Therefore, this study aimed to assess the level of nurses' knowledge of antipsychotic medication, determine nurses' knowledge of antipsychotic health education, and determine the characteristics associated with nurses' knowledge of medication for nurses working in an inpatient psychiatric hospital in Rwanda. The results for this study suggest that nurses have average knowledge of antipsychotic medication management.
Chapter one: Introduction
- Introduction and Background to the study
- Problem statement
- Purpose of study
- Research objectives
- Research questions
- Significance of the study
- Definition of concepts
- Nurse
- Knowledge
- Antipsychotic medication
- Adverse effect
- Medication process
- Conceptual framework
- The core drug knowledge
- Knowledge on patient variables
- Conclusion
To investigate nurses' knowledge of medication management specific to antipsychotic medications and factors associated with them. This study examined nurses' knowledge of the different classifications and indications of antipsychotic medications.
Chapter two: Literature review
Introduction
Nurse’s pharmacological knowledge
- Nurses educational preparation to their role
- Nurses knowledge of medication management
The literature highlights that continuing education is essential to increase nurses' knowledge of medication management (Carithers, 2011:38) and emphasized the need to revise the nursing curriculum to increase basic knowledge of pharmacology (Bullock and Manias, 2002:13). Medication administration is a core nursing role and requires knowledge of medications and the process (Lexshimi et al., 2009:18).
Antipsychotic medication
- Antipsychotic classification
- Mechanism of action of antipsychotic medications
- Antipsychotics adverse effects
- Dopamine system adverse effects
- Non dopamine adverse effects
- Syndrome malignant of antipsychotics
- Contraindications, precautions
- Antipsychotic medication and pregnancy
- Antipsychotic medication in elderly people
- Antipsychotic medication in children
- Interactions
The new generation of antipsychotics has been linked to diabetes in people treated with antipsychotics. According to Fritz (2006:8), children can suffer for a long time from certain side effects (weight gain, diabetes) of antipsychotic drugs even in adulthood.
Nursing role in medication management
- Nursing assessment
- Medication administration
- Treatment monitoring
- Clinical effectiveness monitoring
- Adverse effect monitoring
- Patient and Family Education
- Medication adherence
It is reported that nurses were reluctant to ask the patient about medication when dispensing medication to protect patient confidentiality (Duxbury et al. The nurses' underestimation of problems associated with adverse effects will lead to exacerbating risks and therefore patient hinders adherence. Patients should be taught to manage their symptoms and adverse effects and this will help them feel more responsible and reduce worries and anxiety (Lan et al. It is advised to include a support person in the medication planning close if necessary to improve patient compliance (Davies et al.
Conclusion
The role that mental health nurses and other clinicians play in promoting patient adherence to medication is indisputable. According to Drymalskin and Campbell (2009:12), the motivational interviews are essential instruments for nurses to help patients to be compliant with medication. According to Rummel-Kluge et al, in order to achieve patient compliance, nurses must rationalize the antipsychotic drug treatments, provide telephone support, use psychosocial interventions and promote a supportive environment.
Chapter three: Research methodology
Introduction
Research paradigm and approach
Research design
Research setting
At Ndera Hospital, psychiatric nurses are allowed to prescribe medication in outpatient service for the main hospital and for inpatient and outpatient for Icyizere psychotherapeutic center and CARAES Butare branches (Iyamuremye, 2011).
Population
Sample and sampling
Data collection instrument
Some statements were modified to fit this study and the Likert scale (strongly agree, agree, neutral, disagree, strongly disagree) was used to assess nurses' knowledge.
Validity and reliability
Test reliability was therefore conducted according to section B7, measuring understanding (27 items) was reliable (Cronbach's alpha 0.77), section B8 (10 items) measuring knowledge about names of antipsychotic drugs (Cronbach's alpha 0.67), section C10 ( 14 items) measuring . The translated version was reviewed by mental health experts at the Kigali Health Institute to ensure that the translated instrument had the correct meaning.
Pilot study
Data collection procedure
The participant was examined individually and the questionnaire was delivered to each participant by hand by the researcher who assisted them and returned to the researcher by placing it in a box located in the office of the unit manager. A cover letter was included with detailed information about the study and consent, as well as clear and concise instructions for completing the questionnaire (Appendix 3, 4). In order to increase the number of participants and include all categories of nurses, as the hospital planning required all nurses to be available within 5 working days, the researcher collected data for one week and saw nurses who were not available during the night shift. in five days.
Data analysis
Ethical considerations
Informed consent was obtained from participants after the purpose of the study was explained (see Appendices 5, 6). The researcher provided information both on a sheet and verbally to participants to ensure their right to additional information about the study. To ensure scientific fairness, the researcher acknowledged the ideas or works of others used in this study.
Dissemination of the findings
The participants participated in the study voluntarily and had the right to withdraw from the study without prejudice; all information will remain confidential and will be kept in a locked cabinet by the researcher and then destroyed after five years of analysis and report of the findings.
Conclusion
Introduction
Demographic characteristics of the sample
- Gender and age
- Respondents nursing experience and experience in psychiatric setting
- Qualification of respondents
- Training in psychopharmacology
For the purpose of this study, respondents were asked to indicate their experience in categories of years, and most participants are young in the nursing profession (n have not had more than 5 years of experience. There is one (1.4%) respondent who has more than 20 years as a nurse and has worked at Ndera hospital for more than 20 years, which can be explained by the fact that the majority of participants have undergone studies at higher education institutions.
