The Effect of Applying Care Bundle on Nurses’ Knowledge, Attitude, and Practice for Children Symptomatic COVID-19 under Hemodialysis

Background: COVID-19 presents challenges for the management of children with chronic kidney disease and acute kidney injury requiring dialysis. Hemodialysis nurses play a pivotal role in the management of infection control at hemodialysis units. Aim: Evaluate the effect of applying the care bundle on nurses’ knowledge, attitude, and practice for children symptomatic of COVID-19 under hemodialysis. Research design: A quasi-experimental (pre/post-test) design was utilized. Setting: This study was applied at the Pediatric Unit of Hemodialysis, Benha University Hospital. Tools of data collection: Tool (I): A Structured Interview Questionnaire: consists of part (1): characteristics of the studied nurses and part (2): Nurses’ Knowledge Assessment regarding hemodialysis, COVID-19, and infection control measures. Tool II: Nurses' attitude toward children with Covid-19. Tool III: An Observational Checklist Sheet, adopted from the Center for Diseases Control and Prevention and the International Society of Nephrology to assess the nurses’ performance regarding the care of children due to hemodialysis, and Tool (IV) for Child medical assessment. Results: The majority (88.6% & 71.4%) of studied nurses had a satisfactory level of knowledge at post and follow-up phases as compared to pre-implementing the care bundle, as well as most of them (92% & 80%) had a competent level of practice at post and follow-up phases. Regarding nurses’ attitude, many of them (85% & 70%) show a positive level of attitude at post and follow-up implementation of the care bundle as compared to pre-implementation phase. Conclusion: Applying the bundle of care effectively improved the studied nurses’ knowledge, attitude, and practice regarding the care of children symptomatic with COVID-19 under hemodialysis at the post and follow-up phases compared to pre-phase. Recommendation: Continuous in-service training regarding applying bundle of care on nurses’ knowledge, attitude, and practice for children symptomatic with COVID-19 under hemodialysis with periodic follow-up is urgently needed.