Determinants of the Flowchart Use by Registered Nurses and Associates in the Kasa-vubu Health Zone in Kinshasa, Democratic Republic of the Congo

Main Article Content

Oscar Kolnziam Nsutier
Désiré L. Nsobani
Tshiama Claudine
Deborah Mujinga Tshimungu
Jacques Murazini Kanika
Judith Gegeso Scherpes
Gédéon Ngiala Bongo


Aims: The aims of this research was to identify the main determinants (factors) that contribute to the low flowchart use registered nurses in Kasa-Vubu Health Zone, and to verify the existence of a relationship between the studied factors and the socio-demographic characteristics of the respondents.

Study Design: This analytical study with a correlational estimate aims to explore the relationships between variables related to intention and seeks to determine whether the variables involved are associated with facts.

Place and Duration of the Study: This survey was carried out in the health facilities of Kasa-vubu health zone between May and June 2017.

Methods: A questionnaire was used to collect data thru a structured interview. A pre-test was conducted in Bandalungwa health zone in order to provide quality care while using the flowchart. The Likert-type scale with seven choices was used in the design of different items. The sample size was established based on the number of participants per predictor variable in order to meet the statistical power in a multiple regression analysis. After calculation, the sample size was 105 respondents. The target study population was registered nurses, assistant registered Nurses and the executive nurses who use the flowchart during clinical consultation within their respective health centre including all the health centres in the aforementioned health zone. Data analysis was performed using SPSS version 20 software and the p-value <0.05 was considered to be significant whereby descriptive statistics and correlation of Pearson were used. For ethical reasons, the consent of the respondent was needed.

Results: The analysis showed that 60% of the respondents were under 40 years of age, 50.5% were married, 80% had more than 5 years of service and 89.5% had a graduate degree. However, 59.0% were executive nurses. In addition, there is a statistically significant association between the use of the flowchart and motivation (p=0.014), the importance given by registered nurses and executive nurses in the therapeutic management of patients (p=0.001). Moreover, there is a statistically significant association between the flowchart systematic use and the education level during patient management (p=0.000). Last, there is an association between the flowchart systematic use and the importance given to facilitating and/or detrimental factors (p=0.001).

Conclusion: The socio-demographic parameters, factors related to the importance given to facilitating and/or detrimental factors and motivational factors significantly influence the systematic use of the flowchart in the therapeutic management of patients in the Health zone of Kasa-vubu. Yet, key determinants, which favor the low use of the flowchart by nurses of Kasa-vubu health zone, were identified. Hence, this would draw the attention of decision-makers for a better improvement of the health system in order to have a better patient management in different health zones of Kinshasa in DRC.

Flowchart, health zone, nurses, socio-demography, therapeutic management

Article Details

How to Cite
Nsutier, O. K., Nsobani, D. L., Claudine, T., Tshimungu, D. M., Kanika, J. M., Scherpes, J. G., & Bongo, G. N. (2019). Determinants of the Flowchart Use by Registered Nurses and Associates in the Kasa-vubu Health Zone in Kinshasa, Democratic Republic of the Congo. Archives of Current Research International, 18(1), 1-16.
Original Research Article


Ministère de la santé congolais. Ordinogramme des soins au Centre de santé. Direction de développement des soins de santé primaires. Instructions for the Use of Ordinogramme; 2011

Fountain D. Infirmier, comment traiter votre malade. harmattan: Simani ; 1992.

Kwete D, Binanga A, Mukaba T, Nemuandjare T, Mbadu MF, Kyungu MT, Bertrand JT. Family planning in the Democratic Republic of the Congo: Encouraging momentum, formidable challenges. Global Health: Science and Practice. 2018;6(1):40-54.

Isono H, Suzuki S, Ogura J, Haruta J, Maeno T. Improving the workflow of nursing assistants at a general hospital in Japan. BMJ Open Qual. 2017;6(2): e000106.

Haegeman F, Ledecq L, Wyffels A, Damak K. Evaluation of the use of diagnostic / trachement equipment in the center of Nord-Cameroun. Service département de la santé publique du diamaré. Cameroun; 1994.

