African Journal of Nursing and Midwifery

African Journal of Nursing and Midwifery | Vol. 14, No. 9, September 2026 | pp. 189–197

DOI: 10.46882/2026/AJNM/000153

Original Research Article

Title: Evaluation of Pressure Injury Prevention Compliance and Resource Access in Orthopedic Wards

Names of Authors: Faith C. Chepngetich¹, Fatoumatta B. Jallow²

Authors’ Affiliations:
¹School of Nursing Sciences, University of Nairobi, Nairobi, Kenya
²National Malaria Control Programme, Ministry of Health, Banjul, The Gambia

Abstract:
Immobilized orthopedic inpatients face elevated risks for pressure injury development, requiring disciplined preventative nursing tracking and structural support devices. This study evaluated nurse compliance rates with standard pressure injury prevention (PIP) guidelines and mapped material resource availability inside public hospital orthopedic units. A facility-based cross-sectional design utilized independent clinical audits across 130 orthopedic beds and surveyed 90 practicing staff nurses. The results showed an overall PIP compliance rate of 43.8%. While skin assessments on admission were common (81.1%), executing the two-hourly turning schedule occurred in only 32.2% of audited files. Severe structural shortfalls were widespread, with 74.4% of nurses reporting an absolute absence of high-specification pressure-redistributing mattresses, and 61.1% citing chronic understaffing as an absolute barrier to safe body turning maneuvers. Logistic regression confirmed that units holding a baseline supply of specialized turning sheets and clear skin safety protocols achieved significantly lower hospital-acquired injury rates (AOR = 2.81, 95% CI: 1.42–5.58, p = 0.003). Elevating patient safety indices requires solving acute ward staffing levels and expanding access to specialized positioning resources.

Keywords: Pressure Injury; Orthopedic Nursing; Turning Schedules; Patient Safety; Resource Allocation; Compliance.

Manuscript Timeline: Received July 08, 2026; Revised August 25, 2026; Accepted September 11, 2026; Published September 23, 2026.

Citation: Chepngetich, F. C., & Jallow, F. B. (2026). Evaluation of Pressure Injury Prevention Compliance and Resource Access in Orthopedic Wards. African Journal of Nursing and Midwifery, 14(9), 189–197. DOI: 10.46882/2026/AJNM/000153

African Journal of Nursing and Midwifery | Vol. 14, No. 9, September 2026 | pp. 179–188

DOI: 10.46882/2026/AJNM/000152

Original Research Article

Title: Assessment of Pain Management Competencies Among Critical Care Nurses in Pediatric Wards

Names of Authors: Selamawit G. Mengistu¹, John M. Ndwiga²

Authors’ Affiliations:
¹School of Allied Health Sciences, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
²Neonatal Intensive Care Unit, Kenyatta National Hospital, Nairobi, Kenya

Abstract:
Accurate pediatric pain relief remains a major challenge in intensive care environments due to communication limits and unstandardized medication practices among bedside personnel. This multi-site cross-sectional study investigated pediatric pain assessment knowledge, therapeutic behaviors, and structural barriers among critical care nurses. A sample of 145 pediatric ICU nurses completed the Pediatric Pain Knowledge and Attitudes Questionnaire (PPKAQ), backed by observational audits of pain charting behaviors. The mean correct score on the PPKAQ was 54.8% (SD = ±6.1). Critical knowledge deficits were noted regarding opioid calculation rules and distinguishing infant withdrawal signs from active pain cues. Observational indicators showed that valid pediatric scaling choices (such as the FLACC scale) were regularly deployed in only 36.6% of monitored shift assessments. Prominent structural barriers identified included an absolute lack of clinical autonomy for nurses to adjust analgesic dose boundaries (78.2%) and inconsistent medical provider orders. Advanced specialty certifications significantly predicted superior clinical pain tracking scores (p < 0.005). Developing expert pediatric ICU workflows requires updating advanced nurse pain training and creating collaborative clinical autonomy paths.

Keywords: Pediatric Pain; Critical Care Nursing; FLACC Scale; Analgesic Management; Clinical Competence; Intensive Care.

Manuscript Timeline: Received July 05, 2026; Revised August 22, 2026; Accepted September 08, 2026; Published September 21, 2026.

