A Study to Assess the Effectiveness of Informative Booklet Regarding Knowledge, Attitude and Practice Among Intensive Care Unit (ICU) Staff Nurses Regarding Prevention of Central Line Associated Blood Stream Infection (CLABSI)
Prathipati.Manasa1, Neelam Usha Rani2
1Dept. Medical Surgical Nursing, Nri College of Nursing, Chinakakani, Guntur, Andhra Pradesh.
2Associate professor cum HOD, Dept. Medical surgical Nursing. Nri College of Nursing,
Chinakakani, Guntur, Andhra Pradesh.
*Corresponding Author E-mail: Prathipatimanasa1997@gmail.com
ABSTRACT:
Background: Nurses in Intensive Care Units (ICU) have a vital role in reducing Central line associated blood stream infections (CLABSI) if they are well educated to use strategies to decrease Central line associated blood stream infections (CLABSI) rate which are based on the center for disease control and prevention guidelines (CDC) to improve patient’s outcomes. Health-care-associated infections are a huge concern in the intensive care units (ICUs) across the globe. Nearly 90% of catheter-related bloodstream infections are caused by central venous catheters (CVCs). Central venous catheters (CVC) are commonly inserted in critically ill patients and play an important role for hemodynamic monitoring and delivery of crucial treatments. Central line-associated bloodstream infection (CLABSI) is a laboratory confirmed bloodstream infection occurring in a patient with a CVC in place for >48 hours that is not related to an infection at any other site. Preventing nosocomial infections pose a great challenge in ICU, because of the multi-drug resistant organisms treated with broad-spectrum antibiotics. Clinical practice guidelines from various organizations are available for prevention of vascular catheter related infections. The Institute for Healthcare Improvement has introduced a “central line bundle” that includes the five best evidence-based practices to prevent CLABSI. This bundle includes hand hygiene, maximal barrier precautions during catheter insertion, skin antisepsis with chlorhexidine, optimal selection of the catheter site, with avoidance of the femoral vein and a daily assessment of line necessity, including the removal of an unnecessary line. Of these components, “hand hygiene” (HH) is the most convenient and cost effective to follow. “Hand Hygiene” HH prevents the transmission of pathogens and is a universal strategy to prevent all nosocomial infections. The World Health Organization has proposed a multimodal strategy; which includes five elements called the “Five Moments for Hand Hygiene”, as an evidence-based approach to prevent hospital-acquired infections. The five moments include, before touching the patient, before performing any a clean/aseptic procedure, after exposure/risk of body fluid, after touching the patient and after touching the patient surroundings. Therefore, the researcher was curious to know the effectiveness of informative booklet regarding knowledge, attitude and practice of intensive care unit staff nurses regarding prevention of central line associated blood stream infection (CLABSI).
KEYWORDS: Knowledge, Attitude, Practice, CLABSI, ICU Staff Nurses.
INTRODUCTION:
Central line associated blood stream infections (CLABSI) are defined by the centers for disease control and prevention (CDC) as laboratory confirmed blood stream infection that cannot be attributed to a source other than the presence of a central line and develop 48 hours after central line placement. Germs, including fungi and bacteria are common on skin central line blood stream infection (CLABSI) are often caused by skin bacteria from a patient or care giver. The skin forms a protective barrier to help germs from entering the body. A central line blood stream infection (CLABSI) can provide an entry point for germs either from the central line skin site or from the line hub that leads directly to the bloodstream. When the immune system is because of cancer or cancer treatments, the body can’t fight infection as well as normal. Six pathogens are responsible for central line bloodstream infection (CLABSI) they are candida/yeast, enterococcus species, staphylococcus species (excluding staphylococcus aureus), Klebsiella species and Enterobacter species.2
Staff nurses working in the clinical field are said to be the backbone of the hospital. Most of the care of patients is taken by the staff nurses working in the hospital. Staff nurse is the person who stays most of the time with patient and relatives who are present in the hospital or comes in the clinic with patients3
OBJECTIVES:
1. To assess the existing knowledge, attitude and practice regarding prevention of Central Line Associated Blood Stream Infection (CLABSI) among Intensive Care staff Nurses.
