Effectiveness of video assisted teaching module on knowledge regarding Neonatal Resuscitation protocol as per NSSK guidelines of staff nurses in IMS and SUM Hospital, Bhubaneswar, Odisha

Rubi Pradhan¹, Mrs. Geeta Rani Nayak²

¹Tutor, SUM Nursing College, Sector-8, Kalinga Nagar, Ghatikia, Bhubaneswar-751030

²Assistant Professor, SUM Nursing College, Sector-8, Kalinga Nagar, Ghatikia, Bhubaneswar-751030

*Corresponding Author Email: rpradhan49@gmail.com, geetaraninayaks@yahoo.com

ABSTRACT:

Newborn care and resuscitation is an important starting point for any neonatal programme that is required to ensure the best possible start in life. The important causes of neonatal deaths is birth asphyxia and along with serious infections results in more than 50% of all neonatal deaths. Neonatal Resuscitation skills are essential for all health care providers who are involved in the delivery of newborns. Nurses play an important role in improving intra natal and immediate post natal care. This can be done by demonstration, health education and guidance to the staff nurses and making changes toward better care practice. Hence the present study was conducted to assess the pre and post knowledge of staff nurses on neonatal resuscitation. The data was collected from 40 staff nurses using structured knowledge questionnaire .The study results revealed that the mean post test knowledge score (17.92) was higher than the mean pre test knowledge score(13.17).Enhancement between the pre-test and post test was obtained by paired “t” test value 6.81 for knowledge on neonatal resuscitation at p <0.001.which was highly significant in improving the knowledge of staff nurses. There is extremely significant association between the demographic variables like mass media exposer and the post test knowledge as the chi square value is 17.14 at p value 0.002.

KEYWORDS: Effectiveness, structured teaching module, neonatal Resuscitation knowledge, staff nurse, NSSK.

INTRODUCTION:

Newborn care often receives less than optimum attention. It is now well known that the newborns themselves require special attention separate from that of their mothers to assure a healthy start to life. The immediate causes of newborn death include infection, birth asphyxia, complications related to premature birth, and congenital anomalies. Most of the neonatal deaths can be prevented with simple, cost-effective solutions that do not depend on highly trained provider or sophisticated equipment.⁽^{3) (2)}

The important causes of neonatal deaths is birth asphyxia and along with serious infections results in more than 50% of all neonatal deaths.⁽³⁾

Globally, the neonatal mortality rate is 5.1millio annual neonatal deaths of these five million neonatal deaths (98% of the world total) occurring in developing countries. In other words ,of 136 million babies born annually, around 10 million require assistance to breath.⁽¹⁾

Newborn care and resuscitation is an important starting point for any neonatal programme that is required to ensure the best possible start in life. Neonatal Resuscitation skills are essential for all health care providers who are involved in the delivery of newborns.⁽^3)
(4)

Perinatal asphyxia and extreme prematurity are the 2 complications of pregnancy that most frequently necessitate complex resuscitation by skilled personnel. However, only 60% of asphyxiated newborns can be predicted ante partum. The remaining newborns are not identified until the time of birth. Additionally, approximately 80% of low-birth-weight infants require resuscitation and stabilization at delivery.⁽⁵⁾

Nearly one half of newborn deaths (many of which involve extremely premature infants) occur during the first 24 hours after birth. Many of these early deaths also have a component of asphyxia or respiratory depression as an etiology. For the surviving infants, effective management of asphyxia in the first few minutes of life may influence long-term outcome.⁽³⁾

In spite of major advances in neonatal care, there are many gaps in our understanding of the transitional fetal/neonatal physiology, and evidence-based neonatal resuscitation practices to facilitate a smooth transition from fetal to neonatal period.

In many hospitals there is yet insufficient awareness of the need to address the problem using preventive measure.

