NURSES KNOWLEDGE ABOUT DRESSING PROCESS IN SURGICAL
WARDS IN MOSUL HOSPITALS
Myasar Mohsin Azeez Ali ([1])
ABSTRACT
Background and aim: The dressing is a covering or bandage applied to a wound, Bleeding cases, Open fractures, and superficial burns to protect it, prevent the complication, and the patient's dressings need to be changed regularly. The study aimed to identify the level of knowledge about the Dressing Process among nurses and to examine the relationship between demographic characteristics of the nurses and their Knowledge with regard to the Dressing Process. Materials and Method: This descriptive study design as a quantitative approach was adopted through the period from 1st of August - 2011 to the 1st of September - 2012. The sample of the study included (140) nurses working in two hospitals in Mosul city in the center of Nineveh Governorate. In order to collect the data, a questionnaire was constructed depending on the previous studies and related works of literature. Content validity of the questionnaire was determined by presenting the questionnaire to a panel of (15) experts and the reliability of the study was determined by applying the tool to (20) nurses in Ibn-Sina Teaching Hospital, while Person's Correlation Coefficient was (r = 0.83; P.< 0.05).Results: The data analysis showed that there were significant statistical relationships among some categories of knowledge regarding the Dressing Process with the attributes of the sample.Conclusion: The study concluded that knowledge of the dressing process acceptable, while gender and enrolment in training sessions had an obvious association with nurses' knowledge.
Keywords: Nurses, Knowledge, Dressing, Surgical Wards.
INTRODUCTION
From the wound, containing it in one place, Ease pain – some dressings may have a pain-relieving Dressing is a covering or bandage applied effect, and others may have a placebo effect, to a wound to protect it, The patient's dressings Debride the wound – The removal of slough and need to be changed regularly (Adams et al., foreign objects from the wound, Protection from 2007). A dressing to promote designed to be in infection and mechanical damage, and Promote direct contact with the wound, which makes it healing (Caruso et al., 2004). Dressing types different from an in place. Dressings are including Low adherent dressings, frequently used in first aid and nursing (Caruso Semipermeable films, hydrocolloids, Hydrogels, et al., 2004). Surgical dressings include both Alginates, Foam dressings, Antimicrobial primary dressings (for example, therapeutic or dressings, Unwanted effects of dressings and protective coverings applied directly to wounds Wet to dry (Ackley et al.,2007). Apply sterile or lesions either on the skin or caused by dressings to open wounds and Open fractures opening to the skin) and secondary dressings and Cover superficial burns with sterile saline (for example, materials that serve therapeutic dressings and Bleeding should be treated with or protective function and are needed to secure an appropriate direct pressure dressing (American primary dressing). For example, elastic college of radiology, 2001). Conventional bandages, adhesive tape, elastic roll gauze, and dressings are usually changed once daily. Some non-elastic roll gauze is covered when used as authorities prefer to have most patients return in a secondary dressing to hold wound cover 24 hours for the first dressing change. Home dressings in place (Corporate Medical Policy, care consists of removing the dressing, removing 2008). A dressing can have a number of all antibacterial cream, cleansing with a mild purpose, depending on the type, severity, and soap and water, and reapplying the dressing as position and cases, the purposes of dressing; previously outlined. Outpatient analgesics such as Stem bleeding – Helps to seal the wound to as acetaminophen with codeine should expedite the clotting process, absorb exudates – supplied for the first few dressing changes. soak up blood, plasma and other fluids exuded Follow-up visits with a primary care provider at 3 and 7 days are recommended, with more frequent visits for supervised dressing changes if compliance is a problem. The parent is instructed to return if signs of infection develop (Henretig and Fred, 2008). The aim of the study was adopted to identify the level of Knowledge about the Dressing Process among nurses and to examine the relationship between demographic characteristics of the nurses and their Knowledge with regard to the Dressing Process.
MATERIALS AND METHOD
The descriptive study design was dependent. Accidental sample of the study consisted of (140) nurses from two main teaching hospitals divided as; Al-Salam Teaching Hospital (15 female and 30 male) and Al-Jamhuri Teaching Hospital (16 females and 79 male) from 1st of August - 2011 to the 1st of September - 2012. The instrument depended in the study composed of two parts: Part one- included (7) items which focus on demographic characteristics of the nurse such as (Age, Gender, Years of experience, Educational level, Hospital, Number of Training sessions).
