Factors associated with non-compliance to wound care guidelines among nurses working at the University Teaching Hospital of Kigali, Rwanda

Factors associated with non-compliance to wound care guidelines among nurses working at the University Teaching Hospital of Kigali, Rwanda | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Factors associated with non-compliance to wound care guidelines among nurses working at the University Teaching Hospital of Kigali, Rwanda Viateur Hakorimana, Ejike Daniel Eze, Vedaste Bagweneza, Priscilla Musabirema, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6235039/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Wounds are a significant burden to the global health care since they are more common. Noncompliance to wound care guideline can cause many different effects. Aim To identify the factors associated with noncompliance to wound care guidelines among nurse working at University Teaching Hospital of Kigali. Methodology : A cross-sectional design with quantitative approach was used. The target population were 105 nurses working in the Surgical Department. The participants were recruited with convenience sampling, all eligible nurses included, resulting in a sample size of 76 nurses. Bilingual questionnaires covering demographic information and factors associated with non-compliance to wound care guidelines was used and analyzed by using the descriptive statistics through SPSS Version 23. Results Results revealed that although nurses had a general understanding of wound care guidelines, various factors affected their adherence. These factors included inadequate training, lower education levels, time constraints, workload. Organizational factors such as lack of resources, poor communication played significant roles. The study found positive correlations between knowledge and adherence to guidelines (r = 0.762, p < 0.01), between individual attributes and non-compliance (r = 0.623, p < 0.01), organizational factors and non-compliance (r = 0.609 p < 0.01,), and demographic factors and non-compliance (r = 0.584). Conclusion Addressing gaps in training, individual constraints, and organizational support are crucial for improving adherence. Wound Noncompliance Guidelines BACKGROUND A wound is a break in the continuity of the epithelium. Wounds are a significant burden to the global health care system and also have economic impact on the health care because of there are common occurrence( 1 ). The estimate of 1 to 2% of people are predicted to experience a chronic wound at their lives to the worldwide. The incidence of chronic wound in developing countries is between 2 to 6% ( 2 ). About 8.2 million peoples in the United States are affected by wounds, with an estimated annually cost of 28 to 31 billion US dollars ( 3 ). According to a study done in 2017–2018, the cost of treating acute and chronic wounds was 68% and 85%, respectively, and secondary care accounted for the remaining costs( 4 ). The National Health System(NHS) spend £8.3 billion annually on wound care ( 4 ). In Rwanda the study conducted at University teaching hospital of Kigali found that 76.8% of hospital acquired infection are related to surgical site infection which were attributed to noncompliance with wound management guidelines ( 5 ). Inappropriate use of standard or guideline for wound care can cause the delay of wound healing. The body can recover more quickly and prevent infection with proper wound care and delay in wound healing may result from a variety of intricate etiologies. Although providing high-quality wound care is a crucial component of healthcare, there is currently a lack of research and standardized procedures( 6 ). Nurses plays a critical role in wound care to facilitate wound healing and reduce patients admission days with its attended costs; This they achieve through selective wound dressing.( 7 ). Management of wound is the crucial for wound healing with minimal complications ( 8 ). Noncompliance of wound care guideline can cause the many different effects such as delay of wound healing, infections, spending more time for hospitalization and decrease economy to the patients, families, society and the county. The factors that may contribute to poor wound care and noncompliance to wound care guidelines among nurses may include: Personal factors, Health system factors and there is a dearth of information on these factors, hence this study is an attempt to fill this gap. METHODS Clinical trial number: Not applicable Study design and Approach The study used a cross-sectional design with a quantitative approach, allowing for data collection at a single point in time, over three weeks. This method was chosen for its cost-effectiveness and practicality within a limited timeframe( 9 ) Study setting The study was conducted at the University Teaching Hospital of Kigali, the largest hospital in Rwanda, which receives many patients with wounds which require adherence to wound care guidelines. The hospital is located in Nyarugenge District, Kigali City's, specifically in Nyarugenge sector, Kiyovu cell on KN 4 Avenue. With a capacity of 519 beds. The hospital provides training, clinical research, and technological support to District Hospitals, helping to deliver high-quality healthcare to the public. The Surgical Department one of hospital’s key departments offers specialized services to patient needing wound care. Target population The participant in this study were Nurses working in the surgical department at the University Teaching Hospital of Kigali. The total number of nurses is 105 including 91 females and 14 males. Inclusion criteria Registered nurses in the department who volunteered to participate, with no exclusion based on gender or experience. Exclusion criteria Nurses on maternal, annual, or sick leave were excluded Sample size The sample size was calculated according to the total number of nurses which is 105 by using the formula of Slovin. Slovin formula is n = N/(1 + Ne 2 ). Where n: number of samples, N: Total population, e: margin error of 0.05( 10 ). Sample size was n = 105/(1 + 105x0.05 2 ) = 83 Nurses. Although only 76 nurses participated in this study. Sampling strategy A convenience sampling technique with non-probability method was used to choose participants working in the surgical department at the University Teaching Hospital of Kigali. Participants who are available during the time of data collection was included. Data collection Data were collected using a self-administered questionnaire structured into four parts, covering sociodemographic information, wound care knowledge, factors influencing guideline adherence, and organizational factors. The questionnaire was translated from English to French and underwent a pilot study to ensure validity and reliability. Data collection took three weeks from 19 April 2024 to 10 May2024, with 83 questionnaires distributed and 76 returned, corresponding to 91.6% response rate. Data analysis plan. Data was analyzed using SPSS version 23, employing descriptive statistics and Pearson correlation analysis to explore factors affecting non-compliance with wound care guidelines. Ethical considerations Ethical approval was obtained from the University of Rwanda, College of Medicine and Health Science (CMHS), Institutional Revied Board (IRB) (Ref: CMHS/IRB/123/2024) and Ethics committee of the University Teaching Hospital of Kigali (Ref: EC/CHUK/032/2024), with informed consent from participants, ensuring anonymity and voluntary participation. Data management Data was securely stored, with measures against unauthorized access and measures to prevent data loss. RESULTS The findings, presented in tables, are numerical in nature. The chapter is divided into sections covering the social demographic details of the participants, nurses' understanding of wound care, individual factors influencing non-compliance with wound care guidelines, factors linked to wound care practices within healthcare organizations, and correlation analysis. Socio-demographic characteristics of participants The study involved seventy-six (76) respondents whose characteristics were examined to gain insights into the composition of the sample population. Distribution of the Participants Table 1 Distribution of characteristics of the participants SEX Frequency Percent Men 11 14.47 Women 65 85.53 Total 76 100.0 Age Frequency Percent Less than 35 years old 17 22.36 Between 35 and 45 40 52.07 Above 45 19 25.57 Total 76 100.0 Marital status Frequency Percent Single 21 27.63 Married 53 69.72 Separated 2 2.63 Total 76 100.0 Academic Qualification Frequency Percent Advanced Level Diploma A1 16 21.05 Bachelor’s degree A0 58 76.32 Masters and above 2 2.63 Total 76 100.0 Working Experience in years Frequency Percent Less than 10 years 14 18.42 More than 10 years 62 81.58 Total 76 100.0 Working Unit Frequency Percent Orthopedic Unit 13 17.16 General Surgery Unit 12 15.89 Urology and Pediatric Unit 9 11.54 Plastic and Burn Unit 13 17.16 Pre-operative and Neurosurgery Unit 15 19.75 Private Ward (Pavilion General and Ophthalmology 14 18.32 Total 76 100.0 Time (hours) Frequency Percent 8 hours 25 32.88 12 hours 51 67.12 Total 76 100.0 Number of patients per shift Frequency Percent 1–8 patients 27 35.53 8–16 patients 36 47.37 16 patents and above 13 17.10 Total 76 100.0 Source: (Field data, 2024) On the distribution of sex among nurses responded in the study. Among the 76 respondents, 11 were men, accounting for 14.47% of the total, while 65 were women, representing 85.53%. This suggests a predominance of female nurses in the sample population. For the age, among the 76 nurses surveyed, 17 were younger than 35 years old, making up 22.36% of the total. 40 were aged between 35 and 45, constituting 52.07%, while 19 nurses were over 45 years old, representing 25.57% of the total. A part from marital status. Out of the 76 respondents, 21 were single, accounting for 27.63% of the total. The majority, 53 nurses, were married, making up 69.72%, while only 2 nurses were separated, representing 2.63% of the total. Linking marital status with non-compliance to wound care guidelines, for instance, married nurses might have different responsibilities or priorities compared to single nurses, which could affect their ability to comply with wound care guidelines. Additionally, separated nurses might experience personal challenges that could impact their focus on observing to guidelines. On the working experience in nursing 14 nurses had less than 10 years of experience, representing 18.42% of the total. and the majority, 62 nurses, had more than 10 years of experience, accounting for 81.58% of the total. The distribution of working units among nurses at University Teaching Hospital of Kigali (CHUK), The Pre-operative and Neurosurgery Unit has the highest frequency at 19.75%, indicating a significant portion of nurses are likely involved in surgical preparation and neurosurgical procedures. Similarly, the Orthopedic Unit and Plastic and Burn Unit, both with frequencies of 17.16%, suggest a notable focus on orthopedic and reconstructive surgeries, as well as the management of burn injuries. These units may encounter specific wound care challenges that necessitate adherence to specialized guidelines. Conversely, units such as the General Surgery Unit (15.89%) and the Urology and Pediatric Unit (11.54%) may have comparatively lower frequencies, indicating lesser demand or specialization in these areas. Nurses working in units with higher frequencies may face unique wound care challenges and workload pressures, potentially impacting their adherence to wound care guidelines. Therefore, understanding the distribution of working units and their respective specialties can provide valuable context for examining factors contributing to non-compliance with wound care guidelines among nurses. The distribution of nurses based on the duration of their shifts at Among the 76 respondents, 25 nurses work 8-hour shifts, constituting 32.88% of the total. The majority of nurses, 51 in total, work 12-hour shifts, representing 67.12% of the total. The information on the number of patients cared for per shift by nurses. Among the 76 respondents, 35.53% reported caring for 1–8 patients per shift, 47.37% cared for 8–16 patients, and 17.10% cared for 16 patients or more per shift. Linking this data to the non-compliance to wound care guidelines among nurses, the patient load per shift could influence adherence to guidelines. When nurses have lots of patients to care for, it can be hard for them to give each patient the attention they need for wound care. They might have to rush or focus on the most urgent tasks, which could mean they don't follow all the wound care rules properly. But if nurses have fewer patients to look after, they can spend more time with each one, making it easier to stick to the guidelines for wound care. Nurse’s Knowledge related to wound care. This part outlines findings on nurse’s knowledge related to wound care. This part covers wound care essentials, including risk factors for infection, wet therapy's efficacy, wound assessment methods, and nursing practices. It highlights challenges like identifying pressure ulcers in dark-skinned individuals and emphasizes professional evaluation of wound pain. It also discusses infection signs in specific patient groups and the benefits of enzyme-based debridement and irrigation over swabbing. It touches on nurses' role in debridement and the preference for wet gauze in chronic wound management. Finally, it queries the use of the Braden scale for assessing vascular ulcer risk. Table 2 Table Nurse’s Knowledge related to wound care Variables N Mean Std. D Answers in percentage Correct Incorrect Immobility, impaired nutrition, and location of the wound are risk factors of wound infection. 76 1.960 .249 71(93.42) 5(6.58) Wet therapy is the “gold standard” for treating chronic wounds. 76 1.215 .715 16(21.05) 60(78.95) The selection of the coverage of the wound should be based on characteristics of his deathbed (moisture, drainage, or presence of devitalized tissue). 76 1.711 .453 54(71.05) 22(28.95) The pain in the wound must be evaluated by the health-care professional, not by the patient. 76 1.321 .513 24(31.58) 52(68.42) The first stage of pressure ulcers is easily identified in people of dark skin. 76 1.658 .474 50(65.78) 26(34.22) Assessment of a wound is a cumulative process that comprises observation, data collection, and evolution. 76 1.776 .417 60(78.94) 16(21.06) The classic signs of infection (pain, heat, redness, swelling, pus) may not be present in patients with chronic wounds or those who are immunosuppressed. 