| Summary: | Abstract Background More than four million people die worldwide within 30 days of surgery each year. Poor assessment and management of risk factors are prone to adverse postoperative outcomes. The literature indicates that the implementation of preoperative care minimizes postoperative complications through risk assessment of surgical patients. Although some studies have been conducted across the globe on preoperative care, to the best of our knowledge, only a limited number of studies have been conducted on preoperative care in Ethiopia. Methods An institution-based cross-sectional study was conducted among 366 randomly selected nurses from southern Ethiopian specialized hospitals from May 15–June 15, 2021. A self-administered questionnaire and observational checklists, which were adopted from different studies designed for the same study purpose, were used. The data were entered into Epidata version 3.1 and exported to SPSS version 21 for analysis. Both descriptive and inferential analyses were performed. All covariates that were significant at p values < 0.25 in binary logistic regression analysis were considered for further multivariable logistic regression analysis, and the results were considered statistically significant at P < 0.05 according to the odds ratio and 95% CI. Results According to the findings of this study, the rates of poor practice of preoperative patient care among surgical unit nurses in three southern Ethiopian specialized hospitals were 45.4% (95% CI: 39.9, 50.3) and 61.4% (95% CI: 54.5, 71.7) according to self-administered and observational check lists, respectively. The following factors were significantly associated with the poor practices of nurses: education level, AOR 8.55 (95% CI: 4.56, 16.02); professional experience, AOR 3.01 (95% CI: 1.45, 6.25); poor knowledge, AOR 2.78 (95% CI: 1.52, 5.08); workload, 2.95 (95% CI: 1.36, 6.41); unavailable resources, AOR 2.36 (95% CI: 1.34, 4.14); and job attributes, AOR 3.51(95% CI: 1.77, 6.97). Conclusion In this study, nearly two-thirds and nearly half of the nurses working in the surgical units of southern Ethiopian comprehensive specialized hospitals had poor practices of preoperative care according to the observational checklist and self-administered questionnaires, respectively. Being a diploma nurse, having less than 6 years of professional seniority, having poor knowledge of nurses, having work overload for nurses, having resource unavailability, and having job attributes were significantly associated with poor practices by preoperative nurses. The overall significance of this study includes enhancement of nursing practice and patient outcome, Informing policy & training programs, highlighting area for improvement and foundation for future research. Hospital administrators need to arrange structured in-service training modules or resource allocation frameworks and quality assurance programs, and nurse educators need to integrate preoperative care training.
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