Effectiveness of an Education Program on Nurses knowledge concerning in Nursing Management for patients with Third degree and bundle branch block in Kirkuk Teaching Hospitals

Effectiveness of an Education Program on Nurses knowledge concerning in Nursing Management for patients with Third degree and bundle branch block in Kirkuk Teaching Hospitals

Abid Salih Kumait AL-Jumaily MSc adult nursing*

Ass.Prof. Khalidah  Mohammed  Khudur, Ph.D. **

*(Lectrer, Department of Adult Nursing, College of Nursing, University of Kirkuk ).
** (Ass. Professor, Head of Department of Adult Nursing, College of Nursing, University of Baghdad).

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Background and Objectives: Heart block is a disease or acquired condition that causes a fault within the heart's natural pacemaker due to some kind of obstruction (or "block") in the electrical conduction system of the heart.Nurses play an important role in maintaining the health and well-being of patients. Aims of the study was to assess the effectiveness of nursing education  program on nursing knowledge concerning in nursing management toward  third degree and bundle branch block in Kirkuk's teaching hospitals and to identifying the relationship between the  nurses'  knowledge  and  their  demographic characteristics such as ( age ,gender and education level)

  Material and Method :A descriptive study design (quasi experimental study )was carried out at Azadi teaching hospital and Kirkuk general hospital in Kirkuk  city for nursing staff  who worked at CCU ,RCU  unit , emergency unit and internal medicine unit  ,from February  up to May, 2018. A non – probability (purposive) sample was selected and composed of (80) Nurses (male and female) .Nurses was divided into two groups, study group consisted of  (40)  nurses  exposed to the nursing educational program and control group consisted of (40) nurses were not exposed to the program from Azadi Teaching Hospital and Kirkuk General Hospital in Kirkuk city. The program and instruments were constructed by the researcher for the purpose of the study .The  questionnaire  was constructed for the purpose of the study which consisted of three parts: the first part include the  demographic data (5 ) items (age, gender,residencr ,  Educational achievement and marital status.The second about training in cardiac care (2) items ( work place and  name of training in cardiac care  . The third part consist from (18 ) items of general knowledge toward management of third degree of   heart block and bundle branch block of   heart block. The (SPSS) ver. (22.0) was used for data analysis. Mean, SD, and ANCOVA test, compare means were used to analyze the collected data. Level of significance was the threshold at p<0.05

Results: There were 40 nurses included in the study. Relative to "Gender" 23(57.5%) from sample were female are more illustrated, since, also the study shows the high percent of nursese were at age between (20-39  years) and constitute 35(87.5%) and most of "Age Groups", are focused at the first two groups since .(72.5% ) .Also the  results shows (65.0%) were female. With regard to residence  28(70.0%) were living in urban areas, The study findings indicated  that there were  highly significant differences between pre and post tests  in the  study group in overall main domains related to nurses' knowldg abou management of third degree heart block  and bundle branch block  

Conclusion: The studyconcluded that the effectiveness of educational program regarding nurses' nurses' knowldg abou management of third degree heart block  and bundle branch block .

Keywords: Education Program  , nursing management, Heart Block

^(*)  NS: Non Sig. at P>0.05; Testing based on a contingency coefficient  (C.C.) test.

 Relative to "Gender" subjects are from female are more illustrated, since 23(57.5%), and 25(62.5%) are accounted in the study and controlled groups respectively, and most of "Age Groups", are focused at the first two groups since 35(87.5%), and 37(92.5%) are accounted in the study and controlled groups respectively, as well as most of residential subjects, are focused at urban area, since 28(70.0%), and 31(77.5%) are accounted in the study and controlled groups respectively.With regard to marital status, shows that single subjects has recorded the most od study group, while married status has recorded the most of studied subjects in the controlled group, and they are accounted 26(65.0%), and 20(50.0%) respectively. Finally, educational achievement of studied subjects shows that most of them has graduate institute, and bachelor or more degrees, and they are accounted 34(85.0%), and 33(82.5%) in the study and controlled groups respectively.

