A pre- experimental study to assess the effectiveness of structured teaching programme on knowledge regarding Arterial Blood Gas analysis and interpretation among staff nurses working in selected hospitals of district Mohali, Punjab.
Anita Kumari1, Rashmi Choudhary2, Poonam Sharma2
1Vill. Tatahar, P.O. Nabahi, Tehsil Sarkaghat, Distt. Mandi 175024, Himachal Pradesh, India
2Mata Sahib Kaur College of Nursing, Mohali, Punjab, India
*Corresponding Author Email: suryaanita43@gmail.com
ABSTRACT:
Arterial blood gas analysis is a diagnostic test performed on blood taken from an artery for diagnosing and managing a patient’s oxygenation status and acid–base balance. The aim of the study is to assess the effectiveness of structured teaching programme on knowledge regarding Arterial Blood Gas analysis and interpretation among staff nurses working in selected hospitals of district Mohali, Punjab. A quantitative research approach with pre experimental one group pre test post test research design was adopted for the study. 100 staff nurses were selected through convenient sampling technique. Result showed that 72 (72%) staff nurses were having average knowledge in pre test and 75 (75%) staff nurses were having good knowledge in post test regarding arterial blood gas analysis and interpretation. Study concluded that structured teaching programme was effective in enhancing the level of knowledge of staff nurses regarding arterial blood gas analysis and interpretation.
KEYWORDS: Effectiveness, Structured Teaching Programme, Knowledge, Arterial blood gas analysis and interpretation, Staff nurses
INTRODUCTION:
Arterial blood gas analysis is a diagnostic test performed on blood taken from an artery for diagnosing and managing a patient’s oxygenation status and acid–base balance.1 Measurement of Arterial Blood Gas involves analysis of components: pH, partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), , bicarbonate (HCO3-), and base excess (BE).2 All components of arterial blood gases have different normal values and represent different aspects of the blood gas.
According to the National Institute of Health, typical normal values are: pH: 7.35-7.45, partial pressure of oxygen (PaO2): 80 - 100 mmHg, partial pressure of carbon dioxide (PaCO2): 35-45 mmHg, bicarbonate (HCO3): 22-26 mEq/L and base excess (BE): -2 - +2.3
Due to an increase in patient dependency, it is no longer unusual for nurses to be caring for patients who need frequent arterial blood gas analysis. Nurses are often the first members of the health care team to see arterial blood gas results, understand its significance and have the ability to decide when the medical staff needs to be informed. For this purpose nurse should have a thorough knowledge about arterial blood gas analysis and its interpretation.4
Knowledge of patient pH, PaCO2 and HCO3- is sufficient to determine if acid-base status is normal (all three parameters within their respective normal range) and if it is not, will indicate which of four uncompensated acid-base disturbances (respiratory acidosis, respiratory alkalosis, metabolic acidosis and metabolic alkalosis) is present. Each of these uncompensated acid-base disturbances is characterized by a particular pattern of pH, PaCO2 and HCO3- results, and depends on the notion that PaCO2 is the respiratory component of acid-base balance and HCO3- is the metabolic (non- respiratory) component of acid-base balance.5
OBJECTIVES:
1. To assess the pre-test knowledge regarding Arterial Blood Gas analysis and interpretation among staff nurses working in selected hospitals of district Mohali, Punjab.
2. To plan and administer structured teaching programme regarding Arterial Blood Gas analysis and interpretation among staff nurses working in selected hospitals of district Mohali, Punjab.
3. To determine the effectiveness of structured teaching programme regarding Arterial Blood Gas analysis and interpretation among staff nurses working in selected hospitals of district Mohali, Punjab.
4. To find out the association between research findings and selected socio demographic variables.
METHOD AND MATERIAL:
Research approach: Quantitative research approach
Research design: Pre experimental one group pre test post test design
Research design: Private hospitals in Mohali, Punjab
Sampling technique: Convenient sampling technique
Sample: 100 staff nurses
Variables:
· Independent variable – Structured teaching programme
· Dependent variable – Knowledge of staff nurses
Tool: Tool consisted of 2 sections:
· Section A: Socio- demographic variables- This section consists of 7 variables
· Section B: Structured knowledge questionnaire - This section consists of 24 items to assess the knowledge regarding arterial blood gas analysis and interpretation.
Inclusion criteria: The study included the staff nurses who were:
· willing to participate in the study.
· willing to give written informed consent.
· available at the time of data collection.
Exclusion criteria: The study excluded the staff nurses who were:
· at night duty during the period of data collection.
· on leave during the period of data collection.
Data Analysis: Analysis is done by using statistical software SPSS 20 V and Microsoft Excel.
