Development and validation of a questionnaire to assess the doctors and nurses knowledge of acute oxygen therapy

An exploration of healthcare professionals' knowledge and perceived barriers about acute oxygen therapy: a survey in a tertiary care hospital, Sudan

BACKGROUND

Oxygen is an essential drug that is commonly used in clinical practice, and its misadministration can result in severe consequences. This research sought to evaluate the knowledge and perceptions of physicians and nurses regarding acute oxygen therapy and delivery barriers.

METHODOLOGY

This was a cross-sectional hospital-based survey. The study was conducted at Managil Teaching Hospital, Sudan. The study included 159 physicians and 25 nurses who were working at the hospital during the study period. The previously validated acute oxygen therapy questionnaire (AOTQ) was used to assess knowledge and barriers regarding acute oxygen therapy (AOT). The collected data were then analysed via R software.

RESULTS

A total of 184 medical professionals were included in the survey. The mean age of the study participants was 26 years, and 66.2% of all participants were male. A total of 74% of the physicians were junior physicians. Among the physicians, 15 (9.4%) had good knowledge (score > 80%), 75 (47.2%) had moderate knowledge (score > 60% & less than 80%), and 69 (43.4%) had poor knowledge about acute oxygen therapy (score < 60%). Among the nurses, 2 (8%) had good knowledge, 10 (40%) had moderate knowledge, and 13 (52%) had poor knowledge. Most of them were from medical departments, with 33% from physicians and 40% from nurses. Approximately 64% of the physicians and 68% of the nurses stated that oxygen is not a medication rather than a supportive therapy, and only 13% of the physicians and 28% of the nurses knew that oxygen should be given only after the doctor's prescription. The availability of oxygen was reported as a barrier by 85% of the physicians and 72% of the nurses.

CONCLUSION

A considerable percentage of physicians and nurses exhibited a limited understanding of acute oxygen therapy, demonstrated infrequent adherence to AOT guidelines due to a lack of awareness, and reported germane barriers to delivery that necessitate administrative and educational interventions.

Knowledge, attitude, practice and associated factors of oxygen therapy among health professionals in Ethiopia: A systematic review and meta-analysis

BACKGROUND

Oxygen therapy is a life-saving intervention used in various healthcare settings to maintain adequate tissue oxygenation while minimizing cardiopulmonary work. Its effective and safe administration depends largely on the knowledge, attitudes, and practices of health professionals. However, there are no pooled studies that examined these skills in the context of Ethiopia. Therefore, this study aimed to assess the pooled prevalence of health professionals' knowledge, attitude, practice, and determinant factors about oxygen therapy in Ethiopia.

METHODS

The databases PubMed, Web of Science, Scopus, Hinari, Science Direct, African Journal of Online, and Google Scholar were used to search for published studies; Direct Google searches and institutional repositories were used to search for unpublished studies. Duplicate studies were eliminated with Endnote X8 and reported according to PRISMA guidelines. The quality of the included studies was assessed using the Joanna Briggs Institute critical appraisal checklist. A random-effects model was used to estimate the pooled prevalence of KAP among health professionals. Heterogeneity was assessed using Cochran's Q test and I2 statistics. Publication bias was checked by visual inspection of a funnel plot and Egger's regression test. STATA version 11 software was used for statistical analysis.

RESULTS

A total of 14 studies with 2,960 participants for knowledge and practice and 9 studies with 1,991 participants for attitude were used to estimate the pooled prevalence of KAP among health professionals. The pooled prevalence of good knowledge, positive attitude, and good practice regarding oxygen therapy were 52.13% (95% CI: 43.88, 60.39), 55.08% (95% CI: 50.80, 59.35%), and 48.94% (95% CI: 41.14, 56.74) respectively. Both good knowledge and positive attitude were affected by the availability of oxygen therapy guidelines, with adjusted odds ratios (AOR) of 6.11 (95% CI: 2.45, 15.22) and 2.17 (95% CI: 1.39, 3.39) respectively. Additionally, good knowledge (AOR: 4.31, 95% CI: 1.53, 12.11), training (AOR: 4.09, 95% CI: 2.04-8.20), and having an adequate oxygen supply and delivery system (AOR: 3.12, 95% CI: 1.92-5.07) were statistically associated with good practice.

CONCLUSION AND RECOMMENDATIONS

The national pooled prevalence of good knowledge, positive attitude, and good practice among health professionals was low. Therefore, thorough monitoring, supervision, and evaluation of their oxygen therapy is highly recommended for all stakeholders. Yet again, we strongly advise that the identified factors be improved by organizing training sessions, making oxygen therapy guidelines available, and maintaining an adequate oxygen supply system.

