Thesis:

Determinants of clinical practice guideline utilization in patient management for traumatic spinal cord injury in national spinal injury referral hospital, kenya

Spinal cord injuries have major implications for public health all around the world. An additional 9.27 million new cases were reported during a 29-year period, bringing the number of people affected by spinal injuries to 20.64 million. Additionally, there were 900,000 incident cases and 6.2 million years of total spinal injury impairment. Road traffic accidents topped the list of causes of spinal cord injuries in research conducted at Kenyatta National Hospital, followed by falls from heights, industrial accidents, and animal attacks. The prevalence of acute traumatic spinal cord injuries remains unknown in Kenya. Only the National Spinal Injury Referral Hospital provides comprehensive care for those with spinal cord injuries at the level 6 hospital. This study's goal was to assess the level of utilization of the clinical practice guideline among health care workers at the National Spinal Injury Referral Hospital, as well as the factors that are related to it. Specifically, the study was designed to assess the determinants of clinical practice guideline utilization among patients with acute traumatic spinal cord injury. The research used a cross-sectional, analytical methodology. Census sampling was used to choose a sample size of 40 healthcare professionals. All participants were selected. A semi-structured research questionnaire was provided by an interviewer to acquire quantitative data. Expert evaluation and analysis were utilized to determine validity, while Cronbach's alpha was used to assess the reliability of data collection tools. This study was given ethical approval by the Mount Kenya University Institutional Ethics Review Committee, and the research permission was issued by the National Commission for Science Technology and Innovation. The relevant county departments were contacted for further approval. The Quantitative Analysis was performed using Statistical Package for the Social Sciences version 27. The chi-square test of independence was used in a bivariate analysis to gauge the statistical significance of the association between the dependent variable and the independent variables. A p-value of less than or equal to 0.05 was used as the threshold for statistical significance. In testing for additional relationships and to account for confounders, binomial logistic regression was used on the components that were statistically significant in bivariate analysis. Text, tables, and graphs were used to convey the findings. The level of utilization of the clinical practice guideline was 22.5%. Being trained to use the clinical practice guideline (OR=25, 95% C.I: 1.06-616.022) increased the level of utilization of the clinical practice guideline. The study concluded that the level of utilization was low (22.5%) and further concluded that training on clinical practice guidelines influenced its utilization by the health care providers. This study conceived the need for clinical practice guideline training programs, the development of guideline implementation tools, and feedback mechanisms for clinical practice guideline performance assessment.