Browsing by Author "Nabulime, Josephine"

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    A qualitative study exploring nurses’ attitudes, confidence, and perceived barriers to implementing a traumatic brain injury nursing chart in Uganda
    (African journal of emergency medicine, 2018) Wynveen, Leslie; Nabulime, Josephine; Luggya, Tonny; Kalanzi, Joseph K.; Mowafi, Hani
    In Africa, traumatic brain injuries frequently result from road traffic injuries and assaults. Despite limited resources and the high costs of life-saving neurosurgical interventions, secondary brain injury prevention has the potential for improving outcomes. However, nurses and other medical personnel infrequently monitor vital signs, blood sugar, and pulse oximetry and only sporadically re-assess neurological status. In one-on-one, semi-structured interviews, 27 nurses from Mulago Hospital’s emergency centre, a tertiary care trauma hospital in Kampala, Uganda, provided feedback regarding a traumatic brain injury-focused education session and use of a nursing chart for detecting secondary brain injury. The interviews explored the nurses’ confidence and perceived barriers to long-term chart implementation and traumatic brain injury care, as well as their ideas for improving this intervention. Interviews were audio recorded, transcribed, and coded using ATLAS.ti: Qualitative Data Analysis and Research Software (Cleverbridge, Inc., Chicago, USA) and Microsoft Word and Excel (Microsoft Office, Redmond, USA) for thematic content analysis. Key findings identified in the interviews included the nurses’ attitudes toward the chart and their feelings of increased confidence in assessing and caring for these patients. The main barriers to continuous implementation included inadequate staffing and resources. Nurses were receptive to the education session and nursing chart, and felt that it increased their confidence and improved their ability to care for traumatic brain injured patients. However, lack of supplies, overwhelming numbers of patients, and inadequate staffing interfered with consistent monitoring of patients. The nurses offered various suggestions for improving traumatic brain injury care that should be further investigated. More research is needed to assess the applicability of a standardised traumatic brain injury nursing education and chart in a broader context.
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    Impact of Nursing Education and a Monitoring Tool on Outcomes in Traumatic Brain Injury
    (African journal of emergency medicine, 2020-12-27) Gamble, Miriam; Luggya, Tonny Stone; Mabweijano, Jacqueline; Nabulime, Josephine; Mowafia,Hani
    Throughout the world, traumatic brain injury (TBI) is one of the leading causes of morbidity and mortality. Low-and middle-income countries experience an especially high burden of TBI. While guidelines for TBI management exist in high income countries, little is known about the optimal management of TBI in low resource settings. Prevention of secondary injuries is feasible in these settings and has potential to improve mortality.
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    The landscape of perioperative nursing education in Africa: a scoping review
    (Frontiers in Medicine, 2024-09-13) Wong, Maddie; Nabulime, Josephine; Matunda, Nira; Nkangala, Edina; Silvers, Rebecca
    Not everyone across the globe has access to safe surgical care. There exist stark disparities in surgical mortality between high-income and low-and middle-income countries. Quality perioperative care across the surgical care continuum can mitigate these disparities. Nurses play a vital role in providing quality perioperative care and their competency in perioperative nursing directly impacts surgical outcomes. Across Africa, formal educational opportunities for nurses in perioperative care is not well understood. This is an informal scoping review of the existing literature investigating the current state of perioperative nursing education across the African continent. Ten articles were included in the analysis. Few programs exist across Africa that provide specialized training for nurses in perioperative medicine. Programs that have been formally evaluated show improved knowledge and clinical skills among nurses. Conclusion: Greater research is necessary to establish a more robust evidence base in support of increasing access to perioperative nursing education to improve patient outcomes. Obstacles remain to designing, implementing, and evaluating new educational programs.
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    Trauma unit admissions at the Ugandan National Referral Hospital: a descriptive study
    (African Health Sciences, 2022) Luggya, Tonny Stone; Ngabirano, Annet Alenyo; Sarah, Richardson; Mabweijano, Jackie; Osire, John; Achieng, Lilian; Nabulime, Josephine; Bangirana, Alex
    Injuries are a neglected epidemic globally accounting for 9% global deaths; 1.7 times that of HIV, TB and malaria combined. Trauma remains overlooked with key research and data focusing on infectious diseases yet Uganda has one of the highest rates of traumatic injury. We described demographics of patients admitted to Mulago Hospital’s Shock Trauma Unit within the Emergency Department. This was a retrospective record review Trauma Unit admissions from July 2012 to December 2015. Information collected included: age, sex, time of admission, indication for admission and mechanism of trauma. 834 patient records were reviewed. The predominant age group was 18-35 with majority of patients being male. 54% of patients presented during daytime with 46% admitted in the evening hours or overnight. Mechanism of injury was documented in 484 cases. The most common mechanism was Road Traffic Accident (67.4%), followed by assault (12.8%) and mob violence (5.6%). The most common indication for admission was traumatic brain injury (84.5%), followed by haemodynamic instability (20.0%) and blunt chest injury (6.1%).There’s a significant burden of high-acuity injury particularly among males with RTAs as the leading cause of admission associated with Traumatic Brain Injury as main admission indication.
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    Trauma unit management and outcomes at an urban tertiary hospital in sub-Saharan Africa: a descriptive study
    (African Health Sciences, 2021-12-14) Luggya, Tonny Stone; Ngabirano, Annet Alenyo; Sarah, Richardson; Achieng, Lilian; Nabulime, Josephine; Mabweijano, Jackie
    Injuries are a neglected burden despite accounting for 9% of deaths worldwide which is 1.7 times that of hiv, tb and malaria combined. Trauma remains overlooked as research and resources are focused on infectious diseases. Uganda with limited trauma epidemiological data has one of the highest traumatic injury rates. This study describes demographics, management and outcomes of patients admitted to mulago hospital trauma unit. This study was a retrospective record review from july 2012 to december 2015. A data collected included age, time and vitals of admission plus interventions, management and outcomes after which it was analyzed. 834 patient records were reviewed. The predominant age group was 18-35 and 86% of the patients were male. 54% of the patients presented during day and majority of the admission had gcs of less than 8. Antibiotics were given to 467 patients with mechanical ventilation (301) and intubation (289) as the frequent interventions done. 52% of admitted patients were discharged and 40% died. Most admissions’ were of youthful age and had severe head injuries (gcs<8). 56% received antibiotics with frequent interventions beig mechanical ventilation and intubation. 52% of admitted patients were discharged and 40% died.