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Background. Preoperative fasting is important to reduce the risk of pulmonary aspiration during anesthesia. The influence of prolonged fasting time on glucose levels during anesthesia in children remains uncertain. Therefore, this study is aimed at assessing preoperative fasting time and its association with hypoglycemia during anesthesia in pediatric patients undergoing elective procedures at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. The research hypothesis of the study is as follows: there is a prolonged preoperative fasting time, and it influences the glucose levels during anesthesia among pediatric patients undergoing elective procedures at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods. Institutional based cross-sectional study was conducted among 258 pediatric patients who had undergone elective procedures in a tertiary care center. A systematic sampling method was used to select study participants. The data were collected through face-to-face interviews and medical record reviews. Binary logistic regression was used to identify associated factors of hypoglycemia during anesthesia among pediatric patients undergoing elective procedures. All explanatory variables with a p value of ≤0.25 from the bivariable logistic regression model were fitted into the multivariable logistic regression model to control the possible effect of confounders, and finally, the variables which had an independent association with hypoglycemia were identified based on adjusted odds ratio with 95% confidence interval, and a p value less than 0.05 was significant. Results. The mean (standard deviation) fasting hours from breast milk, solid foods, and clear fluids were 7.75 (2.89), 13.25 (3.14), and 12.31 (3.22), respectively. The majority (89.9%, 57.9%, and 100%) of participants had fasted from solid, breast milk, and clear fluids for more than 8, 6, and 4 hours, respectively. More than one-fourth (26.2%) of participants were hypoglycemic immediately after induction. Residence, order of nothing per mouth, source of patient, and duration of fasting from solid foods had a significant association with hypoglycemia during anesthesia in children. Conclusion. Children undergoing elective procedures were exposed to unnecessarily long fasting times which were associated with hypoglycemia during anesthesia.

Background Patients with mental disorders have high rates of co-existing alcohol use disorder and vice versa. Alcohol use disorder has emerged as a major challenge to intervene patients with severe mental disorders. It is under-recognized and has not been investigated well in low-income countries like Ethiopia. The aim of this study was to assess the prevalence and associate factors of alcohol use disorder among patients with severe mental disorders attending psychiatric follow-ups at the University of Gondar comprehensive specialized hospital, northwest Ethiopia. Methods A total of 384 patients with severe mental disorders selected by a systematic random sampling technique took part in the interviews for this cross-sectional study. The alcohol use disorder identification test was used to assess the problem. Univariate and multivariate binary logistic regressions were computed to examine the associated factors. An adjusted odds ratio with a 95% confidence interval (CI) was used for reporting the result. Results The prevalence of alcohol use disorder among patients with severe mental disorders was 36.2%. Of the participants, 23.5%, 8.6%, and 4.1% had hazardous, harmful alcohol drinking and alcohol dependency, respectively. In the multivariate analysis, male sex, younger age, psychotic and bipolar disorder diagnoses, having poor social support, moderate and high perceived stress, and current tobacco smoking were factors significantly associated with alcohol use disorder. Conclusion The prevalence of alcohol use disorder among patients with severe mental disorders was found to be high. Early intervention and integrating treatment services for co-existing mental disorders and alcohol use disorder is important. The special treatment, where it is offered for young male patients and those with the diagnosis of psychotic and bipolar disorders, is recommended to promote the uptake of alcohol and mental health treatment services.

