Introduction
The important functions of the skin are to protect the underlying tissue and serve as a surface barrier to the external environment, barrier against invasion of bacteria and viruses and excessive water loss, fat insulates the body and provides protection from trauma, sensory perception for external stimuli, heat regulation, homeostasis by fluid and electrolyte balance, synthesis of vitamin D.1, 2 The pressure level that closes capillaries in healthy people is 25–32 mm of Hg. When pressure applied to the skin is greater than this pressure in the capillary bed, it can impair cellular metabolism. It decreases blood supply to the tissue and eventually causes tissue ischemia, this reduction in blood flow causes blanching of the skin. The longer the pressure lasts, the greater is the risk of skin breakdown and development of pressure ulcer.3, 4
Need of The Study
“Constant attention by a good nurse may be just as important as major operation by a surgeon”5
Pressure ulcer affect the quality of life of patients and their care givers. Because the recurrence of pressure ulcer is common, the knowledge level of both nursing personnel and the patient in prevention techniques is extremely important. The nurse needs to know the etiology of pressure ulcer, prevention techniques, early signs, nutritional supports, and care techniques for actual pressure ulcer. It is suggested that a minority of hospital residents with stage 2 or higher pressure ulcer received wound care in accordance with the clinical practice guidelines.5
Aim of Study
The aim of the study is to provide knowledge regarding prevention of pressure ulcer among the GNM Internship students.
Objectives
To assess the pretest knowledge regarding prevention of pressure ulcer among GNM internship students.
To assess the effectiveness of structured teaching programme regarding the prevention of pressure ulcer among GNM Internship students.
To compare the pre-test and post-test knowledge regarding the prevention of pressure ulcer among GNM Internship students.
Operational definition
Assess- To evaluate or estimate or to make a judgment about something. In this study, it is to evaluate the effectiveness of structured teaching programme on knowledge regarding prevention of pressure ulcer.
Effectiveness- Effectiveness is the capability of producing a desired result or the ability to produce desired output. In this study it is the degree to which structured teaching program in producing a desired result.
Structured Teaching Programme- It refers to organized teaching activity performed by the investigator or researcher with validated lesson plan to impart knowledge regarding the prevention of pressure ulcer which includes definition ,purpose ,etiology of pressure ulcer, prevention technique ,early signs ,nutritional support and care techniques
Knowledge- Knowledge is information and understanding about a subject which a person has. In this study it is specific information about prevention of pressure ulcer that is perceived, discovered or learned through structured teaching program.
Prevention- It includes primary and secondary measures adopted to protect patients from developing pressure ulcer.
Pressure Ulcer- It is localized area of tissue necrosis caused by unrelieved pressure, tissue layer sliding over the tissue layer shearing and excessive moisture.
Hypothesis
H1- There will be a significant difference between pre-test post-test result.
H2- There will be a significant effect of structured teaching programme on knowledge regarding prevention of pressure ulcer among GNM internship students working in Era hospital.
H0- There will be no significant effect of structured teaching programme on knowledge regarding prevention of pressure ulcer among GNM internship students.
Ethical consideration
Written permission will be obtained from concerned authority of the nursing college for conducting the study.
Written permission will be obtained from concerned authority of the hospital.
Consent will be taken from the sample and confidentiality of the sample will be maintained by giving code to them and not mentioning their name anywhere in the study.
Conceptual framework
In this study the conceptual framework used will be based on Donabedian’s theory.
According to this model, the information about the quality of care can be drawn from three categories:
Research analysis and interpretation
This chapter deals with the analysis of the data obtained from the responses of the sample of 50 students of Era College of Nursing Lucknow.6, 7, 8, 9, 10, 11, 12 This study was done with the objective to assess the pretest knowledge regarding prevention of pressure ulcer among GNM Internship students, to assess the effectiveness of Structured Teaching Program regarding prevention of pressure ulcer, to compare the pre-test and post test knowledge regarding prevention of pressure ulcer among GNM Internship students.
The section describes the characteristics of the subjects under study. The data obtained describes the sample characteristics pertaining to their age group, gender, present area of working, additional educational exposure and previous knowledge of pressure ulcer. Frequency and percentage distribution of the sample by these characteristics are presented in table and pie diagrams.
Table 1
Frequency and percentage distribution of demographic characteristics of the subjects N=50
Table 1 Revealed
56% of GNM internship students were aged between 18-21 years, 38% were aged between 22-25 years, 4% were aged between 26-29 years and remaining 2% ≥30 years.
98% 0f subjects were female and remaining 2% of subjects were male.
Majority 48% of the subjects had present area of working in general wards, 36% of the subjects had present area of working in critical wards and remaining 16% of the subjects had present area of working in triage and emergency.
Majority 70% of subjects had additional educational exposure and remaining 30% of subjects had no additional educational exposure.
