الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 129 |  |  |
| | | from | 129 | | |
Abstract
Initial antenatal visit is a critical opportunity for maternity nurses to deliver care and support as well as give information to the pregnant women in the first trimester of pregnancy. It is paramount for ensuring optimal health outcomes for women and children. A competent maternity nurse can influence women’s continued use of antenatal care services and can affect pregnancy outcome. If the nurse lacks knowledge and does not compliance with initial antenatal visit guidelines, this could cause pregnant women to avoid antenatal care services, resulting in an increased number of maternal morbidity and mortality.
The study aimed to:
Assess maternity nurses’ compliance level with initial antenatal visit guidelines.
To fulfill the study aim:
The study was conducted at antenatal clinics affiliated to five hospitalsthat are randomly selected one from each health agencies in Alexandria.
Subjects: the study was included (100) nurses who are working at the antenatal clinics affiliated to the previously mentioned hospitals.
Tools used in this study: two tools were used for data collection:
Tool (I): Nurses’ knowledge about initial antenatal visit Questionnaire: this tool was developed by the researcher and it entailed the following 2 parts: Part one: socio- demographic data such as: age, level of nursing education, position, years of experience, attended training programs.
Part two: nurses’ knowledge about initial antenatal visit that contain 13 items such as importance of antenatal care, signs and symptoms of pregnancy, antenatal visit schedule, component of initial antenatal visit, nursing management and health teaching during initial antenatal care visit.
Tool (II): maternity nurses’ compliance with initial antenatal visit observational checklist: this tool was developed by the researcher based on the ministry of health guideline in Egypt for initial antenatal visit. It contains 20 items divided into 7 constructs. The tools were tested for content validity by five juries who were expert in the field. A pilot study was carried out on ten nurses who excluded from sample.
The main findings of the present study were:
Socio- demographic data:
Seventy percent of the studied nurses aged 40 years or more. While (22%) of them aged thirty years or more. More than three quarters of them (76%) are married.
More than three quarters of them (79%) are diploma graduates. While (14%) of them have technical nursing certificate. Only (7%) have Bachelor of nursing education.
Two fifths of the subjects’ years of nursing experience (40%) work for twenty to thirty years while approximately less than one- thirds (31%) of them work for an equal or more than thirty years. More than one- fifths (22%) of them work for ten to twenty years.
In maternity nursing: less than one-thirds (30%) of nurses work either for less than ten years or twenty to thirty years. While approximately more than one- quarters (26%) work for ten to twenty years and only (14%) of them work for an equal or more than thirty.
Nurses’ knowledge about initial antenatal care visit:
Nearly, more than one half (55%) of the studied nurses had fairly answers compared to (44%) of them who had good answers.
More than half of the study subjects answered correct but incomplete answers for the schedule of antenatal visits.
Less than two thirds of them who did not know the time of pregnant attend of the first antenatal visit.
The majority of the subjects answered incorrect answers for the number of pregnant visits.
Maternity nurses’ compliance with initial antenatal visit:
More than one half (55%) of the subjects’ preparation for room was incompletely done while (67%) of the subjects’ preparation for equipment was incompletely done. Regarding to the preparation of the mother, it was incompletely done by more than three quarters (76%). Meanwhile, (85%) of the subjects’ preparation for themselves was incompletely done.
Complete history was taken incompletely (45%) of the subjects.
Physical assessment: (93%) of the subjects did not observe posture, gait and physical characteristics. While (87%) of the subjects did not measure weight and height. Also, the vital signs were measured incompletely by more than two fifths (43%). All of them did not examine neck (100%) and breast examination respectively. As well as, the examination of the legs was not done by (96%) of the subjects.
Local abdominal examination: All nurses (100%) did not perform inspection and palpation to the abdomen. Regarding to auscultation about (87%) of them did not do it.
Laboratory investigations: most of the subjects (91%) performed urine analysis correct and complete. Most of them (95%) performed blood analysis correct and complete.
Determination of high risk pregnancy: less than three quarters (72%) of the subjects did not provide information about high risk pregnancy.
Health teaching during initial antenatal care visit: more than half of the subjects (53%) did not provide information about the warning signs. All the studied nurses (100%) provided health teaching about follow up and its importance. More than two thirds (69%) provided health teaching completely according to the pregnant woman’s needs.
Less than three quarters (70%) of the studied nurses were fairly compliant with initial antenatal visit in ANC clinics compared to (27%) of them who had poor in their compliance and only (3%) of them had good compliance.
There is a positive significant correlation between knowledge of maternity nurses about the initial antenatal visit and their compliance (0.002*).
Recommendations
Based on the findings of the present study, the following recommendations are suggested:
The nursing curriculum should be revised and updated to include guidelines about initial antenatal visit.
The Ministry of Health should provide nurses with hand out guidelines to improve the health of pregnant women and their fetal health.
The periodic participation of nurses in training programs about ANC should be provided in order to improve their knowledge and skills as well as to ensure their compliance with guidelines for initial antenatal visit.
The ANC guidelines for nurses based on hospitals protocol should be provided.
Regular supervision of nurses in the antenatal clinics should be reinforced to ensure that they compliance with initial antenatal guidelines.