INTRODUCTION:

Obstetric emergencies are life-threatening medical problems that develop during pregnancy, labor, or delivery.

There are a number of pregnancy-related illnesses and disorders that can endanger both the mother's and the child's health. Obstetrical emergencies may also occur during active labor and after delivery.¹

While the vast majority of pregnancies and births proceed without a hitch, all pregnancies are not without risk. Pregnancy can be a time of happiness and anticipation, but it can also be a period of anxiety and concern.²

For a smooth transition from life in the womb to life outside the womb, a delicate balance between the mother's health, the course of the pregnancy, the delivery method, and early postoperative care is essential. Pregnancy and the neonatal period significantly impact maternal and child survival outcomes.³

Adverse pregnancy outcomes are those pregnancy outcomes other than normal live birth, which mostly include preterm birth, stillbirth, and low birth weight, which are the major causes of neonatal morbidity, mortality, and long-term physical and psychological problems.⁴

In both developing and developed countries, adverse birth outcomes such as prematurity, low birth weight, and stillbirth are major issues. Around 15 million babies are born prematurely worldwide, accounting for more than one in every ten births. More than one million newborns die soon after birth, and countless others are left with lifelong physical, neurological, or educational problems, frequently at a high cost to families and societies. Moreover, women also die as a result of complications during and after pregnancy and childbirth. Many women suffering obstetrical related problems and increase rate of disease. Maternal mortality and morbidity is now common due to incomplete and lake of care in hospitals. Propre Advanced trained staff must require.⁶

In every country mother and child are constitute a major segment of the total population. Therefore, a service to women during pregnancy and delivery is tremendously significant in health care delivery system. Pregnancy is the major exciting period of expectation and fulfillment in a women’s life and its unique natural gift to women. The birth of a normal infant is the expectation of parent when pregnancy is considered, however there is threat to the fulfillment of the prospective parent’s dreams, resulting from the very dangerous disorders that contribute to unhealthy babies.⁷

NEED FOR THE STUDY:

In every country mother and child are constitute a major segment of the total population. Therefore, a service to women during pregnancy and delivery is tremendously significant in health care delivery system Pregnancy is the major exciting period of expectation and fulfillment in a women’s life and its unique natural gift to women. The birth of a normal infant is the expectation of parent when pregnancy is considered, however there is threat to the fulfillment of the prospective parents dreams, resulting from the very dangerous disorders that contribute to unhealthy babies.⁸

The quality of healthcare is determined by the availability of resources, the actual provision of care, and the patient’s level of satisfaction. Nurses represent the largest workforce in the field, and they play an important role as primary healthcare providers. Their preparedness for obstetrical emergencies is of paramount importance in reducing maternal and neonatal mortality and morbidity Conducting regular training programs for the staff nurses can help to improve the expected level of care.⁹

The key to reducing maternal and newborn morbidity and mortality is competent skilled birth attendance. Worldwide, from 2015 to 2021, approximately 84% of births were assisted by skilled health professionals, which included medical doctors, nurses, and midwives. This number was 77% from 2008 to 2014. Although many children are still dying, progress has been observed in under-five and neonatal mortality.¹⁰

Ensuring healthy lives and promoting well-being at all ages has to be a priority for all countries and communities.Unless and until the quality of care is improved and standardized, the desired impact cannot be achieved by just increasing the number of health facilities. Midwifery has not received the importance it deserves and is often neglected, although a series of four papers in the Lancet and evidence in 2014 suggested that more than 80% of maternal and newborn deaths including stillbirths could be averted by strengthening midwifery services across the world.¹¹

Obstetrical emergencies may turn catastrophic in women, so every little contribution to save maternal and neonatal mortality and morbidity. Among all the emergencies situations which may arise across the field of obstetrics, there are small numbers which call urgent practical steps to taken in order to safeguard the life of the mother or the baby or both. Emergency obstetric care is set of critical lifesaving functions commonly called signal functions provided by health care facility throughout the day and week. Obstetric complications can neither be predicted nor be prevented but can be managed by timely provision of life saving services. Prompt diagnosis, timely performed intervention and positive impact of maternal and neonatal management have significantly improved the maternal and neonatal outcome. Most maternal deaths could be preventable if women are assisted by skilled attendants at birth and those experiencing complications could reach quality emergency obstetrical care in timely manner. Obstetrical emergencies are more common with low socioeconomic status with poor access to antenatal care.¹²

In majority of cases, the complications are preventable and treatable with proper antenatal and intra-natal care. The management of emergencies is usually the responsibility of hospital obstetricians. As more maternity care is now given in community, however midwives, general practitioners and paramedics may be involved and must know the outline of management of emergencies and the possible side effects.¹³

OBJECTIVES:

· To assess the exiting knowledge of staff nurses on major obstetric emergencies and their management among staff nurse of selected hospital.

· To evaluate the effectiveness of self- instructional module on major obstetric emergencies and their management among the staff nurses.

· To find association between pretest level of knowledge obstetric emergencies and their management among sample and selected demographic variable.

HYPOTHESIS

H1There will be a significant difference between the pre-test knowledge score and post-test knowledge score related to major obstetric emergencies and their management among the staff nurses of selected hospital.

H2 There will be a significant association between their selected demographic variable and their pre-test knowledge regarding major obstetric emergencies and their management.

METHODOLOGY:

Research Appeoach:

Quantitative research approach.