Helen Lamesgin Endalew,1 Bikis Liyew,2 Tilahun Kassew,3 Gebrekidan Ewnetu Tarekegn,4 Ambaye Dejen Tilahun,2 Tesfa Sewunet Alamneh4 1Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 4Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Bikis LiyewDepartment of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, P.O.Box 196, Gondar, EthiopiaTel +251932731964Email biksliyew16@gmail.comBackground: Myocardial infarction is the fifth leading causes of disability-adjusted life years in low-income countries including Ethiopia. The aim of this study was to construct a hypothetical model to determine the factors affecting the health-related quality of life of myocardial infarction survivors at the cardiac center Ethiopia.Methods: A cross-sectional study design was employed, and 421 myocardial infarction patients were enrolled through consecutive sampling technique from the outpatient clinic at the cardiac center of Ethiopia. The World Health Organization Quality of Life-BREF-26 tool was used to assess the problem. It consists of four domains such as physical, psychological, social relationships, and environmental health domains. The structural equation modeling (SEM) analysis was employed using STATA-14 software to examine the relationship between various exogenous and endogenous or mediating variables with overall quality of life.Results: Psychological, physical, environmental health domains and sex had significant association with health-related quality of life (β=0.708, p< 0.001, β= 0.237, p=0.046, β=0.242, p=0.020, and β=0.189, p=0.017, respectively), whereas age had direct, negative association with health-related quality of life (β=− 0.007, p=0.026). Residence and level of education were not directly associated with health-related quality of life. Residence indirectly, negatively influenced health-related quality of life (β= − 0.379, p< 0.001). On the other hand, level of education indirectly, positively affects health-related quality of life (β=i0.133, p< 0.001).Conclusion: Psychological health factors had the most substantial causal effect on health-related quality of life, which was larger than the causal effects of physical and environmental health-related factors. Developing and providing comprehensive interventions are necessary to assess and manage psychological, physical, and environmental health factors and to improve the quality of life in myocardial infarction patients.Keywords: health-related quality of life, myocardial infarction, structural equation model, Ethiopia

Background Neonatal hypothermia leads to adverse clinical effects ranging from mild metabolic stress to death. Objectives To assess the magnitude of neonatal hypothermia and associated factors among neonates admitted in the neonatal intensive care unit at Northwest Amhara referral hospitals. Methods Institution based cross-sectional study, 356 sample, systematic random sampling method were used. The data were by Epi-Info 7.2 and analyzed by SPSS 22. Multivariable logistic regression were used to predictor variables using odds ratio with a confidence interval of 95% and a p-value of 0.05. Results The magnitude of Neonatal hypothermia was 61.5%. Age Conclusion The magnitude of Neonatal hypothermia was high.

Background. Needlestick and sharp injuries are a big risk to the health of nurses. Every day, nurses face the likelihood that they will injure themselves. Although many injuries will have no adverse effect, the possibility of acquiring infections like hepatitis C virus, hepatitis B virus, and human immunodeficiency virus can cause untold psychological harm. Nurses are in danger of injuries caused by needlestick and sharp instruments in hospitals. Objective. The objective of this study was to assess the magnitude and determinants of needlestick and/or sharp injuries among nurses working at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2018. Methods. An institution-based cross-sectional study was conducted among 268 nurses working at Tikur Anbessa Specialized Hospital from February to March 2018. A stratified random sampling technique was used to select the study participants. Data were collected using a self-administered questionnaire. A bivariate and multivariate logistic regression model was fitted to spot factors associated with needlestick and/or sharp injury. An adjusted odds ratio with a 95% confidence interval was computed to determine the level of significance. Result. The prevalence of needlestick and/or sharp injuries among nurses was 36.2% (95% CI 30.2%, 42.3%). Presence of contaminated needles and/or sharp materials in the working area ( AOR = 2.052 (95% CI 1.110, 3.791)), needle recapping after use ( AOR = 1.780 (95% CI 1.025, 3.091)), working in the pediatric ward ( AOR = 0.323 (95% CI 0.112, 0.930)), and being female ( AOR = 0.461 (95% CI 0.252, 0.845)) were significantly associated with needlestick and/or sharp injury at p value of ≤0.05. Conclusion and Recommendation. The proportion of needlestick and/or sharp injury was high among nurses. The safety of nurses depends directly on the degree to which nurses can identify and control the numerous occupational hazards specific to jobs. Thus, working unit specific safety precautions, a safe working environment, and appropriate needle and sharp disposal improve nurses’ safety practices and thereby decrease the injuries.