76 1.273 .725 21(27.64) 55(72.36) Enzymes (pepsin, collagens,) are effective in the removal of devitalized tissue of chronic wounds. 76 1.592 .491 45(59.21) 31(40.79) When taking a wound culture, the swab is dipped in wound drainage to assess infection. 76 1.513 .499 56(73.68) 20(26.32) Irrigation removes debris from wounds better than swabbing. 76 1.526 .492 40(52.64) 36(47.36) The nurses are authorized to use conservative debridement (superficial). 76 1.618 .486 47(61.42) 29(38.16) Wet gauze is more indicated for treating chronic wounds. 76 1.684 .464 51(67.11) 25(32.89) Braden scale is an instrument used to assess the risk of a patient developing a vascular ulcer? 76 1.921 .269 70(92.11) 6(7.89) Source: (Field data, 2024) In examining nurses' knowledge related to wound care, several key findings emerge from the provided table. Nurses display a good understanding of certain aspects, such as recognizing immobility, impaired nutrition, and wound location as risk factors for infection, as indicated by a mean of 1.960 and a standard deviation of 0.249, indicating consistent understanding among participants. However, there are areas where clarification may be needed. Despite being false statement that wet therapy is the gold standard for treating chronic wounds, the relatively low mean (1.215) and high standard deviation (0.715) suggest a lack of consensus or understanding among nurses regarding the use of wet therapy as the gold standard for chronic wound treatment. Nurses exhibit a good understanding of wound coverage selection criteria, with a high mean (1.711) and relatively low standard deviation (0.453), indicating consistent knowledge among participants. Regarding the pain in the wound to be evaluated by the health-care professional, not by the patient, despite being false, the moderate mean (1.321) and relatively high standard deviation (0.552) suggest some uncertainty or inconsistency among nurses regarding the role of patients in assessing wound pain. Nurses demonstrate awareness of the challenges in identifying pressure ulcers in darker skin tones, with a moderate mean (1.658) and standard deviation (0.474), indicating varying levels of understanding among participants. Nurses show a strong understanding of wound assessment as a cumulative process, with a high mean (1.776) and relatively low standard deviation (0.417), indicating consistent comprehension among participants. Despite statement being false, the moderate mean (1.273) and relatively low standard deviation (0.725) suggest some uncertainty or inconsistency among nurses regarding the complexities of infection presentation in certain patient populations. Nurses demonstrate a reasonable understanding of the use of enzymes in debridement, with a moderate mean (1.592) and standard deviation (0.491), indicating varying levels of understanding among participants. Despite the statement being false that when taking a wound culture, the swab is dipped in wound drainage to assess infection, the moderate mean (1.513) and standard deviation (0.499) suggest some uncertainty or inconsistency among nurses regarding the proper procedure for wound culture collection. Nurses show a reasonable understanding of wound cleaning methods, with a moderate mean (1.526) and standard deviation (0.492), indicating varying levels of understanding among participants. Nurses demonstrate a reasonable understanding of their scope of practice in wound care, with a moderate mean (1.618) and standard deviation (0.486), indicating varying levels of understanding among participants. Nurses understand wound dressing options reasonably well, with some differences in how well each nurse understands, shown by the moderate average score (1.684) and the standard deviation (0.464). Nurses understand the purpose of the Braden scale very well. Most nurses grasp it consistently, as shown by the high average score (1.921) and the relatively small range of scores (standard deviation of 0.269). Overall, most nurses understand important things about taking care of wounds, but there are some areas where they might need more teaching or explanation, especially when it comes to wrong information and topics that some nurses understand better than others. These topics include wet therapy as the "gold standard" for treating chronic wounds, the patient's role in evaluating wound pain, identification of pressure ulcers in people with dark skin, and the proper procedure for wound culture collection. Individual factors associated with noncompliance to wound care guidelines in practice The section explores factors influencing adherence to wound care guidelines, such as knowledge gaps, training deficiencies, workload issues, and resource limitations. It delves into the accessibility of updated guidelines in the workplace and investigates whether stress affects consistent guideline adherence. Table 3 Individual factors associated with noncompliance to wound care guidelines in practice Variables N Mean Std. D Answers in percentage YES NO Familiar with the wound care guidelines 76 1.789 .407 60(92.11) 16(7.89) Lack of knowledge 76 1.421 .493 32(42.11) 44(57.89) Inadequate training 76 1.737 .440 56(73.68) 20(26.32) Level of education 76 1.368 .482 28(36.84) 48(63.16) Lack of time 76 1.579 .493 44(57.89) 32(42.11) Higher workload 76 1.605 .488 46(57.89) 30(42.11) Lack of necessary resources 76 1.592 .491 42(60.52) 34(39.48) Lack of clear communication 76 1.597 .459 53(69.73) 23(30.27) Access to up-to-date wound care guideline 76 1.408 .491 31(40.79) 45(59.21) Experienced stress 76 1.618 .486 47(61.84) 29(31.16) Source: (Field data, 2024) Table 3.3 shows that there are several nurses’ individual factors contributing to non-compliance with wound care guidelines among nurses. The question that assessed the nurses' familiarity with wound care guidelines has scored the relatively high mean a mean of 1.789 with Std. Deviation of 0.407 suggests that most nurses are familiar with the guidelines, but there might still be some who are not completely knowledgeable. Lack of knowledge as a factor contributing to non-compliance to wound care guidelines has scored the moderate mean of 1.421with Std. Deviation of 0.493 indicating that some nurses acknowledge their own lack of knowledge regarding wound care guidelines. Inadequate training appears to be a significant factor to non-compliance to wound care guidelines as indicated by the high mean of 1.737 with Std. Deviation of 0.440 suggesting that many nurses feel they haven't received sufficient training to adhere to wound care guidelines effectively. The level of education might play a role in compliance to wound care guidelines, with a moderate mean of1.368 with Std. Deviation of 0.482 indicating that education level could influence nurses' adherence to wound care guidelines to some extent. Time constraints seem to be another significant factor to non-compliance to wound care guidelines, with a moderate mean of 1.579 with Std. Deviation of 0.493 suggesting that many nurses feel they don't have enough time to follow the guidelines as they should. A higher workload appears to contribute to non-compliance to wound care guidelines, as indicated by the high mean of 1.605 with Std. Deviation of 0.488, this suggests that nurses feel overwhelmed by their workload, making it difficult to adhere to guidelines. The availability of necessary resources is another contributing factor on compliance to wound care guidelines, with a moderate mean of 1.592 with Std. Deviation of 0.491, suggesting that some nurses feel they lack the resources needed to follow the guidelines effectively. Communication issues or misunderstandings regarding wound care guidelines seem to contribute to non-compliance, with a moderate mean of 1.597 with Std. Deviation of 0.459 indicating that this is a common concern among nurses. Access to up-to-date guidelines might be an issue for some nurses, as indicated by the moderate mean of 1.408 with Std. Deviation of 0. 491.This suggests that not all nurses have easy access to the latest guidelines, which could affect their compliance. Stress appears to be a common barrier to compliance, with a relatively high mean of 1.618 and Std. Deviation of 0.486, suggesting that many nurses have experienced stress that impacts their ability to follow guidelines consistently. Overall, the data indicates that various factors, including lack of knowledge, inadequate training, time constraints, workload, resource availability, communication issues, access to guidelines, and stress, contribute to non-compliance with wound care guidelines among nurses at Kigali University Teaching Hospital. Factors associated with wound care practice related to Health service organizational This section examines factors related to wound care practices within healthcare organizations. It covers guideline and dressing material availability, patient load, training provision, support resources, familiarity with antiseptics, hierarchy pressure, leadership support, supervision adequacy, feedback, accountability, and interdisciplinary coordination. Table 4 Factors associated with wound care practice related to Health service organizational. Variables N Mean Std. D Answers in percentage YES NO Availability of guideline 76 1.671 .470 51(67.11) 25(32.89) Availability of Dressing material 76 1.829 .377 63(82.89) 13(17.11) Patient load. 76 1.789 .407 60(78.95) 16(21.05) Sufficient training and education on wound care guidelines? 76 1.355 .478 27(35.52) 49(64.47) Satisfaction with overall support and resources provided by health care system. 76 1.763 .472 48(63.16) 28(36.84) Familiarity with antiseptics solution to wound care 76 1.803 .398 61(80.26) 15(19.74) Lack of opportunity 76 1.605 .488 37(48.68) 39(51.32) Hierarchy pressure 76 1.329 .470 25(32.89) 51 (67.11) Experience in wound care management 76 1.881 .325 67(88.16) 9(11.84) Lack of motivation in adhering to wound care guideline 76 1.381 .485 29(38.16) 47(61.84) Lack of leadership support 76 1.434 .495 32(42.11) 44(57.89) Inadequate supervision to wound care guideline 76 1.552 .497 33(43.42) 43(56.58) Regular feedback and guidance from your supervisors on wound care 76 1.380 .485 29(38.16) 47(61.84) Absence of accountability 76 1.460 .483 41(53.95) 31(46.05) Lack of interdisciplinary coordination (physician, nurses, other health care providers) 76 1.841 .364 64(84.21) 12(15.79) Source: (Field data, 2024) Table 3.4 shows that guideline availability in working unit has scored a high mean of 1.671suggests that the availability of guidelines is somewhat satisfactory, indicating potential influence on compliance. However, the Std. Deviation of 0.470 indicates some variability in responses. Dressing material availability indicates a higher mean of 1.829 and lower Std. Deviation of 0.377, it appears that the availability of dressing materials is generally better, possibly contributing to improved adherence to guidelines. Mean of 1.789 suggests a moderate patient load, which could impact adherence due to time constraints and workload pressure, as indicated by the Std. Deviation of 0.407. Training and education provision has scored the mean of 1.355 with Std. Deviation of 0.478 indicates that training and education provision are somewhat inadequate, which might lead to lower compliance rates. The standard deviation shows variability in responses. Satisfaction with support and resources has scored a higher mean of 1.763 suggests better satisfaction with support and resources, potentially positively impacting compliance. However, the wide Std. Deviation of 0.472 indicates varying perceptions among respondents. Familiarity with antiseptic solutions has scored a higher mean of 1.803 indicates good familiarity with antiseptics, which is crucial for proper wound care practices. The standard deviation of 0.398 shows some variability in responses. Opportunity to express opinions has scored the mean of 1.605 suggests moderate satisfaction with the opportunity to express opinions, with variability in responses indicated by the standard deviation of 0.488. Hierarchy pressure has scored a lower mean of 1.329 suggests lower hierarchy pressure, which could positively impact compliance and the standard deviation of 0.470 indicates variability in perceptions of hierarchy pressure. Experience in wound care management shows a higher mean of 1.881 suggests greater experience, potentially correlating with better adherence to guidelines. The standard deviation of 0.325 indicates some variability in experience levels among respondents. Lack of motivation shows the mean of 1.381 indicates a moderate level of motivation, which could influence compliance. The standard deviation of 0.485 suggests variability in motivation levels among respondents. Lack of leadership support has scored the mean of 1.434 suggests some lack of leadership support, potentially hindering compliance. The standard deviation of 0.495 indicates varying perceptions among respondents. Inadequate supervision has scored the mean of 1.552 suggests some inadequacy in supervision, which may contribute to inconsistent adherence to guidelines. The standard deviation of 0.497 indicates variability in perceptions of supervision. Feedback from supervisors has scored the mean of 1.380 suggests moderate satisfaction with feedback from supervisors, which can positively influence compliance. The standard deviation of 0.485 indicates variability in perceptions of feedback. Absence of accountability has scored the mean of 1.460 suggests some absence of accountability, which may contribute to non-compliance. The standard deviation of 0.483 indicates variability in perceptions of accountability. Interdisciplinary coordination has scored a higher mean of 1.841 indicates good interdisciplinary coordination, crucial for effective wound care management. The standard deviation of 0.364 suggests some variability in perceptions of coordination among respondents. Discussion Discussing and comparing current study at university teaching hospital of Kigali with empirical review, Among the 76 respondents, most were female (85.53%). Similar findings have been noted in literature, where gender can influence healthcare practices and adherence to guidelines. For instance( 12 ) highlighted that gender-specific factors can affect adherence to wound care guidelines, although the specific impacts were not detailed in this study. Male in nursing have opportunistic advantages when it comes to joining the advanced practice nursing workforce, but they are not motivated for the position and do not stay in the field long