ABSTRACT

Some of the issues encountered during immediate post-operative care of patients include ineffective or inappropriate post-operative care management, negligence, and a lack of focused medical supervision by nurses.

The overall goal of this study is to analyze nurses’ knowledge and practice in the Limbe and Buea regional hospital’s immediate post-operative care of patients.

The study’s objectives are to determine the percentage of nurses who are knowledgeable about post-operative care, the percentage of nurses who practice adequate and standard post-operative care, and the barriers to providing patients with adequate post-operative care.

Interviewer-administered guided questionnaire was recruited for data collection with a sample size population of 100.

The study design was cross sectional and participants were recruited in to this study using convenient and purposive sampling method. Data was imputed into Microsoft 2016, analysed using the statistical package for social sciences and presented in frequencies of graphs, tables and charts.

Results showed that majority of the respondents had a good knowledge of post-operative care (a proportion of 50.0% and 9.0% of the respondents had good and very good knowledge related to Environmental/patient Preparation).

Nurses’ practice was generally moderate with the proportion of 56.8% had a good monitoring practice, 74.0% had good respiratory care practices, 77.8% practices good position in bed and mobilization, 56.25% practices good diet, 60.8% practices good medication, and 57.0% carry out lab testing and imaging.

The study revealed that Shift rotation affects pain management, Lack of protocol, Unavailability of the drug, Language barrier, Patient inability to communicate, and the Unavailability of sufficient pain medication in the ward were the major barriers to adequate post-operative care of patients in both Limbe and Buea Regional Hospitals.

Health facilities should set up strict guidelines, policies and routine supervision for all nurses attending to post-operative patients to ensure all nurses adhere to post-operative care guidelines

Keywords: Nurses knowledge, immediate post-operative care, patients

                                                      CHAPTER ONE

                                                      INTRODUCTION

1.1 Background to the study

Postoperative care is the care a patient receives after a surgical procedure. The type of postoperative care provided depends on the type of surgery performed, as well as health history. Postoperative care includes pain management and wound care.(1)Postoperative care begins immediately after surgery.

It lasts for the duration of a patients stay in the hospital and may continue after patients have been discharged. As part of postoperative care, Nurses should educate patients about the potential side effects and complications of the procedure.

The aim of post-operative care is to ensure the patient has a quick, painless and safe recovery from surgery as possible. There are three phases of post-operative care: immediate (post-anesthetic-Phase 1), intermediate (Hospital stay-phase 2), convalescent (After discharge to full recovery). The aim of phase 1&2  is to ensure homeostasis, treatment of pain and prevention and early detection of complications

The recovery from major surgery can be divided into three phases: an immediate, or post anesthetic, and phase; The intermediate phase, encompassing the hospitalization period; and a convalescent phase.

During the first two phases, care is principally directed at maintenance of homeostasis, treatment of pain, and prevention and early detection and management of complications. The convalescent phase is a transition period from the time of hospital discharge to full recovery. The trend toward earlier postoperative discharge after major surgery has shifted the venue of this period. We often say “postop starts preop,” which essentially means that the postoperative plan should be considered and discussed before surgery to set expectations for the patient and their family. The surgeon is responsible for the operative site and all other aspects of the care not directly related to the effects of anesthesia.

Before patients have surgery, nurses need to ask their doctor what the postoperative care will involve. This will give them time to prepare beforehand. However, doctors may revise some of their instructions after surgery, based on how surgery went and how well the patient is recovering.

This postoperative care relationship has been deemed the “essence”; “crux” “core” and the “heart” of the discipline. It’s a professional and interaction form of relationship which guarantees that the patients’ needs are placed on the priority, where the nurse takes the responsibility for the establishment and the maintenance of the boundaries with the patients, irrespective of how the patients behave.

It is a helping relationship between a nurse and a patient based on mutual trust and respect, empowering of faith and hope with positive attitude and care in assisting the patient meet his/her gratification needs physically, emotional and spiritually. It is geared towards enhancing patient’s well-being.

Globally the prevalence of postoperative complications ranges from 50% to 75%

of postoperative patients. In United Kingdom, a recent study has reported that 30% of postoperative patient experienced pain post-surgery. In sub-Saharan Africa, there are variations of postoperative complication reported from one place to another. In Nigeria, it was reported that 95% of postoperative patients experienced various degrees of postoperative pain

Nurses are not the only healthcare providers who are responsible for relieving patients’ pain but they also play a key role in managing patients’ pain. This is attributed to the fact that the nurses are in a central position between the responsible doctor and their patients.

This study assess nurses’ knowledge and practices on immediate post-operative care of patients and will be carry out from March 2021 to April 2021 in Limbe Regional hospital and Buea Regional hospital which is found in the South-west region, Fako division of Cameroon.

Using nurses working in the Regional Hospital, data will be collected using self-administered questionnaire by the researcher herself with objectives to investigate the nurses’ knowledge of practice on the immediate post-operative care of patients 

1.2 Statement of Problem

The following problems were identified in this study

1. Ineffective or inappropriate post-operative care management:

Studies conducted among Jordanian nurses indicated that nurses provide inadequate pain management during post operative care. Daibes (10) found that nurses did not perform pain management for their patients. In particularly, Daibes’s findings revealed that nurses in Jordan’s hospitals provide inadequate intervention to relieve patients’ pain and did not undertake any immediate action to manage the patients’ pain(10).

1. Another problem study is Negligence and lack of focused.

Negligence from nurses in charge of post-operative care after a wound surgery can cause discomfort and make the patient to contract a disease as a result of that Comparing the study conduct in some region in sub Saharan Africa by A. K. Karani et al 2013, described some sort of negligence some nurses portray in response to the patients’ ability. It was noted that most patients stay with their family members in the ward who take care of most of their physical/non-medical needs while the nurses only handle the medical or professional part of care.

• Poor and inadequate medical management by nurses after operation.

Medical management is very important in post-operative care of patients, however, nurses practices on medical management are inadequate. This could be because they have other patients to attend to, and in the course of being fast, they tend to give inadequate medical attention to patients

1. Lack of well trained nurses on post-operative care of patients
2. Improper management of post-operative acute pain.

This can contribute to medical complications including pneumonia, deep vein thrombosis, infection and delayed healing(11)

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