A Study to Assess the Effectiveness of Structured Teaching Programmed on Knowledge regarding Cardiac Emergencies among the Staff Nurses working in selected hospital of Mehsana District

Mr. Kaushal Patidar¹, Mr. Aakash Soni²

¹HOD of Medical Surgical Department, Joitiba College of Nursing, Bhandu, Dist: Mehsana

²2^nd Year M.sc Nursing Student, Joitiba College of Nursing, Bhandu, Dist: Mehsana

*Corresponding Author Email: aakashsoni6288@gmail.com

ABSTRACT:

INTRODUCTION: Cardiovascular diseases exert a huge burden on individuals and society, with coronary heart disease the single most common cause of death in the United Kingdom and other developed countries. Improved clinical care has been responsible for around two fifths of the decline in mortality from coronary heart disease in England and Wales over the past decade. Developments in cardiac care, most of which have closely engaged nurses, have contributed to improvements in care for patients with acute myocardial infarction and other acute coronary syndromes. DESIGN: A quantitative approach using pre experimental pre-test post-test design with one group. PARTICIPANTS: 100 staff nurses were selected using Non-Probability Convenience sampling technique in Mehsana District. INTERVENTIONS: Structured teaching programmed was given to the Staff nurses. TOOL: Self-Structured Questionnaire and ‘yes’ & ‘no’ questions was used to assess the level of Knowledge of Staff nurses regarding cardiac emergencies. RESULTS: In this study overall the highest percentage in the demographic data including the Age group 55% (21-35y), Gender 71% (Female), Educational Status 82% (GNM), Total Year of Experience 65% (Less then 5 year), Folowing area who have presently worked 68% (Ward), Attend any training programmed 71% (Yes), and Previous Experience regarding cardiac emergencies 71% (Yes). The post- test knowledge mean score (21.45 ± 2.77) higherthan the mean pre-test knowledge score (9.72 ± 1.99). The calculated ‘t’ value (34.5) was greater than the table value (1.98) at 0.05 level of significance. The Structured teaching programmed was effective in increasing the knowledge regarding cardiac emergencies. CONCLUSION: The findings of the study revealed that structured teaching programmed helps in improving knowledge regarding cardiac emergencies among the staff nurses.

KEYWORDS: Assess, Effectiveness, Structured teaching programmed, Knowledge, cardiac emergencies, staff nurse.

INTRODUCTION:

“Every heart that has beaten strong and cheerfully has left a hopeful impulse behind it in the world, and bettered the tradition of mankind."

Robert Louis Stevenson

Cardiovascular diseases exert a huge burden on individuals and society, with coronary heart disease the single most common cause of death in the United Kingdom and other developed countries. Improved clinical care has been responsible for around two fifths of the decline in mortality from coronary heart disease in England and Wales over the past decade. Developments in cardiac care, most of which have closely engaged nurses, have contributed to improvements in care for patients with acute myocardial infarction and other acute coronary syndromes. The success of the coronary care unit concept was, and remains, highly reliant on the expertise of nurses working in close collaboration with medical colleagues. From the early days of the coronary care unit, there has been recognition of the value of nurses developing specialist knowledge and skill in, for example, ECG interpretation, the understanding of treatment of acute myocardial infarction complications and expertise in cardiopulmonary resuscitation.¹

NEED OF THE STUDY:

Recent data on the global burden of disease have shown that cardiovascular diseases will soon become the leading cause of death worldwide, killing close to 15 million people in the world each year. The emergence of cardiovascular diseases as the major cause of death in the world's most populated regions, such as India and China, along with falling death rates from infectious communicable diseases in these countries, are clearly the major reasons for the elevation of cardiovascular diseases to their position as the leading cause of death globally. Projections of mortality, taking into account the expected increases in population and increased life expectancy, suggest that cardiovascular diseases will be the leading cause of mortality, measured as "lost years of life," and the leading cause of "years lived with disability" in all parts of the world by the year 2020.²