Background. Physical restraint is a common practice in the intensive care units which often result in frequent skin laceration at restraint site, limb edema, restricted circulation, and worsening of agitation that may even end in death. Despite the sensitivity of the problem, however, it is felt that there are nurses’ evidence-based practice gaps in Ethiopia. To emphasize the importance of this subject, relevant evidence is required to develop protocols and to raise evidence-based practices of health professionals. So, this study aimed to assess the knowledge, attitude, and influencing factors of nurses regarding physical restraint use in the intensive care units in northwest Ethiopia. Methods. An institution-based cross-sectional study was maintained from March to September 2019 at Amhara regional state referral hospitals, northwest Ethiopia. A total of 260 nurses in the intensive care units were invited to take part in the study by a convenience sampling technique. The Level of Knowledge, Attitudes, and Practices of Staff regarding Physical Restraints Questionnaire was used to assess the nurses’ knowledge and attitude. Linear regression analysis was employed to examine the influencing factors of knowledge and attitude. Adjusted unstandardized beta (β) coefficient with a 95% confidence interval was used to report the result of association with a p value Result. The mean scores of nurses’ knowledge and attitude regarding physical restraint use among critically ill patients were 7.81 ± 1.89 and 33.75 ± 6.50, respectively. These mean scores are above the scale midpoint nearer to the higher ranges which imply a moderate level of knowledge and a good attitude regarding physical restraint. Lower academic qualification and short (Conclusion. The nurses working in the intensive care unit had a moderate level of knowledge and a good attitude regarding physical restraint use. So, developing and providing educational and in-service training to the nurses regarding physical restraint are necessary to strengthen the quality of care for critically ill patients.

Background. In the intensive care units, patients need special consideration and monitor frequently with appropriate physical assessment skills. Nurses working in the intensive care units play a fundamental role in detecting patients at risk of deterioration through ongoing assessment and action in response to changing health status. Most of the nursing activities were poorly assessed in low-income countries including Ethiopia. Therefore, this study was aimed to assess the nurses’ practice and barriers to physical assessment among critically ill patients in Northwest Ethiopia. Methods. An institution-based multicenter cross-sectional study was conducted at Amhara regional state referral hospitals from March to September 2019. A total of 299 nurses working in the intensive care units were recruited through the convenience sampling method. A 30-item physical assessment practice and 36-item barriers to nurses’ use of the physical assessment scale inventory were used. The linear regression analysis model was fitted, and the adjusted unstandardized beta (β) coefficient with a 95% confidence interval was used. A p value < 0.05 was considered statistically significant. Results. The mean score of the nurses’ practice towards physical assessment among critically ill patients was 101.26 ± 24.99 . Greater perceived reliance on others and technology ( β = − 0.78 , 95% CI (-1.07, -0.48)), ward culture ( β = − 0.48 , 95% CI (-0.85, -0.11)), specialty area ( β = − 1.46 , 95% CI (-2.01, -0.90)), lack of nursing role model ( β = − 0.54 , 95% CI (-1.06, -0.02)), being unmarried ( β = − 6.10 , 95% CI (1.75, 10.46)), taken training ( β = 11.53 , 95% CI (6.34, 16.72)), and knowledge score ( β = 2.81 , 95% CI (2.00, 3.63)) were the factors significantly associated with the nurses’ practice score towards physical assessment. Reliance on others and technology towards physical assessment practice was the most important barrier followed by ward culture and specialty area. Conclusion. Nurses working in the intensive care units had a good practice towards physical assessment among critically ill patients. Hence, to increase the practice towards physical assessment in intensive care settings, especially for married nurses, experienced critical care nurses, and specialist professionals, practice support training, modifying ward environment, and educational support care are recommended.