2. To evaluate the effectiveness of informative booklet on knowledge, attitude and practice regarding prevention of Central Line Associated Blood Stream Infection (CLABSI) among Intensive Care staff Nurses.
3. To associate the level of knowledge, attitude and practice regarding prevention of Central Line Associated Blood Stream Infection (CLABSI) among Intensive Care staff Nurses.
4. To find out the association of pre-test and post- test knowledge, attitude and practice regarding prevention of Central Line Associated Blood Stream Infection (CLABSI) among Intensive Care staff Nurses with their selected demographic variables.
H1: There is significant difference between the knowledge, attitude and practice of staff nurses working in Intensive care unit (ICU) regarding Central line associated blood stream infections (CLABSI).
H2: There is significant association between knowledge and attitude of staff nurses working in Intensive care unit (ICU) regarding Central line associated blood stream infections (CLABSI).
H3: There is significant association between knowledge and practice of staff nurses working in Intensive care unit (ICU) regarding Central line associated blood stream infections (CLABSI).
MATERIALS AND METHODS:
For the present study, a quantitative research (Pretest and posttest research design) approach was adopted to assess the effectiveness of informative booklet regarding prevention of Central Line Associated Blood Stream Infection (CLABSI) among ICU staff nurses at selected hospital, Guntur (district), Andhra Pradesh. The samples are ICU staff nurses of NRI General Hospital, sample consist of 60 Intensive care unit (ICU) staff nurses.
INCLUSION CRITERIA:
The present study includes the staff nurses who are
· Working Intensive Care Unit (ICU) of NRI General Hospital, Chinakakani, Guntur district, Andhra Pradesh.
· Willing to participate in the study.
· Available at the time of data collection.
· Able to understand, read and write English
EXCLUSION CRITERIA:
The study excludes ICU staff nurses of NRI General Hospital who are;
· Not willing to participate in the study
· Not available at the time of data collection
DESCRIPTION OF THE TOOL:
Section-A: It consists of socio-demographic variables such as age, gender, educational qualification, years of experience, area of working, attendance of any training course related to Central Venous Catheter, source of information, area of working, CVC assessment form, CVC checklist. Section- B: Knowledge questionnaire: This part of the tool consisted of 30 closed ended objective type questions (multiple choice questions) each question consists of 4 options Section-C: It consists of attitude scale regarding prevention of central line associated blood stream infections (CLABSI). Section-D: It consists of practice- check list based on central line associated blood stream infections (CLABSI) prevention.
The informative booklet was developed for ICU staff nurses of NRI general and super specialty hospital. The following steps were adopted for developing the informative booklet.
Reliability of the tool:
Tool was administered to 6 ICU staff nurses the reliability of the knowledge, attitude and practice checklist was established by using Test Re-test method. In order to establish the reliability, the tool was administered to 6 ICU staff nurses Guntur Government General Hospital, Guntur, Andhra Pradesh. The reliability quotient was obtained for the knowledge tool was r=0.9, for attitude r=1 and for practice r=1 hence the tool is reliable.
Data collection procedure:
A formal permission was obtained from the hospital authorities and the subjects before commencement of the study. Data was collected from 60 Intensive Care Unit staff nurses with structured knowledge questionnaire, attitude scale and practice checklist. It took 30min-45min of time to complete the tool. Informative booklet was given and after 1week of informative booklet post test was conducted.
RESULTS:
We have received the total 60 total responses.as per table 1 Out of 60 ICU staff nurses 38 (63.33 %) were aged between 25years to 30 years, 10(16.67%) were aged between31 to 35 years of age, 9 (15%) were aged between 36-40years of age, 3(5%) were aged above 41years of age. It is observed that 14(23.33%) were males and 46(76.67%) were females. Educational qualification of ICU staff nurses of NRI general and super specialty hospital are 24(40%) were GNM, 30(50%) were B.Sc. nurses, 4(6.67%) were M.sc nursing and 2(3.33%) were Ph.D. Years of experience in hospital setting are less than 1 year 20(33.33%), 2-4years were15(25%),5-7years were 12(20%) above 7years are 13 (21.667%).