It is estimated that by 2020, cardiovascular disease (CVD) will be the largest cause of disability and death in India. The country already has more than 118 million people with hypertension, which is expected to increase to 213 million by 2025.Within CVD, coronary heart disease (CHD) and congestive heart failure are major contributors to the disease burden. CHD has led to an estimated 23% of deaths across all age ranges and 32% of adult deaths from 2010 to 2013. In 2010, it was the leading cause of disability-adjusted life years worldwide (up from fourth in 1990 and increased by 29%).³

The Indian rural population and urban poor especially are facing a "double burden" - with incidences of acute diseases continuing, while there is a rapid growth in incidences of chronic diseases. Heart disease is now the world's leading causes of death, claiming 17.3 million lives each year, he said, adding, India has seen a rapid transition in its heart disease burden over the past couple of decades. Death due to cardiovascular disease in India increased from 1.3 million in 1990 to 2.8 million in 2016, and more than half the deaths caused by heart ailments in 2016 were in persons less than 70 years of age.⁴

Cardiac diseases have nearly doubled in India, an alarming fact, considering that it has almost halved in Europe and the USA. Latest data culled from the World Health Organization and reports published in medical journals like Lancet and Indian Heart Journal, suggest that by 2010 there would be close to 100 million cardiac patients in India. It is 30 million now. These rather frightening facts were revealed at a press conference on cardiac prevention, held by a top team of cardiologists at the Apollo Gleneagles Hospital in Kolkata on Friday. Prevalence of heart problems among US and European citizens under 40 years of age accounts for just 25% and is declining. This patient population in India accounts for 60% and is growing, said, senior cardio-thoracic surgeon at the District's Apollo Gleneagles Hospitals. As per the world heart day 29^th sep.2015 approximately 7 lakh people die each year from sudden cardiac arrest. Heart Disease is still the leading cause of death in India killing 1.7 million Indians in2016.As per the world heart day 29^th sep.2018 17.5 million people die each year. According to EMRI an average of 6 calls /hr. or 1 call every 10 min related to chest pain. where received in 2017-18.follow up of these cases after 48 hrs. reveal that 3 patient suffered from cardiac emergencies.⁵

· In Gujrat 3 person suffering from heart attack in every hour.

· According to District wise cardiac emergencies over 5years are

DISTRICT	2013-14	2017-18	RISE
AHEMDABAD	4,334	7,341	69%
SURAT	1,178	1,596	35%
RAJKOT	1,609	1,577	-2%
VADODRA	1,148	1,209	5%
GUJRAT	20,015	26,529	33%

· Going by the trend, WHO has estimated that by 2010, India will have 60% of world's cardiac patients, and in another five years it is likely to become the world capital for heart ailment.

STATEMENT OF THE PROBLEM:

A study to assess the effectiveness of structured teaching programme on knowledge regarding cardiac emergencies among the staff nurses working in the selected hospitals of meshsana district.

OBJECTIVES OF THE STUDY:

· To assess the knowledge of the staff nurses regarding cardiac emergencies

· To assess the effectiveness of structured teaching programme regarding cardiac emergencies among the staff nurses.

· To find out the association of the knowledge score with their selected demographic variable.

HYPOTHESIS:

· H0= There will be no significant difference between pretest and posttest knowledge score of cardiac emergencies among the staff nurses at 0.05 level of significance.

· H1=There will be significant difference between pretest and posttest knowledge scores after administration of structure teaching programme regarding cardiac emergencies among the staff nurses at 0.05 level of significance.

MATERIAL AND METHODS:

Quasi experimental one group Pretest/Post test research design and Quantitative Approach. Effectiveness of Structured teaching programme knowledge regarding cardiac emergencies among the staff nurses working in selected hospital of Mehsana District . The data were collected from 100 Staff nurses working in selected hospital of Mehsana District.

