THE NURSES’ KNOWLEDGE ON PSYCHIATRIC PATIENT ADMISSION PROCEDURES AT THE NATIONAL TEACHING AND REFERRAL MENTAL HEALTH HOSPITAL IN KENYA

Abstract

Mental illness is a global health crisis which results in significant morbidity and is a major factor that influences the social determinants of health of individuals, families and communities. To deal with this health crisis, mentally sick patients have to be admitted in psychiatric hospitals for management. In Kenya, the Mental Health Act cap 248 (Laws of Kenya) prescribes procedures that must be followed in the admission of patients to a mental health hospital. Nurses, among other health care workers have a great role in the provision of the initial care of the mentally ill patients presenting in various outpatient departments. This calls for the nurses to be skillful when handling the mentally ill patients at the OPD, during admission. 
 Aim: The aim of this study was to determine the knowledge on admission procedures among nurses working at the National Teaching and Referral hospital. 
 Methods and material: This was a descriptive cross-sectional, with national hospital being purposively selected since it admits mentally sick patients who have been referred from different parts of the country. Systematic sampling was used to select the sample size of 132 nurses for the purposes of documenting their knowledge and attitude on admission procedures while purposive sampling was used to observe nurses for the purposes of documenting their admission practices at the outpatient department. Semi-structured questionnaires were used to document the knowledge of the nurses whereas predetermined checklist was used to document observations made at the outpatient department in relation to patient admission process. The collected data was analyzed using SPSS version 20 and presented in form of charts, tables and narratives. 
 Findings: Results of the study revealed that majority of the respondents 69% were knowledgeable regarding admission of voluntary patients to psychiatric units, although most of the respondents, 79.7% displayed knowledge deficit in relation to discharge of voluntary admission patients from psychiatric units. About 31% of the respondents lacked knowledge on the admission procedures for voluntary patients. The results also demonstrated that some of the respondents were utilizing the prescribed patient admission procedures while others were not. Various challenges to the implementation of the prescribed admission procedures were also identified by the respondents. 
 Recommendations: The study recommended that the hospital management should ensure that most of the nurses who work in the institution have specialization in psychiatric nursing. In house education on patient admission and discharge procedures should be carried out to reach the nurses who lacked knowledge in this aspect.