INTRODUCTION:

The health professionals are inevitable to provide scientific prevention or medication in the human history. In the past era and even now, magicians, herbalists, priests the list goes on they have been treated the sick. But it is not according to the scientific knowledge. In this present scenario, various innovative technologies and inventions are used for prevention and restoration of health.

Cardiovascular diseases (CVD) connected with heart and blood vessel disorders. The Common types of coronary artery diseases are stroke, hypertension and myocardial infarction etc. The rate of cardiovascular diseases varies according to the different risk factors such as lifestyle, genetics and health care access. The main cause of these disease is due to atherosclerosis. Atherosclerosis is a condition in which the plaque become deposited on the arterial wall, as a result arteries become narrow and hard.

Reports shows that in developed countries higher incidences of coronary artery disease are due to high rate of obesity, smoking, and sedentary lifestyle. But in the developing countries the increased rate is due to lifestyle changes and the risk factors are smoking and unhealthy diets. Globally, morbidity and mortality rates are shooting up due to the alarming growth of cardiovascular disease. Identification and handling of these risk factors are highly crucial for prevention and treatment of cardiovascular disease. Genetics also have a vital role in this disease. CVD affects, various demographic groups in divergent ways. Men generally develop heart disease at a younger age compared to women. But in women, the risk will increase than men after menopause is one of the common examples of CVD. Balanced diet, regular exercises and smoking cessation are essential for its prevention. Life style adjustments and medications are the normal treatment modalities but sometimes surgical interventions also needed. It depends up on the severity and type of cardiovascular condition. Advanced progression in medical research and technology is highly helpful in prevention, diagnosis and treatment of this disease conditions.

Anticoagulation therapy is the best remedy for cardiovascular diseases. It also helps us for the prevention and treatment of the cardiovascular diseases. Anticoagulation therapy is used to prevent or treat blood clots. It works by interfering with the blood clotting process, thereby reducing the risk of conditions such as stroke, deep vein thrombosis, pulmonary embolism, and heart attack.

The advanced medical research provides several types of anticoagulants. For example: Vitamin K Antagonists (warfarin), Direct Oral Anticoagulants (rivaroxaban, apixaban, and dabigatran), Heparins (available forms are low molecular weight forms (like enoxaparin) and unfractionated forms Direct Thrombin Inhibitors (dabigatran). It is a key enzyme in the clotting process, directly inhibit thrombin.

The choice and selection of anticoagulant depends upon the factors like, the type of clot, patient’s medical history, and risk of bleeding. So regular monitoring and adjustment of doses are often required to balance the benefits and prevent the risks of anticoagulation therapy. Anticoagulation therapy is the best medicine for cardiovascular disease in the last 50 years. Currently reports shows that, Vitamin K antagonist is an anticoagulant that can be used for the longest period of time. So, this is the most favorable medicine for doctors in this treatment.

NEED OF STUDY:

Medication errors is one of the grave faults by nurses and it has serious consequences. Also giving a significant concern for correcting medication errors. Incorrect dosage, wrong medication, erroneous route, timing errors and documentation mistakes are the common types of medication errors. In health care sector nurses are responsible for administration of medications. Nurses are the final step of the medication administration process. If there is no adequate knowledge about drug and lack of important patient information that may causes major medication errors. In administering medications, nurses are accountable for knowing why the medication is being used, what are the possible side effects to monitor and how much therapeutic dosage would be given. Because the inadequate knowledge of drugs can cause 15% of administration related medication errors. Before the administration of medications, nurses must check the rights of medications. During the period of their service, they must have up to date their knowledge through various methods.

The third most common cardiovascular illness is Venous thromboembolism. In this present era, anticoagulation therapy is escalating due to numerous types of heart diseases. This therapy has its own side effects, if patients discontinue anti-coagulation therapy, it may lead to major complications such as stroke, thromboembolism, cardiovascular complications and cardiac arrest. On the other hand, a regular anticoagulation therapy can also cause for bleeding. Even though Anticoagulation therapy is the best remedy for cardiovascular diseases but it is a high-risk treatment. It can lead to adverse drug reaction due to the complexity of dosing these medications. So, we have to vigilant and monitor the condition of the patient also ensuring the adaptation with this therapy.

Double-checking of the medicine, using advanced technology, self-updating and prepare an ambient work environment are some of the preventive strategies. Education and ameliorate practices can help to reduce medication errors and enhance patient safety. So, the investigator realised that either the staff nurse or student should have the knowledge regarding anticoagulation therapy. It can be acquired through the structured teaching programme and the guided practical experience. So, it will facilitate efficient and fearless service also help them to avoid complications and death. It will generate companionable and diligent medical professionals

Key words: Heart disease, cardio vascular disease (CVD), Myocardial infarction, anticoagulation therapy, Thrombo embolism, structured teaching programme, Atherosclerosis

METHODS:

Research approach:

Quantitative approach was used in this study to assess the effectiveness of structured teaching programme on knowledge regarding anticoagulation therapy in cardiovascular disease among nursing students in selected college of nursing Mangalore.

Research design: One group pre-test post test, pre-experimental design.

Settings: This study was conducted in Shree Devi College of nursing Mangalore

Population:

Target population: The target population of the study is the B.Sc. nursing students’ study in Shree Devi College of Nursing Mangalore.