enough to become advanced practice nurses( 13 ). The present study indicates that nurse with more than 10 years of experience constituted the majority (81.58%). This aligns with findings from( 14 ) in Nigeria, which emphasized the correlation between experience and adherence to treatment protocols. Both studies suggest that experienced nurses might have developed certain practices that could either facilitate or hinder guideline adherence. This study found nurses with higher education levels (e.g., Bachelor's degree) were more prevalent. This show the importance placed on education in wound care management, as highlighted by Saleem ( 15 ), emphasizing that proper training and education are crucial for adherence to guidelines. The study conducted at University Teaching Hospital of Kigali (CHUK) revealed that most nurses had a Bachelor's degree (76.32%) and significant experience (81.58% with over 10 years), yet there remained a need for further training in specific wound care areas, with a mean knowledge score of 1.605. This finding aligns with research from Ethiopia, where nurses with higher education and training were significantly more knowledgeable and practiced better wound care (AOR 3.27, 95% CI 1.97–5.43; AOR 3.71, 95% CI 2.37–5.81)( 7 ). Nurses worked in various units, with the Pre-operative and Neurosurgery Unit having the highest representation (19.75%). Shift durations varied, with 67.12% of nurses working 12-hour shifts. This was confirmed to the study done by Rogers et al.,2004, The nurses worked overtime or longer shifts than twelve hours, their chances of making a mistake climbed dramatically( 16 ). Concerning patient load, 47.37% cared for 8–16 patients per shift. According to Assaye et al., (2020), providing care to many patients during a shift, which may have an effect on patient safety( 17 ). These factors, including gender, experience, unit assignment, shift duration, and patient load, could influence how well nurses follow wound care guidelines, highlighting the need to address these aspects for improved wound care practices. Factors such as time constraints, workload, and resource availability were as significant contributors to non-compliance. Similar challenges were noted in other studies, such as those in Indonesia( 14 )and in South Africa( 18 ), where inadequate resources and heavy workloads hindered adherence to wound care guidelines. While the present study highlighted moderate satisfaction with support and resources (mean of 1.763), studies in South Africa( 18 ) and the UK( 19 ) have shown varied satisfaction levels regarding support and organizational resources. These findings suggest a relatively better environment in this regard compared to other regions. In current study, perceptions of leadership support (mean of 1.434) and supervision (mean of 1.552) were moderate. Contrastingly, in studies like those in the US( 1 ), leadership support and effective supervision were critical factors influencing adherence to guidelines. The variance emphasizes potential differences in organizational cultures and management styles across different healthcare settings. The correlation between nurses' knowledge related to wound care and non-compliance (Pearson coefficient = 0.762) in the study indicates a strong association. This contrasts with findings from Nigeria ( 12 ), where the correlation was not as explicitly quantified but emphasized the need for continuous education and training to improve adherence. In south Africa studies highlighted similar issues with resource affecting compliance ( 18 ). Leadership problems at CHUK, like low motivation and insufficient supervision, were also seen in South Africa and Tanzania, underlining the need for better support to help nurses follow guidelines( 18 , 20 ). Generally, addressing these factors may improve adherence to wound care guidelines among nurses at the hospital. The mean overall score of 1.570 provides a comprehensive perspective on nurses' individual factors associated with noncompliance to wound care guidelines in practice. When analyzing individual factors such as familiarity with guidelines, lack of knowledge, inadequate training, education level, time constraints, workload, resource availability, communication issues, access to guidelines, and stress, it's apparent that these aspects collectively influence nurses' adherence to wound care protocols. The mean score serves as a quantitative representation of the degree to which each factor impacts noncompliance, offering insights into areas requiring targeted interventions or support to enhance compliance with wound care guidelines among nurses. The analysis of factors associated with wound care practice related to health service organizational reveals several key insights. The availability of guidelines and dressing materials in the working unit appears satisfactory, potentially contributing to compliance. However, inadequate training and education provision could hinder adherence. Satisfaction with support and resources is generally positive, but variability in perceptions exists. Familiarity with antiseptic solutions is 80,26% which was good, while opportunities to express opinions are moderately satisfactory. Hierarchy pressure is low, and experience in wound care management is high, possibly enhancing compliance. These findings are similar to the study done in Ethiopia where hierarchy pressure, familiarity with antiseptic were significant to the factors associated to wounds care practice( 7 ). Lack of motivation and leadership support, as well as inadequate supervision and accountability, may negatively impact adherence. This were similar also seen in South Africa and Tanzania, underlining the need for better support to help nurses follow guidelines( 21 ). However, moderate satisfaction with feedback from supervisors and good interdisciplinary coordination are observed. These findings show the importance of addressing organizational factors to improve compliance with wound care guidelines among nurses. The overall mean score of 1.605 indicates a moderate level of compliance with wound care guidelines among nurses in relation to health service organizational factors. The present study revealed a positive correlation (r = 0.584, p < 0.01) between social demographic factors such as gender, age, and non-compliance with wound care guidelines. This suggests that individual characteristics may influence adherence to wound care guidelines. A strong positive correlation (r = 0.762, p < 0.01) was found between nurses' knowledge of wound care and adherence to guidelines. This indicates that a higher level of understanding is associated with better compliance. A Significant positive correlation (r = 0.623, p < 0.01) were observed between nurse's individual attributes, attitudes, or beliefs and non-compliance with wound care guidelines. This highlights the personal aspect's role in adherence. A substantial positive correlation (r = 0.609, p < 0.01) emerged between health service organizational factors and non-compliance with wound care guidelines. This suggests that the hospital's organizational environment significantly influences adherence levels. Understanding these correlations can guide interventions aimed at improving adherence to wound care guidelines among nurses, thereby enhancing patient care outcomes at University Teaching Hospital of Kigali Limitations of the study The participant in this study may not represent the broader nurse’s population. Social and culture factors may not fully explore the influence for noncompliance to wound care in nursing. The sample size was small because it is focus on nurses working in surgical department only and it focused on single teaching hospital. The study didn't look at all possible factors that could affect adherence. To improve, future research should address these limitations to get a better understanding of how nurses follow wound care guidelines and how to help them do it better for patient care. Conclusion The study conducted at the University Teaching Hospital of Kigali (CHUK) identified multiple factors contributing to nurses' non-compliance with wound care guidelines. Despite nurses having a basic understanding of these guidelines, there were still significant gaps that require further training. Key factors affecting compliance included insufficient training, time constraints, high workload, limited resources, communication issues, and stress. Organizational aspects like the availability of guidelines and dressing materials, leadership support, supervision, accountability, and interdisciplinary collaboration also played a crucial role in adherence. The study found strong correlations between nurses' knowledge, individual attributes, organizational factors, and their adherence to wound care guidelines. The findings underscore the need for continuous education and training, along with improvements in organizational support, to enhance guideline adherence and ultimately improve patient care outcomes at CHUK. Abbreviations %: Percentage AVE: Average Variance Extracted, CHUK: Centre Hospitalier Universitaire de Kigali, CMHS: College of Medicine and Health Science, IRB: Institutional Revied Board KUTH: Kigali University Teaching Hospital, NHS: National Health Services SPSS: Statistical Package for the Social Science, Std. D: Standard Deviation, U.S: United States, UR: University of Rwanda Declarations Ethical Declarations Ethics approval and consent to participate The study adhered to the declaration of Helsinki concerning to research carried out on humans. Approval for the execution of this study was granted me the permission to conduct study. After receiving approval letter for data collection from University of Rwanda through Institutional Review Board (Reference: CMHS/IRB/123/2024) and the approval from the Research Ethics Committee at CHUK (Reference: EC/CHUK/032/2024) begin data collection. The researcher has visited interacted with the participant in their wards through their unit managers to explain the aims of the study and give the instruction on how they fill the questionnaire. Informed consent was sought by the participants and they signing on consent form given to them indicate their participation in the study. Participation in the study was voluntary. To maintain anonymity and confidentiality was respected, we assured that their names and identities would not be included in the study. the completed questionnaires kept in a secure and locked cupboard. To make sure that data was not permanently lost in the event of computer loss or technical difficulties, digital data that was extracted from the questionnaires using a computer was uploaded to Google Drive as a password-protected folder. Consent for publication Not applicable Availability of data and material The results section of this manuscript encompasses all pertinent data and we have included data set of SPSS version 23, questionnaire and ethical approval as supplementary documents to facilitate verification of the results reported here Competing interests No competing interests by the authors Fundings No fundings received on this study Author’s information Author’s and affiliation Viateur HAKORIMANA, Department of surgery, University Teaching Hospital of Kigali, Rwanda. Viateur HAKORIMANA, Ejike Daniel Eze, Vedaste BAGWENEZA, Priscille MUSABIREMA, Liberathe RUMAGIHWA, Leoncie UZIKWAMBARA, Speciose UMUTANGAMPUNDU. College of Medicine and Health Science, School of Nursing and Midwifery, University of Rwanda. Speciose UMUTANGAMPUNDU. Department of Nursing and Midwifery, University Teaching Hospital of Kigali, Rwanda Author’s contributions Ejike Daniel Eze, Vedaste BAGWENEZA, Priscille MUSABIREMA, Liberathe RUMAGIHWA Leoncie UZIKWAMBARA, Speciose UMUTANGAMPUNDU, All authors have contribution to my study. Corresponding author Viateur HAKORIMANA Acknowledgments Special thanks for my family for their support and encouragement. The Authors Dr Ejike Daniel Eze and Vedaste BAGWENEZA are thankfully for their guidance, also I thankfully Dr Priscille MUSABIREMA, Liberathe RUMAGIHWA and Leoncie UZIKWAMBARA, Speciose UMUTANGAMPUNDU for their input in this study. We are also grateful to all participants who are voluntary agreed to take part of study. References Sen CK. Human Wound and Its Burden: Updated 2020 Compendium of Estimates. Adv Wound Care. 2021 May;10(5):281–92. Järbrink K, Ni G, Sönnergren H, Schmidtchen A, Pang C, Bajpai R, et al. Prevalence and incidence of chronic wounds and related complications: a protocol for a systematic review. Syst Rev [Internet]. 2016 [cited 2024 Jan 13];5(1). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5017042/ Cilliers MGCG, Nair A, Pressentin KB von, Coetzee F, Saeed H. A ‘game of dressings’: Strategies for wound management in primary health care. South Afr Fam Pract [Internet]. 2022 Feb 28 [cited 2023 May 1];64(1). Available from: https://www.ajol.info/index.php/safp/article/view/235484 Maheshwari G, Gupta S, Tripathi S, Sagar S, kisaka tomohika. Chronic wounds -Magnitude, Socioeconomic Burden and Consequences. 2021 Mar 15; Mukagendaneza MJ, Munyaneza E, Muhawenayo E, Nyirasebura D, Abahuje E, Nyirigira J, et al. Incidence, root causes, and outcomes of surgical site infections in a tertiary care hospital in Rwanda: a prospective observational cohort study. Patient Saf Surg. 2019 Feb 18;13(1):10. Ward J, Holden J, Grob M, Soldin M. Management of wounds in the community: five principles. Br J Community Nurs. 2019 Jun 1;24(Sup6):S20–3. Tegegne B, Yimam F, Yalew ZM, Wuhib M, Mekonnen L, Yitayew YA, et al. Knowledge and Practice of Wound Care and Associated Factors among Nurses Working in South Wollo Zone Government Hospitals, Ethiopia. Chronic Wound Care Manag Res. 2022 Jul 20;9:1–11. Bondi ME, Rahim SSSA, Avoi R, Hayati F, Ahmedy F, Omar A, et al. Knowledge, Attitude and Practice on Diabetic Wound Care Management among Healthcare Professionals and Impact from A Short Course Training in Sabah, Borneo. Medeni Med J. 2020;35(3):188–94. Aggarwal R, Ranganathan P. Study designs: Part 2 – Descriptive studies. Perspect Clin Res. 2019;10(1):34–6. Abimana JB, Kato CD, Bazira J. Methicillin-Resistant Staphylococcus aureus Nasal Colonization among Healthcare Workers at Kampala International University Teaching Hospital, Southwestern Uganda. Can J Infect Dis Med Microbiol J Can Mal Infect Microbiol Médicale. 2019 Mar 10;2019:4157869. Stratton SJ. Population Research: Convenience Sampling Strategies. Prehospital Disaster Med. 2021 Aug;36(4):373–4. Builders MI, Joseph SO, Bassi PU. A Survey of Wound Care Practices by Nurses in a Clinical Setting. 