Study Area, design and period
A survey was conducted from January 1 to 30, 2018 in Felege Hiwot tertiary referral hospital found in Bahir Dar city. Bahir Dar is a capital city in the Amhara region in the Northwest of Ethiopia about 578 km from Addis Ababa and is one of the leading tourist destinations in Ethiopia, nearby Lake Tana and Blue Nile River . In the city, there are 12 public health facilities, 10 health centres and 2 hospitals. The hospital is a tertiary hospital, serving over 7 million people as the referral centre and has around 400 beds and 9 operating tables and 750 members of staff and among those 292 are nurses. The hospital provides obstetrics, paediatrics, internal medicine, ophthalmology, ENT and surgery services .
Population and sampling
Source populations were all nurses who work in Felege Hiwot hospital. All sampled nurses of Felege Hiwot hospital who selected in a simple randomly technique will be included and nurse managers were excluded. The total number of representative sample was selected using a single population formula as follows:
Where n= minimum sample size required for the study, (Z=1.96) with confidence interval of 95% and α =0.05, P=prevalence (p=0.5), w=is a tolerable margin of error (w=0.05). Using the correction formula with a 10% nonresponse rate, 182 was the final sample size. Stratified with Simple random sampling method was used by using the sampling frame which found from the head of nurses/ matron.
Variables and measurements
The dependent variables were knowledge and practice of wound care and the independent variables included were sociodemographic factors (age, occupation, educational background, marital status and facility-related factors (working area, and training on wound care).
Good Knowledge: participants who answer more than 80% of the knowledge questions correctly.
Moderate knowledge: those study participants who answer 60-79% of the knowledge question correctly.
Poor knowledge: those study participants who answer less than 60% of the knowledge questions correctly.
Good Practice: those study participants who correctly respond to practice questions and score above 80%
Moderate practice: those study participants who correctly respond to practice questions score 60-79%.
Poor Practice: study participants who correctly respond to practice questions score below 60% . Data collection procedure and quality control
The data was collected using self-administered structured questionnaires adopted from different related kinds of literature [38-40] and modified in our context. A questionnaire was prepared in English and translated into the local language, and back to English for consistency. Two nursing staffs were collecting the data and one senior staff was recruited as supervisors and pretest was conducted in Finote Selam hospital on 5% of sample size. The data were checked daily basis for completeness and consistency.
Data processing and analysis
Data were entered and analyzed using SPSS version 23 and descriptive analysis such as percentages, frequency distribution was used. The bi-variable and multi-variable proportional odds model (POM), was fitted to assess factors associated with knowledge and practice of wound healing and care. Chi-square parallel line tests were checked (p-value = 0.46), indicating that the assumption was not violated. Model fitness using the chi-square goodness-of-fit test (p = 0.152) was checked. All variables with a p-value ≤ 0.25 in the bivariable analysis were entered into the multivariable analysis to control the confounding effect. Adjusted proportional odds ratio (POR) with a 95% CI was used to assess the association between explanatory and outcome variables. Variables with p-values < 0.05 in the multivariable analysis were considered to be statistically significant. The analysis was done by reporting of STROBE statement checklist .
Ethical clearance was obtained from Bahir Dar University, department of nursing. A formal letter was written to Bahir Dar specialized Hospital and permission was secured from the medical director. All study participants were informed that they have the right not to participate in the study or stop the interview at any time they want if that was their choice. Written consent was obtained from all participants before the interview. All information obtained in the study was stored confidential and secured.