RESEARCH DESIGN:

Pre-experimental, one group pre-test and post-test design.

Population:

· Target population: Target population for present study is staff nurse.

· Accessible population: Accessible population is staff nurse in selected hospital at Fatepur.

Sample:

The samples of present study are staff nurse in selected Hospital at Fatepura.

Sample Size:

The total sample size was 40 staff nurses in selected Hospital at Fatepura.

Technique of Sample Selection:

Convenience nonprobability sampling technique.

Data Analysis Plan:

The collected data was analyzed using both descriptive and inferential statistics.

RESULTS:

Major study findings includes.

Findings related to demographic variables of the study:

· According to the age distribution 24(60%) belong to 21-30 years, 11(27.5%) belong to 31-40 years, and 5(12.5%) belong to 41-50 years.

· According to the professional qualification distribution 12(30%) belong to BSc, 6(15%) belongs to MSc level, 14(35%) belong to GNM, and 8(20%) belong to ANM.

· According to the working experience distribution 26(65%) samples had 1-5 years’ experience, 24(35%) samples had 6- 10 years

· According to the previous experience in maternity related ward distribution 27(67.5%) samples had experience, and 13(32.5%) samples had experience in maternity related ward.

· According to the present working ward distribution 14(35%) belong to medical ward, 12(30%) belong to surgical ward, 11(27.5%) belongs to maternity ward and 3 (7.5%) belong child ward.

· According to the religion distribution 36(80%) samples had Hindu and 3(7.5%) samples had Muslim, and 1(2.5%) belong to Christian.

· According to the marital status distribution 23(57.5%) samples had married, 17(42.5%) samples are unmarried.

· According to the residence distribution 16(40%) belong to rural area, and 24(60%) belong to urban area.

Staff nurse shown improved knowledge after self-instructional module on knowledge major obstetrical emergencies and their management. Staff nurse, pre-test knowledge score reported 24(60%) has inadequate knowledge, 16(40%) has moderate knowledge and there was nil reported on adequate knowledge. After administration of self-instructional module post-test knowledge of Staff nurse was 32(80%) has moderate knowledge, 08(20%) has adequate level of knowledge and there was nil reported of inadequate level of knowledge.

It reveals that there was significant improvement in level of knowledge. It revealed that pre-test mean was 14.25 and post-test mean was 20.5 and mean difference was 6.25, standard deviation of pre-test was 4.253, standard deviation of post-test was 2.17208 The obtained “t-test” value for the level of knowledge on major obstetrical emergencies and their management among staff nurse 11.669 that was highly significance at p<0.05. Hence formulate H1 was accepted. This show that there is significant improvement in knowledge score on major obstetrical emergencies and their management among staff nurse after giving self-instructional module. Through the study the researcher personally found that the structured teaching was effective in improving knowledge of staff nurse on major obstetrical emergencies and their management.

CONCLUSION:

The main conclusion from this present study is that most of the nurse had moderate knowledge about obstetrical emergencies and their management.

Researcher found that some obstetrical emergencies and high-risk deliveries were experienced, large number cases of emergency pregnancy conditions and postnatal emergencies were experienced so infrequently that the clinical skills required to competently, to enhance patient safety, reduce burnout in healthcare professionals and minimize litigation costs, investing in supplementary training activities is the way forward to improving patient care.

Staff nurse from an integral and important component of maternal health care delivery system and their contribution in the event of complications as a part of team can be of paramount significance. The education and skill of nurse is designed to enable her fulfil their wide and varied role. The aim of developing self-instructional module for nurses is to prepare them for occupying the first-level position in nursing in all kin of health care setting for better maternal outcome.

REFRENCES:

1. Chhabra S. Emergency obstetric care, Essentialities for prevention of Maternal/Neonatal Mortality/Morbidity. Obstetrics and Gynaecology International Journal. 2017; 8(2): 1-5.

2. Prasad Dipali, Nishat Huma, Tiwary Bhawana, Nisha Swet, Sinha Archana, Goel Neeru. Review of obstetrical emergencies and fetal outcome in a tertiary care centre. International Journal of Research in Medical Sciences. 2018; 6(5): 1554-1558.

3. Bijoy Gifty, Lawrence Sunita. A pre-experimental study to assess the effectiveness of video assisted teaching on knowledge regarding selected obstetrical emergencies during labor among staff nurses in selected hospital of Bhopal, MP. International Journal of Nursing and Midwifery Research. 2018; 5(1): 6-11.

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8. World Health Organisation. The Word Health report: Making every mother and child count. Geneva. 2015.

9. World Health Organization. The World fact Book. 2013. Available from: http//www.cia.gov/library/ publications/the-worldfactbook/geos.

10. Progress has been made in maternal and child health, but glaring regional disparities must be addressed. 2022.

11. The projected effect of scaling up midwifery. Homer CS, Friberg IK, Dias MA, ten Hope-Bender LA. Lancet. 2014; 384: 1146–1157

12. Jayanthi. A study to assess the effectiveness of STP on ante-partum haemorrhage among staff nurses. International Journal of Applied Research. 2013; 4(3): 164-167.

13. Danasu R. A study to assess the effectiveness of skill training programme on management of selected obstetrical emergencies among staff nurses. International Journal of Research & Review. 2013; 274(11).

Received on 09.03.2024 Modified on 25.03.2024

A and V Pub J. of Nursing and Medical Res. 2024; 3(2):55-58.

DOI: 10.52711/jnmr.2024.12