Assessment of Nurses’ Knowledge on the Implementation of Atraumatic Care in Hospitalized Children at a Level-5 Hospital in Kenya

Abstract

Hospitalization can be a traumatic experience for children due to pain, fear, separation from caregivers, and unfamiliar clinical environments. Atraumatic care is a child-centered approach in pediatric nursing aimed at minimizing physical and psychological distress during medical procedures. Nurses, as primary caregivers, play a vital role in implementing atraumatic care, and their knowledge is key to its successful application. This study aimed to assess the knowledge of nurses on the implementation of atraumatic care in hospitalized children at Nakuru Level-5 Hospital in Kenya. A cross-sectional descriptive design was employed. The study was conducted at Nakuru Level-5 Hospital, a major referral and teaching facility in Kenya’s Rift Valley region. The target population included nurses working in the pediatric ward. A purposive sampling method was used to select 48 eligible nurses with at least three months of continuous experience in pediatric care. Data were collected using a structured self-administered questionnaire, validated through expert review and pretested for reliability. Data were analyzed using SPSS version 25 to generate descriptive statistics. Most respondents (91.7%) correctly identified pain and discomfort reduction as the primary goal of atraumatic care. A significant majority (81.3%) also recognized physical restraints as inappropriate for pain management in children. However, some respondents incorrectly classified distraction techniques (8.3%) and procedural instructions (8.3%) as unsuitable. Additionally, while 81% accurately described non-pharmacologic care as involving parental presence during procedures, a few misclassified sedatives and severe language as appropriate methods. Notably, 38% of nurses were uncertain about the effectiveness of atraumatic care in reducing physical discomfort. Although nurses demonstrated general awareness of atraumatic care principles, gaps in technical knowledge remain. Targeted professional development programs are essential to improve understanding and consistent application of atraumatic care in pediatric nursing practice.