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Article History

Received: 31 December 2024

Accepted: 13 October 2025

First Online: 4 December 2025

Declarations

:

: Ethical approval for this study was obtained from the Institutional Review Board (IRB) of Asrat Woldeyes Health Science Campus, Debre Berhan University. The IRB granted a waiver of informed consent as the study was based on a retrospective review of existing medical records with no direct contact with patients and no collection of identifiable personal information. Following IRB approval, an official cooperation letter was issued by the School of Nursing and midwifery to each selected hospital, and formal permission was secured. Data collection was carried out only after obtaining authorization from the hospitals and respective units, as the study involved a retrospective review of medical records.The research was conducted in accordance with the principles of the Declaration of Helsinki, ensuring strict confidentiality and anonymity of patient data. No personal identifiers were recorded or included in the analysis.

: Not applicable.

: The authors declare no competing interests.