Structures and Processes of Critical Care Nursing Practice: Insights from Four Ugandan Intensive Care Units

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Background: Global epidemiological data on structures, processes, and outcomes of intensive care units (ICUs) are scarce, yet key in understanding the global burden of critical illness across all demographics. Critical care nursing practice in Uganda faces challenges in structure and process, impacting patient outcomes. Despite increasing demand, there is limited documentation and understanding of the structures and processes of critical care nursing practice in Uganda, necessitating a comprehensive exploration. Study objectives 1. To assess the structure and processes of critical care nursing practice in Uganda. 2. To determine the correlation between the structures and processes and the quality of critical care nursing practice in Ugandan intensive care units. Methods: A cross-sectional observational study was conducted in four Ugandan ICUs. Nurses’ demographics, critical care nurse characteristics, physical and critical care structure, process flow, and perceived quality of nursing practice were collected using modified observation checklists with an interview administered portion. Results: A diverse critical care nursing workforce, with 75% of nurses being female and an average age of 35.89 years. However, there were significant disparities in education levels, with only 10% having post-graduate training. Regarding infrastructure, all ICUs followed an open model, but deficiencies in essential facilities like reception areas and laboratories were noted. Process-wise, while 94.7% acknowledged leadership and administrative factors, challenges included inconsistent adherence to critical care protocols (63.2%) and occasional lack of knowledge in patient management (94.7%). Despite these challenges, 100% of nurses reported family involvement in patient care. These findings accentuate the need for targeted interventions to address structural and process-related disparities, ultimately enhancing the quality of critical care nursing practice in Ugandan ICUs. Recommendations: To enhance critical care nursing practice in Uganda, recommendations include standardizing protocols, improving infrastructure, and providing specialized training. Addressing these issues can lead to improved patient outcomes and quality of care delivery in Ugandan ICUs.

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