INTRODUCTION:

Pregnancy and Child birth are special events in women’s lives and indeed, in the lives of their families¹.

The world Health organization defines maternal mortality includes all death among pregnant and recently pregnant women except for death from accidental or incidental causes. In India every five minutes one Indian woman dies from complication related to pregnancy and child birth, which adds up to approximately 1,30,000 per year India is confronted by the highest number of maternal deaths anywhere in the world, with over 70,000 deaths each year due to pregnancy and related causes. Nurses being the back bone of the health care services at all levels, play a vital role in achieving this goal².

The majority of these deaths occur during and immediately following birth: 25% are caused by severe bleeding, 15% by infection, 12% by eclampsia (a seizure disorder), and 8% by obstructed labour³.

The GOI and many national and international organizations have taken many cost effective strategies to reduce MMR in India. The suggestion were 3 antenatal check up, 3 postnatal check up, clean safe delivery, given by National health and family welfare department.⁴

A study was conducted on knowledge practice among Ironies nurse, midwifes students regarding standard isolation procedures in labour room at Iran.The goal was to assess the knowledge and practice regarding infection control measures and standard precaution among a group of nursing and midwifery students.⁵

Nursing personnel working in the labour room unit should be knowledgeable and skill full in prevention of maternal and neonatal infection mainly in the labour room. So the student midwifes has to be knowledgeable and as good practice activities, regarding Infection control measures in labour room to prevent the puerperal infection. Today’s student nurses are tomorrow staff nurses who can contribute themselves more in the field of treatment “Educating these students and creating awareness in helping them to learn more about prevention of infection in labour room, and they will be able to control the infection to the mothers.

OBJECTIVES:

· To assess the knowledge of fourth year BSc Nursing students regarding infection control measures in labour room before structured teaching programme

· To identify the practice of fourth year BSc(N) students regarding infection control measures in labour room.

· To assess the knowledge and practice of fourth year Bsc nursing student regarding infection control measures in labour room after administration of structured teaching programme

· To evaluate the effectiveness of structured teaching programme on knowledge and practice regarding infection control measures among fourth year BSc(N) students.

· To correlate the mean improvement level of knowledge and practice among fourth year Bsc nursing students regarding infection control measures in labour room.

· To associate the demographic variables with knowledge and practice regarding infection control measures among fourth year BSc nursing students.

MATERIALS AND METHODS:

Researchapproach:

The evaluative approach was considered to be the most appropriate in assessing the knowledge and skill gained in respect of programme objectives after the administration of structured teaching programme.

Research Design:

The research design selected for present study was quantitative- pre experimental one group pre and post test design.

Setting of the study:

The study was conducted in the Aruna college of Nursing, Tumkur, Karnataka, labour room District hospital at Tumkur.

Target population:

The target population for the study was fourth year Bsc nursing studying in the Aruna college of nursing, 60, age limit 20-23.

Sample size:

The sample of the study comprised of 60 student nurses who fulfilled the inclusive criteria was selected. Convenient method was used to draw the sample.

SAMPLING TECHNIQUE:

The non- probability convenient sampling technique was used to collect the samples.

Selection of the Tools:

A self administered structured questionnaire to assess the knowledge and observational check list to assess the practice was selected for the study.

Protection from human subject:

The proposed study was conducted after the approval of research committee of the college; permission was obtained from the principals of the selected nursing colleges. The written consent of each individual was obtained before the data collection. Assurance was given to the study participants regarding confidentiality of the procedure of data collection.

Data collection procedure:

The pre-test and post-test level of knowledge and skill was assessed using a Structured Knowledge Questionnaire and Observational Checklist respectively. The intervention devised by the investigators was the Infection Control measures in labour room in the form of PowerPoint aided lecture cum discussion and demonstration was performed to the fourth year B.Sc(N) Students. The post-test was conducted after a week following the intervention.

RESULTS:

Table 1: Pre test overall knowledge score on infection control measures in labour room N=60

Questions	Mean	SD	Mean % of Knowledge
Overall pre-test Knowledge	16.03	2.95	64.12

Table 2: Post test overall knowledge score on infection control measures in labour room. N=60

Knowledge	Mean	SD	Mean % of Knowledge
Overall post-test Knowledge	22.30	2.52	89.2

Table 3: Comparison of average knowledge score on infection control measures in labour room before and after administration of S.T.P

Area of Knowledge	Pre-test		Post-test		Enhancement		PAIRED t- TEST
Area of Knowledge	Mean	SD	Mean	SD	Mean	SD	PAIRED t- TEST
Preparation of mother	1.03	0.410	1.63	0.486	0.80	0.86	t=7.209 s
preparation of articles	5.72	1.668	9.87	1.127	2.03	1.47	t=10.696
Preparation Of Staff	6.05	1.917	11.53	1.282	0.90	0.88	t=7.947
Asepsis During Delivery	1.73	0.861	3.28	0.691	1.28	1.22	t=8.131
Asepsis After Delivery	1.45	0.723	2.48	0.596	1.25	1.26	t=7.702

HS, P-0.000, DF=59

Table 3 shows that comparison of level of knowledge score on infection control measure in labour room before and after administration of structured teaching programme.

