Marwa Nyakanda P, Tarimo Edith A M
1Muhimbili National Hospital, P O Box 65000, Dar es Salaam, Tanzania.
2Muhimbili University of Health and Allied Sciences, School of Nursing, P.O Box 65004, Dar es Salaam, Tanzania.
BMC Nurs. 2019 Mar 12;18:8. doi: 10.1186/s12912-019-0335-1. eCollection 2019.
Burn injury is a significant problem in low and middle-income countries. Moreover, across regions children are more affected by burn injury than adults. The outcome of burn injury is greatly influenced by the quality of care patients receive. This care includes meeting nutritional needs, availability of resources such as dressing supplies, and skills among health care providers. This study describes factors that influence provision of nursing care to the hospitalized pediatric patients with burn injuries at Muhimbili National Hospital, Dar es Salaam, Tanzania.
A descriptive qualitative study was conducted among registered nurses working in the Pediatric Burn Unit. Purposeful sampling was used to recruit the participants in the study. Five in-depth interviews were done and content analysis approach was used.
The nurses in the study described how they provided nursing care to pediatric patients with burn injuries. They described the use of closed method wound dressing, as an essential skill that accelerated wound healing, decreased the risk of wound contamination, and the incidence of contractures. The nurses felt gratified when they saw patients who had sustained severe burn injury recover well and be discharged home. They appreciated the influence of teamwork in burn patients' recovery. However, the interviews revealed systematic deficiencies that hindered provision of quality care to patients with burn injuries. The flaws included: inadequate staffing resulting in increased workload among the nurses; a lack of standard skills in burn care among nurses; lack of access to water, which is the mainstay of infection prevention control, and lack of specimen collection equipment.
Findings in this study revealed both positive and negative factors which appear to influence care of burn patients. The positive factors (motivation) need to be maintained, and immediate actions should be taken to address the negative (hindering) factors. Large scale studies to quantify these results are deemed necessary, and public health measures are needed to prevent burn injuries in children.
烧伤在低收入和中等收入国家是一个重大问题。此外，在各个地区，儿童比成人更容易受到烧伤影响。烧伤的治疗结果在很大程度上受到患者所接受护理质量的影响。这种护理包括满足营养需求、敷料等资源的可获得性以及医护人员的技能。本研究描述了影响坦桑尼亚达累斯萨拉姆穆希姆比利国家医院住院烧伤儿科患者护理提供的因素。
对儿科烧伤病房工作的注册护士进行了一项描述性定性研究。采用目的抽样法招募研究参与者。进行了五次深度访谈，并采用了内容分析法。
研究中的护士描述了他们如何为烧伤儿科患者提供护理。他们描述了使用封闭式伤口敷料，这是一项加速伤口愈合、降低伤口污染风险和挛缩发生率的基本技能。当看到严重烧伤的患者恢复良好并出院回家时，护士们感到很欣慰。他们赞赏团队合作对烧伤患者康复的影响。然而，访谈揭示了阻碍为烧伤患者提供优质护理的系统性缺陷。这些缺陷包括：人员配备不足导致护士工作量增加；护士缺乏烧伤护理的标准技能；缺乏作为感染预防控制主要手段的用水，以及缺乏标本采集设备。
本研究结果揭示了似乎影响烧伤患者护理的积极和消极因素。积极因素（动力）需要保持，应立即采取行动解决消极（阻碍）因素。认为有必要进行大规模研究以量化这些结果，并且需要采取公共卫生措施预防儿童烧伤。