RESULTS:
Table 1: Frequency and percentage distribution of staff nurses according to their socio- demographic variables. N = 100
|
Sr. No. |
Socio- Demographic Variables |
Frequency (f) |
Percentage |
|
|
Age (in years) |
21-25 |
76 |
76% |
|
|
26-30 |
23 |
23% |
||
|
31-35 |
1 |
1% |
||
|
Gender |
Male |
0 |
0% |
|
|
Female |
100 |
100% |
||
|
Transgender |
0 |
0% |
||
|
3. |
Educational qualification |
GNM |
58 |
58% |
|
Basic B.Sc. Nursing |
33 |
33% |
||
|
Post basic B.Sc. Nursing |
9 |
9% |
||
|
Post Graduation in Nursing and above |
0 |
0% |
||
|
Total clinical experience (in years) |
0-1 |
53 |
53% |
|
|
1-2 |
17 |
17% |
||
|
2-3 |
19 |
19% |
||
|
3-4 |
4 |
4% |
||
|
4-5 |
4 |
4% |
||
|
5-6 |
1 |
1% |
||
|
6-7 |
1 |
1% |
||
|
7-8 |
1 |
1% |
||
|
5.
|
Present area of work |
OPD |
8 |
8% |
|
Ward |
50 |
50% |
||
|
ICU |
36 |
36% |
||
|
Emergency |
6 |
6% |
||
|
Other |
0 |
0% |
||
|
6.
|
Duration of work in the present area (in years) |
0-1 |
79 |
79% |
|
1-2 |
15 |
15% |
||
|
2-3 |
5 |
5% |
||
|
3-4 |
1 |
1% |
||
|
7.
|
Attended any in service education programme on ABG analysis and interpretation within last 2 years |
Yes |
22 |
22% |
|
No |
78 |
78% |
||
|
|
||||
Figure 1: Bar graph showing frequency of pre test and post test level of knowledge regarding arterial blood gas analysis and interpretation among staff nurses.
Table 1:Depicts that the majority of staff nurses i.e. 76 (76.0%) were in age group of 21-25 years, 100 (100.0%) were females, 58 (58%) nurses were qualified as GNM, 53 (53.0%) nurses had 0-1 year of total clinical experience, 50 (50.0%) nurses were working in ward, 79(79.0%) nurses had 0-1 year as duration of work in present area and 78 (78.0%) nurses have not attended any in-service programme on ABG analysis and interpretation within last 2 years.
Table 2: Criteria for level of knowledge according to total knowledge score
|
Level of knowledge |
Total knowledge score |
|
Poor |
0-8 |
|
Average |
9-16 |
|
Good |
17-24 |
Table 3: Paired t – test to find out the effectiveness of structured teaching programme on knowledge among staff nurses.
N = 100
|
Knowledge |
Mean |
Median |
S.D. |
Mean difference |
Paired t test, p- value |
|
Pre- test |
10.98 |
11 |
3.324 |
7.56 |
20.825, 0.001* |
|
Post test |
18.54 |
19 |
3.066 |
* Significant at p < 0.05 level
Table 3: Depicts that the calculated paired ‘t’ value was found to be higher than the tabulated value (t = 1.98) at 0.05 level of significance which depicts that the difference between pre- test and post- test is a true difference and not by chance. Thus, hypothesis (H1) is accepted which states that there is a significant difference between the pre- test and post -test knowledge score of staff nurses regarding Arterial Blood Gas analysis and interpretation among staff nurses.
Table 4: Association between pre- test level of knowledge and selected socio demographic variables of staff nurses. N= 100
|
Socio- demographic variables |
Level of knowledge |
c2, df, p- value |
||||
|
Good |
Average |
Poor |
||||
|
Age (in years) |
21-25 |
3 |
54 |
19 |
1.653, 4, 0.799NS |
|
|
26-30 |
2 |
17 |
4 |
|||
|
31-35 |
0 |
1 |
0 |
|||
|
Educational qualification |
GNM |
1 |
43 |
14 |
6.364, 4, 0.174NS |
|
|
Basic B.Sc. Nursing |
4 |
21 |
8 |
|||
|
Post basic B.Sc. Nursing |
0 |
8 |
1 |
|||
|
Post Graduation in Nursing and above |
0 |
0 |
0 |
|||
|
Total clinical experience (in years)
|
0-1 |
3 |
34 |
16 |
9.510, 14, 0.797NS |
|
|
1-2 |
0 |
15 |
2 |
|||
|
2-3 |
1 |
15 |
3 |
|||
|
3-4 |
0 |
3 |
1 |
|||
|
4-5 |
1 |
2 |
1 |
|||
|
5-6 |
0 |
1 |
0 |
|||
|
6-7 |
0 |
1 |
0 |
|||
|
7-8 |
0 |
1 |
0 |
|||
|
Present area of Work |
OPD |
1 |
5 |
2 |
10.701, 6, 0.098NS |
|
|
Ward |
1 |
32 |
17 |
|||
|
ICU |
3 |
29 |
4 |
|||
|
Emergency |
0 |
6 |
0 |
|||
|
Other |
0 |
0 |
0 |
|||
|
Duration of work in the present area (in years)
|
0-1 |
4 |
55 |
20 |
6.180, 6, 0.403NS |
|
|
1-2 |
1 |
13 |
1 |
|||
|
2-3 |
0 |
4 |
1 |
|||
|
3-4 |
0 |
0 |
1 |
|||
|
Attended any in service education programme on ABG analysis and interpretation within last 2 years? |
Yes |
1 |
19 |
2 |
3.192,2, 0.203NS |
|
|
No |
4 |
53 |
21 |
|||
NS= Non- Significant
Table 4: Depicts that there was no significant association of pre- test level of knowledge regarding arterial blood gas analysis and interpretation with selected socio demographic variables.