Citation: Mengistu, G. S., & Ndwiga, J. M. (2026). Assessment of Pain Management Competencies Among Critical Care Nurses in Pediatric Wards. African Journal of Nursing and Midwifery, 14(9), 179–188. DOI: 10.46882/2026/AJNM/000152

African Journal of Nursing and Midwifery | Vol. 14, No. 9, September 2026 | pp. 170–178

DOI: 10.46882/2026/AJNM/000151

Original Research Article

Title: Knowledge and Attitude of Medical Wards Nurses Regarding Inpatient Fall Prevention Frameworks

Names of Authors: Grace M. Malfoya¹, Yonas T. Abreha²

Authors’ Affiliations:
¹Kamuzu College of Nursing, University of Malawi, Lilongwe, Malawi
²Department of Nursing, Addis Ababa University, Addis Ababa, Ethiopia

Abstract:
Accidental inpatient falls increase hospitalization intervals and trigger preventable clinical injuries, requiring consistent risk monitoring from ward staff. This descriptive cross-sectional study evaluated the clinical knowledge base, professional attitudes, and implementation limits regarding inpatient fall prevention models among nurses inside adult medical wards. A sample of 160 staff nurses across three large metropolitan facilities filled out a pre-validated fall prevention questionnaire index. The descriptive analysis indicated that while 85.0% of the nurses understood basic intrinsic fall hazards (e.g., patient disorientation or pharmacological side effects), only 42.5% performed systematic fall risk scaling assessments (such as the Morse Fall Scale) during admission windows. Missing low-height beds and inadequate physical assistance handles were highlighted by 73.8% of the cohort as structural barriers. Nurses working understaffed evening shifts expressed a significantly higher perceived risk of patient fall events due to surveillance gaps (p = 0.012). While overall professional attitudes toward fall prevention were highly supportive (89.4%), structural shortfalls and unstandardized screening models weaken care safety. Systematic use of validation scales and corrected nighttime staffing ratios are required.

Keywords: Fall Prevention; Inpatient Safety; Morse Fall Scale; Medical Wards; Nursing Assessment; Clinical Surveillance.

Manuscript Timeline: Received July 02, 2026; Revised August 20, 2026; Accepted September 05, 2026; Published September 18, 2026.

Citation: Malfoya, G. M., & Abreha, Y. T. (2026). Knowledge and Attitude of Medical Wards Nurses Regarding Inpatient Fall Prevention Frameworks. African Journal of Nursing and Midwifery, 14(9), 170–178. DOI: 10.46882/2026/AJNM/000151

African Journal of Nursing and Midwifery | Vol. 14, No. 9, September 2026 | pp. 161–169

DOI: 10.46882/2026/AJNM/000150

Original Research Article

Title: Competency and Barriers to Neonatal Resuscitation Among Midwives in Low-Resource Public Facilities

Names of Authors: Abena S. Boateng¹, Kwame O. Mensah²

Authors’ Affiliations:
¹Directorate of Nursing, Komfo Anokye Teaching Hospital, Kumasi, Ghana
²Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

Abstract:
Birth asphyxia is a primary contributor to early newborn deaths, requiring swift and highly skilled resuscitation maneuvers from delivering clinicians. This study evaluated theoretical knowledge and practical resuscitation competencies among midwives working within low-resource public maternity units. A descriptive quantitative design surveyed 135 midwives across eight regional centers using a 25-item standardized knowledge tool and a validated objective checklist during hands-on neonatal simulation models. The mean score for theoretical knowledge was high at 81.2% (SD = ±5.4). However, only 39.3% of the observed midwives achieved full practical competency marks during simulated asphyxia events. The most frequent clinical errors involved incorrect ventilation pressure applications and delayed heat maintenance steps. Major barriers to performance included missing functional suction devices (64.4%) and neonatal bag-valve-mask sets (52.6%) in the delivery suites. Midwives who engaged in simulation exercises within the prior half-year achieved significantly superior score profiles (p = 0.008). The study concludes that equipment deficits and low simulation practice create dangerous operational gaps. Securing essential infant resuscitation devices and mandating frequent low-dose high-frequency practical reviews are vital.

Keywords: Neonatal Resuscitation; Midwifery Competency; Birth Asphyxia; Low-Resource Care; Equipment Shortages; Simulation Performance.

Manuscript Timeline: Received June 28, 2026; Revised August 18, 2026; Accepted September 03, 2026; Published September 16, 2026.

