Critical care nursing practice and education in Rwanda

Background Nursing is widely known as a stressful profession but intensive care unit is the most stressful; when nurses fail to cope with workplace, stresses’ complications such as burnout and depression ensue, and this can compromise the quality of nursing care. In Rwanda, there is a limited literature about workplace stress and coping strategies. Research objectives To assess the workplace stress and coping strategies of intensive care unit nurses at University Teaching Hospitals. Methodology This study used a cross-sectional study design, recruited 92 ICU nurses through the census sampling method; ENSS and Brief COPE Inventory, while SPSS was used for data analysis. Results Eighty percent experienced moderate to high stress, while 19.6% had low stress. Married nurses tend to experience high stress than singles, while those with Bachelors or Master’s degree were less likely to be stressed. Main stressors are care for suffering/dying, or agitated patients; and heavy workload, while main coping strategies were alcohol use, emotion support from friends and religion comfort. Conclusions Nurses experience workplace stress, while workplace stressors are nursing care for suffering/dying or agitated patients and heavy workload. The coping strategies were alcohol use, emotional support and comfort from religion. Rwanda J Med Health Sci 2021;4(1):53-71

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“…Such trainings would ensure that the ICU nurses become familiar with ICU patient's management and keep updated. [25]…”

Section: Socio-demographic Characteristics Of Participants and Levels Of Workplace Stressmentioning

confidence: 99%

Workplace Stressors and Coping Strategies of Intensive Care Unit Nurses at University Teaching Hospitals, in Rwanda

Munyanziza

Bhengu

Cishahayo

et al. 2021

RJMHS

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“…However, the study has its own limitations such as the small sample size to allow this extrapolation to the general population. To achieve, it would be necessary to collect data for a longer period given the limited number of ICU and ICU beds in the country [28]. Furthermore, it could have been interesting to follow up those patients after their discharge from ICU to also report the mortality at 28 and 90 days but many of them were discharged before those dates and could not be reached anymore.…”

Section: Discussionmentioning

confidence: 99%

High Mortality Rate of Obstetric Critically ILL Patients in Rwanda and Its Predictability

Rudakemwa

Cassidy

Twagirumugabe

2020

Preprint

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BackgroundReasons for obstetric admission in intensive care unit (ICU) vary from a setting to another. Outcomes from ICU and its prediction models are not well explored in Rwanda because of lack of appropriate scores. This study intended to assess profile and accuracy of predictive models for obstetric patients admitted in ICU in the two public tertiary hospitals in Rwanda.MethodsWe prospectively collected data from all obstetric patients admitted in the ICU of public referral hospitals in Rwanda from March 2017 to February 2018 to identify reasons for admissions and factors for prognosis. We analysed the accuracy of mortality prediction by the quick Sequential Organ Failure Assessment (qSOFA) and Modified Early Obstetric Warning Score (MEOWS). ResultsObstetric patients represented 12.8% of all ICU admissions and 1.8% of all deliveries. Sepsis (31.9%) and haemorrhage (25.5%) were the two commonest reasons of admission. Mortality was 54.3% while the average length of stay was 6.6 days. MEOWS was an independent predictor to mortality (adjusted OR=1.25[1.07-1.46]; p=0.005). Similarly, one point of increase of the qSOFA increased odds of ICU mortality by 181% (adjusted OR=2.81[1.25-6.30]; p=0.012). The Area Under the Receiver Operating Characteristic Curve (AUROC) for MEOWS was 0.773[0.666-0.880], p=0.0001 and that of the qSOFA was 0.764[0.654-0.873]; p=0.0001.ConclusionSepsis is the most common reason for obstetric admissions to ICU in Rwanda. MEOWS and qSOFA could accurately predict the mortality for those patients but further explorations on a larger sample size are guaranteed.

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“…However, the study has its own limitations such as the small sample size to allow this extrapolation to the general population. To achieve this, it would be necessary to collect data for a longer period given the limited number of ICU and ICU beds in the country [31]. Furthermore, it could have been interesting to follow up those patients after their discharge from ICU to also report the mortality at 28 and 90 days but many of them were discharged before those dates and could not be reached anymore.…”

Section: Discussionmentioning

confidence: 99%

High mortality rate of obstetric critically ill patients in Rwanda and its predictability

Rudakemwa

Cassidy

Twagirumugabe

2020

Preprint

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Background Reasons for admission at the intensive care units (ICU) for obstetric patients vary from a setting to another. Outcomes from ICU and its prediction models are not well explored in Rwanda because of lack of appropriate scores. This study intended to assess profile and accuracy of predictive models for obstetric patients admitted in ICU in the two public tertiary hospitals in Rwanda.Methods We prospectively collected data from all obstetric patients admitted in the ICU of public referral hospitals in Rwanda from March 2017 to February 2018 to identify reasons for admissions and factors for prognosis. We analysed the accuracy of mortality prediction models including the quick Sequential Organ Failure Assessment (qSOFA) and Modified Early Obstetric Warning Score (MEOWS) by using the Logistic Regression and adjusted Receiver Operating characteristic (ROC) curves. Results Obstetric patients represented 12.8% of all ICU admissions and 1.8% of all deliveries. Sepsis (31.9%) and haemorrhage (25.5%) were the two commonest reasons for ICU admission in our study participants. The overall ICU mortality for our obstetric patients was 54.3% while the average length of stay was 6.6 days. MEOWS score was an independent predictor to mortality (adjusted OR=1.25[1.07-1.46]; p=0.005) and so was the qSOFA score (adjusted OR=2.81[1.25-6.30]; p=0.012). The adjusted Area Under the ROC (AUROC) for MEOWS was 0.773[0.666-0.880] and that of the qSOFA was 0.764[0.654-0.873] signing fair accuracies for ICU mortality prediction in these settings for both models.Conclusion Sepsis is the commonest reason for admissions to ICU for obstetric patients in Rwanda. Simple models comprising MEOWS and qSOFA could accurately predict the mortality for those patients but further larger studies are needed before generalization.

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Critical care nursing practice and education in Rwanda

Cited by 14 publications

References 13 publications

Workplace Stressors and Coping Strategies of Intensive Care Unit Nurses at University Teaching Hospitals, in Rwanda

Workplace Stressors and Coping Strategies of Intensive Care Unit Nurses at University Teaching Hospitals, in Rwanda

High Mortality Rate of Obstetric Critically ILL Patients in Rwanda and Its Predictability

High mortality rate of obstetric critically ill patients in Rwanda and its predictability

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