INTRODUCTION:

Birth of healthy neonate baby is one of the greatest gifts of the nature. The mechanism of birth takes only a few hours, but it is finest period of life since it is the most precarious period of life, it is associated with largest number of deaths as compared to any other phase of life.

A newborn is precious not only to his parents but also to community, nation and to the world. The maintenance of child health is not only desired but also positively valued by every society and improved level of child health is the accepted goal of all communities “A healthy child has a sure future” is one of the themes of WHO.

Every birth must be considered as medical emergency and labor room must be provided with adequate infrastructure and facilities for resuscitation of babies who fail to establish Spontaneous breathing. Prenatal hypoxia is one of the leading causes of prenatal mortality in developing countries. Most babies have a smooth transition from fetal to neonatal life and they are able to establish spontaneous breathing without any assistance. But 5.0-7.5% of neonates are likely to face difficulties in initiating spontaneous breathing at birth and they need active resuscitation. Every nurse must have the training and expertise to resuscitation an apneic or asphyxiated newborn baby.

Neonatal resuscitation skills are essential for all health care providers who are involved in the delivery of newborns. The transition from fetus to newborn requires intervention by a skilled person or individual. About 90% of neonates successfully make transition without any help. The remaining 10% of newborns require some assistance to being breathing at birth and 1% or more require intensive resuscitative effort.

STATEMENT OF THE PROBLEM:

A Pre-Experimental study to assess the effectiveness of structured teaching programme regarding neonatal resuscitation among the G.N.M Interns Students in selected Nursing colleges, Jalandhar Punjab.

AIM OF THE STUDY:

To enhance the knowledge regarding neonatal resuscitation by structured teaching programme among GNM interns students in order to prepare them to manage effectively in new born in future.

OBJECTIVES OF THE STUDY:

1. To assess the pretest knowledge regarding neonatal resuscitation among GNM interns students.

2. To assess the post test knowledge regarding neonatal resuscitation among GNM interns students.

3. To compare pre test and post test knowledge regarding neonatal resuscitation among GNM interns students.

4. To find out the association between post test knowledge regarding neonatal resuscitation among GNM interns students with their selected socio-demographic variables

REVIEW OF LITERATURE:

1. Tenorio V, Alascon A, Area G, Camprubim (2012) Conducted a retrospective study on effect of whole body hypothermia on patients with moderate severe hypoxic ischemic encephalopathy (HIE) in Barcelona, result of the study revealed that no potentially severe complications related to hypothermia were observed. Seven patients ( 35%) died; all of them with severe HIE. No potentially severe complication related to it was recorded. ¹

2. Ever A, et. Al (2012) conducted a prospective control study to assess substandard care factors in the case of delivery related asphyxia on term infants, without congenital malformations who died intrapartum of were admitted due to asphyxia in Netherlands. The study results revealed that in 58% cases a substandard care factor was indentified that was possibly or probably related to prenatal deaths or neonatal unit admission.²

3. Sabir H, Jary S, Tooley J, Liu X, Thorlsen M (2012) did on conducted a descriptive study to assess whether increased inspired oxygen and lypocardia during the first 6 hours of life are associated with adverse outcome at 18 months in term neonates treated with therapeutic hypothermia in United Kingdom/ result of the study shows that increased fraction of inspired oxygen with in the first 6 hours of life was significantly associated with adverse outcome in newborn treated with therapeutic hypothermia following hypoxic ischemic encephalopathy.³

4. Huo L, Zhang F et. al (2011) criticized a study on the early diagnose of hypoxic ischemic encephalopathy in the new born by fuzzy back- propagation neural network, with a clinical compressive indicators, exhibited a high accuracy for the early diagnose of hypoxic ischemic encephalopathy.⁴

5. Neogi SB (2011) Examine a cross sectional study to assess the functioning of special care newborn units in india. Result of the study shows that the case fatality rate reduce from 40% to 4% within one year of their functioning and proportional mortality due to sepsis and low birth weight declined significantly over 2 year due to quality of case provided by these units.⁵

6. Ferrari F, et. al (2011) examined a co-relational study to co-relate the site and severity of brain lesions seen on magnetic resonance imaging with the quality of general movements in term infants with hypoxic ischemic encephalopathy and compare the prognostic value of general movements and MRI scores were 100% sensitive and 72.2% specific for motor outcome and cramped synchronized general movements wre 100% specific and 68% sensitive for motor outcome. In term infants with HIE, the site and severity of brain lesions on early MRI are highly co-related with general movements.⁶

