A Study to Assess the Effectiveness of the Structured Teaching Programme on Knowledge of Staff Nurses regarding use of Braden Scale on Pressure Sore in selected Hospital

 

Mr. Dayalal D. Patidar1, Mr. Kaushal Patidar2, Mr. Jitendra patel3

1Principal, Joitiba College of Nursing, Bhandu, Dist: Mehsana,

2HOD, Medical Surgical Department, Joitiba College of Nursing, Bhandu, Dist: Mehsana

3Second Year M.Sc. Nursing student, Joitiba college of Nursing, Bhandu, Dist: Mehsana

*Corresponding Author E-mail: jitendrapatel908@gmail.com

 

ABSTRACT:

Background: The word “Pressure” means stress or strain. It is the force exerted by one object upon another. In the Pressure areas of the body where the tissues may be compressed between the bed and the underlying bone, especially the sacrum, greater tronchanters, and heels, the tissues become ischemic.1 Pressure sores are called Pressure-ulcers, friction burn, decubites ulcers as well as Bed sores. How serious they depend on the amount of damage to skin and tissue. A Pressure sore (or Bed-sore) is an injury to the skin and tissue under it, and caused usually by unrelieved Pressure, constant Pressure against the skin which reduces the blood supplies to that area and the affected tissue will be necroses.2 Aims and Objective: To assess the level of knowledge regarding use of Braden scale on Pressure sore among Staff Nurses. To assess the effectiveness of Structured Teaching Programme regarding use of Braden scale on Pressure sore among Staff Nurses. To find out the association of the knowledge score with their selected demographic variables. Methods- a quantitative approach using pre experimental one group pre test –post test design. 100 staff nurses were selected using non probability purposive sampling at Mehsana district. structured teaching programme was given to the staff nurses working at Mehsana district. Self structure questionnaire will prepare and used to assess the knowledge of staff nurses regarding use of Braden scale on pressure sore. Results :  In  this study overall the highest percentage in the demographic data including the Age group 66% (39-48y), Gender 74% (Female), Professional qualification 68% (GNM), Years of experience 34% (Above 10 years), Monthly income 54% (Above 30 years), Type of hospital 60% (Government) Current working area 75% (General ward),In service education programme  No (90%), and First source of knowledge 08% (In service education). The post- test mean (20.88 ± 2.60) was apparently higher than that of mean pre-test (9.72 ± 2.77) knowledge score. The calculated “T” value (89.64) was greater than the table value (1.98) at 0.05 level of significance the structured teaching was effective in increasing the Knowledge of staff nurses regarding use of Braden scale on pressure sore. Chi-square test to associate the level of knowledge and selected demographic variable.

 

KEYWORDS: Assess effectiveness, structured teaching programme, knowledge, pressure sore. Dietary awareness.

 

 


INTRODUCTION:

Pressure ulcers are a common, expensive and painful health-care problem, with prevalence rates ranging from 3% to 66% in health-care organizations. The estimated annual treatment costs are 21.07 billion in the UK, 22.4 billion in the USA and 20.6 million and Netherland.3

 

An estimated 1.7 million patients develop Pressure ulcers annually. Both prevention and treatment of Pressure ulcers are costly in term of health care dollars and quality of life for patients at risk because the cost in term of pain and suffering for a person with Pressure ulcer can’t be quantified, the old saying “an ounce of prevention is worth a pound of cure” is particularly applicable to Pressure ulcers.4

 

Pressure sores are health problems which has impact on health of Nation. In UK the treatment of Pressure sore imposes a large financial and manpower burden. Also it was suggested that an annual reduction of 5-10% in their incidence would be a reasonable target, justified by the belief that “are largely preventable”. Numerous reports have been published on the prevalence and incidence of Pressure sore due to the large groups of the patients, it is impossible to determine how many of the reported one could have been prevented.5

 

95% of all Pressure ulcers occur over the bony prominences, primarily pelvic girdle. The Pressure ulcers are graded or staged according to their degree of tissue damaged by the National Pressure Ulcer Advisory Panel (NPUAP). They have recommended the staging system from stage I-to-stage IV according to their depth.6

