INTRODUCTION:

“Start where you are. Use what you have. Do what you can” (Arthur Ashe)

Sudden Cardiac Arrest (SCA) is one of the most common causes of death in many countries. According to world Health Organization (WHO) estimates, 17.5 million people around the globe, die of Heart disease each year. This is over 31% of all deaths globally. WHO estimates that by 2020 close to 60% of cardiac patients worldwide will be Indian CPR is a series of actions done by witnesses at the scene, and its aim is to restore cardiac and pulmonary functions and prevent brain damage. The AHA-recommended steps for resuscitation are known as DRS CABD: Check for Danger, check for a Response, Send for help, C directs rescuers to perform 30 Compressions to patients who are unresponsive and not breathing normally, followed by 2 rescue breaths, A directs rescuers to open the Airway, B directs rescuers to check Breathing but no need to deliver rescue breaths, D directs rescuers to attach an AED as soon as it is available and follow prompts. If the patient is unresponsive and not breathing, the responder begins CPR with chest compressions. If responders are unwilling or unable to perform rescue breathing, they are to perform compression-only CPR, because any attempt at resuscitation is better than no attempt.

A study was conducted in Finland to assess the knowledge and skill regarding Basic Cardiac Life Support among nurses and nursing students, results showed that the best predictors for good response assessment and resuscitation skills went to those who were nursing students who had studied Basic Life Support sometime during the previous 6 months. In a survey conducted in Hainan Province regarding the knowledge of Basic Life Support and cardio pulmonary resuscitation was found that the knowledge level was very low among nurses. A pre-experimental study was conducted in Rohtak, Haryana to assess the effectiveness of Planned Teaching Program on knowledge regarding Basic Life Support among 200 students. The Study articulated that the overall post-test mean with SD (21.31±3.80) was higher than pre-test mean with SD (14.42±3.75) with mean difference of 6.89. This result reveals that the planned teaching programme was effective in increasing the knowledge of the students regarding basic life support. In a study conducted among nurses, regarding skill and knowledge of Basic Life Support shows that retention of skill and knowledge quickly deteriorates if not used or updated regularly. In another study, the student performing Basic Cardiac Life Support for the second time achieved better results than those undertaking skill and testing for the first time. These data and studies figure out the need of repeated teaching and assessment to ensure adequate knowledge and skill gained among the nursing students.

So the aim of our study is to evaluate the effectiveness of structured teaching plan on knowledge and skills of basic cardiac life support among students. Educational activities should provide the skills and knowledge that enable nurses to meet this goal. The new nursing generation need to grow in proper and timely provision of essential care to their patients. For that, they need necessary knowledge and skill by repeated training and practice.

STATEMENT OF THE PROBLEM:

“A study to evaluate the effectiveness of structured teaching programme on knowledge and skill regarding basic cardiac life support among Basic B.Sc. (N)1^st year students of selected Nursing college at Dehradun, Uttarakhand.”

OBJECTIVES OF THE STUDY:

· To assess the knowledge level and skill score regarding basic cardiac life support among of Basic B.Sc. (N) 1^st year students of selected college of nursing at Dehradun before administer the structured teaching programme.

· To administer the structured teaching programme on knowledge and skill regarding basic cardiac life support among Basic B.Sc. (N) 1^st year students of selected college of nursing at Dehradun.

· To evaluate the effectiveness of structured teaching program in terms of gained knowledge and skill score regarding basic cardiac life support among Basic B.Sc. (N) 1^st year students of selected college of nursing at Dehradun.

· To find out the association between the knowledge level and skill score regarding basic cardiac life support and the selected demographic variables.

MATERIALS AND METHODS:

HYPOTHESIS:

Hypothesis will be tested at 0.05 level of significance.

H1-There will be significant difference in the pretest and posttest knowledge and skill scores regarding basic cardiac life support H2-There will be significant association between knowledge and skill scores of nursing students with selected demographic variables

METHODOLOGY:

Research approach:

Quantitative research

Research design:

Pre experimental one group pretest posttest design

Research setting:

State College of Nursing

Sample:

First year B.Sc. nursing students

Sample size:

50 First year B.Sc. nursing students

Sampling technique:

Convenience sampling

Data collection instruments:

1. Tool A

It consist of demographic variables include Age, gender, family background, previous clinical exposure to cardio-pulmonary resuscitation, if yes when, Previous information about basic cardiac life support and If yes, source of information.

2. Tool B

It consists of 32 structured knowledge questionnaires regarding basic cardiac life support.

3. Tool C

It consists 18 items of skill checklist regarding basic cardiac life support.

Methods of data collection:

1. Written permission was obtained from the Principal of State College of Nursing, Dehradun

2. The sample was selected based on the sampling criteria and using convenience sampling.

3. 50 B.Sc. Nursing I year students were selected and pretest knowledge regarding basic cardiac life support assessed by structured knowledge questionnaire and skill assessed by skill checklist.

4. Structured teaching programme on basic cardiac life support.

5. After administer the structured teaching programme, the Knowledge and skill was assessed through knowledge questionnaire and skill checklist and tabulated by descriptive and inferential statistics.