7. Opiyo N, Govedi F, et. al (2006) conducted a study on effect of new born resuscitation training on health worker practices in Kenya result of the study revealed that there was a statistically significant reduction in the frequency of inappropriate and potentially harmful practices per resuscitation in the trained group (trained 0.53, control 0.92) this study concluded implementation of a simple, one day new born resuscitation training can be followed immediately by a significant improvement in health workers practices.⁷

8. Hare B, Makauto M, et. al (2005) conduct a pilot study on neonatal resuscitation among staff nurse in Uganda. This study result shown that basic neonatal resuscitation in this setting decreased the incidence of asphyxia improved APGAR and a decrease in the mortality of babies weighing more than 2 kg. This study concluded that the resuscitation team reduced the incidence of and mortality from asphyxia and improved the outcome of babies greater than 2 kg.⁸

9. Murlia F, Obimbo MM, et. al (2012) conducted a descriptive study to assess the knowledge of health provider on neonatal resuscitation (85.41) with only 23 receiving formal training. The average duration of neonatal training was 3 hours with 50% having missed out on practical exposure. When asked on steps of resuscitation only 68 (35.4%) of the participants scored above 85%. More than 70% of them considered their knowledge about neonatal resuscitation inadequate and blamed it on inadequate medical training programmed. Health providers, as the key personnel in the management of neonatal resuscitation, in this survey seem to have inadequate training and knowledge on this subject.⁹

10. Haidary M (2009) Conducted a study to see the types and outcome of management of birth asphyxia was occur due to (21.92%) acute respiratory infection (22.73%), low birth weight ( 12.97%), neonatal jaundice (9.64%) septicemia (4.38%) Meningitis (2.98%), Diarrhea (2.75%), Birth trauma (2.75%), Neonatal tetanus (0.45%). Out of the total birth aasphyxiated babies, mild type was (18.32%), moderate type was (20.94%), and severe birth asphyxia was (60%). The recovery rate in mild birth asphyxia was (100%), in moderate case was (95%) and in severe cases the rate was (74.13%).¹⁰

MATERIAL AND METHODS:

The research design adopted for the present study was Pre-experimental. A structured questionnaire is basically designed to obtain information regarding the distribution and interrelation of variables within the given population. This study was conducted in S.G.L. Nursing College, Jalandhar district, Punjab. Nearly 60 nursing students. Purposive sampling technique was adapted for this study.

Criteria for sample selection: The nursing students were selected based on predetermined criteria.

Sample characteristics	Frequency (f)	Respondent Percentage (%)
1. Age( years)
a) 20-22years	39	65%
b) 23-25years	20	33.3%
c) 26-28years	1	1.7%
2. Gender
a) Male	0	0.0%
b) Female	60	100%
3. Religion a) Sikh b) Hindu c) Christian d) Muslim	35 24 1 0	58.3% 40.0% 1.7% 0.0%
4. Steam of education a) Medical b) Non medical c) Commerce d) ARTS	13 7 5 35	21.7% 11.7% 8.3% 58.3%
5. Previous knowledge a) Class teaching b) Work shop c) Clinical area d) others 6. Residence area a) urban b) rural 7. Basic qualification a) ANM b) B.A c) B.com d) Others 8. Occupation of father a) Business b) Medical profession c) Para-medical profession d) Other profession 9. Occupation of mother a) House wife b) Medical profession c) Paramedical profession d) Other profession	50 1 8 1 28 32 5 5 0 50 9 6 1` 44 51 2 0 7	83.3% 1.7% 13.3% 1.7% 48.7% 53.3% 8.3% 8.3% 0.0% 83.3% 15% 10.0% 1.7% 73.3% 85.0% 3.3% 0.0% 11.7%

Objective -III to Compare the pre test and post test knowledge regarding neonatal resuscitation among GNM interns students. N=60

Group	n mean	SD	t value
Pre test	60 12.93	2.96		28.543
Post test	60 24.42	2.63

S: Non significant P value>0.0000, *: Significant p<0.05; #Paired

DISCUSSION:

This chapter relates the findings of the present study to the studies done earlier the present study is “ A pre- experimental study to assess the effectiveness of structured teaching programme on knowledge regarding neonatal resuscitation among GNM interns students in selected nursing college of Jalandhar, Punjab”

A Self structured knowledge questionnaire was used to collect the data. Study was done to enhanced the knowledge regarding neonatal resuscitation among GNM Interns student in the selected nursing college of Jalandhar the investigator utilized the convenience sampling technique to selected subject the finding were discussed on the basis of demographic characteristics objectives of the research study

The first objective of the study was to assess pretest knowledge regarding neonate resuscitation among GNM intern’s students

The finding of the study was supported by Bhimanna Hokrani structured knowledge question was used to assess the knowledge regarding neonatal resuscitation among GNM interns students by giving structured teaching programme. Sixty students were selected from selected nursing college of Jalandhar Results of the study showed that in the pretest knowledge score , 1.7% students had inadequate knowledge , 20% had moderate knowledge and 78.3% student had adequate knowledge regarding neonatal resuscitation second objective of the study was assess post test knowledge regarding neonatal result among the student GNM Interns students

The finding of the study was supported by Bhimanna Hokrani structured knowledge questionnaire was used to asses the knowledge regarding neonatal resuscitation among GNM interns student by giving structured teaching programme. Sixty students were selected from selected nursing college of Jalandhar. Results of study showed that the in post test 90% students had adequate knowledge and 10% had moderate knowledge and no students had below averge knowledge regarding neonatal resuscitation.

