Factors affecting compliance to preoperative patient care guidelines among nurses working in surgical wards of a tertiary referral hospital in Nairobi, Kenya

Abstract

BACKGROUND 
 Worldwide, over 234 million surgical patients are operated on yearly with 3%-16% of them developing complications and other preventable surgical mistakes. To mitigate these negative surgical outcomes, pre-operative patient care guidelines (PPCG) have been developed. However, poor compliance with the guideline may lead to surgical errors. In Kenyatta National Hospital (KNH) 20% of surgical errors and 10% of cancelled surgeries are due to poor compliance with PPCG. Therefore, this study aimed to establish the level of compliance with PPCG and its associated factors among perioperative nurses at KNH. 
 MATERIALS AND METHODS 
 This was an analytical cross-sectional study that was conducted at the KNH surgical wards. The census method was utilized to collect data among 103 nurses and analyzed using SPSS version 22. Bivariate analysis with Fischer’s exact test was used for the correlation between the independent and dependent variables, with a p-value of <0.05 being considered to be statistically significant at a 95% confidence interval. 
 RESULTS 
 Most [59(57.3%)] of the participants had low compliance to PPCG, with nurses’ experience (p=<0.001), gender (p=0.02), level of education (p=<0.001), having post-basic nursing training (p=0.02), not having training in PPCG (p=<0.001) and knowledge on PPCG (p=<0.001) being significantly associated with compliance to PPCG. 
 CONCLUSION 
 Most of the nurses have low compliance levels to PPCG, with nursing experience, nurses of the male gender, not having post-basic nursing training and not having training in PPCG use being the main contributing factors.