors in federally administered government hospitals, AddisAbaba, Ethiopia from October 2019 to June 2020. Methods: institution based quantitative cross-sectional study was conducted from February to April,2020 among federally administered government hospitals in Addis Ababa. Well-structured questionnaire for socio-Demographic characteristics, attitude, knowledge and checklist for practice was adopted from literatures with little modification. The data was entered into Epi-data, version 4.6then analyzed by using SPSS 24 Software. Finally the result was computed and interpreted through use of descriptive statistics. Association between variables was analyzed by using logistic regression at pvalue<0.2and<0.05considering as significantrespectively. Result: - out of 166 study participants the response rate was 96.4% with 28 ± 3.5 years mean age of study participants. Around 85(53.12%) of study participants were female in sex. Majority ofparticipants 108(67.5%) had less than 5-years work experience. From all study participants around 85(53.1%), 85(53.1%) and 90( 56.1%) of Nurses working in ICU had good knowledge, negative attitude and good practice toward fluid balance monitoring for critically ill patients respectively. Strong association and positive relationships were found between practice and knowledge Conclusion and recommendation:- The knowledge and practice of study participants found relativelygood which was above the mean score but the perception were below the mean score. So that, better to build capacity of nurses working in ICU on fluid balance monitoring was recommended for the responsible body.
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    Assessment of knowledge, Attitude, Practice and Associated Factors towards Health care Ethics among Physicians and Nurses Working in Emergency Departments in Selected Governmental Hospitals Addis Abeba,Ethiopia2019.
    (Addis Abeba University, 2019-06) Addisu Betelhem; Bacha Tigist; Tadele Achamyelesh
    Background: Healthcare ethics is concerned with moral values and judgment as it applies to clinical practice, which involves consideration of risks versus benefits from procedures or health care decisions. Recently questions are being asked on healthcare ethics about the possible threats to the accepted principles of equity and social justice in the delivery of care within the health sector. Despite these gaps little was studied about healthcare ethics so far. Therefore, this study aimed to assess knowledge, attitude, practice and associated factors of healthcare ethics among healthcare providers. Methods: Institution based cross sectional study was carried out among 230 healthcare providers working in governmental hospitals in Addis Ababa from April 1-28, 2019. Data was collected using pre-tested self-administered questionnaires. The data cleaned, coded, entered into EPI info version 7.1 and SPSS version 24 statistical package for analysis. Descriptive statistics was used to describe those continuous and categorical independent variables. Those independent variables in bivariate analysis with the cut of point p<0.2 was transferred to multivariate logistic regression. P-value< 0.05 was declared statically significant. Results: This study showed that 61.3% of study participants had good knowledge on medical ethics. Professional qualification, training and attitude were significantly associated with knowledge of healthcare ethics. Among healthcare professionals only 108(47%) had favorable attitude and 113 (57%) poor practice towards healthcare ethics. Work experience, level of satisfaction, knowledge, practice had significant effect on attitude towards healthcare ethics.Whereas attitude was found to be determinant factor on practice of healthcare ethics. Conclusion and recommendations: The findings of this study show healthcare professionals had good knowledge on healthcare ethics. And also indicate gaps in the attitude and practical of medical ethics/health care ethics among physicians and nurses. Therefore, it is important to aware and change attitude of healthcare professionals and improve their practice about healthcare ethics by continuous training, increase public awareness about healthcare delivery and client/patient right and strengthen competency based medical education and well-integrated course.
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    Assessment of Knowledge, Attitude, Practice and Associated Factors towards Infection Prevention among Cleaners Working in Tikur Anbessa Specialized Referral Hospital, Addis Abeba, Ethiopia, November to June2019.
    (Addis Abeba University, 2019-06) Yumura Buna; Tadele Achamyelesh; Worku Tigist
    Back ground: Infection prevention and control is referred to “the measures, practices,protocols and procedures aimed at preventing and controlling infections and the transmission of infections in the health care settings”. The high burden of health care associated infections is due to lack of standardized infection prevention program, which is neglected due to limited resources, poor sanitary conditions and hygiene practices. Objective: The aim of this study is to assess knowledge, attitude and practice of cleaners towards infection prevention and associated factors at TikurAnbessa specialized hospital,Addis Ababa, Ethiopia, from November 2018-June 2019. Methodology: An Institutional based a descriptive cross-sectional study design was carriedout at TikurAnbessa specialized hospital, Addis Ababa, Ethiopia from November - June 2019G.C. A total of 211 cleaners participated in the study with a response rate of (91%). Study participants were recruited by simple random sampling and interview was conducted with astructured questionnaire to collect data. The collected data was coded and entered in to Epidata 4.2.0 and transferred to SPSS version 21 for further analysis. Logistic regression model was used for association between independent versus out-come variables and considering the AOR, 95% CI and p < 0.05 cutoff point as significant for all the independent variables. Result: The knowledge scores of participants had a mean value of 9.4 (SD = 1.81) out of 18.The mean score of attitude was 10.7(SD =1.76) out of 17 and the mean score for the cleaners level practices was found to be 9.8 (SD =2.20) out of 21 possible maximum score. There was a significant relationship between cleaners’ knowledge scores and the level of work experience, attitude, and level of practice and attitude was significantly associated with inadequate knowledge. Finally, cleaners’ inadequate knowledge was factor for poor infection prevention practices. Conclusion and Recommendation: Results showed that cleaners had poor performance and inadequate knowledge towards infection prevention. However, majority of cleaners had favorable attitude towards infection prevention. The hospital’s administrative bodies should provide convenient training program regarding infection prevention to hospital cleaners.