TRIAL REGISTRATION

The review protocol was registered in the international prospective register of systematic reviews with registration number PROSPERO: CRD42023486036.

Assessment of knowledge, attitude and practice for oxygen therapy among medical staff at the Colonial War Memorial Hospital in Fiji

BACKGROUND

Oxygen therapy (OT) is a commonly prescribed essential medicine for people of all ages in the management of hypoxia. The adverse effects of inappropriate OT supplementation may be underestimated by health professionals and lead to poor health outcomes among hospitalised patients. Knowledge, attitude and practice (KAP) assessments of medical staff members to OT guidelines are essential to ensure optimal patient care.

AIMS

To perform a KAP assessment of OT administration among doctors and nurses employed at the national hospital of Fiji in 2021.

METHODS

Prospective cross-sectional study design. KAP assessment was performed with an online questionnaire and clinical observation.

RESULTS

The study population (N = 116) consisted of doctors (20.7%) and nurses (79.3%) representing the acute medical, burns, cardiac care, intensive care, surgical and postanaesthetic recovery units. Overall, the proportion of participants who obtained a good score (>70%) was 87% for knowledge, 87.93% for attitudes and 84% for practice. Best knowledge scores were obtained for general OT indications (71%) and scenarios where immediate oxygen application is required (70%). Lowest knowledge scores were for OT contraindications (14%) and oxygen saturation for acute myocardial infarction (32%), asthma (36%) and healthy newborns (43%). The most positive attitudes were in response to the statement that OT guidelines are essential (96%). A total of 78 (80.4%) patients were being cared for with good OT practice.

CONCLUSIONS

Good KAP scores were obtained for medical staff in Fiji regarding OT administration. Ongoing professional education activities should include updated training of OT contraindications and optimal oxygen saturation levels for special patient groups.

Barriers to Safe Oxygen Therapy and the Effect of the Training on the Knowledge and Performance of ICU Nurses

Introduction

Proper oxygen therapy is crucial in hospitals, particularly intensive care units, to ensure safety and accuracy. The role of nurses during oxygen therapy is vital, as their knowledge and correct performance significantly impact patients' clinical conditions. A study was carried out to examine the knowledge and performance of nurses regarding safe oxygen therapy. The study aimed to identify the obstacles hindering safe oxygen therapy and assess the impact of training on the knowledge and performance of intensive care nurses.

Methods

This study was conducted among the ICU nurses at Shahid Rahnemoun Teaching Hospital in Yazd, Iran. The study method is a sequential combination of descriptive, qualitative, and educational phases. The first stage involved examining the knowledge and performance of 80 ICU nurses in oxygen therapy. The study employed content analysis to elaborate on participants' perspectives on safe oxygen therapy challenges and potential solutions. The third phase involved a two-group study with pre- and post-tests to examine the effect of training on ICU nurses' knowledge and performance in oxygen therapy.

Results

The study found that intervention and control groups had low average scores in knowledge, performance, and total score of oxygen therapy before the study, with no significant difference. There was a significant difference between intervention and control groups one and three months after the intervention in the areas of knowledge (after-1 month 24.41 vs. 20.29, 95% CI [3.144-5.098], after-3 month 22.13 vs. 20.24, 95% CI [0.729-3.053]), performance (after-1 month 21.54 vs. 18.05, 95% CI [2.898-4.073], after-3 month 19.74 vs. 18.63, 95% CI [0.400-1.824]), and total score of oxygen therapy (after-1 month 45.95 vs. 38.34, 95% CI [6.288-8.925], after-3 month 41.87 vs. 38.87, 95% CI [1.394-4.613]).

Conclusion

The study's findings revealed that nurses in ICUs lack the appropriate knowledge and performance in oxygen therapy. A lack of knowledge and correct practice, insufficient monitoring of oxygen therapy, and defects in hospital equipment are contributing factors. The training was found to improve the knowledge and performance of nurses significantly. Consistent training at shorter intervals is suggested for nurses to keep their knowledge current.

Effect of an Educational Program on Nurses' Knowledge and Practice of Oxygen Therapy

INTRODUCTION

Past studies have shown that healthcare professionals may lack awareness and knowledge regarding oxygen therapy, and its implementation often has several obstacles. This study was carried out to investigate the effect of an educational program about oxygen therapy on nurses' knowledge and practices.