Attended any in-service educational program related to Central Venous Catheter were 32(53.33%)and no are 28(46.67%).Source of information related to prevention of Central line Associated Blood Stream Infections (CLABSI) from newspaper was 6(10%), mass media5(8.33%), hospital 41 (68.33%) and from books and journals 8 (13.33%).Area of working was SICU 9 (15%), PICU/NICU 13(21.67%), ICU28 (46.67%) and MICU 10 (16.667%)Written policy related to civic, yes were 44 (73.33%)and no were 16 (26.667%).Knowledge regarding CVC Checklist yes was 44(73.33%) and no were 16 (26.667%)Knowledge regarding CVC assessment form yes 30(65%) and no were 21(35%)
Table 1. n=60
|
S. No |
Demographic variables |
Frequency (f) |
Percentage % |
|
1. |
Age in years |
||
|
|
a.25years to 30years |
38 |
63.33 |
|
|
b.31years to 35years |
10 |
16.67 |
|
|
c. 36 years to 40 years |
9 |
15 |
|
|
d. Above 41 years |
3 |
5 |
|
2. |
Gender |
|
|
|
|
Amole |
14 |
23.33 |
|
|
b. Female |
46 |
76.67 |
|
3. |
Educational qualification |
||
|
|
a. GNM |
24 |
40 |
|
|
b.B.sc Nursing |
30 |
50 |
|
|
c. M. Sc Nursing |
4 |
6.67 |
|
|
d. Ph.D. |
2 |
3.333 |
|
4. |
Years of experience in hospital setting |
||
|
|
a. Less than 1year |
20 |
33.33 |
|
|
b. 2years to 4years |
15 |
25 |
|
|
c. 5years to 7 years |
12 |
20 |
|
|
d. 8years and above |
13 |
21.67 |
|
5. |
Attended any in-service educational programme related to central venous catheter |
||
|
|
a. If yes, specify |
32 |
53.33 |
|
|
b. No |
28 |
46.67 |
|
6. |
Source of information |
||
|
|
a. News paper |
6 |
10 |
|
|
b. Mass media |
5 |
8.33 |
|
|
c.Hospital |
41 |
68.33 |
|
|
d. Books/journals |
8 |
13.33 |
|
7. |
Area of working |
||
|
|
a. SICU |
9 |
15 |
|
|
b. PICU/NICU |
13 |
21.67 |
|
|
c. ICU |
28 |
46.67 |
|
|
d. MICU |
10 |
16.667 |
|
8. |
Written policy |
||
|
|
a. Yes |
44 |
73.33 |
|
|
b. No |
16 |
26.667 |
|
9. |
CVC checklist |
||
|
|
a. Yes |
44 |
73.33 |
|
|
b. No |
16 |
26.667 |
|
10. |
Central venous catheter assessment form |
||
|
|
a. Yes |
39 |
65 |
|
|
b. No |
21 |
35 |
Comparison of pre-test and post-test range of scores about knowledge and attitude regarding regarding prevention of Central line Associated Blood Stream Infections (CLABSI) among ICU staff nurses of NRI general and super specialty hospital.
Table-2.
|
Variables |
(f) |
Minimum score |
Maximum score |
Range of score |
|||
|
Pre-test |
Post -test |
Pre -test |
Post -test |
Pretest |
Post-test |
||
|
Knowledge |
60 |
2 |
8 |
30 |
30 |
2-22 |
8-25 |
|
Attitude |
60 |
3 |
5 |
10 |
10 |
3-6 |
5-9 |
|
Practice |
60 |
3 |
8 |
15 |
15 |
3-8 |
8-14 |
The above table reveals that range of scores about knowledge regarding prevention of Central line Associated Blood Stream Infections (CLABSI) among ICU staff nurses of NRI general and super specialty hospital was 2-22 in pre-test, while in post test 8-25.