2020 [cited 2024 Jan 11]; Available from: http://localhost:8080/xmlui/handle/123456789/712 Woo BFY, Goh YS, Zhou W. Understanding the gender gap in advanced practice nursing: A qualitative study. J Nurs Manag. 2022 Nov;30(8):4480. Candra A, Wijaya D, Ardiana A. FACTORS RELATED TO NURSES NON-COMPLIANCE IN IMPLEMENTING STANDARD OPERATING PROCEDURES (SOP) IN HEALTHCARE SETTINGS: A SYSTEMATIC REVIEW. UNEJ E-Proceeding. 2023 Jun 17;321–9. Saleem S, Hussain M, Afzal M, Gilani SA. Assessing Nursing Practices Regarding Standard Approaches on Post-Operative Wound Care Dressing. Pak J Neurol Surg. 2020 Jul 14;24(2):179–86. Rogers AE, Hwang WT, Scott LD, Aiken LH, Dinges DF. The Working Hours Of Hospital Staff Nurses And Patient Safety. Health Aff (Millwood). 2004 Jul;23(4):202–12. Assaye AM, Wiechula R, Schultz TJ, Feo R. Nurse staffing models in medical-surgical units of acute care settings: A cross-sectional study. Int J Nurs Pract. 2020;26(1):e12812. Mogakwe LJ, Ally H, Magobe NBD. Reasons for non-compliance with quality standards at primary healthcare clinics in Ekurhuleni, South Africa. Afr J Prim Health Care Fam Med. 2020 May 27;12(1):2179. Iqbal A, Jan A, Wajid M, Tariq S. Management of Chronic Non-healing Wounds by Hirudotherapy. World J Plast Surg. 2017 Jan;6(1):9–17. Mwakanyamale AA, Mukaja AMA, Ndomondo MD, Zenas JP, Stephen AM, Mika EZ. Nursing Practice on Post-Operative Wound Care in Surgical Wards at Muhimbili National Hospital, Dar-es-Salaam, Tanzania. Open J Nurs. 2019 Jul 31;9(8):870–90. Builders PF, Builders MI, Builders PF, Builders MI. Wound Care: Traditional African Medicine Approach. In: Worldwide Wound Healing - Innovation in Natural and Conventional Methods [Internet]. IntechOpen; 2016 [cited 2024 Jun 25]. Available from: https://www.intechopen.com/chapters/53204 Additional Declarations No competing interests reported. Supplementary Files ViateurDataentry1.sav QUESTIONNAIREINENGLISH.pdf Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6235039","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":488661093,"identity":"287e66b5-e928-482c-8f9c-11800da5e996","order_by":0,"name":"Viateur Hakorimana","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA10lEQVRIiWNgGAWjYBACAwY2MMnAwN4AYlgQr0WCgecAiCFBrBYGoBaJBAhNEJizH0t8zFNgV8cv+fzqhh8FEgz87d0JeLVY9qQdNuYxSJaQnJ1TdrMH6DCJM2c34HfYgfQ2yRkGzBIGt3PSbvAAtRhI5BLQcv45SEu9hP3NM2k3/xCl5UbaMYkPBoclDCTYj90mzpYbz5INPhgcl5xxJofttoyBBA9hv5xPM3yQ8Kean7/9+LObb/7YyPG39+LXggR4DMAkscpBgP0BKapHwSgYBaNgBAEAYeNE/a4igC8AAAAASUVORK5CYII=","orcid":"","institution":"University Teaching Hospital of Kigali","correspondingAuthor":true,"prefix":"","firstName":"Viateur","middleName":"","lastName":"Hakorimana","suffix":""},{"id":488661094,"identity":"c8a7d036-5d14-4ad9-8da7-56bea6e48efa","order_by":1,"name":"Ejike Daniel Eze","email":"","orcid":"","institution":"University of Rwanda","correspondingAuthor":false,"prefix":"","firstName":"Ejike","middleName":"Daniel","lastName":"Eze","suffix":""},{"id":488661095,"identity":"7a124074-5127-415d-a8f7-f5f91454a14e","order_by":2,"name":"Vedaste Bagweneza","email":"","orcid":"","institution":"University of Rwanda","correspondingAuthor":false,"prefix":"","firstName":"Vedaste","middleName":"","lastName":"Bagweneza","suffix":""},{"id":488661098,"identity":"a897c77e-df34-4716-860f-f7c220ae754b","order_by":3,"name":"Priscilla Musabirema","email":"","orcid":"","institution":"University of Rwanda","correspondingAuthor":false,"prefix":"","firstName":"Priscilla","middleName":"","lastName":"Musabirema","suffix":""},{"id":488661099,"identity":"5db335e5-4142-41da-be62-1f33b3b42fcb","order_by":4,"name":"Liberathe Rumagihwa","email":"","orcid":"","institution":"University of Rwanda","correspondingAuthor":false,"prefix":"","firstName":"Liberathe","middleName":"","lastName":"Rumagihwa","suffix":""},{"id":488661100,"identity":"8c902978-5b0b-4f90-8482-e35fe87e49ee","order_by":5,"name":"Leoncie Uzikwambara","email":"","orcid":"","institution":"University of Rwanda","correspondingAuthor":false,"prefix":"","firstName":"Leoncie","middleName":"","lastName":"Uzikwambara","suffix":""},{"id":488661101,"identity":"9891ae9d-fb10-400b-a2c9-442a288a72e7","order_by":6,"name":"Speciose Umutangampundu","email":"","orcid":"","institution":"University Teaching Hospital of Kigali","correspondingAuthor":false,"prefix":"","firstName":"Speciose","middleName":"","lastName":"Umutangampundu","suffix":""}],"badges":[],"createdAt":"2025-03-15 23:38:07","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6235039/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6235039/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":90783511,"identity":"cbc7b75e-1b66-4b82-9658-f494fcab7edf","added_by":"auto","created_at":"2025-09-08 06:17:18","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1223229,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6235039/v1/dc14598a-352a-48a2-bec3-34b9d70364da.pdf"},{"id":87325627,"identity":"737f8c1e-ae74-41ff-9a6a-1e2f682c2675","added_by":"auto","created_at":"2025-07-22 17:33:16","extension":"sav","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":12493,"visible":true,"origin":"","legend":"","description":"","filename":"ViateurDataentry1.sav","url":"https://assets-eu.researchsquare.com/files/rs-6235039/v1/8251b531257f533d9c782ab3.sav"},{"id":87326528,"identity":"3db484a9-b877-4b5c-8587-a0cebe869d90","added_by":"auto","created_at":"2025-07-22 17:49:16","extension":"pdf","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":240661,"visible":true,"origin":"","legend":"","description":"","filename":"QUESTIONNAIREINENGLISH.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6235039/v1/781be745930453f93263f481.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Factors associated with non-compliance to wound care guidelines among nurses working at the University Teaching Hospital of Kigali, Rwanda","fulltext":[{"header":"BACKGROUND","content":"\u003cp\u003eA wound is a break in the continuity of the epithelium. Wounds are a significant burden to the global health care system and also have economic impact on the health care because of there are common occurrence(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). The estimate of 1 to 2% of people are predicted to experience a chronic wound at their lives to the worldwide. The incidence of chronic wound in developing countries is between 2 to 6% (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAbout 8.2\u0026nbsp;million peoples in the United States are affected by wounds, with an estimated annually cost of 28 to 31\u0026nbsp;billion US dollars (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). According to a study done in 2017\u0026ndash;2018, the cost of treating acute and chronic wounds was 68% and 85%, respectively, and secondary care accounted for the remaining costs(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). The National Health System(NHS) spend \u0026pound;8.3\u0026nbsp;billion annually on wound care (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). In Rwanda the study conducted at University teaching hospital of Kigali found that 76.8% of hospital acquired infection are related to surgical site infection which were attributed to noncompliance with wound management guidelines (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Inappropriate use of standard or guideline for wound care can cause the delay of wound healing. The body can recover more quickly and prevent infection with proper wound care and delay in wound healing may result from a variety of intricate etiologies. Although providing high-quality wound care is a crucial component of healthcare, there is currently a lack of research and standardized procedures(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eNurses plays a critical role in wound care to facilitate wound healing and reduce patients admission days with its attended costs; This they achieve through selective wound dressing.(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Management of wound is the crucial for wound healing with minimal complications (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Noncompliance of wound care guideline can cause the many different effects such as delay of wound healing, infections, spending more time for hospitalization and decrease economy to the patients, families, society and the county. The factors that may contribute to poor wound care and noncompliance to wound care guidelines among nurses may include: Personal factors, Health system factors and there is a dearth of information on these factors, hence this study is an attempt to fill this gap.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eClinical trial number: Not applicable\u003c/h2\u003e\u003cdiv id=\"Sec4\" class=\"Section3\"\u003e\u003ch2\u003eStudy design and Approach\u003c/h2\u003e\u003cp\u003eThe study used a cross-sectional design with a quantitative approach, allowing for data collection at a single point in time, over three weeks. This method was chosen for its cost-effectiveness and practicality within a limited timeframe(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e)\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\n\u003ch3\u003eStudy setting\u003c/h3\u003e\n\u003cp\u003e The study was conducted at the University Teaching Hospital of Kigali, the largest hospital in Rwanda, which receives many patients with wounds which require adherence to wound care guidelines. The hospital is located in Nyarugenge District, Kigali City's, specifically in Nyarugenge sector, Kiyovu cell on KN 4 Avenue. With a capacity of 519 beds. The hospital provides training, clinical research, and technological support to District Hospitals, helping to deliver high-quality healthcare to the public. The Surgical Department one of hospital\u0026rsquo;s key departments offers specialized services to patient needing wound care.\u003c/p\u003e\n\u003ch3\u003eTarget population\u003c/h3\u003e\n\u003cp\u003e The participant in this study were Nurses working in the surgical department at the University Teaching Hospital of Kigali. The total number of nurses is 105 including 91 females and 14 males.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eInclusion criteria\u003c/strong\u003e\u003cp\u003eRegistered nurses in the department who volunteered to participate, with no exclusion based on gender or experience.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eExclusion criteria\u003c/strong\u003e\u003cp\u003eNurses on maternal, annual, or sick leave were excluded\u003c/p\u003e\u003c/p\u003e\n\u003ch3\u003eSample size\u003c/h3\u003e\n\u003cp\u003eThe sample size was calculated according to the total number of nurses which is 105 by using the formula of Slovin. Slovin formula is n\u0026thinsp;=\u0026thinsp;N/(1\u0026thinsp;+\u0026thinsp;Ne\u003csup\u003e2\u003c/sup\u003e).\u003c/p\u003e\u003cp\u003eWhere n: number of samples, N: Total population, e: margin error of 0.05(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Sample size was n\u0026thinsp;=\u0026thinsp;105/(1\u0026thinsp;+\u0026thinsp;105x0.05\u003csup\u003e2\u003c/sup\u003e)\u0026thinsp;=\u0026thinsp;83 Nurses. Although only 76 nurses participated in this study.\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eSampling strategy\u003c/h2\u003e\u003cp\u003eA convenience sampling technique with non-probability method was used to choose participants working in the surgical department at the University Teaching Hospital of Kigali. Participants who are available during the time of data collection was included.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eData collection\u003c/h3\u003e\n\u003cp\u003e Data were collected using a self-administered questionnaire structured into four parts, covering sociodemographic information, wound care knowledge, factors influencing guideline adherence, and organizational factors. The questionnaire was translated from English to French and underwent a pilot study to ensure validity and reliability. Data collection took three weeks from 19 April 2024 to 10 May2024, with 83 questionnaires distributed and 76 returned, corresponding to 91.6% response rate.\u003c/p\u003e\u003cp\u003e\u003cb\u003eData analysis plan.\u003c/b\u003e\u003c/p\u003e\u003cp\u003e Data was analyzed using SPSS version 23, employing descriptive statistics and Pearson correlation analysis to explore factors affecting non-compliance with wound care guidelines.\u003c/p\u003e\n\u003ch3\u003eEthical considerations\u003c/h3\u003e\n\u003cp\u003eEthical approval was obtained from the University of Rwanda, College of Medicine and Health Science (CMHS), Institutional Revied Board (IRB) (Ref: CMHS/IRB/123/2024) and Ethics committee of the University Teaching Hospital of Kigali (Ref: EC/CHUK/032/2024), with informed consent from participants, ensuring anonymity and voluntary participation.\u003c/p\u003e\u003c/p\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eData management\u003c/h2\u003e\u003cp\u003eData was securely stored, with measures against unauthorized access and measures to prevent data loss.\u003c/p\u003e\u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003eThe findings, presented in tables, are numerical in nature. The chapter is divided into sections covering the social demographic details of the participants, nurses' understanding of wound care, individual factors influencing non-compliance with wound care guidelines, factors linked to wound care practices within healthcare organizations, and correlation analysis.\u003c/p\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003eSocio-demographic characteristics of participants\u003c/h2\u003e\u003cp\u003eThe study involved seventy-six (76) respondents whose characteristics were examined to gain insights into the composition of the sample population.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003eDistribution of the Participants\u003c/h2\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDistribution of characteristics of the participants\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eSEX Frequency\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercent\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMen\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14.47\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWomen\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e85.53\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e100.