Audibert M, et al. and Roodenbeke E. Application of services of santé de premier niveau au Mali: Analyze the situation et perspectives. Région Afrique. Département du développement humain. Région Afrique. Banque Mondiale; 2005.

Audibert M, Mathonnat J, Roodenbeke E(. Le financement de la santé dans les pays d'Afrique et d'Asie à faible revenu, Ed. Karthala. Paris; 2003.

Wangata J. Les mutuelles de santé : une panacée pour les soins de santé primaires en RDC, Kinshasa DEP; 2002.

Achterberg TV, Getty GJ. Huisman-de Waal, Nicole ABM. Ketelaar Rob A, Oostendorp, Johanna E. Jacobs, Hub CH. Wollersheim. How to promote healthy behaviours in patients? An overview of evidence for behaviour change techniques. Health Promotion International, 2011; 26(2):148-162.
DOI: 10.1093/heapro/daq050

Fortin MF, Gagnon J. Fondements et étapes du processus de recherche: Méthodes quantitatives et qualitatives. Montréal, Qc: Chenelière Éducation; 2010. [UdeM : H61 F676 2010]

Fortin MF, Gagnon J. Fondements et étapes du processus de recherche: méthodes quantitatives et qualitatives. 3ème édition, Chenelière éducation, Montréal, Canada. 2016;518.

Joshi A, Kale S, Chandel S, Pal DK. Likert scale: Explored and explained. British Journal of Applied Science & Technology. 2015;7(4):396-403.

Godin G, Gagné C, Sheeran P. Does perceived behavioural control mediate the relationship between power beliefs and intention? Br. J. Health Psychol. 2004;9: 557-568.

Heelis R, Graham H, Jackson C. A preliminary test of the interpersonal psychological theory of suicidal behavior in young people with a first episode of psychosis. Journal of Clinical Psychology. 2016;72(1):79-87.

Koo TK, Mae YL. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. Journal of Chiropractic Medicine. 2016;15(2):155-163.

Nunnally J, Bernstein I. Psychometric theory (3rd ed.). New York: McGraw-Hill; 1994.

Aoufi H. Les facteurs de risque du pied diabétique à la province de Tétouan: Etude Cas-Témoin. Mémoire de fin d'études. Master in administration sanitaire et sante publique. Ministère de la Santé. Institut National d'Administration Sanitaire. Royaume du Maroc. En ligne. Consulter le; 2012.

Kanika M. Knowledge, attitudes and practices of health practitioners in the prevention of nosocomial infections in the health services of the General Hospital of Référence of N'djili. Unpublished BSc thesis, Section of Nursing Sciences, Option of Teaching and Administration in Nursing cares, Higher Institute of Medical Techniques, Kinshasa, Democratic Republic of the Congo; 2015.

Lamchahab FZ, El Kihal AN, Khoudri AI, Chraibi A, Hassam B, Ait Ourhroui M. Factors influencing the awareness of diabetic foot risks. Annals of Physical and Rehabilitation Medicine; 2011.

Denis J, Contandriopoulos A. Intégration des soins, dimensions et mise en œuvre, Revue transdisciplinaire en santé, ruptures 2001;8.

Luk E, Burry L, Rezaie S, Mehta S, Rose L. Critical care nurses’ decisions regarding physical restraints in two Canadian ICUs: A prospective observational study. The Canadian Journal of Critical Care Nursing. 2015;26(4):16-22.

Adovohekpe P. The rationalisation des soins curatifs. Etude de quelques obstacles à l'utilization des ordinogrammes au bénin. Anvers. Institut de médecine tropicale; 1991.

Essix B. Diagnostic pathways in clinical medicine. 2nd ed. Edindurgh. Chirdill. Livingstone; 1976.

Daveloose P. Methodological study of the paediatric consultation. Establishment and evaluation of diagnostic-treatment strategies used by auxiliaries (Unpublished PhD dissertation). Antwerpen: Tropical Medicine Institute. 1976;110.