The above table reveals that range of scores about attitude regarding prevention of Central line Associated Blood Stream Infections (CLABSI) among ICU staff nurses of NRI general and super specialty hospital was 3-6 in pre-test, while in post test 5-9.
The above table reveals that range of scores about practice regarding prevention of Central line Associated Blood Stream Infections (CLABSI) among ICU staff nurses of NRI general and super specialty hospital was 3-8 in pre-test, while in post test 8-14.
Frequency and percentage distribution of pre-test and post-test level of knowledge scores regarding prevention of Central line Associated Blood Stream Infections (CLABSI) among ICU staff nurses of NRI general and super specialty hospital.
Table-3. n=60
|
Variable |
Level of knowledge |
Score |
Pre-test |
Post-test |
||
|
(f) |
% |
(f) |
% |
|||
|
knowledge regarding prevention of Central line Associated Blood Stream Infections (CLABSI) |
Poor knowledge 50% |
0-10 |
35 |
58.3% |
4 |
6.67 % |
|
Fair knowledge 51-75% |
11-20 |
22 |
36.67% |
50 |
83.33 % |
|
|
Good knowledge ≥76% |
21-30 |
3 |
5% |
6 |
10% |
|
The above table shows that knowledge regarding prevention of Central line Associated Blood Stream Infections (CLABSI) among ICU staff nurses of NRI General and super specialty Hospital was 58.3% are having poor knowledge, 36.67% are having fiar knowledge and 5% are having good knowledge in pre-test.
In post-test 6.67% are having poor knowledge, 83.33% are having fair knowledge and 10% are having good knowledge regarding prevention of Central line Associated Blood Stream Infections (CLABSI) among ICU staff nurses of NRI General and super specialty Hospital.
SECTION II (b)
Frequency and percentage distribution of pre-test and post-test level of attitude scores regarding prevention of Central line Associated Blood Stream Infections (CLABSI) among ICU staff nurses of NRI general and super specialty hospital.
Table-4. n=60
|
Variable |
Level of attitude |
Score |
Pre-test |
Post-test |
||
|
(f) |
% |
(f) |
% |
|||
|
Attitude regarding prevention of Central line Associated Blood Stream Infections (CLABSI) |
Poor attitude (≤50%) |
1-3 |
13 |
21.67% |
0 |
0 |
|
Fair attitude (51-75%) |
4-7 |
47 |
78.33% |
41 |
68.33 % |
|
|
Good attitude (≥75%) |
8-10 |
0 |
0 |
19 |
31.67 % |
|
The above table shows that attitude regarding prevention of Central line Associated Blood Stream Infections (CLABSI) among ICU staff nurses of NRI General and super specialty Hospital was 21.67% are having poor attitude, 78.33%are having fair attitude and 0% are having good attitudein pre-test.
In post-test 0% are having poor attitude, 68.33%% are having fair attitude and 31.67% are having good attitude regarding prevention of Central line Associated Blood Stream Infections (CLABSI) among ICU staff nurses of NRI General and super specialty Hospital.
SECTION II(c)
Frequency and percentage distribution of pre-test and post-test level of practice scores regarding prevention of Central line Associated Blood Stream Infections (CLABSI) among ICU staff nurses of NRI general and super specialty hospital.
Table-5. n=60
|
Variable |
Level of practice |
Score |
Pre-test |
Post-test |
||
|
(f) |
% |
(f) |
% |
|||
|
Practice regarding prevention of Central line Associated Blood Stream Infections (CLABSI) |
Poor practice (≤50%) |
1-5 |
26 |
43.33% |
0 |
0 |
|
Fair practice (51-75%) |
6-10 |
34 |
56.67% |
27 |
45% |
|
|
Good practice (≥75%) |
11-15 |
0 |
0 |
33 |
55% |
|
The above table shows that attitude regarding prevention of Central line Associated Blood Stream Infections (CLABSI) among ICU staff nurses of NRI General and super specialty Hospital was 43.33% are having poor practice, 56.67% are having fair practice and 0% are having good practice in pre-test.
