DEVELOPING A STRATEGIC MODEL TO ENHANCE UPTAKE AND EFFECTIVENESS OF CPD IN CLINICAL PRACTICE AMONG NURSES AND MIDWIVES IN KENYA

Abstract

The global Maternal Mortality Rate (MMR) is 223 per 100,000 live births, with hemorrhage being the leading cause of death.  In Sub-Saharan Africa, the need for nurses and midwives is increasing. Incidentally, only 3.5% of the world’s health staff are accountable for 27% of the disease burden. The depicted heavy workloads have largely contributed to poor participation in Continuous Professional Development activities among nurses and midwives. Kenyas MMR burden exceeds the global MMR, which is a great concern. However, the Nursing Council of Kenya stipulates a total of 20 CPD hours to be met annually for all nurses and midwives. The aim of the study was to develop a strategic CPD uptake model for the nurses and midwives.  This study seeks to inform the public on the gaps in the uptake and implementation of CPD, and provide recommendations to improve its effectiveness. The study used both qualitative and the quantitative techniques, and adopted a Randomized Clinical Trial design. A sample of 78 nurses and midwives was obtained from a target population of 98. Quantitative data was collected using questionnaires and completion of patograph case studies. Data was analysed using SPSS version 26, to derive descriptive statistics, while qualitative data was collected through interview schedules and observation checklists, which were analysed thematically. Pearson’s chi square tested the relationship between knowledge and CPD uptake in clinical practice(p=0.00) at 95%CI. Paired t-test compared means within the control and intervention groups(t=1.000).  Despite the provision and use of BEmONC guidelines, major gaps were observed in Active Management of Third stage of labour (17.9%)and also in completion of the patograph(mean=1.7).  Despite the efforts to maintain competence levels in clinical practice, gaps pertaining to structuring and organization still exist. Theere is therefore need for continuous training to bridge quality gaps and development of a CPD uptake model that can be adopted for use by the nurses and midwives.