Accessible population: The accessible population of the study is the nursing students in selected college of nursing in Mangalore.

Sample and sample size: Samples are second year B S.c nursing students, who met inclusion criteria. In this study sample size is 60.

Sampling Technique: Random sampling technique is used to collect data.

Description of tool:

The tool consists of:

Section I: Description of demographic of variables.

Section II: Evaluation of effectiveness of the structured teaching programme on anticoagulation therapy

Part A: Comparison of knowledge score of nursing students.

Part B: Area wise effectiveness of structured teaching programme.

Section II: Association of the pre-test knowledge score of nursing students with demographic variables

Result:

Section I: Description of demographic of variables.

Table:1 Frequency and percentage distribution of nursing students according to their demographic variables as explained.

variables	Frequency (f)	(%)
Demographic variables
1.Age group
a) 18 years	0	0.0
b) 19 years	12	20.0
c) 20 years	38	63.3
d) 21 years	10	16.7
2.Sex
a) Male	4	6.7
b) Female	56	93.3
3. Religion
a) Christian	19	31.7
b) Hindu	38	63.3
c) Muslim	3	5.0
d) Other	0	0
4.Type of area
a) Urban	47	78.3
b) Rural	13	21.7
5) Previous knowledge
a) Yes	46	76.7
b) No	14	23.3
6.If yes, source of knowledge
a) Mass media, TV, radio, news paper	7	15.2
b) Information from academic studies	10	21.7
c)Books, magazine, articles	5	10.9
d)Clinical experience	24	52.2

The socio demographic data of the students shows that 38 of them (63.3%) belongs to age group 20 years. And 56 of them (93.3%) are females. In this 38 students (63.3%) were Hindhu.Majority 47(78.3%) of the students were from urban areas.46(76.7%)of the students were previous knowledge. The source of knowledge of 24(52.2%) were from clinical experience.

Section II: Evaluation of effectiveness of structured teaching programme on anticoagulation;

Part A: Comparison of knowledge score of nursing students.

Table 2: Overall pre-test, post-test and Mean Knowledge Scores on anticoagulation therapy N=60

Aspect	Max score	Mean	SD	Mean %	SD%	Paired t test	Table value	P value
Pre-test	30	14.23	1.94	47.43	6.46	25.021	2.011	0.001*
Post-test	30	23.317	1.742	77.23	5.80
Enhancement	30	9.08	2.81	30.28	9.37

Df=59; 0.05 Level of significance * Significance

Table: 3 Area wise effectiveness of STP with mean, SD, and mean percentage of pre-test and post-test knowledge scores on anticoagulation therapy N=60

Knowledge Aspect	Pre-test		Post-test		Paired t test	Table value	P value
Knowledge Aspect	Mean	SD	Mean	SD	Paired t test	Table value	P value
Anatomy and physiology of heart	56.00	15.6	80.34	17.08	8.405	2.011	0.001*
Related Knowledge	48.75	7.91	79.59	5.915	22.482	2.011	0.001*
Management related anticoagulation therapy	33.66	14.5	67.66	19.52	10.626	2.011	.001*
Combined	47.43	6.46	77.23	5.80	25.021

Table 4:

Demographic variables	f	Levelof knowledge		Chi-square (Yates	df	Table value	Pvalue	Significance**
		Inadequate	Moderate
Age in years
19	12	09	03	0.111	2	5.991	0.946	NS
20	38	29	09
21	10	07	03
Sex
Male	04	04	00	0.357	1	3.841	0.551	NS
Female	56	41	15
Religion
Christians	19	13	06	0.409	2	5.991	0.815	NS
Hindhu	38	30	08
Muslim	03	02	01
Type of area
Urban	47	38	09	3.961*	1	3.841	0.04	S
Rural	13	07	06
Previous knowledge
Yes	46	33	13	0.497	1	3.841	0.481	NS
No	14	12	02
If yes, source of knowledge		(33)	(13)	0.268	3	7.815	0.966	NS
Massmedia:TV, radio, newspaper. n=46	07	04	03
From academic studies	10	08	02
Books, magazines, articles	05	03	02
Clinical experience	24	18	06

Association of the pre-test knowledge score of nursing students with demographic variables shows that; there is no significant association between pre-test knowledge score of nursing student and their age, sex, religion, previous knowledge and source of information

In pre-test it has been found that majority of the nursing students had inadequate knowledge. After the intervention as structured teaching programme it has been found that there was gain in adequate knowledge. It is evident that STP was effective in improving the knowledge of nursing students regarding anticoagulation therapy. There was no association between pre-test knowledge score and demographic variables.

CONCLUSION:

The present study attempted the effectiveness of structured teaching programme on knowledge regarding anticoagulation therapy among nursing students, and concluded that there was a significant improvement in the knowledge after structured teaching programme. Hence structured teaching programme was effective in improving the knowledge in students regarding anticoagulation therapy.

ETHICAL STANDARDS:

This study was conducted after getting approval from the Institutional Ethics Committee and after obtaing written consents from all subjects.

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Received on 04.09.2024 Revised on 12.10.2024

Accepted on 16.11.2024 Published on 20.11.2024

Available online on December 28, 2024

Int. J. of Advances in Nursing Management. 2024;12(4):194-198.

DOI: 10.52711/2454-2652.2024.00043