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eFrequency\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003ePercent\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLess than 35 years old\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22.36\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBetween 35 and 45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e52.07\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAbove 45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e25.57\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e100.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eFrequency\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003ePercent\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e27.63\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e69.72\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSeparated\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.63\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e100.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAcademic Qualification\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eFrequency\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003ePercent\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAdvanced Level Diploma A1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e21.05\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBachelor\u0026rsquo;s degree A0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e76.32\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMasters and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.63\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e100.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eWorking Experience in years\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eFrequency\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003ePercent\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLess than 10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18.42\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMore than 10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e81.58\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e100.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eWorking Unit\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eFrequency\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003ePercent\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOrthopedic Unit\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17.16\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGeneral Surgery Unit\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15.89\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUrology and Pediatric Unit\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11.54\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePlastic and Burn Unit\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17.16\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePre-operative and Neurosurgery Unit\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19.75\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrivate Ward (Pavilion General and Ophthalmology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18.32\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e100.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTime (hours)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eFrequency\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003ePercent\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8 hours\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e32.88\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e12 hours\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e67.12\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e100.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNumber of patients per shift\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eFrequency\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003ePercent\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u0026ndash;8 patients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e35.53\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8\u0026ndash;16 patients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e47.37\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e16 patents and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17.10\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e76\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e100.0\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\u003ch2\u003eSource: (Field data, 2024)\u003c/h2\u003e\u003cp\u003eOn the distribution of sex among nurses responded in the study. Among the 76 respondents, 11 were men, accounting for 14.47% of the total, while 65 were women, representing 85.53%. This suggests a predominance of female nurses in the sample population. For the age, among the 76 nurses surveyed, 17 were younger than 35 years old, making up 22.36% of the total. 40 were aged between 35 and 45, constituting 52.07%, while 19 nurses were over 45 years old, representing 25.57% of the total. A part from marital status. Out of the 76 respondents, 21 were single, accounting for 27.63% of the total. The majority, 53 nurses, were married, making up 69.72%, while only 2 nurses were separated, representing 2.63% of the total. Linking marital status with non-compliance to wound care guidelines, for instance, married nurses might have different responsibilities or priorities compared to single nurses, which could affect their ability to comply with wound care guidelines. Additionally, separated nurses might experience personal challenges that could impact their focus on observing to guidelines. On the working experience in nursing 14 nurses had less than 10 years of experience, representing 18.42% of the total. and the majority, 62 nurses, had more than 10 years of experience, accounting for 81.58% of the total.\u003c/p\u003e\u003cp\u003eThe distribution of working units among nurses at University Teaching Hospital of Kigali (CHUK), The Pre-operative and Neurosurgery Unit has the highest frequency at 19.75%, indicating a significant portion of nurses are likely involved in surgical preparation and neurosurgical procedures. Similarly, the Orthopedic Unit and Plastic and Burn Unit, both with frequencies of 17.16%, suggest a notable focus on orthopedic and reconstructive surgeries, as well as the management of burn injuries. These units may encounter specific wound care challenges that necessitate adherence to specialized guidelines. Conversely, units such as the General Surgery Unit (15.89%) and the Urology and Pediatric Unit (11.54%) may have comparatively lower frequencies, indicating lesser demand or specialization in these areas. Nurses working in units with higher frequencies may face unique wound care challenges and workload pressures, potentially impacting their adherence to wound care guidelines. Therefore, understanding the distribution of working units and their respective specialties can provide valuable context for examining factors contributing to non-compliance with wound care guidelines among nurses.\u003c/p\u003e\u003cp\u003eThe distribution of nurses based on the duration of their shifts at Among the 76 respondents, 25 nurses work 8-hour shifts, constituting 32.88% of the total. The majority of nurses, 51 in total, work 12-hour shifts, representing 67.12% of the total. The information on the number of patients cared for per shift by nurses. Among the 76 respondents, 35.53% reported caring for 1\u0026ndash;8 patients per shift, 47.37% cared for 8\u0026ndash;16 patients, and 17.10% cared for 16 patients or more per shift. Linking this data to the non-compliance to wound care guidelines among nurses, the patient load per shift could influence adherence to guidelines. When nurses have lots of patients to care for, it can be hard for them to give each patient the attention they need for wound care. They might have to rush or focus on the most urgent tasks, which could mean they don't follow all the wound care rules properly. But if nurses have fewer patients to look after, they can spend more time with each one, making it easier to stick to the guidelines for wound care.\u003c/p\u003e\u003cp\u003e\u003cb\u003eNurse\u0026rsquo;s Knowledge related to wound care.\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis part outlines findings on nurse\u0026rsquo;s knowledge related to wound care. This part covers wound care essentials, including risk factors for infection, wet therapy's efficacy, wound assessment methods, and nursing practices. It highlights challenges like identifying pressure ulcers in dark-skinned individuals and emphasizes professional evaluation of wound pain. It also discusses infection signs in specific patient groups and the benefits of enzyme-based debridement and irrigation over swabbing. It touches on nurses' role in debridement and the preference for wet gauze in chronic wound management. Finally, it queries the use of the Braden scale for assessing vascular ulcer risk.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eTable Nurse\u0026rsquo;s Knowledge related to wound care\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eStd. D\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003eAnswers in percentage\u003c/p\u003e\u003cp\u003eCorrect Incorrect\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eImmobility, impaired nutrition, and location of the wound are risk factors of wound infection.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.960\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.249\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e71(93.42)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e5(6.58)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWet therapy is the \u0026ldquo;gold standard\u0026rdquo; for treating chronic wounds.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.215\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.715\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e16(21.05)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e60(78.95)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eThe selection of the coverage of the wound should be based on characteristics of his deathbed (moisture, drainage, or presence of devitalized tissue).\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.711\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.453\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e54(71.05)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e22(28.95)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eThe pain in the wound must be evaluated by the health-care professional, not by the patient.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.321\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.513\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e24(31.58)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e52(68.42)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eThe first stage of pressure ulcers is easily identified in people of dark skin.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.658\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.474\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e50(65.78)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e26(34.22)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAssessment of a wound is a cumulative process that comprises observation, data collection, and evolution.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.776\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.417\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e60(78.94)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e16(21.06)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eThe classic signs of infection (pain, heat, redness, swelling, pus) may not be present in patients with chronic wounds or those who are immunosuppressed.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.273\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.725\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e21(27.64)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e55(72.36)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEnzymes (pepsin, collagens,) are effective in the removal of devitalized tissue of chronic wounds.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.592\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.491\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e45(59.21)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e31(40.79)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWhen taking a wound culture, the swab is dipped in wound drainage to assess infection.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.513\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.499\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e56(73.68)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e20(26.32)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIrrigation removes debris from wounds better than swabbing.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.526\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.492\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e40(52.64)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e36(47.36)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eThe nurses are authorized to use conservative debridement (superficial).\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.618\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.486\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e47(61.42)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e29(38.16)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWet gauze is more indicated for treating chronic wounds.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.684\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.464\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e51(67.11)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e25(32.89)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBraden scale is an instrument used to assess the risk of a patient developing a vascular ulcer?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.921\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.269\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e70(92.11)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e6(7.89)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003ch2\u003eSource: (Field data, 2024)\u003c/h2\u003e\u003cp\u003eIn examining nurses' knowledge related to wound care, several key findings emerge from the provided table.