In post-test 0% are having poor practice, 45% are having fair practice and 55% are having good regarding prevention of Central line Associated Blood Stream Infections (CLABSI) among ICU staff nurses of NRI General and super specialty Hospital. Hence, H1 hypothesis is accepted.
SECTION-III
This section deals with mean, standard deviation and paired “t” test for knowledge, attitude and practice scores regarding prevention of Central line Associated Blood Stream Infections (CLABSI) among ICU staff nurses of NRI General and super specialty Hospital.
Section III(a)
Mean, standard deviation of pre-test and post-test for knowledge, attitude and practice scores regarding prevention of Central line Associated Blood Stream Infections (CLABSI) among ICU staff nurses of NRI General and super specialty Hospital.
Table -6. n= 60
|
VARIABLE |
PRE-TEST |
POST-TEST |
||
|
MEAN |
SD |
MEAN |
SD |
|
|
Knowledge |
10.6 |
4.9337 |
14.8 |
3.654859 |
|
Attitude |
4.55 |
1.0 |
6.98 |
0.97395 |
|
Practice |
5.58 |
1.28 |
10.8 |
1.5469 |
The above table explains the knowledge, attitude and practice scores regarding prevention of Central line Associated Blood Stream Infections (CLABSI) among ICU staff nurses of NRI General and super specialty Hospital. Knowledge of ICU staff nurses in pretest mean and standard value was 10±4.9337 and post test knowledge scores are 14.8±3.654859, for attitude pre-test mean and standard deviation value is 4.55±1.0 and for post test 6.98±0.97395. For pre-test practice mean and standard deviation values are 5.58±1.28 and for post test 10.8±1.5469.
Table-7
Mean, standard deviation and paired “t” test for knowledge, attitude and practice scores regarding prevention of Central line Associated Blood Stream Infections (CLABSI) among ICU staff nurses of NRI General and super specialty Hospital.
Table-7. n=60
|
Variables |
Test |
F |
Maximum score |
Range of score |
Mean |
SD |
Paired “t”test (P<0.05) |
Table value |
|
Knowledge |
Pre-test |
60 |
30 |
2-22 |
10.6 |
4.9337 |
*4.5 |
2.78
|
|
Post-test |
8-25 |
14.8 |
3.654859 |
|||||
|
Attitude |
Pre-test |
60 |
10 |
3-6 |
4.55 |
1.0 |
*13.549 |
2.16 |
|
Post-test |
5-9 |
6.98 |
0.97395 |
|||||
|
Practice |
Pre-test |
60 |
15 |
3-8 |
5.58 |
1.28 |
*19.455 |
2.09 |
|
Post-test |
8-14 |
10.8 |
1.5469 |
The above table depicts the knowledge, attitude and practice scores of mean, SD, paired test values regarding prevention of Central line Associated Blood Stream Infections (CLABSI) among ICU staff nurses of NRI General and super specialty Hospital, knowledge pre-test value of mean is 10.6±4.9337 and range of score 2-22 and for post-test mean and standard deviation is 14.8±3.654859 and range of score is 8-25 with paired “t” value is *4.5 with table value is *2.78 in which table value is less than the paired “t” test score of knowledge , for attitude pre-test value of mean is 4.55±1.0 and range of score 3-6 and for post-test mean and standard deviation is 14.8±3.654859 and range of score is 5-9 with paired “t” value is *13.549 with table value is *2.16, and for practice pre-test value of mean is 5.58±1.28 and range of score 3-8 and for post-test mean and standard deviation is 10.8±1.5469 and range of score is 8-25 with paired “t” value is *19.455 with table value is *2.09. Hence, paired “t” test value is more than table value there is correlation with the knowledge, attitude and practice score, so, hypothesis H2 is accepted.