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    Assessment of knowledge, Practice and Associated Factors towards Venous Thrombo-Embolism among Adult Intensive Care unit Nurses at Governmental Hospital, Addis Abeba, Ethiopia, March to April 2019.
    (Addis Abeba University, 2019-06) Yigezu Fikiru; Teklu Sisay; Tadele Achamyelesh
    Background: Venous thrombi-embolism (VTE) is the third leading non-communicable vascular disease following heart attack and stroke worldwide. It is a significant and challenging problem in critically ill patient. Nurses’ knowledge and skill to assess and prevent complications like VTE for admitted patients in ICU is limited in developing nations including Ethiopia which needs insight for possible solution and recommendations. Objective: The aim of this study is to assess knowledge, practice and associated factors towards venous thrombi-embolism among adult intensive care unit nurses at governmental hospitals in Addis Ababa,Ethiopia March to April 2019. Methods: Institution based cross-sectional study was conducted from March to April2019 on 195 nurses working in selected governmental hospitals in Addis Ababa. Respondents were employed with non probability survey sampling technique. The data were collected by using self evaluative structured and pretested questionnaires. The collected data was coded and entered in to Epic data 4.4.2.1 and transferred to SPSS version 21 for further analysis. Vicariate and multi-variety logistic regression model was used for association between independent versus out-come variables. Results; A total of 177 nurses with a response rate of 90.77% were participated in this study from which(55.4%) of the respondents had good knowledge about risk factors of VTE and (42.37%) had good practice towards VTE risk assessment and prevention practice. There was a significant relationship between nurses’ knowledge level and lack of resource (P= 0.027) and experience (p=0.022). Nursing rotation (p=0.038), educational level (p=0.012) and coworker pressure (p= 0.023) were significantly associated with nurse’s practice towards VTE in adult ICU. The statistical significance level was declared at p-value <0.05. Conclusion & Recommendation: The results from this study showed that nurses had poor knowledge of VTE risk factors and poor practice towards VTE risk assessment and prevention in patients admitted to intensive care unit. Lack of guide line, assessment protocol, and resources are contributing factors.Therefore, the hospital’s administrative and supportive organizations would better to provide training regarding VTE risk factors and its management to staff nurses, avail guideline and protocols.
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    Clinical Profile and outcome of Traumatic Brain Injury Patients at Emergency Department of Aabet Hospital ,Addis Ababa,Ethiopia,2020G.C
    (Addis Abeba University, 2020-06) Tesfay Mulubrhan; Kebede Sofia ; Tadele Achamyelesh
    Background: Traumatic brain injury (TBI)is a major global health and socioeconomic issue.In the middle of low and high-income nations, it is widespread and affects people of all ages.According to Communicable Disease Control (CDC)a traumatic brain injury is describes as aloss of normal brain activity that may be caused by banging on the head, moving from side toside, or whirling to the head, or penetrating injury. Objective: To assess the clinical profile and Outcome of Traumatic Brain Injury patients in emergency department, AaBET Hospital, Addis Ababa, Ethiopia, 2019. Methods: An institution based retrospective study was conducted on 324 TBI patients who had attending the AaBET Hospital of Emergency Department. The study was conducted from November 2019 to June 2020. The calculated sample size was addressed by using systematic random sampling technique. The data was entered in to Epi-Data version 3.1 and analyzed withSPSS version 25.0. A Simple descriptive statistic (frequencies, percentages, mean)was used to analyze the results of the study. Result: Among 324 patient charts 82.4 % were male making the male to female ratio 4.7:1.The most commonly affected age group was (36.4%)between 16 – 25 years. RTA was the leading cause of injury (4.7%). On presentation, the severity of TBI based on GCS were mild(71.3%), moderate (21.9%), and severe (6.8%). Finally, Most (90.7%)TBI patients were survived within the trauma center, while the overall mortality rate was 3.4%. Conclusion: Traumatic brain injury is a threatening condition which leads to one of the most significant reasons for attending the emergency department visits with increasing admission from time to time by imposing a high degree of morbidity and mortality.