CONCLUSION:
From the findings, present study concluded that:
1. Majority of staff nurses i.e. 72% were having average knowledge regarding arterial blood gas analysis and interpretation during pre test whereas majority of staff nurses i.e. 75% were having good knowledge regarding arterial blood gas analysis and interpretation during post test.
2. Structured teaching programme was effective in enhancing the level of knowledge of staff nurses regarding arterial blood gas analysis and interpretation.
DISCUSSION:
Study conducted by Kaur A, Charan S G. 2018 showed that 39% of staff nurses had average knowledge in pre test and 40% of staff nurses had good knowledge in post test regarding arterial blood gas analysis.6 In present study, it showed that 72% of staff nurses had average knowledge in pre test and 75% of staff nurses had good knowledge in post test regarding arterial blood gas analysis and interpretation.
Study conducted by Thorat R, Dani P, Gupta H. 2016 showed that the mean knowledge scores about arterial blood gas analysis of staff nurses in pre test was 11.50 and post test was 15.98. This differences was statistically significant at p<0.05 which showed structured teaching programme was effective to enhance the staff nurses knowledge regarding arterial blood gas analysis.7 Similar study conducted by Hemavathy V, Girijabhaskaran, Nongphud J. 2016 revealed the pretest mean knowledge score was 19.5 and post test mean knowledge score was 25.1. Calculated “t” value was 8.4, which was statistically significant at p<0.001 which showed structured teaching programme was effective to enhance knowledge regarding arterial blood gas analysis.8 In present study, it was found that the mean pre test knowledge score and mean post test knowledge score was 10.98 and 18.58 respectively among staff nurses. paired t- test was used which showed structured teaching programme was effective in increasing the knowledge of staff nurses at p<0.05.
Study conducted by Rahane S, De S. 2018 showed that there was no significant association with post test knowledge regarding arterial blood gas analysis among staff nurses and selected socio- demographic variables such as age, gender, educational qualification, working department, year of experience and source of knowledge.9 Similar study conducted by Kaur A, Charan SG. 2018 showed that there is no association between post-test knowledge and practice score among staff nurses with selected socio-demographic variables such as age, sex, professional qualification, clinical experience, current working area and in-service programme.6 In present study there is no significant association between pre test knowledge of arterial blood gas analysis and interpretation among staff nurses and selected socio- demographic variables such as age, educational qualification, total clinical experience, present area of work, duration of work in present area, in-service education programme attended on ABG analysis and interpretation within last 2 years at p<0.05 level of significance.
ACKNOWLEDGEMENT:
Grateful acknowledgement is extended to Mr. Barjinder Kumar Aneja for the valuable help in statistical analysis.
ETHICAL CLERANCE:
· Permission from ethical and research committee of Mata Sahib Kaur College of Nursing, Mohali was obtained.
· A formal permission for conducting research study was obtained from private hospitals of district Mohali, Punjab.
· Written informed consent was taken from the staff nurses who participated in study
· All participants were assured about their confidentiality and anonymity.
REFERENCES:
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2. Arterial Blood Gas Analysis. 2014. Available from: https://www.rnpedia.com/nursing-notes/medical-surgicalnursingnotes/arterial-blood-gas-analysis.
3. Know Your ABG’s: Arterial Blood Gases Explained. Nurse.org. Available from: https://nurse.org/articles/arterial-blood-gas-test/
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8. HemavathyV, Girijabhaskaran, Nongphud J. A study to assess the effectiveness of structured teaching programme on knowledge regarding arterial blood gas analysis among the staff nurses. International Journal of Applied Research.2016;2(4):541-542. Available from: http://www.allresearchjournal.com/archives/2016/vol2issue4/PartI/2-4-22.pdf
9. Rahane S, De S. Effectiveness of structured teaching programme on knowledge regarding ABG analysis among staff nurses working in critical units. Journal of Nursing Research Society of India. 2018 Jun;11(01).
Received on 30.09.2019 Modified on 31.10.2019
Accepted on 21.11.2019 ©A&V Publications All right reserved
Asian J. Nursing Education and Research. 2020; 10(2):235-239.
DOI: 10.5958/2349-2996.2020.00050.6