METHODS

This cross-sectional, quasi-experimental study was conducted in 2022 at the pediatric department of Nishtar Hospital, Multan, where 160 nurses from primary and secondary health centers attended an educational program delivered in the pediatric department. The pre-test-post-test approach was used to evaluate the effectiveness of the structured educational program. The independent variable was the educational program, and the dependent variable was the nurses' knowledge and practice about oxygen toxicity. Data analysis was performed using SPSS version 23 (IBM Corp., New York, USA). The data were tabulated as means and standard deviations for numerical values and frequency percentages for categorical values. The student's t-test and the chi-square test were applied to investigate any associations among variables.

RESULTS

The average test scores before and after the implementation of the educational program were 10.75±2.65 and 17.52±2.04, respectively. The average post-test score was greater than that of the pre-test, and the difference was statistically significant (p<0.001).

CONCLUSION

The study found that after the implementation of the educational program, the knowledge and practices of nurses regarding oxygen therapy improved significantly, with the majority showing a positive attitude toward the program.

Design and validation of a new Healthcare Systems Usability Scale (HSUS) for clinical decision support systems: a mixed-methods approach

OBJECTIVE

To develop and validate a questionnaire to assess the usability of clinical decision support systems (CDSS) and to assist in the early identification of usability issues that may impact patient safety and quality of care.

DESIGN

Mixed research methods were used to develop and validate the questionnaire. The qualitative study involved scale item development, content and face validity. Pilot testing established construct validity using factor analysis and facilitated estimates for reliability and internal consistency using the Cronbach's alpha coefficient.

SETTING

Two hospitals within a single National Health Service Trust.

PARTICIPANTS

We recruited a panel of 7 experts in usability and questionnaire writing for health purposes to test content validity; 10 participants to assess face validity and 78 participants for the pilot testing. To be eligible for this last phase, participants needed to be health professionals with at least 3 months experience using the local hospital electronic patient record system.

RESULTS

Feedback from the face and content validity phases contributed to the development and improvement of scale items. The final Healthcare Systems Usability Scale (HSUS) proved quick to complete, easy to understand and was mostly worded by potential users. Exploratory analysis revealed four factors related to patient safety, task execution, alerts or recommendations accuracy, the effects of the system on workflow and ease of system use. These separate into four subscales: patient safety and decision effectiveness (seven items), workflow integration (six items), work effectiveness (five items) and user control (four items). These factors affect the quality of care and clinician's ability to make informed and timely decisions when using CDSS. The HSUS has a very good reliability with global Cronbach's alpha 0.914 and between 0.702 and 0.926 for the four subscales.

CONCLUSION

The HSUS is a valid and reliable tool for usability testing of CDSS and early identification of usability issues that may cause medical adverse events.

Doctors' and Nurses' Knowledge and Perceived Barriers Regarding Acute Oxygen Therapy in a Tertiary Care Hospital in Nigeria

PURPOSE

Oxygen may cause serious consequences when administered wrongly. This study aimed to assess doctors' and nurses' knowledge of acute oxygen therapy and perceived delivery barriers.

PARTICIPANTS AND METHODS

We conducted a cross sectional study among 202 healthcare providers (134 doctors and 68 nurses) in a Nigerian hospital. The validated Acute Oxygen Therapy Questionnaire (AOTQ), which consisted of 21 knowledge assessment questions, was self administered by participants. Provider's knowledge was classified as good if the score was≥80% and poor if < 60%.

RESULTS

Overall, 26.7% (37.3% doctors and 5.9% nurses) had good knowledge of acute oxygen therapy (AOT), 35.9% were aware, and 19.3% used the AOT guidelines. The commonest source of knowledge on oxygen therapy was medical /nursing school (75.2%). The participants' mean knowledge score was 14.75 ± 2.83(possible score of 0-21). Doctors in postgraduate (PG) training obtained the highest score (15.96±2.48) among the participants (F=12.45, df=4, p<0.001). Most doctors (62%) and 23.5% of nurses considered oxygen as a drug. More doctors (52.2%) than nurses (14.7%) believed that a doctor's order was mandatory before oxygen administration, contrary to guidelines recommendations. Most nurses did not know that breathlessness does not always signify hypoxemia and that asymptomatic anemia was not an indication for oxygen. Concerning oxygen prescription, 39.7% of nurses and 64.2% of doctors knew that it should be prescribed to achieve a target saturation range rather than a fixed dose. In acute oxygen delivery in COPD, doctors and nurses exhibited poor knowledge of the appropriate device and flow rate. The reported barriers to oxygen delivery were: a shortage of oxygen supply, inadequate delivery devices, power outages and out of pocket costs.

CONCLUSION

A significant proportion of doctors and nurses had poor knowledge of acute oxygen therapy, poor awareness and infrequently used AOT guidelines, and reported pertinent delivery barriers that warrant educational and administrative interventions.