Effectiveness of Structured Teaching Programme on Knowledge regarding Management of Pressure sore among the nurses in selected Hospital at Mysore.

Mrs. J. Lissa¹, Ms. Saraswathi K.N.¹, Mrs. Munirathanama K.¹

¹Assistant Professor, JSS College of Nursing, Mysore

Corresponding Author Email: saraswathimysores803@gmail.com

ABSTRACT

Background of the study

Prevention is better than cure. This dependent on awareness of pressure sore risk in all nurses and patient.

The pressure sore are the wound following tissue necrosis from pressure. They occur over bony prominences. Pressure sore commonly occur in paraplegic individual, unconscious or confused patients. They also occur in situation in which perfusion pressure is low such as hypotension and peripheral vascular disease.1

A study to assess the effectiveness of structured teaching programme on knowledge regarding management of pressure sore among the nurses in selected hospital at Mysore.

Objectives

1. To assess the pretest knowledge regarding management of pressure sore among nurses

2. To assess the post test knowledge regarding management of pressure sore among nurses

3. To assess the effectiveness of structured teaching programme on knowledge regarding management of pressure sore among nurses

4. To associate the pre test knowledge regarding management of pressure sore among nurses with their selected demographic variables.

Methodology

Quasi experimental one group pretest post test research design was adopted for the present study. The Structured Knowledge Questionnaire was developed to collect the data. The study was conducted at JSS hospital ,Mysore among 60 nurses who were selected by using non probability convenience sampling technique and the data collected was analyzed using descriptive and inferential statistics.

Major findings and results

 The findings reveals that, in the post test majority of them 54(90%) had adequate knowledge and 6(10%) had moderate knowledge regarding management of pressure sore among nurse.

 The findings depicts that obtained paired‘t’ test value 29.94, it was highly significant at 5% level p< 0.05. This showed the effectiveness of structured teaching programme. Hence, research hypothesis (H1) was accepted.

 The association of demographic variables with pretest level of knowledge by using chi-square test revealed that there was statistically not significant at p < 0.05. Hence the research hypothesis (H2) was not accepted.

Conclusion

The present study attempted to assess the effectiveness of structured teaching programme on knowledge regarding management pressure sore among nurse found that the teaching programme was effective in improving the knowledge of nurse regarding management of pressure sore .

KEY WORDS: Knowledge, Management, pressure sore and nurses.

NEED FOR THE STUDY:

The Pressure ulcers are a common and serious health care problem in all health care settings . A pressure ulcer is defined as 'a localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear'. Pressure ulcers can result in a decreased quality of life, an increased need for intensive nursing and medical care and a rise in morbidity and mortality rates . Studies around the world have reported large differences in pressure ulcer prevalence rates, varying from 4.7% to 22.9% in hospitals and 7.7% to 83.6% in nursing homes² .

MAGNITUDE OF THE PROBLEM:

· Every year an estimated 60,000 people die from the complication of pressure ulcer³.

· Pressure ulcers are among the most common conditions encountered in patients acutely hospitalized or requiring long-term institutional care. Estimates of the rates of pressure ulcers vary widely by clinical setting . An estimated 2.5 million pressure ulcers are treated each year in US acute care facilities alone .

· Studies around the world have reported large differences in pressure ulcer prevalence rates, varying from 4.7% to 22.9% in hospitals and 7.7% to 83.6% in nursing homes² .

· Netherlands in 2007 showed that 18.3% of nursing home residents developed a pressure ulcer within 12 weeks after admission .

· Recently reported that 445,028 pressure ulcers developed in almost 14 million Medicare patients (32 cases/1,000 patients) from 2005 to 2007 and cost $2.41 billion in excess healthcare costs, demonstrating a gap from the desired goal. Of the persons who developed ulcers, 42,213 (9.5%) died;³

A descriptive and exploratory research study was conducted on Knowledge on Pressure Ulcer Prevention Among Nursing Professionals. This study aimed to describe and to analyze knowledge on pressure ulcer prevention among nursing team members working in direct care to adult and elderly patients at a university hospital. Data were collected by administering questionnaire. Sample of 386 professionals, of whom 64.8% were nursing auxiliaries/technicians and 35.2% baccalaureate nurses (BSN). The study result shows that mean percentage of correct answers on the knowledge test was 79.4% (SD=8.3%) for nurses and 73.6% (SD=9.8%) for nursing auxiliaries/technicians. The study concluded that both professional categories display knowledge deficits in some areas related to the theme. ⁴

OPERATIONAL DEFINITIONS:

1) Pressure sore : A pressure ulcer is localized injury to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure, or pressure in combination with shear and/or friction.

2) Nurses:

In this study it refers to nurses who completed GNM, BSc nursing, PBBSC Nursing and registered in council and working in J S S hospital, Mysore.

Research hypotheses

H₁– There is significant differences between pre test and post test knowledge regarding management of pressure sore among nurses

H₂- There is significant association between the pre test knowledge regarding management of pressure sore among nurses with their selected demographic variables.

INTRODUCTION:

Pressure ulcers are a common and serious health care problem in all health care settings. It is a common, painful and costly condition for the clients in critical areas. Various preventive measures are being used in nursing practice. In order to reach care with quality, nursing professionals need scientific knowledge related to Pressure sore and practice very often during care of clients with terminal illness.⁵

METHODOLOGY:

Research Design: The research design selected for study was pre experimental one group pretest posttest design.

Sampling technique: Convenience sampling technique

Sample:, Sample size was 60.

VARIABLES:

Dependent variable

Knowledge regarding management of pressure sore.