Table 4: Determination of overall mean knowledge score before and after STP N=60

Knowledge

No. of Students

Pre-test

Post-test

Mean of differences

paired t-test

Overall Knowledge score

16.03

22.30

6.27S

(SD=3.65)

t=13.285

HS, p-0.000, df=59

The above table shows that over all prêt est mean score was 16.03 and post test score was 22.30. mean differences was 6.27. calculated t value was 13.285, greater than table value showed high statistical significance at p,0.000 level.

Table 5: Pre test overall practice score on infection control measures in labour room. N=60

Practice	Mean	sd	Mean % of practice
Overall pre-test practice	8.33	1.43	55.53

Table 6: Post test overall practice score on infection control measures N=60

Practice	Mean	SD	Mean % of Practice
Overall post-test practice	12.77	1.59	86.13

Table 7: Comparison of average practice score on infection control measures in labour room before and after administration of S.T.P N=60

Practice

Pre-test

Post-test

Enhancement

PAIRED

t- TEST

Mean

Practice score

8.33

1.43

12.77

1.59

4.43

2.32

14.821

HS,P-0.000, df=59

The above table shows that the over all practice score on infection control measures in labour room the mean score was 12.77 and standard deviation was 1.59 and mean percentage of practice was 86.13.

Table 8: Correlation of knowledge and practice scores

	Variables	Karl sspearsons correlation coefficient	Inference
Pre test	Knowledge Practice	r=0.214	p=0.101 NS
Pre test	Knowledge Practice
Post test	Knowledge practice	r=0.802	p=0.000 HS
Post test	Knowledge practice

*p < 0.01 ** p < 0.05 *** p < 0.001 S- Significant

The above table shows that the pretest knowledge and practice correlation was 0.214. The value was less than table value, which shows that there was no correlation between knowledge and practice. The post test knowledge and practice correlation value was 0.82 the value was more than table value, which shows that there is high correlation between knowledge and practice. It was highly significant at p<0.000 value.

Figure 1: Graph correlation between pretest knowledge and practice scores

The table 9 shows that association between pretest level of knowledge with selected demographic variables like age, sex, residence, previous academic grade, sources of information, on infection control measures in labour room. The source of information variable had significant association with knowledge. The other demographic variable had no significant association with knowledge level of student nurses.

The table 10 shows that association between pre test level of practice with selected demographic variables like age, sex, residence, previous academic grade, sources of information, regarding infection control measures in labour room. Only the age variable had significant association with practice. The other demographic variable had no significant association with practice level of student nurses.

DISCUSSION:

The first objective was to assess the knowledge of IV the year BSc Nursing students regarding infection control measures in labour room:

Finding of the analysis revealed that, with regard to pretest level of knowledge, 12(20%) had adequate knowledge, 39(65%) had moderate knowledge and 9(15%) had inadequate knowledge regarding infection control measures in labour room.

Findings of the analysis revealed that, with regard to over all pretest knowledge mean score was 16.0, and standard deviation of 2.95 and mean percentage knowledge score was 64.12.

The second objective was to identify the practice of IVth year BSc(N) students regarding infection control measures in labour room:

Findings of the analysis revealed that, With regard to the pretest level of practice score of student nurses regarding infection control measures in labour room 44(73.3%) had moderately adequate practice level and 16(26.6%) of student nurses had inadequate practice of infection control measures in labour room.

Findings of the analysis shows that the overall practice pretest score of mean was 8.33 and standard deviation was 1.43 and mean percentage was 55.53.

The third objective was to assess the post test level of knowledge and practice regarding infection control measures in labour room among fourth year B.Sc nursing students:

Findings of the analysis revealed that, with regard to the overall post test knowledge score on infection control measures in labour room mean score was 22.3 and standard deviation was 2.52 and mean percentage of knowledge score was 89.2.

Findings of the analysis revealed that the overall practice score on infection control measures in labour room the mean score was 12.77 and standard deviation was 1.59 and mean percentage of practice was 86.13.

The fourth objective was to evaluate the effectiveness of structured teaching programme on knowledge and practice regarding infection control measures among Fourth year BSc(N) students:

The analysis was done by paired ‘t’ test. The over all pre test mean score of knowledge was 16.03, S.D was 2.95 and mean percentage score was 64.12 and the post test mean score was 22.3 and S.D was 2.52 and mean percentage score was 89.2 and the calculated ‘t’ value of 13.285 which had statistically high significance at p<0.0001 level.

