Date of Award

Winter 8-1-2017

Document Type

Thesis

Degree Name

M.Sc. Nursing

Department

Department of Medical Surgical Nursing

First Advisor

Dr. Elsa Sanatombi Devi

Second Advisor

Mrs. Janet Prameela D'Souza

Abstract

ABSTRACT A research study entitled “Effectiveness of a video assisted teaching program on knowledge and preventive practices of Catheter Related Blood Stream Infections (CRBSIs) among health care professionals in selected Intensive Care Units (ICUs) of a tertiary care hospital, Udupi” was carried out at Manipal University, Manipal by Jeffin Thomas Jacob for the award of M.Sc. Nursing degree. The objectives of the study were to develop and validate a video on preventive practices of CRBSI, assess the CRBSI preventive practices and knowledge on prevention of CRBSI among health care professionals as measured by as observational checklists and structured knowledge questionnaire and to evaluate the effectiveness of video assisted teaching programme, in terms of improvement in knowledge scores as measured by structured knowledge questionnaire and practice scores as measured by observation checklists. The conceptual framework of the present study is based on the Context Input Process Product (CIPP) model, devised by Guba in 1960s and further developed by Stufflebeam in 2003 (Zhang, et al., 2011). The study hypothesized that there will be a significant difference between the pre-test and post-test knowledge scores and practice scores on CRBSI preventive practices of the health care professionals working in the intensive care units. The tools used in the study were tool on demographic proforma, structured knowledge questionnaire on catheter related blood stream infections, observation checklist on central line insertion practices for doctors, observation checklist for nurses while assisting for central line insertion, observation checklist on administration of medications through the central line, observation checklist for central line dressing. Content validity and reliability of the tools were established and all the tools were pre- tested. The Pilot study revealed the feasibility of the study and permissions from all the relevant authorities were obtained prior to conducting the study. The study was conducted during the month of January to March 2017 at Kasturba Hospital, Manipal and the areas included ICU1, ICU2, ICU3 and Casuality ICU of Kasturba Hospital, Manipal. A total of 4 ICUs were involved in this study. The gathered data was coded and summarized in a master data sheet and was analyzed using SPSS 16.0 version. Both descriptive and inferential statistics were used for the data analysis. A total of 72 participants were included in the study and majority of the study participants were females 60 (83.3%), with a mean age of 26.31±3.82 years. Years of experience ranged from 1-5 years for 59 (81.9%) of the participants and 13 (18.1%) had more than five years of experience. Only 18 (25%) of the participants had the awareness of Evidence Based Guidelines for CRBSI preventive practices. In the pre-test, out of 72 participants, 16 (22.2%) participants had poor knowledge, 36 (50%) had average knowledge, and 20 (27.8%) had good knowledge whereas in the post –test conducted after seven days of the training program 2 (2.8%) participants had average knowledge, 35 (48.6%) had good knowledge and 35 (48.6%) participants had excellent knowledge on preventive practices of CRBSI. The area wise calculation of mean percentage, actual gain of pre-test and post-test knowledge scores also showed that mean percentage pre-test scores ranged from 67.7% in the area of baseline knowledge on CRBSI and infection control practices and 96.6% in the post-test, 57.2% in the area of knowledge on central line insertion practices and 81.4% in the post –test, ,56.8% in the area of knowledge on central line maintenance practices and 83.63% in the post-test . The actual gain score was highest in the area of baseline knowledge on CRBSI and infection control practices ranged from 67.7 -96.6%. Out of 30 pre-test observations of central line insertion practices majority 28 (93.3%) had worn cap, 29 (96.7%) had worn mask, 27 (90%) had performed hand hygiene, 30 (100%) had compliance in the areas of sterile gown, sterile gloves, sterile drape, skin preparation with chlorhexidine, Aseptic technique throughout the procedure, and disposal of sharps and only 18 (60%) of them had performed hand hygiene procedure after the central line insertion. Whereas in the post-test, out of 30 observations of central line insertion practices, 29 (96.3%) of participants had performed hand hygiene, 30 (100%) had compliance in the areas of wearing cap, wearing mask, sterile gown, sterile gloves, sterile drape, skin preparation with chlorhexidine, aseptic technique throughout the procedure, and disposal of sharps and 19 (63.3%) of them had only performed hand hygiene procedure after the procedure. The data shows that most of the physicians had followed the preventive practice measures while doing central line insertion, even though the video assisted teaching intervention was given there was no much clinically significant difference in the practices of doctors while doing central line insertion in the post-test observations because already they had a good practice towards the preventive practice measures while doing central line insertion, and only in the area of hand hygiene after doing the central line insertion procedure the compliance was less compared to other areas.

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