Thursday, August 27, 2009

Preparedness of Nursing Officers of sentinel hospitals in the Western Province of Sri Lanka in response to a Possible Influenza Pandemic

Building capacity of health workers is a key element in epidemic preparedness and response. A hospital based descriptive cross sectional survey was carried out to describe the capacity of nursing officers in sentinel hospitals in the Western province of Sri Lanka in their preparedness and response to a possible pandemic influenza. A pre tested self administered questionnaire , a likert type attitudinal scale and a desk top pandemic excercise were used to describe their training status, knowledge, attitudes and competencies in relation to pandemic preparedness and response.

Though the majority (95%) had recieved training on infection control during their basic nursing training (85%), participation in training sessions on emerging and re emerging diseases(13%), emergency response (23%) and pandemic influenza (23%) was low.

The proportion of nurses with an adequate knowledge on the cause, mode of transmission, sign and symptoms of avian/pandemic influenza was very high(>85%). But the same for definition of pandemic, treatment and role of vaccines was very low(<50%).Despite a majority being trained on infection control. knowledge on standard precautions (19%) , transmission based precautions ( 0.3%) and isolation of patients (13%) were poor. Overall knowledge was significantly higher among particpants of pandemic infleunza training sessions(p<0.05)and those who had a service more than 10 years(p<0.05).

positive attitudes were recorded for being an important member of the rapid response team, extending their services in a pandemic,providing supplementary services, reducibility of the professional risk by protective measures and self ability in performing expected duty in a pandemic. Negative attitudes were highlighted for having to work in poor facilities, needing to abandon work for safety of them and family and the percieved inadequacy of training on infection control.

Overall competency of the nursing officers(27%) as well as more specific competencies such as isolation of patients (<20%), proper handling of dead bodies(<27%) and decontamination of infected materials (42%) were found to be critically poor.

the study highlighted the need for refresher in service training on infection control and more specific training such as those on emerging and re emerging infectious diseases, epidemic preparedness and response for upgrading the knowledge of nurses. Desktop and simulated excercises are recomended for enhancing the competency of nurses in emergency response to a possible pandemic influenza.These training programmes , provisions fro personal protection and improving facilities for infection control will enable eliminating elicited negative attitudes of the nursing officers to their role in a pandemic.

Key words:capacity, knowledge, attitude, competency, nursing officers, Sri Lanka

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