Application of Richmond agitation sedation scale among nurses in critical care units at Aga kkhan University hospital, Nairobi, Kenya.

Abstract

The Richmond Agitation Sedation Scale (RASS) is a useful tool used in CCU settings to determine the level of alertness or agitation. If properly applied, the tool can reduce common mortalities and morbidities as well as improve patient comfort. However, its application and determinants of its application are not well studied by previous researchers. The study sought to assess the application of the tool among the critical care unit nurses at Aga Khan University Hospital, Nairobi. A sample of 92 nurses was drawn from the target population of 106 nurses through stratified proportionate random sampling to minimize errors of precision that can occur while conducting the study without observing proper representation. Data was obtained from the participants through a checklist and self-administered questionnaires. However, a pretest involving 9 nurses at Intensive care unit of Aga Khan University Hospital which is equated to mean 10% of 92 nurses taken as the sample size was utilized to evaluate the validity and reliability of the tool to be utilized. Data coding and entry was done via SPSS version 25 which helped in the analysis and interpretation of the data. On data presentation, tables, graphs, pie charts, and histograms were utilized. The outcome was then disseminated to Mount Kenya University, presented in seminars and conferences and published in a journal made to contribute to the pool of knowledge on this field. Results were utilized to inform decisions on its application at AKUH with involvement of policy makers. The response rate was 97% and as for socio-demographic characteristics, majorities (51.7%) were aged 31-40years. The mean RASS application score was 85.6% and a standard deviation of 16. Majority (71.9%) had high RASS application level. The findings revealed that, none of the institutional factors influenced RASS application. This necessitates follow-up of nurses through support supervision and regular audits, to oversee the application of RASS. The level of application of RASS was found to be high at AKUH. This was justified by the high application mean score (85.6%) and the high application level by majority (71.6%) of the respondents. The study recommended that; the nurses in conjunction with AKUH administration should strive to increase the number of nurses attending critical care courses. Attendance of these refresher courses actually translates to better RASS application and as such, they need to be taken a bit more resolute. The institution should put in place policy and RASS guidelines.