ASSESSMENT OF KNOWLEDGE, ATTITUDE, PRACTICE AND ASSOCIATED FACTORS TO WARDS FLUID BALANCE MONITORING AMONG NURSES WORKING IN ADULT ICU OF ADDIS ABABA BURN EMERGENCY AND TRUAMA HOSPITAL AND ST.PAUL HOSPITAL MILLENNIUM MEDICAL COLLEGE.
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Abstract
Background: Fluid Balance is net result of intake and output of fluid to provide metabolic processes
to function correctly. In Intensive care unit the patient needs special consideration for Fluid balance
monitoring. Fluid balance monitoring is very vital component in intensive care unit for management
and good patient prognosis. Recent studies show negative fluid balance and positive fluid balance
adversely affects patient morbidity, mortality and patient length of stay in hospitals.
Even if there is some related researches but still little is known regarding fluid balance monitoring.
Objectives: To assess knowledge, attitude and practice of nurses working in ICU towards fluid
balance monitoring and associated factors in SPHMMC and AaBET hospitals, Addis Ababa, Ethiopia .
Methods: institutional based cross-sectional study was conducted from August 1 to 30|2025 in
SPHMMC and AaBET hospitals in Addis Ababa. Well-structured questionnaire for socio
Demographic characteristics, knowledge, attitude and practice was adopted from literatures with little
modification. The data was analyzed by using Stata version17 Software. Finally the result was
computed and interpreted through use of descriptive statistics. Association between variables was
analyzed by using logistic regression at p- value <0.2 and <0.05 considering as significant respectively.
Results: Among the participants, more than half of the nurses (52.3%) demonstrated good knowledge,
25.6% had moderate knowledge, and 22.1% had poor knowledge. Attitudes were moderately positive,
with a mean unified attitude score of 3.08 (±0.46). Self-reported practice was generally high (mean
3.83 ± 0.99), though gaps were noted in monitoring catheterized patients. Knowledge scores and
unified attitude scores were significant predictors of practice (β = 0.275, p = 0.005; β = 0.689, p =
0.006, respectively). Male sex was a significant predictor of good knowledge (OR = 5.84; 95% CI:
1.62–21.06; p = 0.007). Major barriers to practice included lack of time, inadequate staffing, and
unavailability of recording sheets.
Conclusion and recommendation: Despite adequate knowledge and positive attitudes, fluid balance
monitoring practices among ICU nurses were inadequate. Increased workload, insufficient training,
and limited resources contributed to poor practice. Strengthening continuous training, improving
staffing levels, ensuring availability of monitoring tools, and enhancing supportive supervision are
essential to improving fluid balance monitoring in ICUs.
Key words: knowledge, practice, fluid balance, monitoring, attitude, input/output.