“Non-Probability Convenience” sampling technique were used. A structured questionnaire was selected to assess the knowledge regarding Cardiac emergencies.

RESULTS:

Demographic data was analyzed using frequency and percentage. Frequencies, percentage, mean, mean percentage and standard deviation was used to determine the knowledge score. The ‘t’ value was computed to show the effectiveness of teaching programme and chi-square test was done to determine the association between the pretest knowledge of Staff nurses with selected demographic variables.

FINDING RELATED TO DEMOGRAPHIC DATA:

In this study overall the highest percentage in the demographic data including the Age group 55% (21-35y), Gender 71% (Female), Educational Status 82% (GNM), Total Year of Experience 65% (Less then 5 year), Following area who have presently worked 68% (Ward), Attend any training programmed71 % (Yes), and Previous Experience regarding cardiac emergencies71% (Yes).

FINDING RELATED TO PRE AND POST KNOWLEDGE SCORE:

Table 1 shows that Pre-test, prior to the administration of structured teaching programme, (71%) of sample had poor knowledge (score: 0-10)) regarding cardiac emergencies among the staff nurses, while average knowledge (score 11-20) was observed in 29% of the sample. In the post test there was marked improvement in the knowledge of sample with majority (40%) gained average knowledge (score 11-20), (60%) gained good knowledge (score 21-30).

Table : 1:-Frequency and percentage distribution of staff nurses.

Level of Knowledge	Pre – test		Post- test
Level of Knowledge	F	%	F	%
Poor (0-10)	71	71%	00	00%
Average (11 – 20)	29	29%	40	40%
Good (21 – 30)	00	00%	60	60%

FINDING RELATED TO EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME:

The data presented in Table 2 shows that the data also depicts that the mean post-test Knowledge score (21.45 ± 2.77) was apparently higher than that of mean pre-test (9.72±1.99) knowledge score. Hypothesis H1 was accepted hence it can be inferred that the structured teaching programme was highly effective in increasing the knowledge of staff nurses regarding cardiac emergencies.

FINDING RELATED TO ASSOCIATION BETWEEN PRETEST KNOWLEDGE SCORE OF STAFF NURSES WITH SELECTED DEMOGRAPHIC VARIABLES:

The association between the pre-test level of Knowledge and socio demographic variable. Based on the Third objectives used to chi- square test to associate the level of knowledge and selected demographic variable. The chi square value show that three significances between Educational status ,attend any training programme and providing client care with any cardiac emergencies demographic variable and pre– test knowledge score. The calculated chi – square value was less than the table value at the 0.05 level of significance.

CONCLUSION:

The present study aims to evaluate the effectiveness of Structured Teaching Programme on knowledge regarding cardiac emergencies. The study was conducted by using Pre experimental one group pre-test post-test research design. Mehsana district was selected for conducting the study. The sample size was 100 Staff nurses using non probability convenience sampling method.

REFERENCE:

1. Quinn T. The role of nurse in improving emergency cardiac care. Nurs Stand. [Serial on line] 2005 Aug 10-16; 19(48): [cited 2008 Jul 24]; [P. 41-8]. Available from URL: http://:www.ncbi.nlm.nih.gov/sites/entrez.

2. Meltzer LM (1964) The concept and system of intensive coronary care. Bulletin: Academy of Medicine of New Jersey. 10: [P.304-311].

3. Killip T, Kimball JT (1967) Treatment of myocardial infarction in a coronary care unit. A two-year experience with 250 patients. American Journal of Cardiology.20 (4): [P.457-64]

4. Briethardt Gunther, EckardtLars. The global burden of cardiovascular diseases

5. Cardiovascular disease doubles in India, The Economic Times 2006, Sep 22; Kolkota.

Received on 11.05.2019 Modified on 31.05.2019

Asian J. Nursing Education and Research. 2019; 9(3):395-398.

DOI: 10.5958/2349-2996.2019.00085.5