Section –IV
Correction of pre-test knowledge, attitude and practice scores regarding prevention of Central line Associated Blood Stream Infections (CLABSI) among ICU staff nurses of NRI General and super specialty Hospital.
Table-9
Chi-square value showing the association between knowledge regarding prevention of Central Line Association of Blood Stream Infection (CLABSI) among ICU staff nurses of NRI General and super specialty hospital with their demographic variables.
Table-9. n=60
|
S.NO |
VARIABLE |
CHI-SQUARE VALUE (Pre-test) |
CHI-SQUARE VALUE (Post-test) |
TABLE VALUE (P<0.05) |
DEGREE OF FREEDOM |
|
1. |
Age |
6.988 |
7.635 |
12.59 |
6 |
|
2. |
Gender |
0.987 |
2.15388 |
5.99 |
2 |
|
3. |
Educational qualification |
22.021 |
3.8784 |
12.59 |
6 |
|
4. |
Years of experience in hospital setting |
4.19 |
5.588 |
12.59 |
6 |
|
5. |
Attended any in-service education |
2.841 |
0.5979 |
5.99 |
2 |
|
6. |
Source of information |
22.55898 |
6.912 |
12.59 |
6 |
|
7. |
Area of working |
7.728 |
3.69 |
12.59 |
6 |
|
8. |
Written policy related to CVC |
1.1465 |
6.885 |
5.99 |
2 |
|
9. |
Checklist related to CVC |
2.91 |
10.97 |
5.99 |
2 |
|
10. |
CVC assessment form |
5.1439 |
2.35 |
5.99 |
2 |
The present study reveals that the chi-square value computed for pre-test and post-test knowledge scores for ICU staff nurses was age χ2 =6.988/7.635, gender χ2 =0.987/2.15388, educational qualification χ2 =22.021/3.8784, years of experience χ2 =4.19373/5.588, in-service educational program χ2 =2.841/0.5979, source of information related to CVC χ2 =22.55898/6.912, area of working χ2 =7.728/3.69, written policy χ2 =1.1465/6.885, checklist related to CVC χ2 =2.91/10.97 and assessment form related to CVC χ2 =5.1439/2.35. There is significant association of pre-test and post-test knowledge with their selected demographic variables hypothesis H3 is accepted.
Table-10
Chi-square value showing the association between attitude regarding prevention of Central Line Association of Blood Stream Infection (CLABSI) among ICU staff nurses of NRI General and super specialty hospital with their demographic variables.
Table-10. n=60
|
S.NO |
VARIABLE |
CHI-SQUARE VALUE (pre-test) |
CHI-SQUARE VALUE (post-test)
|
TABLE VALUE (P<0.05) |
DEGREE OF FREEDOM |
|
1. |
Age |
0.41467 |
2.997 |
12.59 |
6 |
|
2. |
Gender |
0.0185 |
5.066 |
5.99 |
2 |
|
3. |
Educational qualification |
10.154 |
0.6697 |
12.59 |
6 |
|
4. |
Years of experience in hospital setting |
4.394 |
1.85 |
12.59 |
6 |
|
5. |
Attended any in-service education |
0.15 |
3.0689 |
5.99 |
2 |
|
6. |
Source of information |
1.788 |
0.41176 |
12.59 |
6 |
|
7. |
Area of working |
8.556 |
3.656 |
12.59 |
6 |
|
8. |
Written policy related to CVC |
2.35 |
0.29 |
5.99 |
2 |
|
9. |
Checklist related to CVC |
14.47 |
0.448 |
5.99 |
2 |
|
10. |
CVC assessment form |
52.45 |
0.9 |
5.99 |
2 |
The present study reveals that the chi-square value computed for pre-test attitude scores for ICU staff nurses was age χ2 =0.41467/2.997, gender χ2 =0.0185/5.066, educational qualification χ2 =10.154/0.6697, years of experience χ2 =4.394/1.85, in-service educational program χ2 =0.15/3.0689, source of information related to CVC χ2 =1.788/0.41176, area of working χ2 =8.556/3.656, written policy χ2 =2.35/0.29,checklist related to CVC χ2 =14.47/0.448 and assessment form related to CVC χ2 =52.45/0.9. There is significant association of pre-test and post-test attitude with their selected demographic variables hypothesis H3 is accepted.