\u003c/p\u003e\u003cp\u003eNurses display a good understanding of certain aspects, such as recognizing immobility, impaired nutrition, and wound location as risk factors for infection, as indicated by a mean of 1.960 and a standard deviation of 0.249, indicating consistent understanding among participants. However, there are areas where clarification may be needed. Despite being false statement that wet therapy is the gold standard for treating chronic wounds, the relatively low mean (1.215) and high standard deviation (0.715) suggest a lack of consensus or understanding among nurses regarding the use of wet therapy as the gold standard for chronic wound treatment.\u003c/p\u003e\u003cp\u003eNurses exhibit a good understanding of wound coverage selection criteria, with a high mean (1.711) and relatively low standard deviation (0.453), indicating consistent knowledge among participants. Regarding the pain in the wound to be evaluated by the health-care professional, not by the patient, despite being false, the moderate mean (1.321) and relatively high standard deviation (0.552) suggest some uncertainty or inconsistency among nurses regarding the role of patients in assessing wound pain.\u003c/p\u003e\u003cp\u003e Nurses demonstrate awareness of the challenges in identifying pressure ulcers in darker skin tones, with a moderate mean (1.658) and standard deviation (0.474), indicating varying levels of understanding among participants. Nurses show a strong understanding of wound assessment as a cumulative process, with a high mean (1.776) and relatively low standard deviation (0.417), indicating consistent comprehension among participants.\u003c/p\u003e\u003cp\u003eDespite statement being false, the moderate mean (1.273) and relatively low standard deviation (0.725) suggest some uncertainty or inconsistency among nurses regarding the complexities of infection presentation in certain patient populations. Nurses demonstrate a reasonable understanding of the use of enzymes in debridement, with a moderate mean (1.592) and standard deviation (0.491), indicating varying levels of understanding among participants.\u003c/p\u003e\u003cp\u003eDespite the statement being false that when taking a wound culture, the swab is dipped in wound drainage to assess infection, the moderate mean (1.513) and standard deviation (0.499) suggest some uncertainty or inconsistency among nurses regarding the proper procedure for wound culture collection. Nurses show a reasonable understanding of wound cleaning methods, with a moderate mean (1.526) and standard deviation (0.492), indicating varying levels of understanding among participants.\u003c/p\u003e\u003cp\u003eNurses demonstrate a reasonable understanding of their scope of practice in wound care, with a moderate mean (1.618) and standard deviation (0.486), indicating varying levels of understanding among participants. Nurses understand wound dressing options reasonably well, with some differences in how well each nurse understands, shown by the moderate average score (1.684) and the standard deviation (0.464). Nurses understand the purpose of the Braden scale very well. Most nurses grasp it consistently, as shown by the high average score (1.921) and the relatively small range of scores (standard deviation of 0.269).\u003c/p\u003e\u003cp\u003eOverall, most nurses understand important things about taking care of wounds, but there are some areas where they might need more teaching or explanation, especially when it comes to wrong information and topics that some nurses understand better than others. These topics include wet therapy as the \"gold standard\" for treating chronic wounds, the patient's role in evaluating wound pain, identification of pressure ulcers in people with dark skin, and the proper procedure for wound culture collection.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\u003ch2\u003eIndividual factors associated with noncompliance to wound care guidelines in practice\u003c/h2\u003e\u003cp\u003e The section explores factors influencing adherence to wound care guidelines, such as knowledge gaps, training deficiencies, workload issues, and resource limitations. It delves into the accessibility of updated guidelines in the workplace and investigates whether stress affects consistent guideline adherence.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eIndividual factors associated with noncompliance to wound care guidelines in practice\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eStd. D\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003eAnswers in percentage\u003c/p\u003e\u003cp\u003eYES NO\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFamiliar with the wound care guidelines\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.789\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.407\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e60(92.11)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e16(7.89)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLack of knowledge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.421\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.493\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e32(42.11)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e44(57.89)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInadequate training\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.737\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.440\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e56(73.68)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e20(26.32)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLevel of education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.368\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.482\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e28(36.84)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e48(63.16)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLack of time\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.579\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.493\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e44(57.89)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e32(42.11)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHigher workload\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.605\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.488\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e46(57.89)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e30(42.11)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLack of necessary resources\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.592\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.491\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e42(60.52)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e34(39.48)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLack of clear communication\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.597\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.459\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e53(69.73)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23(30.27)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAccess to up-to-date wound care guideline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.408\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.491\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e31(40.79)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e45(59.21)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExperienced stress\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.618\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.486\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e47(61.84)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e29(31.16)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cdiv id=\"Sec18\" class=\"Section3\"\u003e\u003ch2\u003eSource: (Field data, 2024)\u003c/h2\u003e\u003cp\u003e Table\u0026nbsp;3.3 shows that there are several nurses\u0026rsquo; individual factors contributing to non-compliance with wound care guidelines among nurses. The question that assessed the nurses' familiarity with wound care guidelines has scored the relatively high mean a mean of 1.789 with Std. Deviation of 0.407 suggests that most nurses are familiar with the guidelines, but there might still be some who are not completely knowledgeable. Lack of knowledge as a factor contributing to non-compliance to wound care guidelines has scored the moderate mean of 1.421with Std. Deviation of 0.493 indicating that some nurses acknowledge their own lack of knowledge regarding wound care guidelines.\u003c/p\u003e\u003cp\u003e Inadequate training appears to be a significant factor to non-compliance to wound care guidelines as indicated by the high mean of 1.737 with Std. Deviation of 0.440 suggesting that many nurses feel they haven't received sufficient training to adhere to wound care guidelines effectively. The level of education might play a role in compliance to wound care guidelines, with a moderate mean of1.368 with Std. Deviation of 0.482 indicating that education level could influence nurses' adherence to wound care guidelines to some extent.\u003c/p\u003e\u003cp\u003e Time constraints seem to be another significant factor to non-compliance to wound care guidelines, with a moderate mean of 1.579 with Std. Deviation of 0.493 suggesting that many nurses feel they don't have enough time to follow the guidelines as they should. A higher workload appears to contribute to non-compliance to wound care guidelines, as indicated by the high mean of 1.605 with Std. Deviation of 0.488, this suggests that nurses feel overwhelmed by their workload, making it difficult to adhere to guidelines.\u003c/p\u003e\u003cp\u003e The availability of necessary resources is another contributing factor on compliance to wound care guidelines, with a moderate mean of 1.592 with Std. Deviation of 0.491, suggesting that some nurses feel they lack the resources needed to follow the guidelines effectively. Communication issues or misunderstandings regarding wound care guidelines seem to contribute to non-compliance, with a moderate mean of 1.597 with Std. Deviation of 0.459 indicating that this is a common concern among nurses. Access to up-to-date guidelines might be an issue for some nurses, as indicated by the moderate mean of 1.408 with Std. Deviation of 0. 491.This suggests that not all nurses have easy access to the latest guidelines, which could affect their compliance.\u003c/p\u003e\u003cp\u003eStress appears to be a common barrier to compliance, with a relatively high mean of 1.618 and Std. Deviation of 0.486, suggesting that many nurses have experienced stress that impacts their ability to follow guidelines consistently.\u003c/p\u003e\u003cp\u003e Overall, the data indicates that various factors, including lack of knowledge, inadequate training, time constraints, workload, resource availability, communication issues, access to guidelines, and stress, contribute to non-compliance with wound care guidelines among nurses at Kigali University Teaching Hospital.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec19\" class=\"Section2\"\u003e\u003ch2\u003eFactors associated with wound care practice related to Health service organizational\u003c/h2\u003e\u003cp\u003eThis section examines factors related to wound care practices within healthcare organizations. It covers guideline and dressing material availability, patient load, training provision, support resources, familiarity with antiseptics, hierarchy pressure, leadership support, supervision adequacy, feedback, accountability, and interdisciplinary coordination.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eFactors associated with wound care practice related to Health service organizational.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eStd. D\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003eAnswers in percentage\u003c/p\u003e\u003cp\u003eYES NO\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAvailability of guideline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.671\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.470\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e51(67.11)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e25(32.89)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAvailability of Dressing material\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.829\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.377\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e63(82.89)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e13(17.11)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePatient load.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.789\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.407\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e60(78.95)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e16(21.05)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSufficient training and education on wound care guidelines?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.355\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.478\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e27(35.52)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e49(64.47)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSatisfaction with overall support and resources provided by health care system.