^(*)  HS: Highly Sig. at P<0.01; S: Sig. at P<0.05; NS: Non Sig. at P>0.05; Testing based on repeated Measurement test; Com. : Combination of all probable pair wised.

      Assessments Intervals Scoring Scales of Relative Sufficiency Coefficient (RS%): [L: Low (0.00 – 33.3)]; [M: Moderate (33.3 – 66.7)]; [H: High (66.7 – 100)]

 Table (3) shows a summary statistics of knowledge concerning in management of third degree heart block Results of testing significant reported highly significant differences at P

^(*)  HS: Highly Sig. at P<0.01; S: Sig. at P<0.05; NS: Non Sig. at P>0.05; Testing based on repeated Measurement test; Com. : Combination of all probable pair wised . Assessments Intervals Scoring Scales of Relative Sufficiency Coefficient (RS%): [L: Low (33.3 – 55.5)]; [M: Moderate (55.5 – 77.7)]; [H: High (77.7 – 100)].

 Table (4) reported highly significant differences at P

^(*) HS: Highly Sig. at P<0.01; Non Sig. at P>0.05;  Statistical hypothesis based on  Analysis of Covariance  (ANCOVA).

Results shows that weak relationships are a proved with (SDCv.), since no significant relationships were accounted at P>0.05, and according to that it could be concludes that studied questionnaire of nurse's knowledge concerning management for patients with heart block improvements through applying the suggested of an educational program could be generalize on the studied population even though differences within their socio-demographical characteristics variables of studied subjects.

Discussion:

Throughout the course of data analysis of sample (40 ) nurse , the results shows 23 ( 57.5 %) were females and 17 (42.5%) were males. These finding is agrement with the result of  Ruhwanya  and others (2018) who find More than three quarters of participants were females (79.4%).

Also the the  results shows the most of the nurses at age between (20-29  years) and constitute 26 (65.0% )

But these findings disagree with the study of Mohamed and others  (2016)   in Egypt,  who reported that More than one third of the study sample aged between 40 to 49 years.

 With regard to resideance 28 (70.0%) were living in urban areas.Explanation of this result related to situation of hospitals at center of governorate there fore the researchrer find  most of nurses from urban area . But these findings disagree with the study in Egypt by Mohamed and others (2016) in Egypt, who reported that more than half of the sample (62%), were living in rural areas

Most  of  the nurses  were   single and constituted 26 (65.0% ) .also the result shows high percentage from nurses were complete bachelor of nursing  and more and constitute 20(50. 0%) . Respect to subjects of studied (SDCv.), results shows that studied groups recorded no significant differences at P>0.05

Our study has revealed in table (2)  the majority of studied subjects are worked at CCU unit, since they are accounted 15(37.5%), and 14(35.0%) in the study and controlled groups respectively as well as the most of training named concerned with the studied subjects previously was at CCU unit, since they are accounted 21(52.5%), and 22(55.0%) in the study and controlled groups respectively.

The explanation of this result because of  the nurses worked at this site usually more faced like this cases (heart block ) there for need for more knowldge  program about care of patients with arrhythemia  there for find most of nurses from this site . This suggestion is in agreement with the finding obtained from Kingwood (2012) who has mentioned that  education programs have been designed to keep  nurses up to date with current practices and trends. They ensure nursing staff’ abilities through mandatory annual competency sessions .

In relative to the nurses knowldge to ward  management third degree heart block the result shows in table (6) Results refers to significant with reference of studied items, as well as scoring scales assessments concerning effectiveness of applying an educational program were reported highly significant differences at P

Interpret of this result according to the researcher openion related to impact of an education program on nurses knowldge toward  third degree heart block confirms importance and successfulness of applying this proposed program there for the results appeare  low significant for pre test while  the result range from medera to high significant for both post1 and post2  with regard to the control group the results range from low to moderate assessment during pre and post1 ,post

These findings agrees with study of Ruhwanya and others (2018) ) stated that the resuls is, a low knowledge score was noted regarding complete heart block in the ECG strip, with only 38.3% of participants being able to identify it correctly

 Also other results confirmed by Schultz (2010) suggested that hospital administrators should encourage nurses to