الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
 |  | from | 318 |  |  |
| | | from | 318 | | |
Abstract
The new coronavirus SARS-CoV-2 has rapidly spread over the world causing the disease by WHO called COVID-19. This pandemic poses unprecedented stress on the health care system including programs performing allogeneic and autologous hematopoietic cell transplantation (HCT) and cellular therapy such as with chimeric antigen receptor (CAR T cells). The European Society for Blood and Marrow Transplantation (EBMT) has therefore developed recommendations for transplant programs and physicians caring for these patients. These guidelines were developed by experts from the Infectious Diseases Working Party (IDWP) and have been endorsed by EBMT’s scientific council and board. This work intends to provide guidelines for transplant centers, management of transplant candidates and recipients, and donor issues until the COVID-19 pandemic has passed (Ljungman, 2020).
Nursing is an integral member of the multidisciplinary team who care for the patients undergoing BMT. The pre-transplant period is intensive for delivery of preparative therapy, management of early complications, and teaching and support to the patient and family. Culmination of this period occurs on the day of the marrow transplant, and the focus of care then shifts to address a whole new group of potential problems (Ali, 2019).
Aim of the Study
The aim of this study was to assess the factors affecting nurses’ compliance with Covid-19 preventive measures during caring of patients with bone marrow transplantation.
It was achieved through the following:
1. Assess nurses’ compliance level with Covid-19 preventive measures during caring of patients with bone marrow transplantation.
2. Assess factors that influence nurses’ compliance with Covid-19 preventive measures during caring of patients with bone marrow transplantation.
Research Questions:
This study is directed to answer these questions:
• What is the nurses ’compliance level with Covid-19 preventive measures during caring of patients with bone marrow transplantation?
• What are the factors that influence nurses’ compliance with Covid-19 preventive measures during caring of patients with bone marrow transplantation?
The study was portrayed under the four main designs as the following:
I. Technical design
II. Operational design
III. Administrative design
IV. Statistical design
I- Technical Design:
The technical design was included research design, setting, subjects and tools of data collection.
• Research design:
A descriptive exploratory design was used to achieve the aim of this Study. Descriptive research is a type of quantitative research which an appropriate choice when the research aim is to identify characteristics, trends and categories. While exploratory research is a methodological approach that investigates research question that have not been studied in depth and are used when the issue is new or when the data collection process is challenging for some reason (Scribbr, 2020).
Setting
This study was conducted in BMT unites at two settings, Dar El Salam oncology center, consisting of 6 departments with different specialties distributed within hospitals and BMT unit located in the third floor, consisting of 14 beds. Naser institute hospital consisting of 8 departments with different specialty distributed within hospital and BMT unit located in the seven floor consisting of 20 beds.
Subjects:
A convenient sample of all available nurses working in BMT units at the previously mentioned setting included in this study. Total nurses were (50), 25 nurses in each selected setting.
Tools of data collection
The study included four tools:
Tool 1: Nurse self-administered questionnaire: (Appendix I)
It was consisted of the following parts:
Part 1: Nurses demographic characteristic of nurses.
It consisted of seven items such as [age, sex, social status, level of education, years of experience, specified department, and attendance of training program about covid-19 preventive measures during caring of patient with BMT.
Part 2: Nurses Knowledge assessment:
It was developed by investigator after reviewing recent and related literatures (Warner, 2021; Gugliesi, 2020; Zephir, 2019 and Jaeger, 2018) it used to assess nurses’ level of knowledge towards covid-19 preventive measures during caring of patients with BMT. (Def, Types, indication, contraindication, management& covid-19 preventive measures. It consisted of (32) M.C.Q.
Scoring system of part 2:
The correct answer was scored “1 “while the incorrect answer took” zero” with total score was (32) grades distributed as the following:
• <60% = <20 grade was considered poor knowledge.
• 60-<85%=20-<28 grades were considered average knowledge.
• ≥85% = ≥ 28 grade was considered good knowledge.