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.763\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.472\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e48(63.16)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e28(36.84)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFamiliarity with antiseptics solution to wound care\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.803\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.398\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e61(80.26)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e15(19.74)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLack of opportunity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.605\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.488\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e37(48.68)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e39(51.32)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHierarchy pressure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.329\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.470\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e25(32.89)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e51 (67.11)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExperience in wound care management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.881\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.325\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e67(88.16)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e9(11.84)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLack of motivation in adhering to wound care guideline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.381\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.485\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e29(38.16)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e47(61.84)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLack of leadership support\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.434\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.495\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e32(42.11)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e44(57.89)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInadequate supervision to wound care guideline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.552\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.497\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e33(43.42)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e43(56.58)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRegular feedback and guidance from your supervisors on wound care\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.380\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.485\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e29(38.16)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e47(61.84)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAbsence of accountability\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.460\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.483\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e41(53.95)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e31(46.05)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLack of interdisciplinary coordination (physician, nurses, other health care providers)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.841\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.364\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e64(84.21)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e12(15.79)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec20\" class=\"Section2\"\u003e\u003ch2\u003eSource: (Field data, 2024)\u003c/h2\u003e\u003cp\u003e Table\u0026nbsp;3.4 shows that guideline availability in working unit has scored a high mean of 1.671suggests that the availability of guidelines is somewhat satisfactory, indicating potential influence on compliance. However, the Std. Deviation of 0.470 indicates some variability in responses. Dressing material availability indicates a higher mean of 1.829 and lower Std. Deviation of 0.377, it appears that the availability of dressing materials is generally better, possibly contributing to improved adherence to guidelines.\u003c/p\u003e\u003cp\u003eMean of 1.789 suggests a moderate patient load, which could impact adherence due to time constraints and workload pressure, as indicated by the Std. Deviation of 0.407. Training and education provision has scored the mean of 1.355 with Std. Deviation of 0.478 indicates that training and education provision are somewhat inadequate, which might lead to lower compliance rates. The standard deviation shows variability in responses.\u003c/p\u003e\u003cp\u003eSatisfaction with support and resources has scored a higher mean of 1.763 suggests better satisfaction with support and resources, potentially positively impacting compliance. However, the wide Std. Deviation of 0.472 indicates varying perceptions among respondents. Familiarity with antiseptic solutions has scored a higher mean of 1.803 indicates good familiarity with antiseptics, which is crucial for proper wound care practices. The standard deviation of 0.398 shows some variability in responses.\u003c/p\u003e\u003cp\u003eOpportunity to express opinions has scored the mean of 1.605 suggests moderate satisfaction with the opportunity to express opinions, with variability in responses indicated by the standard deviation of 0.488. Hierarchy pressure has scored a lower mean of 1.329 suggests lower hierarchy pressure, which could positively impact compliance and the standard deviation of 0.470 indicates variability in perceptions of hierarchy pressure.\u003c/p\u003e\u003cp\u003e Experience in wound care management shows a higher mean of 1.881 suggests greater experience, potentially correlating with better adherence to guidelines. The standard deviation of 0.325 indicates some variability in experience levels among respondents.\u003c/p\u003e\u003cp\u003eLack of motivation shows the mean of 1.381 indicates a moderate level of motivation, which could influence compliance. The standard deviation of 0.485 suggests variability in motivation levels among respondents.\u003c/p\u003e\u003cp\u003eLack of leadership support has scored the mean of 1.434 suggests some lack of leadership support, potentially hindering compliance. The standard deviation of 0.495 indicates varying perceptions among respondents. Inadequate supervision has scored the mean of 1.552 suggests some inadequacy in supervision, which may contribute to inconsistent adherence to guidelines. The standard deviation of 0.497 indicates variability in perceptions of supervision.\u003c/p\u003e\u003cp\u003eFeedback from supervisors has scored the mean of 1.380 suggests moderate satisfaction with feedback from supervisors, which can positively influence compliance. The standard deviation of 0.485 indicates variability in perceptions of feedback. Absence of accountability has scored the mean of 1.460 suggests some absence of accountability, which may contribute to non-compliance. The standard deviation of 0.483 indicates variability in perceptions of accountability.\u003c/p\u003e\u003cp\u003e Interdisciplinary coordination has scored a higher mean of 1.841 indicates good interdisciplinary coordination, crucial for effective wound care management. The standard deviation of 0.364 suggests some variability in perceptions of coordination among respondents.\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003e Discussing and comparing current study at university teaching hospital of Kigali with empirical review, Among the 76 respondents, most were female (85.53%). Similar findings have been noted in literature, where gender can influence healthcare practices and adherence to guidelines. For instance(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e) highlighted that gender-specific factors can affect adherence to wound care guidelines, although the specific impacts were not detailed in this study. Male in nursing have opportunistic advantages when it comes to joining the advanced practice nursing workforce, but they are not motivated for the position and do not stay in the field long enough to become advanced practice nurses(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). The present study indicates that nurse with more than 10 years of experience constituted the majority (81.58%). This aligns with findings from(\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e) in Nigeria, which emphasized the correlation between experience and adherence to treatment protocols. Both studies suggest that experienced nurses might have developed certain practices that could either facilitate or hinder guideline adherence.\u003c/p\u003e\u003cp\u003eThis study found nurses with higher education levels (e.g., Bachelor's degree) were more prevalent. This show the importance placed on education in wound care management, as highlighted by Saleem (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e), emphasizing that proper training and education are crucial for adherence to guidelines. The study conducted at University Teaching Hospital of Kigali (CHUK) revealed that most nurses had a Bachelor's degree (76.32%) and significant experience (81.58% with over 10 years), yet there remained a need for further training in specific wound care areas, with a mean knowledge score of 1.605. This finding aligns with research from Ethiopia, where nurses with higher education and training were significantly more knowledgeable and practiced better wound care (AOR 3.27, 95% CI 1.97\u0026ndash;5.43; AOR 3.71, 95% CI 2.37\u0026ndash;5.81)(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eNurses worked in various units, with the Pre-operative and Neurosurgery Unit having the highest representation (19.75%). Shift durations varied, with 67.12% of nurses working 12-hour shifts. This was confirmed to the study done by Rogers et al.,2004, The nurses worked overtime or longer shifts than twelve hours, their chances of making a mistake climbed dramatically(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Concerning patient load, 47.37% cared for 8\u0026ndash;16 patients per shift. According to Assaye et al., (2020), providing care to many patients during a shift, which may have an effect on patient safety(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). These factors, including gender, experience, unit assignment, shift duration, and patient load, could influence how well nurses follow wound care guidelines, highlighting the need to address these aspects for improved wound care practices.\u003c/p\u003e\u003cp\u003eFactors such as time constraints, workload, and resource availability were as significant contributors to non-compliance. Similar challenges were noted in other studies, such as those in Indonesia(\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e)and in South Africa(\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e), where inadequate resources and heavy workloads hindered adherence to wound care guidelines. While the present study highlighted moderate satisfaction with support and resources (mean of 1.763), studies in South Africa(\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e) and the UK(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e) have shown varied satisfaction levels regarding support and organizational resources. These findings suggest a relatively better environment in this regard compared to other regions.\u003c/p\u003e\u003cp\u003eIn current study, perceptions of leadership support (mean of 1.434) and supervision (mean of 1.552) were moderate. Contrastingly, in studies like those in the US(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e), leadership support and effective supervision were critical factors influencing adherence to guidelines. The variance emphasizes potential differences in organizational cultures and management styles across different healthcare settings.\u003c/p\u003e\u003cp\u003eThe correlation between nurses' knowledge related to wound care and non-compliance (Pearson coefficient\u0026thinsp;=\u0026thinsp;0.762) in the study indicates a strong association. This contrasts with findings from Nigeria (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e), where the correlation was not as explicitly quantified but emphasized the need for continuous education and training to improve adherence.\u003c/p\u003e\u003cp\u003eIn south Africa studies highlighted similar issues with resource affecting compliance (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Leadership problems at CHUK, like low motivation and insufficient supervision, were also seen in South Africa and Tanzania, underlining the need for better support to help nurses follow guidelines(\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e Generally, addressing these factors may improve adherence to wound care guidelines among nurses at the hospital. The mean overall score of 1.570 provides a comprehensive perspective on nurses' individual factors associated with noncompliance to wound care guidelines in practice. When analyzing individual factors such as familiarity with guidelines, lack of knowledge, inadequate training, education level, time constraints, workload, resource availability, communication issues, access to guidelines, and stress, it's apparent that these aspects collectively influence nurses' adherence to wound care protocols. The mean score serves as a quantitative representation of the degree to which each factor impacts noncompliance, offering insights into areas requiring targeted interventions or support to enhance compliance with wound care guidelines among nurses.\u003c/p\u003e\u003cp\u003eThe analysis of factors associated with wound care practice related to health service organizational reveals several key insights. The availability of guidelines and dressing materials in the working unit appears satisfactory, potentially contributing to compliance. However, inadequate training and education provision could hinder adherence. Satisfaction with support and resources is generally positive, but variability in perceptions exists. Familiarity with antiseptic solutions is 80,26% which was good, while opportunities to express opinions are moderately satisfactory. Hierarchy pressure is low, and experience in wound care management is high, possibly enhancing compliance. These findings are similar to the study done in Ethiopia where hierarchy pressure, familiarity with antiseptic were significant to the factors associated to wounds care practice(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Lack of motivation and leadership support, as well as inadequate supervision and accountability, may negatively impact adherence. This were similar also seen in South Africa and Tanzania, underlining the need for better support to help nurses follow guidelines(\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). However, moderate satisfaction with feedback from supervisors and good interdisciplinary coordination are observed. These findings show the importance of addressing organizational factors to improve compliance with wound care guidelines among nurses. The overall mean score of 1.605 indicates a moderate level of compliance with wound care guidelines among nurses in relation to health service organizational factors.