An educational intervention on sepsis related to mechanical ventilation in adult public critical care units in the Eastern Cape
- Hlungwane, Emmanuel Zamokwakhe
- Authors: Hlungwane, Emmanuel Zamokwakhe
- Date: 2019
- Subjects: Intensive care nursing -- South Africa -- Eastern Cape , Intensive care units Septicemia -- Treatment
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/40139 , vital:35759
- Description: Sepsis is a leading cause of mortality and morbidity worldwide, and local adult public critical care units continue to experience incidences of sepsis. Professional nurses (PNs) need to base their nursing care on sepsis guidelines in order to properly manage sepsis on a mechanically ventilated adult patient in the critical care units. Adequate knowledge on sepsis guidelines remains crucially indicative to PNs as they endeavour to maintain asepsis on a critically ill patient. The aim was to develop, review and implement an educational intervention and investigate the effect of this intervention on the professional nurses’ knowledge and practices of sepsis in mechanically ventilated patients in adult public critical care units in the Eastern Cape Province. The research study followed a positivistic, quantitative research paradigm, using a quasi-experimental pre-post-test design, with an intervention research approach conducted in three phases. A pre-test questionnaire was administered to explore and describe the knowledge and practices of professional nurses related to sepsis in the mechanically ventilated patients in the adult public critical care units (Phase One). An educational intervention was developed, reviewed, and used to implement the sepsis guideline (Phase Two). The effect of the guideline on the knowledge and practices of the professional nurses in public adult critical care units were assessed through a post-test questionnaire (Phase Three). The questionnaires (pre-and post-) were developed by the researcher to collect the relevant data and were pilot tested to ascertain validity and reliability. The educational intervention to be implemented was developed based on the Surviving Sepsis Campaign Guidelines, reviewed by experts, implemented, and evaluated based on the sepsis guideline. A non-probability purposive sampling method was implemented. The intervention was implemented amongst three groups of PNs, namely experimental group one (EG1) (Powerpoint, Surviving Sepsis Campaign Guidelines and two monitoring visits), experimental group two (EG2) (Powerpoint and Surviving Sepsis Campaign Guidelines) and the control group (CG) (no exposure to intervention). Data was collected by means of a structured questionnaire. The target population was professional nurses working in selected adult public CCUs in the Eastern Cape. Descriptive statistics, such as mean, mode and median and inferential data analysis such as ANOVA and Chi square, have been conducted with the assistance of a statistician. The pre- and post-test questionnaire results on the knowledge related to SSC guidelines revealed a means of 57.72 and 54.61, as well as standard deviations of 13.99 and 12.15 with a difference of 3.11 for EG1. For EG2, the results revealed means of 53.28 and 62.18, standard deviations of 14.39 and 13.60 with a difference of -8.89 indicating a medium difference around 0.63 standard deviation. EG2 indicated more difference of above 0.5 standard deviation as compared to EG1. The control group on the other hand had produce large effect of mean difference above 0.8 standard deviation. Although there was no statistical significance found between the knowledge score between the three groups (EG1, EG2, CG), implementing the SSC guidelines (full intervention) in EG1 had medium effect on the knowledge of PNs on MV adult patient in the CCU. For EG2, there were positive relationships between the knowledge related to SCC Guidelines and practices related to SSC Guidelines. Ethical principles such as respect for person/informed consent, beneficence, privacy, and confidentiality, as well as rigour were maintained throughout the research study.
- Full Text:
- Date Issued: 2019
- Authors: Hlungwane, Emmanuel Zamokwakhe
- Date: 2019
- Subjects: Intensive care nursing -- South Africa -- Eastern Cape , Intensive care units Septicemia -- Treatment
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/40139 , vital:35759
- Description: Sepsis is a leading cause of mortality and morbidity worldwide, and local adult public critical care units continue to experience incidences of sepsis. Professional nurses (PNs) need to base their nursing care on sepsis guidelines in order to properly manage sepsis on a mechanically ventilated adult patient in the critical care units. Adequate knowledge on sepsis guidelines remains crucially indicative to PNs as they endeavour to maintain asepsis on a critically ill patient. The aim was to develop, review and implement an educational intervention and investigate the effect of this intervention on the professional nurses’ knowledge and practices of sepsis in mechanically ventilated patients in adult public critical care units in the Eastern Cape Province. The research study followed a positivistic, quantitative research paradigm, using a quasi-experimental pre-post-test design, with an intervention research approach conducted in three phases. A pre-test questionnaire was administered to explore and describe the knowledge and practices of professional nurses related to sepsis in the mechanically ventilated patients in the adult public critical care units (Phase One). An educational intervention was developed, reviewed, and used to implement the sepsis guideline (Phase Two). The effect of the guideline on the knowledge and practices of the professional nurses in public adult critical care units were assessed through a post-test questionnaire (Phase Three). The questionnaires (pre-and post-) were developed by the researcher to collect the relevant data and were pilot tested to ascertain validity and reliability. The educational intervention to be implemented was developed based on the Surviving Sepsis Campaign Guidelines, reviewed by experts, implemented, and evaluated based on the sepsis guideline. A non-probability purposive sampling method was implemented. The intervention was implemented amongst three groups of PNs, namely experimental group one (EG1) (Powerpoint, Surviving Sepsis Campaign Guidelines and two monitoring visits), experimental group two (EG2) (Powerpoint and Surviving Sepsis Campaign Guidelines) and the control group (CG) (no exposure to intervention). Data was collected by means of a structured questionnaire. The target population was professional nurses working in selected adult public CCUs in the Eastern Cape. Descriptive statistics, such as mean, mode and median and inferential data analysis such as ANOVA and Chi square, have been conducted with the assistance of a statistician. The pre- and post-test questionnaire results on the knowledge related to SSC guidelines revealed a means of 57.72 and 54.61, as well as standard deviations of 13.99 and 12.15 with a difference of 3.11 for EG1. For EG2, the results revealed means of 53.28 and 62.18, standard deviations of 14.39 and 13.60 with a difference of -8.89 indicating a medium difference around 0.63 standard deviation. EG2 indicated more difference of above 0.5 standard deviation as compared to EG1. The control group on the other hand had produce large effect of mean difference above 0.8 standard deviation. Although there was no statistical significance found between the knowledge score between the three groups (EG1, EG2, CG), implementing the SSC guidelines (full intervention) in EG1 had medium effect on the knowledge of PNs on MV adult patient in the CCU. For EG2, there were positive relationships between the knowledge related to SCC Guidelines and practices related to SSC Guidelines. Ethical principles such as respect for person/informed consent, beneficence, privacy, and confidentiality, as well as rigour were maintained throughout the research study.