Table-11
Chi-square value showing the association between practice regarding prevention of Central Line Association of Blood Stream Infection (CLABSI) among ICU staff nurses of NRI General and super specialty hospital with their demographic variables.
Table-11. n=60
|
S.NO |
VARIABLE |
CHI-SQUARE VALUE (pre-test) |
CHI-SQUARE VALUE (post-test) |
TABLE VALUE (P<0.05) |
DEGREE OF FREEDOM |
|
1. |
Age |
0.55 |
2.1531 |
12.59 |
6 |
|
2. |
Gender |
0.324 |
2.7417 |
5.99 |
2 |
|
3. |
Educational qualification |
2.1376 |
0.4469 |
12.59 |
6 |
|
4. |
Years of experience in hospital setting |
41.64 |
10.1257 |
12.59 |
6 |
|
5. |
Attended any in-service education |
0.132 |
0.093 |
5.99 |
2 |
|
6. |
Source of information |
3.7227 |
4.64 |
12.59 |
6 |
|
7. |
Area of working |
5.807 |
6.37 |
12.59 |
6 |
|
8. |
Written policy related to CVC |
0.089 |
1.66 |
5.99 |
2 |
|
9. |
Checklist related to CVC |
0.3 |
2.98 |
5.99 |
2 |
|
10. |
CVC assessment form |
0.35 |
1.92 |
5.99 |
2 |
The present study reveals that the chi-square value computed for pre-test practice scores for ICU staff nurses was age χ2=0.55/2.1531, gender χ2 =0.324/2.7417, educational qualification χ2 =2.1376/0.4469, years of experience χ2 =41.64/10.1257, in-service educational program χ2 =0.132/0.093, source of information related to CVC χ2 =3.7227/4.64, area of working χ2 =5.807/6.37, written policy χ2 =0.089/1.66,checklist related to CVC χ2 =0.3/2.98 and assessment form related to CVC χ2 =0.35/1.92. There is significant association of pre-test and post-test practice with their selected demographic variables hypothesis H3 is accepted.
DISCUSSION:
The aim of the study was to assess the effectiveness of informative booklet on knowledge, attitude and practice of Intensive Care Unit staff nurses of NRI General and super specialty Hospital in prevention of Central Line Associated Blood Stream Infections (CLABSI) Chinakakani, Guntur district, Andhra Pradesh.
A pre-experimental research design with one group pre-test post-test was used to evaluate the effectiveness of informative booklet on knowledge, attitude and practice of Intensive Care Unit staff nurses of NRI General and super specialty Hospital in prevention of Central Line Associated Blood Stream Infections (CLABSI) Chinakakani, Guntur district, Andhra Pradesh. A total of 60 ICU staff nurses who are working in the NRI General and super specialty Hospital were selected by using convenience non-probability sampling technique.
A knowledge questionnaire, attitude scale and practice checklist was used to collect the data from the subjects. Pre-test was conducted on the first day (24-07-2023) after explaining the ICU staff nurses of NRI General and super specialty hospital about the purpose of the study. A Pre-test was conducted and then informative booklet was given after the pre-test to evaluate the effectiveness of informative booklet.