Citation: Boateng, A. S., & Mensah, K. O. (2026). Competency and Barriers to Neonatal Resuscitation Among Midwives in Low-Resource Public Facilities. African Journal of Nursing and Midwifery, 14(9), 161–169. DOI: 10.46882/2026/AJNM/000150

African Journal of Nursing and Midwifery | Vol. 14, No. 9, September 2026 | pp. 152–160

DOI: 10.46882/2026/AJNM/000149

Original Research Article

Title: Occupational Chemical Exposure and Safety Adherence Rates Among Perioperative Nursing Staff

Names of Authors: Pieter J. van der Merwe¹, Sibongile M. Ndlovu²

Authors’ Affiliations:
¹Occupational Health Unit, Steve Biko Academic Hospital, Pretoria, South Africa
²Department of Nursing Science, University of Pretoria, Pretoria, South Africa

Abstract:
Chronic operating room exposure to chemical sterilants, surgical smoke, and anesthetic gases poses subtle but serious toxic hazards to theater nursing human resources. This study quantified safety adherence rates and investigated clinical symptoms linked to occupational chemical exposure among perioperative nurses. A cross-sectional survey evaluated 140 perioperative nurses across four major urban operating complexes using an occupational toxicity checklist and compliance index. The findings showed that while personal protective equipment (PPE) for fluid splashes was consistently used (88.6%), compliance with specialized respirator rules during laser or electrocautery procedures was low at 32.1%. Chronic respiratory irritation symptoms (coughing, wheezing) were reported by 45.0% of respondents, and 51.4% complained of recurrent headaches post-shift. Logistic regression models indicated that inadequate local exhaust ventilation infrastructure (OR = 3.14, 95% CI: 1.62–6.08, p = 0.002) and missing institutional chemical handling training (p = 0.007) significantly elevated risk scores. Theatre spaces require mandatory smoke evacuation systems, simplified toxic monitoring programs, and strict administrative oversight to secure workplace health metrics.

Keywords: Perioperative Nursing; Operating Room Safety; Surgical Smoke; Chemical Sterilants; Ventilation Systems; Occupational Health.

Manuscript Timeline: Received June 25, 2026; Revised August 16, 2026; Accepted September 01, 2026; Published September 14, 2026.

Citation: van der Merwe, P. J., & Ndlovu, S. M. (2026). Occupational Chemical Exposure and Safety Adherence Rates Among Perioperative Nursing Staff. African Journal of Nursing and Midwifery, 14(9), 152–160. DOI: 10.46882/2026/AJNM/000149

African Journal of Nursing and Midwifery | Vol. 14, No. 9, September 2026 | pp. 143–151

DOI: 10.46882/2026/AJNM/000148

Original Research Article

Title: Socio-Cultural Predictors of Home Deliveries Among Women in Perinatal Care Catchment Areas

Names of Authors: Zuhura J. Masanja¹, Erick K. Kiprop²

Authors’ Affiliations:
¹School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
²Department of Nursing Education, Moi University, Eldoret, Kenya

Abstract:
Persistent reliance on unsupervised home childbirth within rural settings contributes substantially to neonatal injuries and maternal complications. This cross-sectional community-based study investigated the socio-cultural and operational predictors of home deliveries among women residing inside active health center catchment zones. A cluster sampling strategy was utilized to enroll 220 mothers who had delivered within the previous 12 months across ten traditional communities. Multivariable logistic regression analysis isolated independent risk indicators. The data showed that 38.6% of the participants chose home delivery over facility care. Key predictive models revealed that high traditional grandmother decision-making authority in the household (AOR = 2.84, 95% CI: 1.48–5.42, p = 0.002) and perceived lack of spiritual respect by clinic midwives (AOR = 2.15, 95% CI: 1.12–4.11, p = 0.014) significantly increased the likelihood of a home birth. Physical distance exceeding 5.0 km from the nearest facility further escalated home delivery choices (p = 0.005). Expanding institutional birth utilization requires re-engineering midwifery delivery models to incorporate traditional birthing choices safely, alongside building local prenatal education campaigns centered on family grandmothers.

Keywords: Home Births; Maternal Health; Traditional Practices; Healthcare Access; Midwifery Outreach; Rural Communities.

Manuscript Timeline: Received June 22, 2026; Revised August 14, 2026; Accepted August 30, 2026; Published September 11, 2026.

Citation: Masanja, Z. J., & Kiprop, E. K. (2026). Socio-Cultural Predictors of Home Deliveries Among Women in Perinatal Care Catchment Areas. African Journal of Nursing and Midwifery, 14(9), 143–151. DOI: 10.46882/2026/AJNM/000148