Introduction. Myocardial infarction is the most frequent manifestation of coronary heart disease and one of the leading causes of death worldwide. The sudden and often profound physiological and psychological effect of the acute onset of myocardial infarction hurts the health-related quality of life. Objective. To assess health-related quality of life and associated factors among myocardial infarction patients at Cardiac Center, Ethiopia, Addis Ababa, Ethiopia, 2020. Method. Institution-based cross-sectional study was conducted from April 10 to June 25, 2020, at the Cardiac Center-Ethiopia, Addis Ababa, Ethiopia. The sample consisted of 421 myocardial infarction patients. Data were collected through an interviewer-administered structured questionnaire by using the World Health Organization Quality of Life Questionnaire. Samples were selected using a consecutive sampling technique. The linear regression analysis model was fitted using SPSS 26 and STATA 14, and the unstandardized beta (𝛽) coefficient with a 95% confidence interval was used. A p value 49.29 ± 14.83 , and the mean score for the physical domain was 47.96 ± 16.50 ; for the psychological domain, it was 50.91 ± 16.07 , and for environmental and social relationship domains, it was 48.30 ± 16.54 and 52.02 ± 24.61 , respectively. In the multiple regression analysis, increased age, living in a rural area, heart failure, and hypertension were inversely associated with overall health-related quality of life, while secondary and higher education were associated with better overall health-related quality of life. Conclusion. Patients with myocardial infarction at Cardiac Center, Ethiopia, had lower health-related quality of life. Hence, the finding of this study suggests the implementation of a cardiac rehabilitation program and comprehensive service given by healthcare providers.

Background: Physical restraint is a common clinical practice in intensive care units. Even though physical restraint is used to prevent the removal of life support tubes and risk of a patient’s falling injure; complications such as edema, laceration, and pain at the restrained site, restricted circulation, worsening of agitation or delirium that may end with death are frequently encountered. Despite the sensitivity of the problem, there are gaps in nurses’ evidence-based practice in Ethiopia. Before developing protocols and guidelines relevant evidence-based practices of nurses are required. So, this study aimed to assess the practice and influencing factors of nurses regarding physical restraint use in the intensive care units in northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted from July to August 2019 at Amhara regional state referral hospitals, Northwest Ethiopia. A total of 260 nurses in the intensive care units were invited to take part in the study by a convenience sampling technique. The Level of Knowledge, Attitudes, and Practices of Staff Regarding Physical Restraints Questionnaire was used to assess the nurses’ knowledge, attitude, and practice. Linear regression analysis was computed to examine the influencing factors of nurses' practice. An adjusted unstandardized beta (β) coefficient with a 95% confidence interval was used to report the result of association. Statistical significance was declared at p-valueResult: The mean score of the nurses’ practice regarding physical restraint use among critically ill patients was 30.94±5.44. This mean score is above the scale midpoint nearer to the higher range that implies the majority of nurses have a satisfactory practice regarding physical restraint. Less than or equal to 2 years of work experience [β= -1.34, 95% CI (-2.47, -0.21)] was significantly associated with poor nurses practice; received training regarding restraints [β= 1.49, 95% CI (0.16, 2.82)], higher level of knowledge [β=0.40, 95% CI (0.03, 0.78)] and better attitude scores [β=0.37, 95% CI (0.27, 0.47)] were associated with good nurses practice regarding physical restraint use.Conclusion: Nurses working in the intensive care units had a satisfactory practice regarding physical restraint use on critically ill patients. So developing and providing educational and in-service training to the nurses on the alternative strategies, complications, and risks of physical restraint are important to strengthening the quality of nursing care for critically ill patients.

