Competence of Health Care Providers on Clinical Management of Myocardial Infarction in Selected Hospitals with Intensive Care Unit Western Kenya

Abstract

Background: The capacity of healthcare providers to execute an accurate initial assessment is crucial for recognizing the urgency and  treatment needs of patients and for creating baseline data from which any changes in patient status may be monitored. In Western  Kenya, there is little evidence of studies carried out on the competence of healthcare providers in the clinical management of myocardial  infractions thus this study's main aim was to investigate the competence of healthcare providers in the clinical management of  myocardial infractions.

Material and Methods: A cross-sectional analytical study design was used. The study population comprised a total sample of 114  healthcare providers. A structured questionnaire and observation checklist were used. Participants will be picked using a systematic  sampling method for those who meet the inclusion criteria. The sample size was determined using Fisher's Method. The data collected  was compiled using SPSS software version 22. The data was analyzed through the application of descriptive statistical analysis.

Findings:  Variables that positively influenced the competency are specialization (AOR: 15.1; 95% CI: 2.6 – 87.3; p = 0.002), knowledge (AOR: 5.4; 95%  CI: 1.1 – 26.5; p = 0.04) and having a protocol in patient's file (AOR: 10.2; 95% CI: 0.9 – 112.6.5; p = 0.06), although the latter was marginally statistically significant. Healthcare provider's qualification (KRCHN) (AOR: 0.04; 95% CI: 0.008 – 0.219; p = 0.002), filling of the protocol  (AOR: 0.03; 95% CI: 0.001 – 0.585; p = 0.02) and use of high dose heparin as opposed to the use of other thrombolytic like Metalase (AOR: 0.1; 95% CI: 0.01 – 0.63; p = 0.02) were all negatively associated with healthcare providers competency.

Recommendation/Conclusion:  The study recommends the need of specialized training and knowledge advancement for health care providers on critical care nursing.  This study found marginal statistical significance between the factors that influence competence among healthcare providers on clinical  management of myocardial infraction.