dc.contributor.author | Kemboi-ngotie, Teckla | |
dc.date.accessioned | 2016-05-23T06:32:19Z | |
dc.date.available | 2016-05-23T06:32:19Z | |
dc.date.issued | 2009 | |
dc.identifier.uri | http://hdl.handle.net/11295/95870 | |
dc.description.abstract | Research based practice in nursing and midwifery is regarded as a means of ensuring that
quality care is provided by integrating individual clinical expertise with the best available
external clinical evidence from systematic research. There is an increasing pressure on
healthcare professionals to ensure that their practice is based on evidence from good
quality research. Becoming abreast with the current evidence based information is not
enough if the information is not translated into clinical practices. This study was to
establish the midwives’ level of evidence based information and how much of it is being
applied into the clinical practice.
Evidence based episiotomy practice by the midwives in Pumwani Maternity hospital
(PMH) was evaluated using cross-sectional qualitative and quantitative descriptive
statistical methods. The study population consisted of fifty eight midwives working in the
labour ward; only thirty five appropriately completed questionnaires were analyzed. The
focus group discussion and the key informants gave their in-depth views and information
during the interview on the study subject. Purposive sampling was used to select the
midwives who met the inclusion criteria. Data cleaning was done by ensuring the
completeness and consistency of responses in the study tools. Quantitative data analyzed
using content analysis and processed according to themes using Statistical Package for
the Social Sciences version 16. Quantitative data analysis was done by using inferential
and descriptive statistics. Correlation coefficient and CHI square was employed to bring
out the relationships among variables.
The study sample included 45 midwives which revealed that 46% of the midwives
obtained the evidence based practice information on episiotomy through continuing
education and personal efforts. The midwives perform an assessment on the patient
before giving an episiotomy and different criteria influence their decision to perform an
episiotomy. The most prevalent type of episiotomy preferred by the midwives was
medio-lateral (86%) unlike the mid-line. These criteria are not exclusively evidence
based. The proportions of midwives based their practices on the following criteria: very
tight perineum (17%), breech presentation (13%), premature labour (12%), FGM (10%),
instrumental delivery (5%), status of the foetus (9%), and (29%) others (big baby,
mothers serological status, shoulder dystocia and poor maternal efforts). Despite the
prevalence of HIV/AIDS among the patient population, episiotomy is still performed
under unavoidable circumstance. The respondents stated actual and potential barriers to
implementation of evidence based practice (EBP) of episiotomy which included lack of
specific guidelines on specific procedures, workload due to high patient population,
inadequate administration support, poor accessibility of research reports and personal
attitudes.
It is evident from the findings that a higher percentage (49%) of midwives rated their
knowledge on evidence based episiotomy practice on high level (4-5 points) but the
actual practice did not correspond to the application of the knowledge. The study
recommends an urgent need for the PMH to put in place modalities to ensure that practice
guidelines are developed, used and reviewed appropriately to ensure standardized
services especially in an institution which trains the midwifery students. | en_US |
dc.language.iso | en | en_US |
dc.publisher | University of Nairobi | en_US |
dc.rights | Attribution-NonCommercial-NoDerivs 3.0 United States | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/us/ | * |
dc.title | Evaluation of evidence based episiotomy practice by the midwives at Pumwani maternity hospital labour ward, Nairobi | en_US |
dc.type | Thesis | en_US |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |