INTRODUCTION:
Intravenous infusion of fluids has become widely used as a therapeutic modality in the care of adult patients and children. The nurse has the important role and responsibility in monitoring this type of therapy. Intravenous therapy is the quickest and most effective means of administering fluid or medicine to the ill infant, child and adults. Intravenous fluid may be infused into a peripheral vein, a central access device, or a peripherally inserted central catheter. It is necessary to understand the principles of intravenous therapy, including the fluid and caloric needs of the patients to act as a second level of protection against over hydration or under hydration during intravenous fluid therapy2.
Peripheral intravenous cannulation is most widely used procedure in a hospital or in a community setting. Peripheral venous devices were introduced more than 40 years ago3.
Intravenous therapy has become a crucial and frequent intervention in modern acute nursing care. Spring House corporation (1993) and Wilkinson (1996) estimate that 18% to 80% of general hospital admissions will include some aspect of intravenous therapy. Managing an intravenous therapy regimen has been a common nursing role. Nurses spend up to 2/3 of their time on Intravenous therapy related responsibilities4.
An article on IV therapy and liability issues also cited that in the US there are many potential complications associated with intravenous therapy. Most law suites arose mainly from two of the main complications such as infiltration and phlebitis. However, these two complications could be easily preventable5.
Although intravenous cannulation is a key procedure in almost all departments of health care, it also has its own disadvantages when not taken proper care of. These vascular access devices cause many types of complications like intravenous (IV) phlebitis, thrombophlebitis, catheter embolism, bleeding, nerve, tendon or ligament damage, needle stick injuries, sepsis, etc. Nosocomial infections are associated with vascular access devices that are the major concern in today’s medical care. 30% of the nosocomial bacteraemia in the US hospitals are associated with intravenous catheters5. The annual incidences of septic phlebitis in the US is unknown but it is the most common cause of fever after the third post-operative day, occurring in at least 12% of patients who have undergone surgery. 9% of ICU patients with central venous catheters develop fever and bacteraemia and have positive results of the culture of the venous catheter tip. The International incidences in the developing countries are unknown6.
Nosocomial infection associated with intravenous therapy area major concern in today’s medical care. There are two major sources of blood stream infection associated with any intravascular devices: colonization of the devices itself and contamination of the fluid administered through devices7.
Infiltration and extravasations of intravenous fluid is a complication of neonatal intensive care that results in varying degree of morbidity. The severity of damage depends on the volume and type of the fluid in filtered. Infiltration is the most common complication of peripheral intravenous therapy. Complication rates of intravenous infiltration range from 0 to 78 percent. Intravenous extravasations are estimated to occur in 11 percent of NICU patients, with tissue sloughing occurring in 43.6 percent of those infants. Common site of extravasations include the dorsum of the hands, the antecubital fosse and the ankle. Serious extravasations can result in pain, infection, disfigurement, prolonged hospitalization, increased hospital costs and possible litigation8.
NEED FOR THE STUDY:
The quality of care received in the hospital is often reflected in patient comfort as well as in the patient’s morbidity status. Intravenous infusion is the most common of all invasive therapy with 60% of inpatients receiving intravenous therapy in the form of fluids, medication and blood9.
The insertion and removal of peripheral intravenous cannula is a common nursing task that requires careful maintenance by constant care. The complications due to intravenous therapy are often overlooked by nurses and losing sight of the aim of therapy can cause discomfort or further injury10.
Nursing is a rewarding career. Becoming a nurse requires a caring personality, proper education and training. It also requires mathematical skills. The use of mathematics is prominent in nursing to evaluate a patient's health and administer medications for each patient. Knowing formulas and simple calculations allows a nurse to effectively perform their duties from patient care to aiding doctors. The recording of information such as fluid intake and output, number of times when medication is given and checking vital signs all require math11.
Inserting, monitoring, and maintaining peripheral venous access is an integral component of nursing practice. The responsibility of the nurse starts from the time the patient is admitted to the hospital seeking health care. Any appropriate practitioner who has obtained or is obtaining the necessary knowledge and supervised practice to complete the skill of administering IV fluids is said to be eligible for the procedure. Nurses have a pivotal role to play in reducing and preventing healthcare-associated infections (HCAIs), because of their links and interaction with families, patients and other healthcare professionals and provision of direct patient care. Administering IV fluids is one of the basic procedures that the nurse must be able to do without assistance. The main responsibility of the nurse is the safety of the patient to whom she is giving care12.
Patient safety is an emerging concern of the health care providers. The nursing professionals are faced with the challenge of providing best possible care. Nurses are the prime responsible personnel in the hospital for the care of the patient and they must be capable of deciding what care must be given to the patients and must not wait for the doctors to suggest treatment protocol. Nurses have an obligation that they and their patients are protected from the complications and hazards associated with intravenous devices. Insertion of intravenous devices is so common that it is found in all the departments of the health care setting. This procedure, being so common, there is a tendency to assume that it is routine and will not be associated with any clinical problems13.
The investigator during her clinical experience observed many patients with disease condition that necessitates Intravenous therapy. This made the investigator to do a study to assess the knowledge and practice on IV fluid therapy among registered nurses. Therefore, the investigator felt the need that nurses are to be given timely and prompt education programs and hence developed the structured teaching program to improve the knowledge and practice regarding IV fluid therapy14.
STATEMENT OF THE PROBLEM:
A study to assess the effectiveness of video assisted teaching on knowledge regarding IV fluid therapy among registered nurses at selected private hospital.
OBJECTIVES:
1. To assess the pre-test knowledge on IV fluid therapy among registered nurses.
2. To assess the post-test knowledge on IV fluid therapy among registered nurses.
3. To assess the effectiveness of video assisted teaching on IV fluid therapy among registered nurses.
4. To associate the findings of post-test knowledge score on IV fluid therapy among registered nurses with their selected demographic variables.
HYPOTHESIS:
H1: There will be significant difference between pretest and posttest scores on knowledge on IV fluid therapy among registered nurses after receiving video assisted teaching.
H2: There will be significant association of post-test level of knowledge on IV fluid therapy among registered nurses with their selected demographic variables.
Operational Definitions:
Assess:
Refers to the determination of level of knowledge on IV fluid therapy among registered nurses.
Effectiveness:
In this study effectiveness refers to, determining the extent to which the video assisted teaching has achieved the desired effects in terms of gain in knowledge on a structured questionnaire among nurses on IV fluid therapy.
Video Assisted Teaching:
A system of recording and reproducing moving visual images using magnetic tape or CD are used to communicate with and see each other to a group of people. In this study teaching with video shall be done on IV fluid therapy.
Knowledge:
It is the ability of the nurses to respond to the questions regarding IV fluid therapy assessed by structured knowledge questionnaire framed by the nurse researcher.
IV Fluid Therapy:
Refers to infusion of liquid substances directly into a vein. The word intravenous simply means "within vein." Intravenous therapy may be used to correct electrolyte imbalances, to deliver medications, for blood transfusion or as fluid replacement to correct.
Registered Nurses:
Refers to a graduate nurse who has been legally authorized (registered) to practice after examination by nurse examiners or similar regulatory authority, and who is legally entitled to use the designation RN.
MATERIALS AND METHODS:
Research Approach:
A quantitative research approach has been used for this study.
Research Design:
The research design used in this study was one group pretest post-test research design.
Population:
The population of the study includes all registered nurses at the selected private hospital.
Sampling Technique and Sample Size:
The investigated selected 30 registered nurses by non-probability convenient sampling technique.
RESULTS:
The major findings of the study was summarized as follows:
· Among 30 samples 11(36.67%) of registered nurses were in the age group of 31 – 40. Considering the sex of the registered nurses, majority 20(66.67%) were females. Regarding the qualification of registered nurses, majority 14(46.67%) were ANM. With respect to experience in years, majority 12(40%) had 0 to 5 years of experience, 11(36.67%) had 6 to 10 years of experience and 7(23.33%) had 11 to 15 years of experience.
· Findings of pre-test analysis majority 28(93.33%) had inadequate knowledge and 2(6.67%) had moderately adequate knowledge on IV fluid therapy whereas in the post test, majority 26(96.67%) had adequate knowledge and 4(13.33%) had moderately adequate knowledge on IV fluid therapy.
· In pretest, the mean score of knowledge was 20.30 with S.D 6.59 and in the post test the mean score of knowledge was 61.13 with S.D 4.75. The mean improvement score was 40.83. The calculated paired ‘t’ value of t = 24.136 was found to be statistically significant at p<0.001 level. This clearly indicates that the video assisted teaching on IV fluid therapy among registered nurses had significant improvement in their level of knowledge on IV fluid therapy in the post test. It shows that video assisted programme was effective in improving the knowledge on IV fluid therapy among registered nurses. Hence Hypothesis H1 is accepted.
· The demographic variable “experience” had shown statistically significant association with post-test level of knowledge on IV fluid therapy among registered nurses at p<0.05 level. Hence the hypothesis H2 is accepted.
Section A: Assessment of Pretest and Post test level of knowledge on iv fluid therapy Among Registered Nurses.
Figure 1: Percentage Distribution of Pre-Test and Post-Test Level of Knowledge on Iv Fluid Therapy Among Registered Nurses n = 30
The Figure 1: Shows that in the pretest, majority 28(93.33%) had inadequate knowledge and 2(6.67%) had moderately adequate knowledge on IV fluid therapy whereas in the post test, majority 26(96.67%) had adequate knowledge and 4(13.33%) had moderately adequate knowledge on IV fluid therapy.
SECTION B: ASSOCIATION OF POST TEST LEVEL OF KNOWLEDGE AMONG REGISTERED NURSES WITH SELECTED DEMOGRAPHIC VARIABLES:
Table 1: Association of post-test level of knowledge on IV fluid therapy among registered nurses with their selected demographic variables n = 30
|
Demographic Variables |
Moderately Adequate (51 – 75%) |
Adequate (>75%) |
Chi-Square Value |
||
|
No. |
% |
No. |
% |
||
|
Age (in years) |
|
|
|
|
d.f = 3 p = 0.197 N.S |
|
21-30 |
0 |
0 |
8 |
26.7 |
|
|
31-40 |
3 |
10.0 |
8 |
26.7 |
|
|
41-50 |
1 |
3.3 |
10 |
33.3 |
|
|
Sex |
|
|
|
|
d.f = 1 p = 0.704 N.S |
|
Male |
1 |
3.3 |
9 |
30.0 |
|
|
Female |
3 |
10.0 |
17 |
56.7 |
|
|
Qualification |
|
|
|
|
d.f = 2 p = 0.385 N.S |
|
BSC nursing |
1 |
3.3 |
8 |
26.7 |
|
|
GNM/Diploma |
2 |
6.7 |
5 |
16.7 |
|
|
ANM |
1 |
3.3 |
13 |
43.3 |
|
|
Experience (in years) |
|
|
|
|
d.f = 2 p = 0.027 S* |
|
0 to 5 |
1 |
3.3 |
11 |
36.7 |
|
|
6 to 10 |
0 |
0 |
11 |
36.7 |
|
|
11 to 15 |
3 |
10.0 |
4 |
13.3 |
|
*p<0.05, S – Significant, N.S – Not Significant
Table 1: Shows that, the demographic variable experience had shown statistically significant association with post-test level of knowledge on IV fluid therapy among registered nurses at p<0.05 level and the other demographic variables had not shown statistically significant association with post-test level of knowledge on IV fluid therapy among registered nurses.
CONCLUSION:
The present study assessed the effectiveness of video assisted teaching on knowledge and practice on administration of IV fluid therapy among registered nurses. The results revealed that video assisted teaching is very effective in increasing the level of knowledge and practice at p< 0.001 level. On the basis of the study, the investigator concluded that video assisted teaching module has an important action in increasing the level of knowledge and practice on administration of IV fluid therapy among nurses.
RECOMMENDATIONS:
· Nursing research is a widely expanding area with need for validating conservative interventions and development of new knowledge. The study recommends the following for achieving this end.
· A descriptive study can be carried out to assess the factors leading to the development of IV infiltration.
· The same study can be replicated.
· The study can be conducted in larger sample for better generalization.
· A comparative study can be conducted to compare the effect of video assisted teaching among experimental group and control group without intervention.
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Received on 12.04.2025 Revised on 30.04.2025 Accepted on 15.05.2025 Published on 22.05.2025 Available online from May 24, 2025 A and V Pub J. of Nursing and Medical Res. 2025;4(2):61-65. DOI: 10.52711/jnmr.2025.15 ©A and V Publications All right reserved
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