 

NEED OF THE STUDY:

An Average of approximately 50% of the hospitalized individuals have mobility impairment. Immobilization and inactivity are frequently present in patients with involvement of musculoskeletal, neurological system and also among critically ill patients. An immobilized individual is at a greater risk of developing Pressure sore.7 ICSI (Institute for Clinical Systems Improvement) 2014 gave health care protocol on pressure ulcer prevention and treatment protocol, a literature review of systematic reviews and randomized control trails from July 2012 thru January 2013 was completed according to the 2014 Minnesota adverse events reports the number of 9 reported pressure ulcer decreased for the second consecutive year falling from 130 to 95.8 Lalan (2011) stated that Pressure ulcer has been a significant problem because it is occurred in every healthcare setting such as hospitals, nursing homes, and hospice  and even at homes. More than one million individuals develop pressure ulcers each year. It is estimated that 11% of residents in skilled-care and nursing homes facilities suffer from Pressure ulcers, 10% in acute care, and 4.4% in home care. In hospitals, the incidence of Pressure ulcers ranges from 2.7% to 29.5%. According to the journal, Pressure ulcers negatively affect a patient's quality of life and are associated with an increased incidence of medical complications, infection, and death. Every year an estimated 60,000 people die from complications related to Pressure ulcers.9

 

STATEMENT OF THE PROBLEM:

“A study to assess the effectiveness of the structured teaching programme on knowledge of staff nurses regarding use of braden scale on pressure sore in selected hospital at mehsana district.''

 

OBJECTIVE:

1    To assess the level of knowledge regarding use of Braden scale on Pressure sore among Staff Nurses.

2    To assess the effectiveness of Structured Teaching Programme regarding use of Braden scale on Pressure sore among Staff Nurses.

3    To find out the association of the knowledge score with their selected demographic variables.

 

HYPOTHISIS:

H0 - There will be no significant difference between pre test and post test knowledge score regarding use of Braden scale on pressure sore at 0.05 level of significance.

H1 - There will be significant difference between pre test and post test knowledge score regarding use of Braden scale on pressure sore at 0.05 level of significance.

 

MATERIAL AND METHODS:

A quantitative research approach using pre experimental one group pre test –post test design.100 staff nurses were selected using non probability purposive sampling at Mehsana district. structured teaching programme was given to the staff nurses working at Mehsana district. Self structure questionnaire will prepare and used to assess the knowledge of staff nurses regarding use of Braden scale on pressure sore.

 

RESULTS:

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

 

FINDING RELATED TO DEMOGRAPHIC DATA:

Highest percentage in the demographic data including  the Age group 66% (39-48y), Gender 74% (Female), Professional qualification 68% (GNM), Years of experience 34% (Above 10 years), Monthly income 54% (Above 30 years), Type of hospital 60% (Government) Current working area 75% (General ward),In service education programme  No (90%), and First source of knowledge 08% (In service education).

 

FINDING RELATED TO PRE AND POST KNOWLEDGE SCORE:

The table 1.  Showed that Out of 100 pre-test samples poor knowledge is 65%, average 35% and good 00%. Post-test poor knowledge is 0%, average 40% and good 60%.

 

Table 1. Frequency and percentage distribution of pre test and post test knowledge

Level of Knowledge

Pre test

Post test

Frequency

%

Frequency

%

Poor

65

65%

00

00%

Average

35

35%

40

40%

Good

00

00%

60

60%

 

 

Figure1. Bar diagram representing percentage wise distribution of the sample according to pre -test and post- test level of knowledge.

 

FINDING RELATED TO EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME:

The pre-test knowledge means score is 9.72 and standard deviation is 2.77. Post test knowledge score is20.88 and standard deviation 2.60. The ‘T’ test calculated value is 89.64 and table ‘T’ test table value is 1.98 which is significant at 0.05 levels. Thus it rejects the null hypothesis and accepts the research hypothesis. The pre test and post test mean % is 32.40% and 69.60% and different is 37.20%. so knowledge is increase after intervention. This indicates that the structured teaching programme is effective in increasing the knowledge of staff nurses regarding use of Braden scale on pressure sore.