\u003c/p\u003e\u003cp\u003eThe present study revealed a positive correlation (r\u0026thinsp;=\u0026thinsp;0.584, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01) between social demographic factors such as gender, age, and non-compliance with wound care guidelines. This suggests that individual characteristics may influence adherence to wound care guidelines. A strong positive correlation (r\u0026thinsp;=\u0026thinsp;0.762, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01) was found between nurses' knowledge of wound care and adherence to guidelines. This indicates that a higher level of understanding is associated with better compliance. A Significant positive correlation (r\u0026thinsp;=\u0026thinsp;0.623, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01) were observed between nurse's individual attributes, attitudes, or beliefs and non-compliance with wound care guidelines. This highlights the personal aspect's role in adherence. A substantial positive correlation (r\u0026thinsp;=\u0026thinsp;0.609, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01) emerged between health service organizational factors and non-compliance with wound care guidelines. This suggests that the hospital's organizational environment significantly influences adherence levels. Understanding these correlations can guide interventions aimed at improving adherence to wound care guidelines among nurses, thereby enhancing patient care outcomes at University Teaching Hospital of Kigali\u003c/p\u003e\u003cdiv id=\"Sec22\" class=\"Section2\"\u003e\u003ch2\u003eLimitations of the study\u003c/h2\u003e\u003cp\u003eThe participant in this study may not represent the broader nurse\u0026rsquo;s population. Social and culture factors may not fully explore the influence for noncompliance to wound care in nursing. The sample size was small because it is focus on nurses working in surgical department only and it focused on single teaching hospital. The study didn't look at all possible factors that could affect adherence. To improve, future research should address these limitations to get a better understanding of how nurses follow wound care guidelines and how to help them do it better for patient care.\u003c/p\u003e\u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003e The study conducted at the University Teaching Hospital of Kigali (CHUK) identified multiple factors contributing to nurses' non-compliance with wound care guidelines. Despite nurses having a basic understanding of these guidelines, there were still significant gaps that require further training. Key factors affecting compliance included insufficient training, time constraints, high workload, limited resources, communication issues, and stress. Organizational aspects like the availability of guidelines and dressing materials, leadership support, supervision, accountability, and interdisciplinary collaboration also played a crucial role in adherence. The study found strong correlations between nurses' knowledge, individual attributes, organizational factors, and their adherence to wound care guidelines. The findings underscore the need for continuous education and training, along with improvements in organizational support, to enhance guideline adherence and ultimately improve patient care outcomes at CHUK.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e%: Percentage\u003c/p\u003e\n\u003cp\u003eAVE: Average Variance Extracted, CHUK: Centre Hospitalier Universitaire de Kigali, CMHS: College of Medicine and Health Science, IRB: \u0026nbsp;Institutional Revied Board \u0026nbsp; KUTH: Kigali University Teaching Hospital, NHS: National Health Services\u003c/p\u003e\n\u003cp\u003eSPSS: Statistical Package for the Social Science, Std. D: Standard Deviation, U.S: United States, UR: University of Rwanda\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical Declarations\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eThe study adhered to the declaration of Helsinki concerning to research carried out on humans. Approval for the execution of this study was granted me the permission to conduct study. After receiving approval letter for data collection from University of Rwanda through Institutional Review Board (Reference: CMHS/IRB/123/2024) and the approval from the Research Ethics Committee at CHUK (Reference: EC/CHUK/032/2024) begin data collection. The researcher has visited interacted with the participant in their wards through their unit managers to explain the aims of the study and give the instruction on how they fill the questionnaire. Informed consent was sought by the participants and they signing on consent form given to them indicate their participation in the study. Participation in the study was voluntary. To maintain anonymity and confidentiality was respected, we assured that their names and identities would not be included in the study. the completed questionnaires kept in a secure and locked cupboard. To make sure that data was not permanently lost in the event of computer loss or technical difficulties, digital data that was extracted from the questionnaires using a computer was uploaded to Google Drive as a password-protected folder.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe results section of this manuscript encompasses all pertinent data and we have included data set of SPSS version 23, questionnaire and ethical approval as supplementary documents to facilitate verification of the results reported here\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo competing interests by the authors\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFundings\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo fundings received on this study\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor\u0026rsquo;s information\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor\u0026rsquo;s and affiliation\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eViateur HAKORIMANA,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDepartment of surgery, University Teaching Hospital of Kigali, Rwanda.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Viateur HAKORIMANA, Ejike Daniel Eze, Vedaste BAGWENEZA, Priscille MUSABIREMA, Liberathe RUMAGIHWA, Leoncie UZIKWAMBARA, Speciose UMUTANGAMPUNDU.\u003c/p\u003e\n\u003cp\u003eCollege of Medicine and Health Science, School of Nursing and Midwifery, University of Rwanda.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSpeciose UMUTANGAMPUNDU.\u003c/p\u003e\n\u003cp\u003eDepartment of Nursing and Midwifery, University Teaching Hospital of Kigali, Rwanda\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor\u0026rsquo;s contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEjike Daniel Eze, Vedaste BAGWENEZA, Priscille MUSABIREMA, Liberathe RUMAGIHWA Leoncie UZIKWAMBARA, Speciose UMUTANGAMPUNDU,\u003c/p\u003e\n\u003cp\u003eAll authors have contribution to my study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorresponding author\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eViateur HAKORIMANA\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSpecial thanks for my family for their support and encouragement. The Authors Dr Ejike Daniel Eze and \u0026nbsp;Vedaste BAGWENEZA are thankfully for their guidance, also I thankfully Dr Priscille MUSABIREMA, Liberathe RUMAGIHWA and Leoncie UZIKWAMBARA, Speciose UMUTANGAMPUNDU for their input in this study. We are also grateful to all participants who are voluntary agreed to take part of study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSen CK. Human Wound and Its Burden: Updated 2020 Compendium of Estimates. Adv Wound Care. 2021 May;10(5):281\u0026ndash;92. \u003c/li\u003e\n\u003cli\u003eJ\u0026auml;rbrink K, Ni G, S\u0026ouml;nnergren H, Schmidtchen A, Pang C, Bajpai R, et al. Prevalence and incidence of chronic wounds and related complications: a protocol for a systematic review. Syst Rev [Internet]. 2016 [cited 2024 Jan 13];5(1). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5017042/\u003c/li\u003e\n\u003cli\u003eCilliers MGCG, Nair A, Pressentin KB von, Coetzee F, Saeed H. A \u0026lsquo;game of dressings\u0026rsquo;: Strategies for wound management in primary health care. South Afr Fam Pract [Internet]. 2022 Feb 28 [cited 2023 May 1];64(1). Available from: https://www.ajol.info/index.php/safp/article/view/235484\u003c/li\u003e\n\u003cli\u003eMaheshwari G, Gupta S, Tripathi S, Sagar S, kisaka tomohika. Chronic wounds -Magnitude, Socioeconomic Burden and Consequences. 2021 Mar 15; \u003c/li\u003e\n\u003cli\u003eMukagendaneza MJ, Munyaneza E, Muhawenayo E, Nyirasebura D, Abahuje E, Nyirigira J, et al. Incidence, root causes, and outcomes of surgical site infections in a tertiary care hospital in Rwanda: a prospective observational cohort study. Patient Saf Surg. 2019 Feb 18;13(1):10. \u003c/li\u003e\n\u003cli\u003eWard J, Holden J, Grob M, Soldin M. Management of wounds in the community: five principles. Br J Community Nurs. 2019 Jun 1;24(Sup6):S20\u0026ndash;3. \u003c/li\u003e\n\u003cli\u003eTegegne B, Yimam F, Yalew ZM, Wuhib M, Mekonnen L, Yitayew YA, et al. Knowledge and Practice of Wound Care and Associated Factors among Nurses Working in South Wollo Zone Government Hospitals, Ethiopia. Chronic Wound Care Manag Res. 2022 Jul 20;9:1\u0026ndash;11. \u003c/li\u003e\n\u003cli\u003eBondi ME, Rahim SSSA, Avoi R, Hayati F, Ahmedy F, Omar A, et al. Knowledge, Attitude and Practice on Diabetic Wound Care Management among Healthcare Professionals and Impact from A Short Course Training in Sabah, Borneo. Medeni Med J. 2020;35(3):188\u0026ndash;94. \u003c/li\u003e\n\u003cli\u003eAggarwal R, Ranganathan P. Study designs: Part 2 \u0026ndash; Descriptive studies. Perspect Clin Res. 2019;10(1):34\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eAbimana JB, Kato CD, Bazira J. Methicillin-Resistant Staphylococcus aureus Nasal Colonization among Healthcare Workers at Kampala International University Teaching Hospital, Southwestern Uganda. Can J Infect Dis Med Microbiol J Can Mal Infect Microbiol M\u0026eacute;dicale. 2019 Mar 10;2019:4157869. \u003c/li\u003e\n\u003cli\u003eStratton SJ. Population Research: Convenience Sampling Strategies. Prehospital Disaster Med. 2021 Aug;36(4):373\u0026ndash;4. \u003c/li\u003e\n\u003cli\u003eBuilders MI, Joseph SO, Bassi PU. A Survey of Wound Care Practices by Nurses in a Clinical Setting. 2020 [cited 2024 Jan 11]; Available from: http://localhost:8080/xmlui/handle/123456789/712\u003c/li\u003e\n\u003cli\u003eWoo BFY, Goh YS, Zhou W. Understanding the gender gap in advanced practice nursing: A qualitative study. J Nurs Manag. 2022 Nov;30(8):4480. \u003c/li\u003e\n\u003cli\u003eCandra A, Wijaya D, Ardiana A. FACTORS RELATED TO NURSES NON-COMPLIANCE IN IMPLEMENTING STANDARD OPERATING PROCEDURES (SOP) IN HEALTHCARE SETTINGS: A SYSTEMATIC REVIEW. UNEJ E-Proceeding. 2023 Jun 17;321\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eSaleem S, Hussain M, Afzal M, Gilani SA. Assessing Nursing Practices Regarding Standard Approaches on Post-Operative Wound Care Dressing. Pak J Neurol Surg. 2020 Jul 14;24(2):179\u0026ndash;86. \u003c/li\u003e\n\u003cli\u003eRogers AE, Hwang WT, Scott LD, Aiken LH, Dinges DF. The Working Hours Of Hospital Staff Nurses And Patient Safety. Health Aff (Millwood). 2004 Jul;23(4):202\u0026ndash;12. \u003c/li\u003e\n\u003cli\u003eAssaye AM, Wiechula R, Schultz TJ, Feo R. Nurse staffing models in medical-surgical units of acute care settings: A cross-sectional study. Int J Nurs Pract. 2020;26(1):e12812. \u003c/li\u003e\n\u003cli\u003eMogakwe LJ, Ally H, Magobe NBD. Reasons for non-compliance with quality standards at primary healthcare clinics in Ekurhuleni, South Africa. Afr J Prim Health Care Fam Med. 2020 May 27;12(1):2179. \u003c/li\u003e\n\u003cli\u003eIqbal A, Jan A, Wajid M, Tariq S. Management of Chronic Non-healing Wounds by Hirudotherapy. World J Plast Surg. 2017 Jan;6(1):9\u0026ndash;17. \u003c/li\u003e\n\u003cli\u003eMwakanyamale AA, Mukaja AMA, Ndomondo MD, Zenas JP, Stephen AM, Mika EZ. Nursing Practice on Post-Operative Wound Care in Surgical Wards at Muhimbili National Hospital, Dar-es-Salaam, Tanzania. Open J Nurs. 2019 Jul 31;9(8):870\u0026ndash;90. \u003c/li\u003e\n\u003cli\u003eBuilders PF, Builders MI, Builders PF, Builders MI. Wound Care: Traditional African Medicine Approach. In: Worldwide Wound Healing - Innovation in Natural and Conventional Methods [Internet]. IntechOpen; 2016 [cited 2024 Jun 25]. Available from: https://www.intechopen.com/chapters/53204\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Wound, Noncompliance, Guidelines","lastPublishedDoi":"10.21203/rs.3.rs-6235039/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6235039/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWounds are a significant burden to the global health care since they are more common. Noncompliance to wound care guideline can cause many different effects.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAim\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo identify the factors associated with noncompliance to wound care guidelines among nurse working at University Teaching Hospital of Kigali.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethodology\u003c/strong\u003e: A cross-sectional design with quantitative approach was used. The target population were 105 nurses working in the Surgical Department. The participants were recruited with convenience sampling, all eligible nurses included, resulting in a sample size of 76 nurses. Bilingual questionnaires covering demographic information and factors associated with non-compliance to wound care guidelines was used and analyzed by using the descriptive statistics through SPSS Version 23.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eResults revealed that although nurses had a general understanding of wound care guidelines, various factors affected their adherence. These factors included inadequate training, lower education levels, time constraints, workload. Organizational factors such as lack of resources, poor communication played significant roles. The study found positive correlations between knowledge and adherence to guidelines (r = 0.762, p \u0026lt; 0.01), between individual attributes and non-compliance (r = 0.623, p \u0026lt; 0.01), organizational factors and non-compliance (r = 0.609 p \u0026lt; 0.01,), and demographic factors and non-compliance (r = 0.584).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAddressing gaps in training, individual constraints, and organizational support are crucial for improving adherence.\u003c/p\u003e","manuscriptTitle":"Factors associated with non-compliance to wound care guidelines among nurses working at the University Teaching Hospital of Kigali, Rwanda","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-22 17:33:11","doi":"10.21203/rs.3.rs-6235039/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f962ec16-0474-429d-881a-c113ccb3b4b0","owner":[],"postedDate":"July 22nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-08T06:09:11+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-22 17:33:11","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6235039","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6235039","identity":"rs-6235039","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}