RESULTS
Part two - concerns dressing categories; General information about dressing: (45) items; Information on the dressing process: (43) items; The items of " General information about dressing " have two options (No = 1; Yes = 2), while the items of the" Information on the dressing process " have rating answer on three options(Never = 1; Some time = 2 ; Always = 3) for that these items tend to be contributing mostly to precautions or practices more than knowledge. face or validity of the questionnaire was determined by presenting the questionnaire to a panel of (15) experts and the reliability of the study was determined by applying the tool on (20) nurses who were out of the study sample and conducted in Ibn-Sina Teaching Hospital, Person's Correlation Coefficient was computed(r = 0.83; P.< 0.05) level. Data were collected through this constructed questionnaire and Self-administered technique as a means of such collection. To describe and analyze the findings of the study, the SPSS program was used to analyze the data as Percentage, Frequency, Mean, Standard Deviation, Paired - samples T-test, Independent T-test, and Analysis of variance (ANOVA).
MATERIALS AND METHOD
The descriptive study design was dependent. Accidental sample of the study consisted of (140) nurses from two main teaching hospitals divided as; Al-Salam Teaching Hospital (15 females and 30 male) and Al-Jamhuri Teaching Hospital (16 females and 79 male) from 1st of August - 2011 to the 1st of September - 2012. The instrument depended in the study composed of two parts: Part one- included (7) items which focus on demographic characteristics of the nurse such as (Age, Gender, Years of experience, Educational level, Hospital, Number of Training sessions).
RESULTS
Part two - concerns dressing categories; General information about dressing: (45) items; Information on the dressing process:(43) items; The items of " General information about dressing " have two options(No = 1; Yes = 2), while the items of the" Information on the dressing process " have rating answer on three options(Never = 1; Some time = 2; Always = 3) for that these items tend to be contributing mostly to precautions or practices more than knowledge. face or validity of the questionnaire was determined by presenting the questionnaire to a panel of (15) experts and the reliability of the study was determined by applying the tool on (20) nurses who were out of the study sample and conducted in Ibn-Sina Teaching Hospital, Person's Correlation Coefficient was computed(r = 0.83; P.< 0.05) level. Data were collected through this constructed questionnaire and Self-administered technique as a means of such collection. To describe and analyze the findings of the study, the SPSS program was used to analyze the data as Percentage, Frequency, Mean, Standard Deviation, Paired - samples T-test, Independent T-test, and Analysis of variance (ANOVA).
Table (1): Demographic Characteristics of the Study Subjects (N = 140)
| Variables |
No. |
% |
| Age |
20-24 |
7 |
5.0 |
| 25-29 |
24 |
17.1 |
| 30-34 |
36 |
25.7 |
| 35-39 |
15 |
10.7 |
| 40-44 |
13 |
9.3 |
| 45-49 |
14 |
10.0 |
| 50-54 |
21 |
15.0 |
| 55-59 |
10 |
7.1 |
| Total |
140 |
100.0 |
| Mean = 37.2929, Standard deviation = 10.33503 |
| Gender |
Male |
109 |
77.9 |
| Female |
31 |
22.1 |
| Total |
140 |
100.0 |
| Years Of experience |
less than 5 |
28 |
20.0 |
| 6-10 |
37 |
26.4 |
| 11-15 |
24 |
17.1 |
| 16-20 |
15 |
10.7 |
| 21-25 |
18 |
12.9 |
| 26-30 |
12 |
8.6 |
| 31-35 |
3 |
2.1 |
| 36-40 |
3 |
2.1 |
| Total |
140 |
100% |
| Educational level |
College |
6 |
4.3 |
| Institute |
31 |
22.1 |
| Preparatory nursing school |
96 |
68.6 |
| Intermediate nursing school |
7 |
5.0 |
| Total |
140 |
100% |
| Hospital |
Al-Jamhuri |
95 |
67.9 |
| Al-Salaam |
45 |
32.1 |
| Total |
140 |
100% |
| Enrolment in the training session |
No |
62 |
44.3 |
| Yes |
78 |
55.7 |
| Total |
140 |
100% |
Table (2): The relationship between Theoretical and Operational Means of knowledge categories using t-test
| Categories |
Theoretical mean |
Operational mean |
d.f. |
t-value |
Sig. |
| X |
SD |
| General information about dressing |
67.5 |
73.84 |
8.09 |
139 |
107.98 |
S |
| Information on the dressing process |
86 |
84.25 |
19.15 |
139 |
52.06 |
S |
| Categories |
SS |
|
d.f. |
MS |
F |
Sig. |
| General information about dressing |
Between Groups |
55.97 |
3 |
29.43 |
0..28 |
NS |
| Within Groups |
9044.57 |
136 |
69.44 |
| Total |
9100.54 |
139 |
| Information on the dressing process |
Between Groups |
2584.80 |
3 |
578.78 |
2.42 |
S |
| Within Groups |
48389.93 |
136 |
357.15 |
| Total |
50974.74 |
139 |
Table (3): Analysis of variance of nurses’ general knowledge and information of the dressing process
| Categories |
SS |
|
d.f. |
MS |
F |
Sig. |
| General information about dressing |
Between Groups |
679.98 |
7 |
97.14 |
1.52 |
NS |
| Within Groups |
8420.55 |
132 |
63.79 |
| Total |
9100.54 |
139 |
| Information on the dressing process |
Between Groups |
10560.23 |
7 |
1508.6 |
4.92 |
S |
| Within Groups |
40414.50 |
132 |
306.17 |
| Total |
50974.74 |
139 |
Table (4): Relationship between nurses’ general knowledge and information of the dressing process according to
their gender
|
Categories
|
Gender
|
No.