Majority 84% of subjects had previous knowledge of pressure ulcer and remaining 16% of the subjects had no previous knowledge of pressure ulcer.
a) Frequency, percentage and mean distribution of Pre-test knowledge about prevention of pressure ulcer among GNM internship students. N=50
Table 2 Revealed
Frequency, percentage, mean and standard deviation of the knowledge regarding prevention of pressure ulcer among GNM Internship students.
Majority 58% of GNM internship student had average knowledge.
32% of GNM internship student had good knowledge and remaining 10% student had poor knowledge before structured teaching program.
Section-3: Post-test knowledge regarding prevention of pressure ulcer among GNM internship students.
a) Frequency, percentage and mean distribution of Post -test knowledge about prevention of pressure ulcer among GNM internship students
Table 3 Revealed
Frequency, percentage and mean distribution of the knowledge regarding prevention of pressure ulcer among GNM internship students.
The majority 64% of GNM internship students had good knowledge.
36% of GNM internship students had average knowledge and none of the student had poor knowledge after structure teaching program.
Section No.4: Comparison between pre-test and post-test knowledge regarding prevention of pressure ulcer among GNM internship student.
Comparison between pre-test and post test knowledge among GNN internship students.
Table 4
|
S. No. |
Knowledge level |
Mean |
Standard Deviation (SD) |
Degree of Freedom (df) |
t value |
|
1. |
Pre-test |
19.32 |
4.83 |
49 |
10.627 ⃰ |
|
2. |
Post-test |
23.94 |
4.63 |
Table 4 Revealed that the pre-test mean was 19.32 which was increased to 23.94 inpost test. Pair t-test performed to find them, difference between pre-test and post-test knowledge score. Calculated ‘t’ value 10.62 was greater than that of table value, p<0.02 and df=49.
Thus, it could be inferred that gain of knowledge was not by chance but because of intervention.
Discussion
Objective 1: To assess the effectiveness of structured teaching program regarding the prevention of pressure ulcer among GNM Internship students. Frequency, percentage and mean distribution of the knowledge regarding prevention of pressure ulcer among GNM internship students. The majority 64% of GNM internship students had good knowledge. 36% of GNM internship students had average knowledge and none of the student had poor knowledge after structure teaching program.Objective 2: To compare the pre-test and post-test knowledge regarding the prevention of pressure ulcer among GNM Internship students. Findings of the study revealed that the pre-test mean was 19.32 which was increased to 32.93 in post test. Pair t-test performed to find them, difference between pre-test and post-test knowledge score. Calculated‘t’ value 10.62 was greater than that of table value, p<0.02 and df=49. Thus, it could be inferred that gain of knowledge was not by chance but because of intervention.
Summary
The present study was conducted to assess the knowledge regarding prevention of pressure ulcer among GNM internship students. A quantitative research design was adopted to conduct the present study. The study was conducted at Era college of nursing, Lucknow.13, 14, 15, 16, 17, 18 By using Probability Simple Random technique 50 GNM Internship students of Era College of nursing, Lucknow was selected. To collect personal information of subjects socio demographic profile was used and to assess knowledge on prevention of pressure ulcer, self structured knowledge questionnaire were used.
Major findings of the study
Major findings of the study were-Sociodemographic variables of the study participants shows
56% of GNM internship students were aged between 18-21 years, 38% were aged between 22-25 years, and 4% were aged between 26-29 years and remaining 2% ≥30 years.
98% 0f subjects were female and remaining 2% of subjects were male.
Majority 48% of the subjects had present area of working in general wards, 36% of the subjects had present area of working in critical wards and remaining 16% of the subjects had present area of working in triage and emergency.
Majority 70% of subjects had additional educational exposure and remaining 30% of subjects had no additional educational exposure.
Majority 84% of subjects had previous knowledge of pressure ulcer and remaining 16% of the subjects had no previous knowledge of pressure ulcer.
Effectiveness of structure teaching program
Paired‘t’ test was computed to examine the mean difference in pre-test and post-test knowledge scores. Findings of the study showed there was increase in post test mean (23.94) as compared to pre-test mean (19.32). The calculated‘t’ value was 10.62. The obtained p value was >0.02 which was statistically significant at >0.02 level. The knowledge score was not obtained by chance but because of intervention.
Conclusion
The present study revealed that there is proper identification problem related to knowledge of pressure ulcer among staff nurses that should be focussed. Structured teaching program was effective in increasing the knowledge about prevention of pressure ulcer among GNM Internship student. The mean post-test knowledge score (23.94) of GNM Internship students on knowledge regarding prevention of pressure ulcer was significantly higher than their pre-test knowledge (19.32) scores. Thus gain in knowledge was because of intervention.
Recommendation
Keeping in view of the present research study findings, the following recommendations have been made:
This study can be replicated by using convenient sampling in selection of a large sample.
A study can be conducted in terms of lnowledge regarding prevention on pressure ulcer.
A study can be conducted to evaluate individual teaching program on knowledge regarding prevention of pressure ulcer.
A survey can be conducted to find out the prevalence of pressure ulcer.
Present study can be done on staff nurses working in critical wards.
