Ousman Adal

Background: Rapid interpretation of electrocardiography (ECGs) is essential for reducing patient mortality and morbidity associated with heart conditions. Despite its significance, many healthcare providers struggle to achieve proficiency in ECG interpretation. Objective: This study assessed nurses’ knowledge, practices, and associated factors regarding ECG interpretation in the emergency and intensive care units of selected public hospitals in Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted to evaluate nurses’ knowledge, practices, and factors related to ECG interpretation in selected public hospitals of emergency and intensive care units in Addis Ababa, Ethiopia. Data were collected using structured, self-administered questionnaires and analyzed using SPSS version 26. Binary logistic regression models were employed to identify associations between the dependent and independent variables. Results: Among 255 of the study participants, only 60 (23.5%) and 69 (27.1%) of them demonstrated good knowledge and practice in ECG strip interpretation, respectively. The most frequently recognized ECG strip was asystole. Factors associated with good knowledge and practice encompassed holding a master’s degree, receiving ECG training, and working in intensive care units. Conclusion: This study identified the lack of knowledge and practice among nurses in ECG interpretation. The findings highlight the need for training programs and experience-sharing initiatives to enhance nurses’ proficiency in ECG interpretation which might ultimately improve patient outcomes.

Background: Infections following orthopedic procedures, such as implant insertion, are common and pose significant burdens globally. Comprehensive evidence of its prevalence and the influencing factors is crucial for developing effective infection prevention strategies across regions. Objective: To assess the prevalence of infection and associated factors after Surgical Implant Generation Network nailing in African countries with the Surgical Implant Generation Network program. Method: A comprehensive search was performed across multiple databases, including PubMed, Global Index Medicus, Scopus, Embase, Science Direct, Hinari, and African Journals Online, complemented by a search of Google Scholar. After data extraction, the data were exported to STATA 17 statistical software for analysis. The pooled prevalence of infection was estimated using a random effects model. The level of heterogeneity was assessed using the I ² test, while publication bias was evaluated through a funnel plot and Egger’s and Begg’s tests. Results: This meta-analysis included 23 full-text studies involving a total of 4266 patients treated with Surgical Implant Generation Network intramedullary nailing for long bone fractures. The pooled prevalence of infection was 5.69% (95% CI: 4.55%–6.83%), with a moderate level of heterogeneity ( I ² = 57.86%, p < 0.001). The review also identified significant predictors of infection, including open fracture type, complex fracture patterns, surgery performed within 15 days of injury, the presence of a prophylactic drain, female gender, and procedures conducted by junior surgeons. Conclusion: This meta-analysis revealed a relatively high infection prevalence in patients who underwent Surgical Implant Generation Network nailing for fractures. Infection risk was significantly higher in cases involving open or complex fractures, early surgical intervention, use of prophylactic drains, female patients, and procedures conducted by less-experienced surgeons. To mitigate this burden, clinical efforts should focus on optimizing the timing of surgery, avoiding unnecessary drain placement, strengthening supervision for junior surgeons, and prioritizing enhanced intraoperative and postoperative care for high-risk fracture types.

Evidence-based practice use refers to the integration of current, reliable, and relevant evidence into healthcare decision-making. This includes findings from studies, professional experiences, and updated guidelines aimed at minimizing biases and enhancing clinical decisions based on comprehensive research. This study aimed to evaluate the use of evidence-based practices and identify associated factors among nurses working in the emergency departments of selected public hospitals in Addis Ababa, Ethiopia, in 2024. This institution-based cross-sectional study assessed evidence-based practice use among emergency department nurses. A lottery method of simple random sampling was used to select 233 participants from 542 nurses registered in the nurse manager office. Only 233 nurses were invited to participate in the study, and only 225 responded, resulting in a non-response rate of 3.4% (equivalent to 8 nurses). Data were collected using a self-administered questionnaire that was adapted and modified, comprising six sections with 59 items. Binary logistic regression was used to explore the associations between dependent and independent variables. Variables with a P value of less than 0.05 were deemed significantly associated with the utilization of evidence-based practices. Among the 225 nurses who participated in the study, 101 nurses (44.9%, 95% CI: 39.0-52.0%) demonstrated good use of evidence-based practice. The analysis revealed several factors associated with the use of evidence-based practice. Female nurses had an adjusted odds ratio (AOR) of 1.4 (95% CI: 1.201-3.923) for evidence-based practice use compared with male nurses. Nurses with a Master's degree (AOR = 6.786, 95% CI: 1.141-40.352) and coordinator nurses (AOR = 13.191, 95% CI: 1.843-94.414) were also more likely to utilize evidence-based practices than staff nurses. Additionally, nurses with good knowledge of evidence-based practices had an AOR of 3.801 (95% CI: 1.700-8.498), and those who believed that relevant literature was unavailable had an AOR of 3.316 (95% CI: 1.334-8.246). This study identified important factors affecting the use of evidence-based practice among nurses. Female nurses, those with advanced degrees, and nurse coordinators are more likely to engage in this practice. Good knowledge of evidence-based methods enhances their utilization, whereas beliefs about limited access to relevant literature can hinder such utilization. These findings suggest that improving education and access to research resources could boost patient care outcomes. Additionally, nursing leaders and administrators can help overcome barriers by providing training, allowing time off for EBP activities, and adjusting work schedules accordingly.

