Knowledge, Attitude & Practice
Laparoscopic Surgery, Patient Preparation, Equipment & Instruments
A survey of Perioperative Nurses across Kenyan health facilities
Presented BY BEATRICE KHANDEGAH & NJERI GAITHO KNH
20
Nurses surveyed
96%
Avg. knowledge accuracy
75%
Cite inadequate training
BACKGROUND
Why Laparoscopic Competence Matters
Minimally invasive surgery is expanding across Kenyan hospitals, but it places new demands on the perioperative nursing workforce who prepare patients, manage equipment, and safeguard sterility.
Rising adoption
More facilities are introducing laparoscopic services, from national referral centres to county hospitals.
Specialized skillset
Nurses must manage CO2 insufflation, camera/light systems, trocars and strict sterility protocols.
Safety-critical role
Equipment checks, patient positioning and surgical counts directly affect complication rates.
Gap in evidence
Limited local data exists on how well-prepared Kenyan perioperative nurses feel for this shift.
THE FOCUS
This study examines what perioperative nurses know, how they feel, and what they actually do — across three domains:
Knowledge — core laparoscopic concepts
Attitude — confidence & training readiness
Practice — equipment & safety routines
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METHODOLOGY
Study Objectives & Methodology
1
Objective
Assess knowledge, attitude and practice on laparoscopic procedures, patient preparation, and equipment among perioperative nurses in Kenya.
2
Design
Cross-sectional, self-administered structured questionnaire covering demographics, knowledge checks, Likert attitude items, and practice frequency.
3
Sample
20 perioperative nurses responded, drawn predominantly from a National Referral Hospital, alongside county, private and faith-based facilities.
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Analysis
Descriptive statistics — proportions of correct knowledge responses, attitude agreement levels, and practice frequency — summarized by theme.
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RESPONDENT PROFILE
Who Took Part: Age & Experience
95%
of respondents were female (19 of 20) — reflecting the gender composition typical of Kenya's perioperative nursing workforce.
60%
of respondents have over 10 years of nursing experience, indicating a seasoned workforce engaging with newer MIS technology.
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RESPONDENT PROFILE
Qualifications & Workplace Setting
Sample skews toward higher-level training (45% hold a Higher Diploma in Perioperative Nursing) and toward a single National Referral Hospital (80% of respondents) — findings should be read as most representative of tertiary-facility practice.
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KNOWLEDGE
Core Laparoscopic Knowledge is Strong
Average correct-response rate across 8 core knowledge items: 96%
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KNOWLEDGE
Where Knowledge Gaps Remain
Two areas show measurable, if small, gaps in full understanding.
Recognizing Complications
Only 60% (12/20) identified that organ injury, gas embolism AND hemorrhage are all common complications — 40% named just one risk.
Sterility & Lighting Awareness
90%
Sterility maintenance
chose proper sterilization & aseptic handling; 10% cited alternative (less rigorous) methods.
90%
Lighting failure
correctly linked poor lighting to loss of visualization; 10% underestimated the risk.
Both gaps are small (10% each) but reinforce the case for refresher training on complication management and troubleshooting.
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ATTITUDE
A Strongly Positive Attitude Toward MIS
Share of nurses selecting “Agree” or “Strongly agree” on each statement (n=20).
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ATTITUDE
Motivation Is High — Institutional Support Lags
Personal drive to grow
95%
are willing to attend training or refresher courses
95%
agree training improves patient safety
90%
feel confident assisting in laparoscopic surgery
Where support is uneven
80%
agree their institution provides adequate support — 20% disagree or are neutral
75%
agree handling equipment requires specialized skills — the lowest agreement score recorded
The gap between enthusiasm and perceived institutional backing is the clearest attitudinal signal in the data.
9
PRACTICE
Safety Routines Are Well Embedded
Share of nurses reporting they “Always” perform each safety step (n=20).
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PRACTICE
The Weak Link: Equipment Follow-Up
Two related practices lag well behind the strong routines on the previous slide.
65%
Document equipment problems
Only 13 of 20 nurses always document problems; 4 sometimes, and 2 rarely or never do.
70%
Report equipment malfunction immediately
14 of 20 always report faults right away; the remaining 6 do so inconsistently.
75%
Verify camera & light source function
Slightly lower than other pre-op checks — 1 respondent reported only doing this “sometimes”.
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BARRIERS
What Holds Practice Back
Multi-select: challenges affecting laparoscopic practice at respondents' hospitals (n=20).
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IN THEIR WORDS
Training Needs Nurses Voiced
Open-ended responses on additional training desired, grouped by theme.
1
Broader MIS exposure
Requests spanned VATS, thoracic and robotic surgery, and “all specialities” — nurses want depth beyond general laparoscopy.
2
Equipment handling
Several asked specifically for training on operating, cleaning and handling new laparoscopic machines.
3
Camera & positioning skills
Practical, hands-on requests — e.g. how to position and hold the camera during surgery.
4
Emergency management
Interest in managing laparoscopic emergencies and complicated cases, not just routine procedures.
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SUMMARY
Key Findings at a Glance
96%
average knowledge accuracy across core laparoscopic concepts
95%
willing to attend refresher training — strong appetite to upskill
100%
always ensure instrument sterility and post-op decontamination
65%
consistently document equipment problems — the weakest practice
75%
cite inadequate training as a barrier to practice
80%
feel their institution provides adequate support
14
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Conclusion & Recommendations
Kenyan perioperative nurses show strong knowledge and a highly positive attitude toward laparoscopic surgery — the gap lies in institutional support, equipment reliability, and follow-through on reporting.
1
Expand structured training
Prioritize refresher courses and exposure to broader MIS techniques (VATS, robotic, emergency management).
2
Invest in equipment reliability
Address equipment breakdown and shortages — cited by 70% and 60% of respondents respectively.
3
Strengthen reporting culture
Reinforce protocols for documenting and immediately escalating equipment malfunctions.
4
Formalize institutional support
Close the gap between staff motivation (95% training-willing) and perceived institutional backing (80%).
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