The thirds objective of the study was to compare present post test knowledge regarding neonatal resuscitation among GNM Interns students

The finding of the study show that mean scare of pretest and post test level of knowledge had moderate knowledge no students had inadequate knowledge regarding neonatal resuscitation.

The thirds objective of the study was to compare present post test knowledge regarding neonatal resuscitation among GNM Interns students the from objective

According to age, Majority of GNM interns 39(65.0%) were in aged group 20-22 (years) followed by 20(33.3%) in age group 23-25 years minority of 1 (1.7%) belongs to the age group 26-28 years as per under majority of 60(100) GNM interns were female whereas the male sample were 0(0.0%)

According to religion majority of Sikhs were 35(58.3%) followed by Hindu were 24(400%) where as Christian were 1(1.17%) followed by none of Muslim.

According to stream of education majority of 35(58.3%) GNM Interns from arts followed by 13(21.7%) were from medical stream 7(11.7) were from Non medicine whereas minor by of 5(8.3%) were belonged to commerce

According to previous knowledge majority of 50(83.3%) cases got knowledge from class teaching followed by 8(13.3) were from clinical area by minority of 1(1.7%) from the others

In accordance’s with the residence status majority of GNM 32(53.3%) were belonged to rural area and Minority of GNM Interns 28(46.7%) belong to urban area

According to basic qualification majority of GNM Interns 50(83.3%) were belonged to others followed by 5(8.3%) were ANM, BA and none of belonged to B.com

According to occupation of father education of majority of GNM interns 44(73.3%) belongs to others professions, followed by 9(15.0%) belongs to business and 6(10.0%) to the medical profession and minority of 1(1.7%) belongs to paramedical profession.

As per occupation of mother education status of mother of majority of GNM Interns 51(85.0%) m were housewife followed by 7(11.7%) were belonged to other profession 2(3.3%) were belonged to medical profession whereas none of belonged to paramedical profession

FINDING RELATED TO ASSESSMENT OF KNOWLEDGE:

In the pretest knowledge, Majority of 47(78.3%) GNM Interns had good knowledge followed by 12(20%) had arrange knowledge only 1(1.7%) had poor knowledge in the post test knowledge majority of 54(90%) GNM interns had good knowledge followed by 6(1.0%) had average knowledge and not ever a single GNM Interns 0(0.0%) had poor knowledge regarding neonatal resuscitation.

REFERENCE:

1. Tanorio V, Alarcon A, Arca G, Compprubi M,

Available from: http://www.ncbi.nlm.nih.gov/pubmed/22406158.

2. Evers AC,Brouwers HA, Nikkels PG, Boon Jand et.al, Obstetrics neonatology pathology, university medical center Utrecht, Netherlands. 2012;12:159.

3. Sabir H, Jary S, University of Bristol, st.Michael’s hospital, Bristal united kingdom. J pediatric 2012; 161(3): 409-16.

4. http://www.ncbi.nlm.nih.gov/pubmed 21936387.

5. Neogi SB, Malhotra S, Indian institute of public health- delhi, public health foundation of india, new delhi, india, 2011; 29(5); 500-9.

6. Ferrari F, Todeschini A, Department of neonatal medicine, university of Modena and reggio Emilia, Modena, Italy. 2011;8(3):21-4.0

7. http://www.ncbi.nlm.nih. Gov/pubmed 2263842.

8. Hare B A pilot study to determine if nurses trained in basic neonatal resuscitation would impact the outcome of neonate, university hospital wales kampala, Uganda, ozford university press 2002 :31(3):1-12.

9. http://www.ncbi. Nlm.nih.gov/pubmed 22655112

10. Haidaery M, Hussain A, clinical profile of birth asphyxia in rajshahi medical college hospital, Bangladesh, the journal of teachers association 2005 dec. ;18(2):106-108

Received on 10.03.2016 Modified on 29.04.2016

Int. J. Adv. Nur. Management. 2016; 4(3): 209-213.

DOI: 10.5958/2454-2652.2016.00048.2