Part 3: Factors influencing nurses ’compliance:
It was developed by investigator after reviewing recent and related literatures (Mizumoto, 2020; Zhao, 2020 and Hafez, 2019). It was used to assess factors influencing nurses ’compliance with covid-19 preventive measures, it included human related factors (5) items and non-human related factors (23) items with total 28 items.
Scoring system of part 3: The items for each statement were scored 1 mark for yes/present and zero for no/ absent. Total score was 28 grades classified as the following.
• < 60% = <17 grade indicated high affecting factors.
• 60 ->85% =17 -<24 grades indicated moderate affecting factors.
• ≥85% =≥24 grade indicated low affecting factors
Tool 2: Nurses’ practice observational checklist (Appendix II)
It was adapted from Dorgahm, (2016) & modified by investigator. It was used to assess nurses practice regarding covid-19 preventive measures during caring of patients with BMT, including. Hand washing (48 steps), PPE (69 steps), caring of patients with BMT (32steps) & the care of BMT unit, apheresis room and reprocessing materials and handling pallets (20 steps) with total steps were (169).
Scoring system: the respond for each step was scored by done correctly took “one” mark while done incorrectly or not done took “zero“ with total score of 169 grades classified as the following:
• <60%=<101 grade was considered low competency level.
• 60-<85%=101-<144 grades were considered moderate competency level.
• ≥85%=≥144 grade was considered high competency level.
Tools 3: Nurses attitude Likert scale. (Appendix III)
This tool adapted from Negrinho, (2017) and modified by investigator. It used to assess nurses attitude regarding covid-19 preventive measures during caring of patients with BMT.
Scoring system
The nurses asked to respond on 5point Likert scale, ranged from 1 to 5 (strongly agree =5, agree=4, neutral=3, disagree=2, strongly disagree=1). for calculating the total score of this scale taking into consideration that strongly agree or agree as a positive attitude while strongly disagree, disagree, neutral as negative attitude. Attitude scale comprised of (24 items) with total score ranged from 24- 120 grades classified as the following:
• <85%=<102 grade was considered negative attitude.
• ≥85%=≥102 grade was considered positive attitude.
Tools 4: Nurses compliance assessment scale (Appendix IV)
This tool adapted from Quan, (2015) and modified by investigator. It used to assess nurses ’compliance with COVID-19 preventive measures during caring of patients with BMT and consisted of (33) items.
Scoring system
Compliance level was ranged from 1-5 (5 usually, 4 always, 3 often, 2 sometimes, 1 never). with total score ranged from 33-165 grades and classified as the following.
• <60%=<99 grade was considered low compliant.
• 60-<85=99-<140 grades were considered moderate compliant.
• ≥85%=≥140 grade was considered high compliant.
Results:
The present study was revealed that:
The study finding demonstrated that, 60% of studied nurses aged group 20<30 with mean 29.60±7.98. 58% of them were female.72% of them was married. As regards qualification, nursing technical institute were 52%. With 70% from urban and 46% of studied nurses had 5-10 nursing experience in BMT. Most of nurses 84% attend training course of infection control. Concerning total level of knowledge 56% of studied nurses had good level of knowledge, 74% of them had low factors affecting, 58% of them had high level of practice, 64% of the studied nurses had positive attitude, 56% of them had high level of compliance with covid-19 preventive measures during caring of patient with BMT.
There was a highly statistically significant positive correlation between score of knowledge and total score of practice, total score of attitudes, total score of factors influencing compliance and total score of compliance with COVID-19 preventive measures during caring of patient with BMT at p-value <0.001.
Conclusion:
Based on findings of the current study, it can be concluded that:
More than half of the studied nurses had good level of knowledge, good competency level of practice, positive attitude & high compliance level & less than three quarters of them reported had low factors affecting on their compliance with Covid-19 preventive measures during caring of patients with bone marrow transplantation. Additionally, there was highly statistically significant positive correlation between the studied nurses total score of knowledge, practice, attitude, factors affecting compliance and their compliance with COVID-19 preventive measures during caring of patients with BMT.