Efficacy of Structured Teaching Program on Knowledge And Practice Regarding Endotracheal Suctioning Amongst Staff Nurses – A Quasi-Experimental Approach

 

Khushbu1, Sathish Rajamani2

1M. Sc (N) Scholar, Ved Nursing College, Panipat.

2Professor, DRIEMS School and College of Nursing, Cuttack.

*Corresponding Author E-mail: sat2careu@gmail.com

 

ABSTRACT:

Tracheostomy is one of the very familiar procedures performed in patients with compromised airway function. Professional nurses are required to perform tracheostomy according to standard procedures to prevent complications and promote recovery. The primary objective of the study was to evaluate the effectiveness of the Structured Teaching Program (STP) on knowledge and practice related to tracheostomy in LHDM staff nurses. Dr.Prem General Hospital in Panipat, Haryana. This study used a pre-trial approach (one group before trial, design after trial) and the researcher selected 50 nursing staff from selected hospitals in Panipat, Haryana. Samples were selected using convenience sampling technique. The data collection tool was a structured knowledge questionnaire about endotracheal aspiration care that was used as the data collection tool. On day one, the researcher collects pre-test data, then a structured curriculum is introduced, and a post-test knowledge assessment is performed on the seventh day. Data analysis was performed with descriptive and inferential statistics such as chi-square analysis and “t” test. The results of the study demonstrated a significant increase in post-test knowledge after the management of the informational dataset. (p < 0.01). Practice was significantly improved after showing a PPT video related to tracheostomy (p < 0.001). No statistically significant association was found between pre-test knowledge and practice and certain sociodemographic variables. No significant correlation was found between knowledge and practice.

 

KEYWORDS: Effectiveness, tracheostomy suction, information booklet, staff nurses of private hospitals.

 

 


INTRODUCTION:

In order to maintain the clear and patent airway among those clients admitted in the nursing care units, endotracheal intubation due to mechanical intubation was widely practiced technique by nursing professionals. The main clinical use of endotracheal intubation was to prevent a severe coughing and impaired mucocilliary function can leads to collection of secretions in in the respiratory pathways.

 

Hence, the Endotracheal Suctioning (ETS) had becomes a vital element of nursing for those who had admitted The nursing care of these clients need prominent expertise skills with regard to suctioning, because it was considered as an undoubtedly critical process affiliated with severe complications like hypoxemia, trauma, cardiac arrest, bronchoconstriction and death.

 

Endotracheal suction (ETS) is an invasive procedure keeping airways patent by the way of endotracheal tube and with the technique of natural taking off the collected pulmonary fluids. Patients who were intubated most often, subjected to over production of secretion of mucous and decreased ability to remove the secretions of airway, which might rattle some risks for those patients with pneumonia infection and atelectasis. Hence, the ETS is a procedure which aimed to save life and to enhance the removal of respiratory tract secretions, improves the oxygen saturation and thus prevents atelectasis.

 

In addition to ETS being a necessary procedure for adult and pediatric patients, if the procedure is not performed correctly it can lead to serious complications such as bleeding, decreased oxygen levels in the blood, atelectasis and atelectasis. intracranial increase. blood pressure, severe heart failure, and sudden death. Therefore, there is an urgent need to impart knowledge and skills through an evidence-based curriculum in the implementation of Health Technology Assessment (HTA) and other related care services.

 

Problem Statement:

“A Quasi-Experimental Approach to Assess the Efficacy of Structured Teaching Program On Knowledge and Practice Regarding Endotracheal Suctioning Amongst Staff Nurses at LHDM. Dr Prem Hospital. Panipat.”

 

Study Objectives:

 

1.     To evaluate and comparison of practices before and after testing of tracheostomy among nursing staff at selected private hospitals in Panipat.

2.     Evaluation and comparison of practices before and after testing of tracheostomy among nursing staff at a selected private hospital in Panipat.

3.     Exploring the relationship between knowledge and practice of tracheostomy among nurses of selected private hospital staff in Panipat.

4.     To identify the statistical association between pre-test average knowledge and tracheostomy practice in nurses and selected demographic variables.