The analysis was done by paired ‘t’ test. The over all pre test mean score of practice was 8.33, S.D was 1.43 and mean percentage score was 55.53 and the post test mean score was 12.77 and S.D was 1.59 and mean percentage score was 86.13 and the calculated ‘t’ value of 14.821 which had statistically high significance at p<0.0001 level. The above findings focused the necessity to conduct structured teaching programme regarding infection control measures among fourth year B.Sc nursing students.

The fifth objective was to assess the correlation between knowledge and practice regarding infection control measures in labour room among fourth year Bsc nursing students:

Findings of the analysis revealed that the pretest knowledge and practice correlation was 0.214. The value was less than table value, which shows that there was no correlation between knowledge and practice. The post test knowledge and practice correlation value was 0.82 the value was more than table value, which shows that there is a high significant correlation between knowledge and practice.

Hence the research hypothesis (H₂) stated earlier “There is a significant correlation of mean improvement knowledge and practice score” was accepted.

The sixth objective was to associate the mean improvement level of knowledge and practice of student nurses regarding infection control measures in labour room with selected demographic variables:

The study findings revealed that the demographic variables had no significant association at p <0.05 level with mean improvement score on knowledge among student nurses in the aspects of age, gender, religion, residence, previous academic performance, except sources of information with respect to the infection control measures in labour room.

The study findings revealed that the demographic variables had no significant association at p <0.05 level with mean improvement score on practice among student nurses in the aspects of gender, religion, residence, previous academic performance, sources of information with respect to the infection control measures in labour room except age.

Hence the research hypothesis (H₃) stated earlier that “there is a significant association of knowledge score with selected demographic variables” was rejected except for sources of information and age related to infection control measures in labour room.

IMPLICATIONS:

Student nurses who have good knowledge and practice regarding care of mother during delivery and newborn will be able to promote the maternal health. While practicing good universal and standard precaution will prevent so many diseases like Hepatitis, HIV and needle stick injury.

The nursing curriculum should be strengthened to enable nurses to excel in knowledge and practice of infection control measures in labour room. Students should be encouraged to have hands on experience in labour room units. Practicing a strict aseptic precaution in labour room should be included as a clinical procedure.

Every student nurse should perform an effective Infection control measures procedures. There is a gap between existing knowledge directly affecting nursing and its application. This gap exists in both nursing education and nursing service. The nursing profession demands increased knowledge and skill that results in significant patient outcomes.

CONCLUSION:

The present study was conducted to assess the effectiveness of structured teaching programme on knowledge and practice regarding infection control measures in labour room among student nurses in Aruna college of nursing at Tumkur. From the results of the study it was concluded that structured teaching programme on infection control measures in labour room is an effective method to improve the knowledge and practice level of student nurses. The findings revealed that the student nurses, who had good knowledge about infection control measures in labour room, will decrease the maternal and neonatal mortality and morbidity rate.

CONFLICT OF INTEREST:

The authors have no conflicts of interest regarding this investigation.

ACKNOWLEDGEMENTS:

My heartfelt thanks to all the study participants who extended their cooperation in data collection process of the study.

REFERENCES:

1. Wong and Perry, Maternal and child Nursing Care Library of Congredd Catologing in Publication. Date; 2006.

2. Farjdar Ram, Usha Ram, Abshik Singh. Maternal mortality is the Indian programme prepared to meet the challenges, January- June 2006; vol2.

3. A Report from WHO on 2005 Regarding MMR.

4. http://nvonews.com./national-seminar-gynaec women-medicon 2008.

5. Tavolacci MP, Ladner J, et.al Prevention of nosocomial infection and standard Precautions knowledge and source of information among midwifery students. Infection Control Hospital Epidemiology. 2008; 29(7): 642-7.

Received on 18.09.2022 Modified on 06.11.2022

Asian J. Nursing Education and Research. 2023; 13(3):221-225.

DOI: 10.52711/2349-2996.2023.00047

Demographic variables		No. of students (n)	Level of Knowledge			Chi-Square Test
Demographic variables		No. of students (n)	Adequate	Moderately adequate	Inadequate	Chi-Square Test
Source of information	Health person	20	1	15	4	Chi-square value=13.357 P=0.0096 S
	Seminar	21	2	16	3
	Both	19	9	8	2

Demographic variables		No. of students (n)	Level of Practice		Chi-Square Test
			Moderately adequate	Inadequate
Age	20-21 Years	33	27	6	Chi-square value=7.079 P=0.029 S
	22-23 Years	25	17	8
	24-25 Years	2	0	2