Data analysis:

1. Descriptive: frequency, percentage, mean and standard deviation

2. Inferential: paired ‘t’ test and chi square test were used for the analysis and interpretation of data

Percentage distribution pretest and posttest level of knowledge and skill

Table 1: Mean, Standard Deviation and t- Test Score and p Value of Knowledge Score n=50

Knowledge	Mean	Standard deviation (SD)	T test	P value
Pre-test Knowledge	11.26	4.16
			31.36	P<0.001
Post test Knowledge	28.12	2.63

Table 2: Mean, Standard Deviation and t- Test Score and p Value of skill Score n=50

Knowledge	Mean	Standard deviation (SD)	T test	P value
Pre-test Knowledge	1.88	2.48
			39.40	P<0.001
Post test Knowledge	17.22	1.01

Table No. 3: Component wise enhancement of knowledge scores on basic cardiac life support n=50

Knowledge Aspect	Pre Test			Post Test			Percentage of Enhancement
Knowledge Aspect	Mean	Mean %	SD	Mean	Mean %	SD	Percentage of Enhancement
Questionnaire on Introduction	8.96	42.67%	9.55	18.46	87.90%	5.55	45.23
Questionnaire on Compression	1.26	18.58%	2.49	6.36	90.85%	1.59	72.27
Questionnaire on Airway and breathing	1.04	28%	1.71	3.3	82.5%	1.52	54.5

Table No. 4: Component wise enhancement of skill scores on basic cardiac life support n=50

Skill Aspect	Pre Test			Post Test			Percentage of Enhancement
Skill Aspect	Mean	Mean %	SD	Mean	Mean %	SD	Percentage of Enhancement
Checklist on assesses victim and activates emergency response system within a maximum of 30 seconds	0.56	11.2%	1.49	05	100%	0.00	88.8%
Checklist on cycle 1 of CPR perform high quality chest compression (initiates compressions immediately after recognition of cardiac arrest)	1.04	20.8%	1.66	4.86	97.2%	0.351	76.4%
Checklist on provides 2 breaths by using a barrier device (Keep airways open, pinch nose and properly cover mouth)	0.2	6.6%	0.741	2.78	92.7%	0.418	86.1%
Checklist on cycle 2 of CPR repeat steps in cycle 1	0.1	2%	0.62	4.58	91.6%	1.08	89.6%

RESULTS:

Data from 50 B.Sc. Nursing I year students is tabulated, analyzed and interpreted considering objectives and hypothesis of the study, using descriptive and inferential statistics. Pretest knowledge scores estimated that 60% having inadequate knowledge, 40% having moderate knowledge, no one had adequate knowledge and Posttest knowledge scores estimated that the subjects had adequate knowledge (96%), moderate (4%) and no one had inadequate knowledge and Pretest skill scores estimated that no one having competent skill and Posttest skill scores estimated that the all subjects had competent skill regarding basic cardiac life support. Hence the intervention is found to be effective.

DISCUSSION:

Among 50 participants majority of subjects had adequate knowledge (96%), moderate (4%) and all subjects had competent skill regarding basic cardiac life support. It was observed that the mean of posttest knowledge and skill score were higher than the mean of pretest knowledge and skill scores. Researcher observed that there is a statistical difference in the average knowledge and skill regarding basic cardiac life support after the intervention (p<0.05). Hence the intervention is found to be effective.

NURSING IMPLICATIONS:

Nursing education:

Nursing students and staffs can be trained to give structured teaching programme regarding basic cardiac life support to deal with respiratory and cardiac arrest and emergency situations in the hospital and in community areas.

Nursing administration:

· Nurse Administrators can conduct in-service education programme to make nurses more aware of knowledge regarding basic cardiac life support.

· They can also adopt the structured teaching programme for making effective teaching for nursing students.

Nursing research:

Nurse researchers can conduct more studies based on improving their knowledge and skill regarding basic cardiac life support.

LIMITATIONS OF THE STUDY:

The study is limited to small group of nursing students of State college of nursing.

SUGGESTIONS:

1. Similar study can be conducted with large sample size.

2. A descriptive study can be done to determine the knowledge and skill regarding basic cardiac life support.

RECOMMENDATIONS:

1 In the view of the findings and limitations of the present study, following recommendations are offered for further research

2 A follow up of study can be taken to determine the long term effectiveness of structured teaching programme.

CONCLUSION:

Basic cardiac life support is used to worldwide to make skilled staffs to various emergency conditions. They are intended to convey essential information quickly and with minimal understanding to staff while preventing stress and panic among visitors of hospital. The aim of this study is to assess the knowledge ans skill of basic cardiac life support among B.Sc. Nursing I year students. The researcher concludes that structured teaching programme is effective in enhancing the knowledge and skill regarding basic cardiac life support of B.Sc. Nursing I year students regarding basic cardiac life support.

ACKNOWLEDGEMENT:

I am grateful to the almighty GOD for bestowing upon me his grace, blessing, strength, guidance, wisdom, love and protection throughout this endeavour. I acknowledge my thanks to Directorate Medical Education and vice chancellor H.N.B. Uttarakhand Medical University, for providing me the opportunity and from whom I had been inspiring in undertaking this research project. Acknowledgement cannot complete without paying gratitude note to my backbone i.e. my family. My heartfelt gratitude to my father Late Mr. Jagdish Chandra Joshi for his divine blessings, My mother Mrs. Hanshi Joshi, My brother Er. Neeraj Joshi, My sister Ms. Hema Joshi and my husband Mr. Harish Kandpal for their constant encouragement, support, prayer, love and blessing. I am incredibly appreciative of all of the sacrifice they have made in order to help me to achieve my educational and professional goals.

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Received on 18.02.2020 Modified on 08.04.2020

Asian J. Nursing Education and Research. 2020; 10(4):396-400.

DOI: 10.5958/2349-2996.2020.00084.1