Independent variable

Structured teaching programme regarding management of pressure sore

Setting

JSS hospital, Mysore

Description of the tool

Part I- It comprised of demographical variables age, gender, educational qualification, year of experience and area of work.

Part II- Structured knowledge questionnaire regarding management of pressure sore.

Score interpretation

The maximum score was 32. To interpret level of knowledge the scores were distributed as follows :

1. Inadequate knowledge < 50%

2. Moderately knowledge 50-75%

3. Adequate knowledge > 75%

RESULTS:

Section 1: Demographic variables of mothers.

Table:1.1 Frequency and percentage distribution of nurses according to age ,gender ,educational qualification, year of experience and area of work.

S.l No

Demographic variables

Frequency(f)

Percentage (%)

Age of the nurse in years

a) 20-30

b) 31-40

c) 41-50

d) 51-60

58.33

3.33

Gender

a) Male

b) female

100

Educational qualification

GNM

100

Year of experience

a) 1-10

b) 11-20

c) 21-30

58.33

Area of work

a) Medical surgical

b) Pediatrics

c) Obstetric and gynecological

d) Intensive care

8.33

TABLE 2 Frequency and percentage distribution of nurses on knowledge regarding pressure sore before STP. n=60

Level of knowledge	Classification of nurses
	Pre test
	Frequency	Percentage
Inadequate knowledge (<50%)	22	36.67
Moderate knowledge (51-75%)	38	63.33
Adequate knowledge (>75% )	-	-

TABLE 3 Mean standard deviation and mean percentage for the level of knowledge variables of nurses regarding management of pressure sore before STP. n=60.

S.l.No	Aspects of Knowledge	Max score	Range Score	Nurses knowledge
				Mean	SD	Mean %
I	Management of pressure ulcer	20	5-14	9.12	2.11	45 .6%

TABLE 4 Frequency and percentage distribution of nurses on knowledge regarding management pressure sore after STP. n=60

Level of knowledge	Classification of nurses
	Post test
	Frequency	Percentage
Inadequate knowledge (<50%)	-	-
Moderate knowledge (51-75%)	6	10%
Adequate knowledge (>75%)	54	90%

TABLE 5 Mean, standard deviation and mean percentage for the level of nurses on knowledge regarding management pressure sore after STP. n=60.

S.I.No	Knowledge variable	Max score	Range Score	Mothers knowledge
				Mean	SD	Mean %
I	Management of pressure ulcer	20	16-20	19.28	0.91	96.4%

TABLE 6 Mean and SD on knowledge scores among nurses before and after STP and statistical significance. n=60

Sl.

Aspects of Knowledge

Pre test Post test Paired t test

Mean

Management of pressure ulcer

9.12

2.11

19.28

0.91

29.94*

Note:* Significant at 5% level for 59 df (i.e. P< 0.05)

Section -3: Association between knowledge with selected demographic variables ofnurses.

Table: 7 Association of pre test level of knowledge of nurses regarding management of pressure sore. n=60

Demographic variable

Knowledge score

Chi-square χ ² -value

Below Median

Above Median

1.Age of the nurse in years

a) 20-30

b) 31-40

c) 41-50

d) 51-60

8.6

2.Year of experience

a) 1-10

b) 11-20

c) 21-30

5.24

3.Area of work

a) Medical surgical

b) Pediatrics

c) Obstetric and gynecological

d) Intensive care

8.6

Note: S-Significant at 5% level (p<0.05), NS- Not significant at 5% level (p>0.05)

CONCLUSION:

The findings revealed that the improvement mean score percentage of nurses on knowledge regarding management of pressure sore between pre test and post test was 50.4 with paired ‘t’ test value 29.9, it was highly significant at 5% level p< 0.005. This showed that structured teaching programme was effective. Hence, the research hypothesis H₁ was accepted, there were significant differences between pre test and post test knowledge regarding management of pressure sore among nurses.

On the basis of the finding of the study it is recommended that:

1. A similar study can be undertaken with a large sample for better generalization of the finding.

2. A descriptive study can be done to describe all the aspects of care of pressure sore

3. A similar study can be conducted to identify knowledge and attitude among health personnel regarding home care management Pressure sore

4. A comparative study can be conducted among mothers of urban and rural areas on home care management of pressure sore.

BIBLIOGRAPHY:

1. R.C.G. Russell, Noeman S. Williams , Christopher J .K Bulstrode, Bailey and Love’s short practice of surgery. 2004, 24^th edition, Edward Arnold publisher

2. Mirjam A Hulsenboom, Gerrie JJW Bours, Ruud JG Halfens Knowledge of pressure ulcer prevention: a cross-sectional and comparative study among nurses. Available fromhttp://www.biomedcentral.com.

3. Robert W. Carter, Jr. is a Virginia attorney, Staggering Statistics on Pressure Sores in Nursing Homes, Other Facilities. Available from http://www.nursing-home-neglect.com/journal-reports-staggering-statistics-on-pressure-sores-in-nursing-homes-other-facilities

4. Margareth Yuri Miyazaki; Maria Helena Larcher Caliri; Claudia Benedita dos Santos, A descriptive and exploratory research study was conducted on Knowledge on Pressure Ulcer Prevention Among Nursing Professionals. Available from http://www.ncbi.nlm.nih.gov/pubmed.

5. Källman U, Suserud BO. Pressure score a common problem. Available from http://www.medicine/terminal.

Received on 16.08.2013 Modified on 08.11.2013

Asian J. Nur. Edu. & Research 4(1): Jan.-March 2014; Page 119-122