The present study was conducted among 60 ICU staff nurses 38 (63.33 %) were aged between 25years to 30 years, 10(16.67%) were aged between31 to 35 years of age, 9 (15%) were aged between 36-40years of age, 3(5%) were aged above 41years of age. It is observed that 14(23.33%) were males and 46(76.67%) were females. Educational qualification of ICU staff nurses of NRI general and super specialty hospital are 24(40%) were GNM, 30(50%) were B. Sc nurses, 4(6.67%) were M.sc nursing and 2(3.33%) were Ph.d. Years of experience in hospital setting are less than 1 year 20(33.33%), 2-4years were15(25%), 5-7years were 12(20%) above 7years are 13 (21.667%). Attended any inservice educational program related to Central Venous Catheter were 32(53.33%) and no are 28(46.67%). Source of information related to prevention of Central line Associated Blood Stream Infections (CLABSI) from newspaper was 6(10%), mass media5(8.33%), hospital 41 (68.33%) and from books and journals 8 (13.33%). Area of working was SICU 9 (15%), PICU/NICU 13(21.67%), ICU28 (46.67%) and MICU 10 (16.667%). Written policy related to cvc, yes were 44 (73.33%) and no were 16 (26.667%). Knowledge regarding CVC Checklist yes was 44(73.33%) and no were 16 (26.667%) Knowledge regarding CVC assessment form yes 30(65%) and no were 21(35%).
The study reveals that 58. 3% are having inadequate knowledge and 36.67% are having moderate knowledge and 5% are having adequate knowledge. And 121.67% are having inadequate attitude, and 78.33% are having moderately adequate attitude and 43.33% are having inadequate practice techniques and 56.67% are having adequate practice skills.
In the present study correlation between post-test knowledge, attitude and practice scores regarding prevention of Central Line Associated Bloodstream Infections (CLABSI) among ICU staff nurses at NRI general and super-specialty hospital has correlation with 4.5 at the level of 0.05 (p=2.78) as “t” value is more than the table value.
The present study explains the knowledge, attitude and practice scores regarding prevention of Central line Associated Blood Stream Infections (CLABSI) among ICU staff nurses of NRI General and super specialty Hospital. Knowledge of ICU staff nurses in pretest mean and standard value was 10± 4.9337 and post test knowledge scores are 14.8±3.654859, for attitude pre-test mean and standard deviation value is 4.55±1.0 and for post test 6.98±0.97395. For pre-test practice mean and standard deviation values are 5.58±1.28 and for post test 10.8±1.5469.
The present study reveals that the chi-square value computed for pre-test and post-test knowledge scores for ICU staff nurses was age χ2 =6.988/7.635, gender χ2 =0.987/2.15388, educational qualification χ2 =22.021/3.8784, years of experience χ2 =4.19373/5.588, in-service educational program χ2 =2.841/0.5979, source of information related to CVC χ2 =22.55898/6.912,area of working χ2 =7.728/3.69, written policy χ2 =1.1465/6.885,checklist related to CVC χ2 =2.91/10.97 and assessment form related to CVC χ2 =5.1439/2.35. The present study reveals that the chi-square value computed for pre-test attitude scores for ICU staff nurses was age χ2 =0.41467/2.997, gender χ2 =0.0185/5.066, educational qualification χ2 =10.154/0.6697, years of experience χ2 =4.394/1.85, in-service educational program χ2 =0.15/3.0689, source of information related to CVC χ2 =1.788/0.41176, area of working χ2 =8.556/3.656, written policy χ2 =2.35/0.29,checklist related to CVC χ2 =14.47/0.448 and assessment form related to CVC χ2 =52.45/0.9. The present study reveals that the chi-square value computed for pre-test practice scores for ICU staff nurses was age χ2 =0.55/2.1531, gender χ2 =0.324/2.7417, educational qualification χ2 =2.1376/0.4469, years of experience χ2 =41.64/10.1257, in-service educational program χ2 =0.132/0.093, source of information related to CVC χ2 =3.7227/4.64, area of working χ2 =5.807/6.37, written policy χ2 =0.089/1.66, checklist related to CVC χ2 =0.3/2.98 and assessment form related to CVC χ2 =0.35/1.92
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Received on 19.07.2024 Modified on 12.08.2024
Accepted on 31.08.2024 ©A&V Publications All right reserved
Int. J. of Advances in Nur. Management. 2024; 12(3):141-148.
DOI: 10.52711/2454-2652.2024.00032