It has also been recognized that inappropriate resuscitation not only complicates recovery from already existing disease processes (e.g., respiratory distress due to immaturity, me conium aspiration syndrome, persistent pulmonary hypertension, diaphragmatic hernia), but also can cause adverse effects due to the act of resuscitation, per-se. The latter may manifest as pneumothorax, baro-trauma leading to prolonged ventilator dependency, injury to the developing brain, kidney, and other vital organs from deviations in oxygenation and abnormalities of acid-base status and circulating blood volume

For this reason, all personnel involved in delivery room care of the newborn should be trained adequately in all aspects of neonatal resuscitation. Additionally, equipment that is appropriately sized to resuscitate infants of all gestational ages should be available in all delivering institutions, even if the institution does not care for preterm or intensive care infants. ⁽³⁾

‘Navjaat Shishu Suraksha Karyakram’ a new program on basic newborn care and Resuscitation, is being launched by the Ministry of Health and Family welfare to address important interventions of care at birth i.e. prevention of Hypothermia, prevention of infection, Early initiation of breastfeeding and Basic Newborn Resuscitation.

The objective of this new initiative is to have persons trained in basic newborn care and resuscitation available at every delivery. The implementation of this programme will help prevent a significant number of newborn deaths and ensure newborn survival.⁽³⁾

Neonatal Resuscitation is intervention after a baby is born to help it breath and to help its heart beat.

Anticipation, adequate preparation, accurate evaluation, and prompt initiation of support are critical for successful neonatal resuscitation. At every delivery there should be at least 1 person whose primary responsibility is the newly born.

Nurses play an important role in improving intra natal and immediate post natal care.

OBJECTIVE OF THE STUDY:

1)To determine the existing knowledge of staff nurses regarding Neonatal Resuscitation .

2) To find out the effectiveness of video assisted teaching module among staff nurses of IMS and SUM Hospital regarding Neonatal Resuscitation

3) To find out the association between the knowledge of staff nurses with selected socio-demographic variables.

HYPOTHESIS:

— Ho 1: There will be no significant difference between pre test score and post test score.

— H1: There will be significant difference between pre test score and post test score.

— Ho 2: There will be no significant association between post test score and demographic variables.

— H2: There will be significant association between post test score and selected socio-demographic variables.

MATERAL AND METHODS:

Research approach:-Evaluative approach

Research design:- pre experimental one group pre-test and post test design

Setting:- IMS and SUM Hospital, Bhubaneswar, odisha.

Sample:- staff nurses working in IMS and SUM Hospital, Bhubaneswar, Odisha.

Sample size:- 40 staff nurse.

Sampling technique:- Non probability convenient sampling technique

Inclusion criteria:-

1.The staff nurses those were working in Labour room, SNCU,NICU, Gyneic OT, Pediatric ward.

2.Staff nurses who were willing to participate.

Exclusion criteria:

1. Staff nurses those who were working other than the child care unit.

2. Staff nurses who were not willing to participate in the study.

Variable:

Independent variable:- video assisted teaching module

Dependent variable:- knowledge of staff nurses on neonatal resuscitation.

Tool:- It consists of two sections.

Section-I consists of 7 items pertinent to socio demographic data of staff nurses.

Section II- consists of 23 items of structured knowledge questionnaires.

· Scoring- Good score:60-100%

· Average score:30-60%

· Poor score :below 30%

Validity and reliability:-

To ensure the validity of tool it was submitted to six experts which include three from pediatric medical profession, three from nursing field. Reliability of tool was found to be 0.71 by using Chronback formula.

PLAN FOR DATA ANALYSIS:-

Data analysis was done according to the objective of the study by using descriptive and inferential statistics. The collected data for each variable was analyzed, categorized, and interpreted in the form of tables and graphs.

Demographic data was analyzed in terms of frequency and percentage. Pre test and post test knowledge score was analyzed in percentage.

Comparison of pre test and post test score of the knowledge was analyzed by comparing the pre test finding of mean score, mean score %, and standard deviation with post test findings. To evaluate the effectiveness of the video assisted teaching module on neonatal resuscitation among staff nurse was analyzed by using “t” test.

RESULT:

Section-I

Majority of staff nurses 36(90%) of total samples were within 21-30 years age group and 10% are within 31-40years age group.

With regards to work experience majority (77.5%) of study sample were having <1 yr experience , 20% were having 1-5 yrs of experience and rest (2.5%) were having more than 5 yrs of experience.

With regards to mass media exposure majority (87.5%) of the study sample were exposed to library, books and news paper, and rest (12.5%) were exposed to television. radio and internet.