|
X
|
SD
|
|
General information about dressing
|
Male
|
109
|
73.88
|
7.92
|
|
Female
|
31
|
73.67
|
8.77
|
|
t value = - 0,12, def. = 138, Sig.
|
|
Information on the dressing process
|
Male
|
109
|
84.22
|
18.20
|
|
Female
|
31
|
84.35
|
22.49
|
|
t value = -0,03, d.f. = 138, Sig.
|
Table (6): Relationship between nurses’ general knowledge and information of the dressing process according to
their enrollment in Training Session of the Study Sample using t-test
| Categories |
training courses |
No. |
X |
SD |
| General information about dressing |
no |
62 |
73.40 |
8.36 |
| yes |
78 |
74.19 |
7.9 |
| t value = - 0, 57, d.f. = 138, Sig. |
| Information on the dressing process |
no |
62 |
84.74 |
18.13 |
| yes |
78 |
83.87 |
20.02 |
| t value = 0,26, d.f. = 138, Sig. |
DISCUSSION
It is obvious from a table (2) that all means of dressing process categories were somewhat more than theoretical means and had statistically significant differences when comparing, this means that nurses had an acceptable level of knowledge regarding the dressing process. Table (3) shows that the information on the dressing process was a significant difference as a category of dressing process knowledge in regard the age. The stage of age may affect the performance of nurses (AL-Simady, 2006). All categories of knowledge of the dressing process in this study had significant differences. Females got mean and standard deviation scores better than males as in table (4). Nurses working in the surgical units had an unsatisfactory level of knowledge and practice related to postoperative wound infection. Nevertheless, there was a significant difference between their knowledge and practice in that field (El-Sayed, 2003). The findings of the present study show that significant differences in the (Information on the dressing process) as a category of dressing process knowledge with regard to the educational level of the sample. The level of education may affect the performance of nurses (AL-Simady, 2006; Najem, 2004). The relationship between knowledge and power helps to employ and implement strategies to reduce infection control and improve patient safety (WHO, 2009). Also referred that education helps to define what a nurse is able to do and what he or she can be expected to do (Coile, 2005). And indicated that nursing qualification has more knowledge than the general nursing staff, it was found to be statistically significant (Bibudha et al., 2010).
In this study, the high percentage of the sample 78% did enroll in such specialized training sessions during their work period. Perhaps, this is one of the reasons, in the present study as in table (6) which presents both of General information about dressing and Information on the dressing process were significant differences with Training Session. Another indicated that the training session is important in developing the work of a nurse, hence, nursing staff should have an advanced level of skill to provide safe and excellent patient care (Brook et al., 2004). Also found via another study; That built a training model and evaluated training effectiveness in terms of improved knowledge conducted in (17) hospitals in Taiwan, that there is a statistical difference before and after the training course on participants' understanding (Lin et al., 2008). The tension and discomfort of nurses during work usually result from a decrease in training and development (AL-Hadeedi, 2006).
CONCLUSIONS
According to the objectives of the present study and the results of data analysis, the following conclusions have been inferred: Knowledge of Dressing was acceptable. Presence of significant differences between theoretical and operational means regarding nurses' knowledge. Gender and Enrollment in training sessions had an obvious association with nurses' knowledge. Educational level and Age had less association with nurses' knowledge.
RECOMMENDATIONS
Depending on the findings and conclusions of the study, the researcher recommended the following: An educational program and continuous education are necessary to improve the nurses' ability to deal with management with acquisition of knowledge about Dressing. Take care of the environment of hospitals especially in surgical wards. Development of the nursing curriculum to encompass all nursing care procedures needed for all nursing specialties and patient's unit care. Enhance or Increase numbers of females of the nursing profession by many social and put on a plan to enhance support and services for females to work in nursing.
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([1]) Assist. Lecturer/ Mosul Technical Institute/ [email protected]