Introduction. Nurses working in the intensive care unit play an essential role in detecting patients at risk of deterioration through ongoing assessment and action in response to changing health status. Objectives. To assess knowledge, attitude, and associated factors towards physical assessment on critically ill patients among nurses working in the intensive care unit at Amhara regional state referral hospitals, Northwest Ethiopia, 2019. The research hypothesis: there is poor physical assessment knowledge, poor physical assessment attitude, and there are factors that are likely to affect nurses’ knowledge and attitude towards physical assessment providing this care to critically ill patients at Amhara regional state referral hospitals, Northwest Ethiopia, 2019. Methods. Institution-based cross-sectional study was conducted among 299 nurses from March to September 2019. A convenience sampling method was used. Data were entered by using Epi Info 7.2.2 and analyzed by using STATA 14. The result was computed by descriptive statistics and to explore predictors of knowledge, and attitude linear regression analysis models were fitted, and the adjusted unstandardized beta (β) coefficient at 95% CI was used. A p-value β = 0.84, 95% CI (0.16, 1.52)] and taken training [β = 1.85, 95% CI (1.14, 2.56)] were factors positively associated with knowledge, whereas has taken training [β = 4.13, 95% CI (2.82, 5.44)], total years of experience [β = 0.59, 95% CI (0.25, 0.93)], and knowledge [β = 0.92, 95% CI (0.0.72, 1.12)] were factors positively associated with attitude towards physical assessment. Conclusion. Based on the result of this study, the knowledge and attitude towards physical assessment regarding critically ill patients among nurses working in intensive care units were good. Hence, training, educational support services, and awareness are recommended to encourage nurse’s knowledge and attitude towards physical assessment.

Background: Nurses working in the intensive care unit commonly use physical restraint on critically ill patients. The main reason for the restraining of patients is to prevent the dislodgement of invasive procedures/ medical equipment, reduce agitation. Patients are exposed to different complications from physical restraint like worsening of agitation and delirium, fall injury, limb edema, restricted circulation, and skin laceration at restraint site, and death as a result of nurses’ improper practice regarding restraining. Despite this impact, there was no documented study in Ethiopia in this regard. Objective: To assess practice and its influencing factors of nurses working in the Intensive Care Unit regarding physical restraint Methods: An institution-based cross-sectional study was conducted from July to August 2019 at Amhara regional state referral hospitals, Northwest Ethiopia. All (260) nurses working in the intensive care unit were invited to participate through a convenience sampling technique. Structured questionnaires which consist of socio-demographic, professional characteristics and Level of Knowledge, Attitudes and Practices of Staff Regarding Physical Restraints Questionnaire were used. Simple and multiple linear regression and beta (β) coefficient at 95% confidence interval was employed with p-value

Introduction. Pain is unpleasant sensory and emotional experience associated with actual and potential tissue damage. Inadequate pain management has been shown to affect patient outcomes by potentially increasing hospital stay and delaying recovery; thus, the management of pain has major implications for nursing. The study was aimed to identify gaps in knowledge and attitude of nurse’s level of pain management.Objective. This study aimed to assess knowledge and attitude towards pain management among nurses working at University of Gondar comprehensive specialized referral hospital, Northwest Ethiopia, 2019.Methods. Institution-based cross-sectional study was carried out during May 20–30, 2019. A stratified random sampling technique was used to select 422 nurses. Hospital departments were classified into 5 main strata having nearly the same working conditions: (1) Internal Medicine, (2) Pediatrics, (3) Surgical, (4) Outpatient Clinics, and (5) Emergency and Intensive Care Departments. The proportional allocation was taken from each stratum, and then a simple random technique was applied. Descriptive statistics like frequency, mean, median, standard deviation, and percentage were used to describe the distribution of data. Independent samplest-test was used in comparing the gender knowledge and attitude mean score of the nurses towards pain management. One-way ANOVA was also used in determining the differences between knowledge and attitude towards pain management with sociodemographic characteristics at thep=0.05level of significance.Result. A total of 411 study participants were involved in this study. More than half of the nurses, 225 (58.1%), were males; 308 (79.5%) of them were in the age category of 19–29 years. The magnitude of good knowledge towards pain management among nurses was 66.9% with a mean score of 7.14 (1.74 SD). The magnitude of favorable attitude towards pain management among nurses was 51.7% with a mean score of 49.33 (7.13 SD).Conclusion and Recommendation. This study revealed that nurses working at University of Gondar hospital had good knowledge and a lower level of attitude towards pain management than those reported in previous studies. Thus, the situation demands various educational and quality improvement initiatives that could enhance the nurse‘s knowledge and attitude in the area of pain management.