 

Hypotheses:

H1: There will be a significant difference between the average pre-test and post-test tracheostomy knowledge among nurses at the p < 0.05 significance level.

H2: There will be a significant difference between the average pre-test and post-test tracheostomy practice among nurses at the p < 0.05 significance level.

 

Conceptual Framework:

In this study, the researcher relied on Weidenbach's theory of assistive arts in clinical nursing (1964). It explains the expected situation and directs action towards a clear goal.

 

Research Design:

Based on the quantitative research method, this study was conducted with quasi-experimental research design. The study was done at LHDM. Dr Prem Hospital, Panipat. The research samples were taken according to the non-probability method. Convenient sampling technique is preferred. The sample size for this study was 50 nurses. The researcher developed a knowledge questionnaire to assess knowledge and a checklist developed to evaluate practice related to tracheal intubation among staff nurses. Data were collected through a self-reported questionnaire method to assess knowledge and an observational method to determine practice. On the first day, a pretest was administered and the intervention structured curriculum introduced the patterns. Tracheostomy tube parts, types of tracheostomy tubes, indications that may require tracheostomy, tracheostomy procedure, management plan and nursing care. Video Power Point covers the steps of tracheostomy in three phases, i.e. preparatory phase (assessment and sterile suction device tray), preparation phase (hand washing and preparation of sterile items) ) and the stage of the procedure (steps of the suction procedure) and post-procedure equipment to worry about. Subjects were met individually, lecture discussion methods were used to impart knowledge, and videos were screened to improve nurses' practice. The data collected in this study were analyzed using descriptive and inferential statistics.

 

Analyze and interpret of data

 

Table – 1: Percentage breakdown of samples based on socio-demographic variables (N = 50)

S. No

Socio – Demographic Variables

f

%

1.

Age

22 – 23 Years

24 – 25 Years

26 – 27 Years

 

19

22

9

 

38.00

44.00

18.00

2.

Gender

Male

Female

 

7

43

 

14.00

86.00

3.

Qualification

Diploma in Nursing

Baccalaureate in Nursing

Post - Basic B. Sc (Nursing)

 

16

32

2

 

32.00

64.00

4.00

4.

Work Experiences in Year

< 1 year

1 – 2 year

2 – 3 year

> 5 year

 

30

11

7

2

 

60.00

22.00

14.00

4.00

5.

Present clinical area

General ward 

Emergency

ICU

Any other

 

14

3

23

10

 

28.00

6.00

46.00

20.00

6.

Monthly Income (Rs)

< 10000

10,001 – 15,000

15,001 – 20,000

> 20,001

 

30

19

1

0

 

60.00

38.00

2.00

0.00

 

Table 1 describes the Percentage breakdown of samples based on socio-demographic variables

 

With regard to age of the samples, a majority of 22 (44.0 %) were in age between 24 – 25 years, gender distribution of the sample reveals majority of 43 (86.0 %) were females. Qualification of the samples in the study shows majority of 32(64.0%) as qualified with B. Sc (N). Regarding experience majority of 30 (60.00%) samples had 1 year of working experience. With regard to the working area of the samples, majority of 23 (46.00%) samples were from ICU. With regard to monthly income of the samples majority of 30 (60.00 %) had their monthly income less than Rs.10,000.

 

Figure 1: Percentage breakdown of Samples According to knowledge level concerning to Endotracheal Suctioning

 

Figure - 1 shows the percent distribution of subjects in relation to the level of knowledge about tracheotomy. in the study samples. During the pre-test, the majority of samples (90.00%) had moderate knowledge and one-tenth of the total samples (10.00%) had incomplete knowledge. Similarly, at the time of the post-test, an overwhelming majority of samples (98.00%) had full knowledge and only one sample (2.00%) had intermediate knowledge. No sample has incomplete knowledge.

 

0

 
Figure 2: Percentage breakdown of Samples According to Practice Levels

 

Concerning to Endotracheal Suctioning:

Figure – 1 depict the percentage distribution of the subjects based on the practice level about tracheostomy suctioning among the samples in the study. During the pre-test an overwhelming majority of 30 (60.00%) samples had average level of practice and 20 (40.00%) samples had poor level of practice. Similarly, in the post-test, majority of 48 (96.00%) samples had good level of practice and 2 (4.00 %) samples had average level of practice. Neither sample exhibited a poor level of practice.