 

 

Table 2. Mean, mean difference, standard deviation, and “T” test value of pre test and post test knowledge score

Parameter

Mean

Standard deviation

Mean difference

‘t’ test

Pre-test

9.72

2.77

 

 11.16

 

89.64

Post-test

20.88

2.60

Comparison of mean percentage of pre-test and post-test knowledge score.

Table no.3. Comparison of mean percentage of pre-test and post-test knowledge score.

Type of test

Knowledge regarding Braden scale on pressure sore

 

Mean

Mean percentage

Pre-test

9.72

32.40%

Post-test

20.88

69.60%

Mean percentage difference

11.16

37.20%

N- 100

 

 

Figure 2. Bar diagram showing the effectiveness of structured teaching programe on knowledge percentage

 

Finding related to association between pretest knowledge score 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 of staff nuses regarding use of Braden scale on pressure sore and selected demographic variable. The chi square value shows that their marital status is significant and other is not significant at the 0.05 level of significance.

 

CONCLUSION:

The conclusions drawn from the finding of the study are as follows:

The ’T’ test is done to find the effect of structured teaching programme. It revealed that there is highly significant gain of knowledge after the administration of intervention. The ’T’ value is 89.64 and research hypothesis is accepted and null hypothesis is rejected. The pre test and post test mean % is 32.40% and 69.60% and different is 37.20%.so knowledge is increase after intervention. This indicates that the structured teaching programme is effective in increasing the knowledge regarding use of Braden scale on pressure sore.

 

REFERENCES:

1.      Moore Z, Price P. Nurse attitude, behaviours and perceived barriers towards pressure ulcer prevention. J Clin Nurs [online] 2004 Nov [cited 2013 Apr 22]; 13(8):p38-2 Available from: URL: http// www.pubmed.com

2.      Smettzer CS, Bare GB. Brunner and Suddarth’s, Text book of Medical Surgical Nursing. 8th ed. Philadelphia: Lippincott publisher; 2004.p1639-42

3.      Hagisawa S, Batbenel J. The limits of pressure sore prevention. JR Soc Med [online] 1999 Nov [Cited 2013 Apr 17]; 92(3):p22-4 Available from:URL:http:// www.pubmed central.nih.gov

4.      Ayello P, Vap W. Pressure ulcer. Medline plus Medical encyclopedia     [online] 1990 Apr [cited 2013 Apr 22]; 4(2):p44-5 Available from: URL: http:// www.medlineplus.com

5.      Lewis M S, Heitkemper MM, Dirksen RS. Medical Surgical Nursing. 6th ed.    St.louis: Mosby publisher; 2000.p1432-35

6.      http://en.wikipedia.org/wiki/Pressure_ulcer

7.      Black MJ, Hoksan J. Medical surgical nursing.7th ed. Singapore: Elsevier publisher; 2002.p1345-46

8.      Bergstrom N. Braden BJ, Laguzza A, Holman V. The Braden scale for predicting pressure sore risk. Nurse Res [Serial online] 1987 [Cited 2007 Aug17]; 36(4):p25-6 Available from: URL: http:// www.ncbi.nlm.nin.gov

9.      Daideri G. Berthier F, Brocker P, Darmon MJ, Miqnolet F. Quaranta JF,et al. Prevalence of pressure sore in a university horpital. Rev epidemiol santle rublique [online] 2006 Dec [Cited 2013 Apr 8]; 54(6):p44-5 Available from: URL: http:// www.ncbi.nlm.nin.gov

 

 

 

 

Received on 04.06.2019         Modified on 24.06.2019

Accepted on 16.07.2019       ©A&V Publications All right reserved

Int.  J. of Advances in Nur. Management. 2019; 7(3): 275-278.

DOI: 10.5958/2454-2652.2019.00064.7