Assessment of nutritional status in pediatric population is necessary to predict growth patterns and signs associated with malnutrition. However, it has become increasingly apparent that pediatric nutritional assessment is not adequately performed and therefore frequently missing out on children with severe nutritional needs. The main objective of this study was to determine the health care workers' practices regarding the nutritional assessment of sick children at the Pediatric Emergency Unit (PEU) at Kenyatta National Hospital. The study population was health care workers comprising doctors, clinical officers and the nurses working at the unit. The study was designed as an observation and descriptive study using self-administered questionnaire and observation checklist. The study results reveal almost all nurses (96.8%) attempted all the required observations for nutritional diagnosis of all the patients. Among the clinicians, majority (78.6%) didn't attempt all the observation required for all the patients. The study showed that only 29.52% of the respondents had knowledge that weight loss was a critical indicator of patient nutritional status. Merely, 12.38% of the respondent had knowledge that change of caregivers and home circumstances had impact on nutritional status of a child. Only 38.64% of the health workers had some training on assessment of nutrition status of HIV/AIDS children. The findings indicated that only 44.44% of the respondents always inquired on who feeds the child. Among the study participants only 47.73% of the respondents often gave nutritional advice to care-givers. Despite the lack of knowledge, universally 98% of the respondents agreed that nutritional assessment for pediatric emergency patients is important with only 2% dissenting. Apparently, Nutritional assessment at the pediatric unit was not optimal. Therefore, measures should be instigated to improve and facilitate efficient nutritional assessment of the children visiting the unit.
In the developing world, there is scarce documentation on the approaches used in the management of hospitalised children. This was a descriptive cross-sectional study that evaluated parental involvement and policies guiding the management of hospitalised children in Kenya. Data were collected by use of questionnaires and interview guides. The results found that slightly more than half (54.6%) of the parents were actively involved in decision-making whereas 45.6% were passively involved. Using Chi square test, the health providers' knowledge of family-centred care and the parents' level of education exhibit statistically significant associations with parental involvement in decision-making (c2=0.444, P<0.001 and c2 = 17.13, P= 0.021, respectively). The importance of children being accompanied during procedures is echoed. Policies guiding the management of hospitalised children are in existence; however, they do not stipulate how health care providers should interact with the parents. We recommend that policies spelling out the nature and extent of parental involvement in the management of their hospitalised children be developed and documented.
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