Date of Award

Winter 8-1-2017

Document Type

Thesis

Degree Name

M.Sc. Nursing

Department

Department of Medical Surgical Nursing

First Advisor

Mrs.Melita Sheilini

Second Advisor

Mr.Harish B

Abstract

ABSTRACT A research study entitled “A study to assess the knowledge on practice of urinary catheter care and compliance to urinary catheter care guidelines by the staff nurses working in a tertiary care hospital, Udupi district” was carried out at Manipal University, Manipal by Ms Maryl Candida Cutinho. The objectives of the study were to assess the knowledge on practice of urinary catheter care and to assess the compliance to urinary catheter care guidelines by the staff nurses working in a tertiary care hospital, Udupi district. The conceptual framework used for the study was based on the “Radical Approach Model On Educational Process(1974)”. A descriptive survey design was used for the study. The samples were the staff nurses working in the intensive care units of Kasturba hospital, Manipal. Nonprobability purposive sampling technique was used to recruit the samples for the study. For assessing practice maximum number of observations were made. The tools used for data collection were Tool1: Demographic proforma, Tool2: Structured knowledge questionnaire on prevention of catheter associated urinary tract infection and , Tool3: Observation checklist on Practice of urinary catheter care which included Tool3.1: Checklist on practice of urinary catheter insertion, Tool3.2: Checklist on practice of urine specimen collection, Tool3.3: Checklist on practice of urinary catheter removal, Tool 3.4: Checklist on urinary catheter maintenance, Tool3.5: Checklist on emptying of urine bag. To ensure the content validity the tools were given to 9 experts from the field of Urology, Nephrology, Microbiology and Nursing. The tool was pretested among 3 participants and the reliability was also established . The pilot study was conducted which revealed the feasibility of the study. Administrative permission was obtained from the Dean, MCON Manipal, Institutional Research Committee, MCON Manipal, Medical and Nursing Superintendent Kasturba Hospital, Manipal and Institutional Ethics Committee clearance was also sought (IEC No. 748/2016). Informed consent was also taken from the participants. The data was collected from 2nd January 2017 to 5th February 2017. Initially a concealed observation of the urinary catheter care practices was made and then the participants were informed about the concealed observation that if they were aware of their practices being observed then there would be change in their behavior. Informed consent was taken from the participants willing to participate in the study . Structured knowledge questionnaire was administered to participants willing to participate in the study and data was obtained. The study sample comprised of 108 staff nurses for assessing knowledge and for assessing practice maximum number of observations were made . The data gathered was coded and analyzed using SPSS version 16.0.

Descriptive statistics was used for data analysis.

Majority 95(88%) of the participants belonged to the age group of 20 to 30years. Majority 92(85.2%) were females. Majority 64(59.3%) participants were GNM qualified and 44(40.7%) were B.Sc(N) qualified. Majority 67(62%) had 1 to 5 years of experience, 31(28.7%) had more than 5 years of experience and 10(9.3%) had less than 1 year of experience. Majority 92(85.2%) had not attended training program on catheter associated urinary tract infections and Majority 94(87%) were not aware of any evidence based practices on prevention of catheter associated urinary tract infection. Majority 89(82.4%) of the participants had average knowledge , around 18(16.7%)had good knowledge on urinary catheter care and guidelines. The mean knowledge score was 17.49±2.98. With regard to practices of urinary catheter insertion there was noncompliance observed to procedural steps in the areas of hand hygiene before the procedure (52.63%) and perineal hygiene with antiseptics (89.5%) . During urine specimen collection there was 100% noncompliance observed in the areas of hand hygiene before procedure, cleaning of port of the tube with disinfectant and aspirating urine with sterile syringe. With regard to the urine catheter removal noncompliance was observed in the areas of performing hand hygiene before the procedure which was 100% and routine perineal hygiene after the removal of the catheter(91.7%). With regard to maintenance of urine catheter, noncompliance was observed in the areas of cleaning of perineal area with soap and water(88.24%). Thus the study recommends that the knowledge of staff nurses is essential in improving infection control practices. Hence comprehensive training program is required to improve knowledge and skills of staff nurses and enhance their adherence to the preventive practice guidelines .

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