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    Magnitude, Clinical Presentation, and Outcome of Pediatric Burn Injuries at Yekatit 12 Hospital, Addis Ababa, Ethiopia
    (Addis Ababa University, 2014-06) Tadele Achamyelesh; Bacha Tigist
    Back ground: Burn injuries are a global public health problem, accounting for an estimated 195000 deaths annually. The majority of these occur in low- and middle-income countries and therate of child deaths from burns is currently over seven times higher in low- and middle-incomecountries than in high-income countries. Burn injuries are largely considered as beingpreventable. However, one needs to know the patterns, causes and outcomes of burn injuries ifintervention measures are to be effective.. Objective: the aim of this study was to determine the magnitude, clinical presentation andoutcome of pediatric burn patients seen in Yekatit 12 hospital from January 2012 – January2014. Methodology: This study was conducted at Yekatit 12 hospitalfromDecember- June 2014 byimplementing a retrospective cross sectional study design. A total of 422 burn patients wererecruited by simple random sampling method. Data was collected from patients’ medical recordcards retrospectively. SPSS version 20 for widows was used for data entry and analysis.Descriptive statistics and logistic regression were used to analyze the data. Result: Burn accounted for 6.4% of patients who had visited the pediatric department of Yekatit12 hospital during the study period. Children less than 3 years of age had the highest proportionof patients (53.3%) and the median total body surface area (TBSA) burned was 11% with a rangeof 1-95% . The most frequent burn injuries were scalds, followed by flame burns, electrical burns, contact burns with hot solid object and chemical burns with 60%,32.9%, 3.8%, 2.4% and 0.9%respectively. Most of the burns ( 49%) healed with no or minor sequelae and 7.85% of patientsdied in the study period. Cause of burn has statistically significant association with death (P=0.027).Conclusion and recommendation: The leading causes of burn are scalds which are preventable.Children should not be allowed in the kitchen and they should be kept in their beds or in theirroom while their mothers are doing housework chores. The most effective way to prevent burnsis public education. Key words/phrases: pediatric burn injuries, scald, partial thickness burn, full thickness burn,TBSA
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    Magnitude, Treatment Outcome and Associated factors with Severe Community Acquired Pneumonia Children Aged 2 to 59 Months Admitted to Pediatric Departments of Two Selected Governmental Hospitals in Addis Ababa, Addis Ababa, Ethiopia, 2017/18.
    (Addis Abeba University, 2018-06) Hatewu Bayisa; Tefera Muluwork ; Tadele Achamyelesh
    ABSTRACT BACKGROUND: Pneumonia is one of the leading causes of morbidity and mortality in under-fives throughout the world, particularly in developing countries. About 20% of all deaths in children under five years of age has been reported to be happen due to acute lower respiratory infection (ALRI). About 90% of ALRI associated deaths takes place due to severe pneumonia. Death attributed to pneumonia has decreased since 2000 G.C., but it remains amajor public health problem. Additionally, there are no enough data to describe pneumonia outcomes in low-income countries even in the era after vaccines have been introduced.Therefore, this study is crucial in identifying major determinants of severe pneumonia outcomes. OBJECTIVE: To assess Magnitude, Treatment Outcome and Associated Factors with SeverCommunity Acquired Pneumonia in Children Aged 2 to 59 Months Admitted to Pediatric departments of two Selected Governmental Hospitals in Addis Ababa, Addis Ababa, Ethiopia, 2017/18. METHODS: An institutional based retrospective chart review study was conducted to assess the magnitude, treatment outcome and associated factors with severe community acquired pneumonia in pediatric departments of Yekatit 12 Hospital and St.Paul’s HospitalMillennium Medical College in the last one year from January 1, 2017 to December 31, 2017.Data were collected by using a structured questionnaire from medical records of patient fulfilling inclusion criteria.For sample size determination all cases fulfilling inclusion criteria admitted from January 1, 2017 to December 31, 2017 were included and the collected data were analysed using SPSS version 23. Result:A total of 1043 children aged 2 to 59months were admitted to Yekatit 12 hospital and St. Paul Hospital Millennium medical college paediatric departments during the study period.Among these 168 were Children with diagnosis of severe community acquired pneumonia (SCAP) fulfilling the inclusion criteria with full documentation.Out of 168 children (meanage 14 months) admitted with severe community acquired pneumonia, 33(19.6%) had severe acute malnutrition (SAM), 2 (1.2%) had a positive HIV antibody test, and 10(6.0%) died inhospital. Conclusion: Child’s nutritional status, immunization status and oxygen saturation at time of admission had significant effect on the patient treatment outcome of children admitted withdiagnosis of severe community acquired pneumonia.