 

 Table –2 depicts the effectiveness of structured teaching programme regarding tracheostomy suctioning among the samples with regard to knowledge and practice.

 

To test the effectiveness of the structured teaching programme on knowledge regarding tracheostomy suctioning, the hypothesis can be stated as,

 

H1: There will be a significant difference between the average pre-test and post-test tracheostomy knowledge among nurses at the p < 0.05 significance level.

 

The mean pre-test knowledge and standard deviation score was 15.08 + 3.089 and the post- test knowledge and the standard deviation scores were 27.02 + 1.491. The Paired‘t’ test score was 25.7 for the degree of freedom 49 at the table value of 2.01 which was statistically significant at the ‘P’ value  < 0.001. The structured teaching programme on knowledge regarding tracheostomy suctioning was effective. Hence, the null hypothesis was rejected and H1was accepted.

 

To test the effectiveness of the structured curriculum on the practice of tracheostomy, the following hypothesis can be formulated.

 

H2: There will be a significant difference between the average pre-test and post-test tracheostomy practice among nurses at the p < 0.05 significance level.

 

Table 2: Efficacy of a structured curriculum on intubation knowledge and practice for nurses (N = 50)

Test

Knowledge

Practice

Mean

SD

Mean

%

Mean

difference

‘t’ test

value

‘P’

value

Mean

SD

Mean

%

Mean

Difference

‘t’ test

value

Value

Pre test

15.08

3.089

50.27

11.94

25.7

(df =49)

0.001

17.68

4.377

36.83

22.88

32.26

(df =49)

0.001

Post test

27.02

1.491

90.07

11.94

25.7 (df=49)

0.001

40.56

4.077

84.50

32.26

(df = 49)

32.26

(df =49)

0.001

Significance level p < 0.05


 

Practice before testing mean and standard deviation score is 17.68 + 4.377 and post-test practice and standard deviation scores were 40.57 + 4.077. The paired ‘t’ test score was 32.26 for the degree of freedom at 49. The table value of 2.01 which was statistically significant at the ‘P’ value of < than 0.001. Hence we reject null hypothesis and H2 was accepted.

 

DISCUSSION:

In this section, we like to discuss the study findings along with the supportive studies done in the past by other researchers.

 

Parihar R.R (2015) did a study which aimed to evaluate the planned curriculum (PTP) and its effect on the knowledge of intubation among caregivers working in intensive care units. Findings of this study shows there was an increase in knowledge level between pre-test and post-test assessment 17.07 to 25.30. The ‘t’ test statistics depicted there was a high significant difference in knowledge level at ‘p’ value < than 0.01.

 

In another study, conducted by Jacob B and Ramesh A, (2015) with the objective to validate whether a planned teaching program will enhance knowledge about tracheostomy among nursing staffs at the selected hospitals at Vidarbha region, Maharastra. Result of this study findings revealed there was an increase in number of nursing staffs (48 %) who had satisfactory knowledge and good level of knowledge (52 %) at the time of pre-test. Post-test evaluation reports showed that (80%) caregivers had an excellent level of knowledge while (20%) of  subjects had a decent level of knowledge and none of the caregivers achieved an excellent level of knowledge.

 

CONCLUSION:

In this study, knowledge and practice regarding endotracheal suctioning was considerably increased after administering the structured teaching programme. Thus, both the information booklet and the power point video can be used as effective aids to enhance knowledge and awareness and upgrade practices of nursing staffs about endotracheal suctioning. As a health professional’s nurses are in the position to impart knowledge and train the nursing staffs to adopt good and healthy practices.

 

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Received on 22.10.2022         Modified on 08.11.2022

Accepted on 22.11.2022       ©A&V Publications All right reserved

A and V Pub J. of Nursing and Medical Res. 2022; 1(1):1-4

DOI: 10.52711/jnmr.2022.01