Evaluation of Critical Care Nurses' Compliance with the External Ventricular Drain Care Bundle for Critically ill Patients at Kenyatta National Hospital

Abstract

ntroduction: The External Ventricular Drain (EVD) care bundle involves insertion, maintenance, troubleshooting, and monitoring for issues related to EVD, which is primarily the responsibility of nurses. Despite significant efforts to address external ventricular drain-related infections (ERIs) in CCUs and other critical care units, current studies suggest a high prevalence rate of external ventricular-related infections, particularly in LMICs and low-resource settings. Material and Method: A mixed-method study was conducted at KNH Critical Care Units with a sample of 81 nurses. Data analysis of Quantitative continuous data was summarized using medians and interquartile ranges, and Categorical data was summarized using frequencies and proportions. Qualitative data was analyzed using manual thematic analysis. Results: Most respondents were between 30 and 40 years old, 43.2%, females were 75.3%, higher diplomas were 54.3%, and 4.9% specialized in EVD care. 48.1% had good knowledge of the EVD care bundle, 46.9% had fair knowledge, and 5% had poor knowledge. Binary logistic regression and chisquare tests showed no factors associated with knowledge of the EVD care bundle (P>0.05 chi-square). A basic diploma and no specialization in EVD care were associated with higher odds of a poor or fair knowledge of the EVD care bundle. Conclusion: Most nurses exhibited fair practice of EVD care bundle but Lacked continuous medical education on EVD care, poor supervision and feedback on EVD care practice, and guidelines on EVD care not being easily accessible and understandable emerged as substantial perceived barriers to EVD care bundle utilization.