Hospital-acquired infection (HAI) refers to an infection that occurs during hospitalization and typically manifests 48 h after admission. Evidence suggests that the prevalence of HAIs in Sub-Saharan Africa (SSA) is significantly higher compared to other regions. These infections remain a major concern in low-income countries, contributing to elevated morbidity and mortality rates. This study aimed to assess the burden and identify predictors of HAIs in intensive care units (ICUs) across SSA. This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed, Scopus, Embase, Web of Science, Africa Index Medicus, ScienceDirect, HINARI, and Google Scholar to identify relevant studies published in English. This systematic review encompasses 44 articles published between 2003 and 2024, with the majority (22 articles) published recently between 2020 and 2024. The actual database search was conducted between January 1, 2025, and February 1, 2025. Articles irrelevant to this study’s objectives, those without abstracts or full texts, unpublished reports, editorials, studies that did not clearly define outcomes, and studies written in languages other than English were excluded. The analysis was conducted using Stata version 17. The protocol was registered with PROSPERO under the registration number CRD 63,194,923,892. Quality assessment was performed using the Newcastle-Ottawa Scale, and data extraction followed the Joanna Briggs Institute methodology. A total of 44 primary samples were included in this meta-analysis. Using the random effect DerSimonian model, we showed that the pooled prevalence of hospital-acquired infections (HAIs) in intensive care units was 28.22% (95% CI: 23.61–32.81). Determinants of HAIs in the intensive care units included neonatal or advanced age (> 50 years), intubation, trauma, surgery, presence of comorbidities, catheterization, prolonged hospital stay, and HIV-positive status. Individuals in extreme age groups, those with chronic diseases or immunocompromised conditions, and patients with specific risk factors (e.g., catheterization, prolonged hospitalization) were more prone to HAIs. Strengthening the quality of care and implementing effective infection control measures are recommended to reduce the burden of healthcare-associated infections (HAIs) in sub-Saharan Africa.

Percutaneous coronary intervention (PCI) is a critical procedure for improving blood flow by alleviating arterial blockage. However, its availability in Ethiopia is limited because of insufficient resources, staff, and infrastructure. To evaluate the clinical characteristics and outcomes of patients who underwent percutaneous coronary intervention at Gesund Cardiac and Medical Center in Addis Ababa, Ethiopia, in 2024. This retrospective observational chart review included 224 patients who underwent percutaneous coronary intervention. Data were collected using a standardized checklist, imported into EPI information v7, and analyzed using SPSS v26. A binary logistic regression model was used to identify factors associated with percutaneous coronary intervention. The study found that most participants (n = 186, 83%) were male, with a mean age of 57.82 ± 11.5 years. Diabetes mellitus was prevalent among participants (n = 135, 60.3%), followed by hypertension (n = 127, 56.7%). A notable portion (n = 31, 13.8%) had previously undergone percutaneous coronary intervention. Most patients presented with typical chest pain, with ST-Elevation Myocardial Infarction (STEMI) being the primary indication for percutaneous coronary intervention. Post-procedure complications includes significant bleeding (n = 6, 2.6%), myocardial infarction (n = 20, 8.9%), death (n = 2, 0.9%), transfer to another hospital (n = 12, 5.4%), and acute kidney injury (n = 16, 7.14%). The use of bare metal stents was significantly associated with transfer to other hospitals (AOR = 5; 95% CI = 1.69-10.29). Male gender (AOR = 0.09; 95% CI = 0.03-0.34) and a history of myocardial infarction (AOR = 10; 95% CI = 2.31-13.31) were linked to an increased risk of post-percutaneous coronary intervention death. Our findings suggest that coronary artery stenosis (CAS) is more prevalent in older individuals and men. Chronic illnesses often coexist with coronary artery stenosis, thereby complicating the prognosis. Interestingly, men exhibited a lower risk of unfavorable outcomes compared to women. Adherence to procedural guidelines and effective management techniques are essential for improving patient outcomes following percutaneous coronary intervention.

Length of stay in the emergency department is used as a quality indicator to gauge the overall efficiency of emergency care. The performance measure was used to evaluate the quality of care provided in the emergency department. To assess the length of stay and associated factors among pediatric patients admitted to the pediatric emergency unit of Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia. An institution-based prospective cross-sectional study design was employed. A systematic random sampling technique was used to select the study participants. Data were collected via semi-structured, interviewer-administered questionnaires and chart reviews. Analysis was performed via the Statistical Package for Social Science software version 27. Binary logistic regression analysis was conducted to identify variables associated with the length of stay. The study was conducted in the Pediatric Emergency Unit of Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, from March 15 to April 15, 2023. A total of 268 patients participated in the study, with a response rate of 97.81%. The majority of the participants were male (157, 58.6%), with a median age of 3 years. The study revealed that 180 participants (67.2%) experienced a prolonged length of stay. The variables significantly associated with prolonged length of stay included residency (AOR = 2.04, CI: 1.03, 4.025), triage category (AOR = 3.25, CI: 1.08, 5.974), number of investigations (AOR = 2.381, CI: 1.038, 5.462), and waiting for imaging (AOR = 4.230, CI: 1.638, 10.93). Many pediatric patients stayed in the emergency room for more than 24 h because of factors such as residency, triage category, number of investigations, and the need for imaging. To address this, we recommend streamlining triage processes, increasing imaging resources, providing additional staff training, developing integrated care pathways, and advocating for policy changes to increase emergency room efficiency and improve patient outcomes.