Participants’ knowledge on antipsychotic medication
- Participants’ knowledge on therapeutic effects of antipsychotic medication
- Knowledge of antipsychotic medication name
- Knowledge on adverse effects of antipsychotic medications
To determine the level of knowledge regarding the therapeutic effects of antipsychotic medication, 27 questions were asked. The level of knowledge on the various therapeutic effects of antipsychotic medication was slightly different between respondents with very high knowledge (n and medium knowledge (n=8, 11%) of respondents with low levels of knowledge. In this section, participants were asked to identify which adverse effect of antipsychotic medication is caused by old or new generation antipsychotics or whether it is caused by both.
Knowledge on the benchmarked monitoring practice of patient taking antipsychotic medication
- Knowledge of monitoring of patient compliance to antipsychotic medication
- Knowledge of patient and family education practices
The question related to monitoring patients' adherence to antipsychotic medications consisted of 14 items that were considered important nursing practices to promote adherence. To determine participants' knowledge of patient and family education, 12 item questions were asked. The majority of participants were very well informed (n followed by well informed participants (n=19, 26%) and 9 (12.3%) participants with a low level of knowledge.
The overall score knowledge on antipsychotic medication
Association between nurses’ demographic variables, their score and level of knowledge
- Association of respondents’ gender and their overall score knowledge on antipsychotic
- Association of age of respondents and their score knowledge on antipsychotic medication
- Association of years of experience as a nurse and participants score knowledge
- Association of years of experience at the actual hospital and their score knowledge
- Association of participants ‘qualification and their score knowledge
- Association of participants training and their score of knowledge
The chi-square test of independence also revealed no significance between knowledge level (low, medium and high) and age groups of the respondents (p=.792). The statistical test (Chi-square) was conducted to determine the relationship between their level of knowledge and their qualifications was found to be significant by illustrated as highlighted in Table 4.7. The chi-square test was performed to determine the relationship between nurses' knowledge level and education and no statistical significance was found (p=0.427).
Conclusion
Introduction
Demographic Information
The results also show that the majority (63%) have several years of experience (0-5 years) in the Ndera Neuropsychiatric Hospital. In this study, the number of nurses with an advanced diploma in mental health (61.1%) was higher than other qualifications. This is not surprising as Ndera Neuro-Psychiatric Hospital is a unique psychiatric hospital in the country, housing most of the mental health specialists.
Nurses knowledge on antipsychotic medication
- Nurses knowledge on therapeutic effects of antipsychotic medications
- Nurses knowledge on antipsychotic medication name
- Knowledge on antipsychotic adverse effects
In this study, nurses were asked to identify the adverse effects that pertain to each group or that are shared by both. The lack of knowledge in the differentiation of adverse effects of classic and new generation antipsychotic drugs can be associated with the fact that at the Ndera Neuro-psychiatric hospital they have a limited number of new antipsychotics, as shown in their 2011 annual report where they reported only have Risperdal in their stock (Hopital Neuro-Psychiatric Caraes Ndera, 2011:31). Additionally, the studies by King Manias and Bullock indicated that nurses' knowledge of pharmacological theories is essential for monitoring adverse effects and identifying patients.
Knowledge on antipsychotic medication’ health education
- Nurses knowledge on monitoring patients’ compliance
- Knowledge on patient and family education practices
Adewuya et al found that Nigerian patients were treated with old generation drugs due to lack of alternative treatment. Also in a study by (Happell et al, the importance of the relationship between medication supervision and the patient's lifestyle was not perceived by nurses working in hospital services. It is emphasized that the clinical effectiveness of antipsychotic medication can only be observed if patients continue to take medication (Davies et al.
Overall knowledge on antipsychotic medication management
Although nurses are knowledgeable about patient and family education, the researcher is not confident that this theoretical knowledge will translate into practice. It was found that nurses working with inpatients found their environment particularly demanding, as they did not have time to devote to patient and family education, even though they were aware of its importance (Happell et al., Ellenbecker et al., and the study does not ignore that the lowest score in the study was 0% and 12.3% (n=9) of participants had poor knowledge.
Association of respondents’ demographic variables and their knowledge
This may be due to the fact that the participant was new to Ndera Neuro-Psychiatric Hospital as the master's degree qualification did not appear in the annual report for the year 2010 (Ndera Neuro-Psychiatric Hospital, 2011:57) and the mental health nursing. may not be the specialty of this participant. This may be due to the fact that there is no difference in medication management job description with their highly qualified counterparts. According to the annual report, Ndera Hospital organizes continuous education for its employees via workshops, peer training and in-service training (Hopital Neuro-Psychiatric Caraes Ndera, 2011).
Limitation of the study
The findings of this study show no association between training and knowledge about antipsychotics. Therefore, participants may not be inclined to disclose their mental state, and the results may be based on guesswork. The actual literature used in this study emphasizes familiarity with antipsychotics in the elderly; medication administration and errors.
Recommendations
Nurses' knowledge of psychopharmacology is an important issue in both hospital settings and the overall health system. In terms of clinical practice, nurses are in a better position to ensure medication management and patient safety. A qualitative study is recommended to analyze and understand the deep specific factors influencing nurses' knowledge of antipsychotics.
Conclusion
Study Title: Exploring Nurses' Knowledge of Antipsychotic Management in Inpatient Psychiatric Settings in Rwanda. Titre d’étude: Exploring nurses’ knowledge of antipsychotic drug treatment in inpatient psychiatric settings in Rwanda. I am currently carrying out a research project entitled: Exploring Nurses' Knowledge of Antipsychotic Use at Ndera Neuropsychiatric Hospital, Rwanda.
Study title: Exploration of nurses' knowledge of antipsychotic medication treatment in inpatient psychiatric settings in Rwanda. The title of the research is "Exploring nurses' knowledge of antipsychotic medication treatment in inpatient psychiatric settings in Rwanda".