Section-II

Table-I Area wise analysis of pre test and post test score of staff nurses on knowledge aspect

SL.NO	Area	Max. score	Pre-test			Post-test
SL.NO	Area	Max. score	Mean	SD	Mean%	Mean	SD	Mean%
1	Assessment	4	2.2	1.13	55%	3.1	0.95	77.5%
2	Initial step	8	4.95	1.55	61.8%	6.25	1.31	78.12
3	Positive pressure ventilation	11	5.95	1.75	54.09	8.57	1.89	77.9%

Table-I depicts that post test knowledge score was higher than the pre test score in all areas.

Section-III

Table II: Evaluation of effectiveness of video assisted teaching module

SL NO

Item

pre

Post

Paired t test

D.F

Tabulated

P=0.05

Inference

Knowledge

Mean

6.81

<0.0001

Extremely

Statistically significant

13.175

3.06

17.925

3.57

The obtained mean difference (4.75) was found to be extremely statistically significant as evident from ‘t’ value 6.81 at p value < 0.001. Hence, null hypothesis was rejected and research hypothesis H1 was accepted which indicate the video assisted teaching module was effective in increasing the knowledge of staff nurses regarding neonatal resuscitation protocol.

Section-IV

There is Extremely Statistically Significant association between knowledge of staff nurses with mass media exposure as the Chi-square value is 17.14 which is more than the tabulated value 5.99 at p=0.0002

DISCUSSION:

The Mean post test knowledge score (17.92) of staff nurses regarding neonatal resuscitation was found to be significantly higher than their mean pre test knowledge score (13.17) as evident from paired t (6.81), at p < 0.001. This study supports with the study of Juliet Cadungog UY, Chan Treary (2006) who reported that the mean pre test knowledge score (43.85) of the trainee regarding neonatal resuscitation) lower than the mean post test knowledge score (85.16). similarly a study conducted by Waldemar A, Carlo A result shown that after training, written scores(knowledge evaluation) improved from 57%+/-14% to 80+/-12% (mean+/-SD; p<0.0001); performance scores (skills evaluation) improved the most from 43%+/-21% to 88%+/-9% (p<0.0001), self efficacy scores improved from 74%+/- 14% to 90%+/- 10% (p<0.0001)

LIMITATIONS OF THE STUDY:

Some limitations of the present study are:

The study was confined to a small group (40) staff nurses. This limits the generalization of the findings to only the study sample.

The sample being the purposive sample was not a true representative of the research study.

In the present study the tool was used to measure only the cognitive domain of staff nurses on neonatal resuscitation protocol.

RECOMMENDATIONS:

Basing on the findings of the study, the investigator proposes the following recommendation for future research.

ü The study can be replicated on large samples in different setting to have a wider generalization of findings.

ü A similar study may be conducted to assess the knowledge and practice of nursing students.

ü A study can be conducted using other strategies like information booklet, guidelines, self instructional module, planned teaching programme etc.

ü An experimental study can be undertaken with control group.

ü A comparative study can be conducted on knowledge and skills of staff nurses in government and private hospital.

ü A longitudinal study can be done using post test after one month, six month and one year to see the retention of knowledge

CONCLUSION:

The findings conclude that the video assisted teaching module developed by the researcher was found to be helpful in enhancing knowledge of staff nurses regarding neonatal resuscitation. Thus it may reduce the incidence of neonatal mortality rate

REFERENCES:

1. Ashwill James, Nursing care of children principle and practice, 3^rd edition, Noida: Elsevier a division of reed Elsevier India private limited, 2009

2. IOSR Journal of Nursing and Health science (IOSR-JNHS) ISSN: 2320-1959, Volume I, Issue 2 (Jan-Feb 2013), pp 14-17.

3. Ministry of Health and Family welfare Govt. of India. Navjaat Shishu Suraksha Karyakram, Basic Newborn care.

4. Ashok K Dutta, Why IMR continues to be high in India. Journal of Indian Pediatrics.2011 August 26;46(3).

5. Martin B Skidmore, Retention of skill in Neonatal Resuscitation. Journal of Pediatric Child Health. 2001 Jan; 6 (1)

Received on 12.06.2015 Modified on 27.07.2015

Asian J. Nur. Edu. and Research 6(1): Jan.- Mar.2016; Page 101-104

DOI: 10.5958/2349-2996.2016.00021.5