- Full Text:
- Date Issued: 2019
An educational intervention on the liberation of ventilated adult patients in public critical care units
- Oamen, Benedict Raphael, ten Ham-Baloyi, Wilma
- Authors: Oamen, Benedict Raphael , ten Ham-Baloyi, Wilma
- Date: 2019
- Subjects: Intensive care nursing -- South Africa -- Eastern Cape , Intensive care units -- South Africa -- Eastern Cape Nursing -- Study and teaching -- South Africa -- Eastern Cape Nurse and patient
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/42968 , vital:36715
- Description: Professional nurses perform liberation of ventilated patients in the critical care units to ensure that ventilated patients can breathe on their own to maintain adequate oxygenation after the removal of an artificial airway and prevent liberation failure. The study aimed to describe the effect of an educational intervention on professional nurses’ knowledge concerning the liberation of ventilated adult patients in public critical care units. The research study described how an educational intervention increased the knowledge of professional nurses working in five public adult critical care units with a total of 54 beds for medical and surgical adult patients who are mechanically ventilated across the Eastern Cape Province. The objectives were first; to investigate the knowledge of professional nurses, concerning the liberation of ventilated adult patients. Secondly, to implement the evidence-based guidelines on liberation using an educational intervention. Thirdly, to describe the effect of an educational intervention on professional nurses’ knowledge concerning the liberation of ventilated adult patients in five public critical care units across the Eastern Cape Province. The researcher conducted an intervention research study using a quantitative, quasi-experimental pre-test/post-test with a control group design. The researcher recruited 150 participants who were professional nurses working in the five adult critical care units in academic hospitals. The five public adult critical care units were purposively divided into three sample groups, which consisted of two experimental groups and a control group. While considering the geographical location and proximity of the academic hospitals the groups were divided into Experimental Group 1 (comprised of 57 professional nurses from two critical care units) and Experimental Group 2 (comprised of 59 professional nurses from two critical care units), plus a Control Group (comprised of 34 professional nurses from one critical care unit). To achieve a large sample, all the professional nurses working in the five academic hospitals across the Eastern Cape Province were included in this study. The research study was conducted in three phases. In Phase One of the study, a pre-test questionnaire was administered to the professional nurses to investigate their current knowledge of the liberation of ventilated adult patients. Subsequently, in Phase Two, an educational intervention that was based on the liberation of ventilated adult patients used a PowerPoint in-service presentation in the form of a formal lecture, printed copies of the evidence-based guidelines on liberation and colour printed posters attached to the notice boards and strategic places such as the tea room and corridor of the critical care units in Experimental Group 1. Equally, Experimental Group 2 received only printed copies of the evidence-based guidelines. In the Control Group, the researcher did not implement the evidence-based guidelines. Three months after the implementation of the evidence-based guidelines, Phase Three was conducted, and a post-test questionnaire was administered to describe the effect of the educational intervention on the professional nurses’ knowledge. With the assistance of the statistician, data were analysed through descriptive analysis using the measure of frequency, central tendency, dispersion/variation and position. In addition to that, an inferential analysis used Analysis of Variance, Chi-square test, t-statistic (t-test), Cohen’s d, Cramér’s V, and Scheffe’s post-hoc test. Since there was no existing questionnaire, the researcher developed the questionnaires that were used in this study. The researcher ensured reliability and validity throughout the study. The ethical clearance reference number, H17-HEA-NUR-019 was obtained for the study from the Nelson Mandela University. A letter of permission was granted by the Provincial’s Department of Health, Bhisho, the Eastern Cape Province, with reference number, EC_201712_017. Other ethical principles were taking into consideration. The implementation of evidence-based guidelines on liberation using an educational intervention in the form of PowerPoint presentation, complemented with printed copies of the evidence-based guidelines and coloured posters as reminders showed an increase (Mean = 65,22; S.D = 12,08) in the mean knowledge score of professional nurses in Experimental Group 1. Contrary, the use of printed copies of the evidence-based guidelines on liberation showed a significant decrease (Mean = 53,41; S.D = 15,44; p = 0.033; Cohen's d = 0.49 small effect) in the mean knowledge score of professional nurses in Experimental Group 2. A single educational intervention method did not affect knowledge increase compared to a combined educational intervention method. Imparting knowledge in the public critical care units across the Eastern Cape Province is still very important. Further recommendations for practice, research and education were provided.
- Full Text:
- Date Issued: 2019
- Authors: Oamen, Benedict Raphael , ten Ham-Baloyi, Wilma
- Date: 2019
- Subjects: Intensive care nursing -- South Africa -- Eastern Cape , Intensive care units -- South Africa -- Eastern Cape Nursing -- Study and teaching -- South Africa -- Eastern Cape Nurse and patient
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/42968 , vital:36715
- Description: Professional nurses perform liberation of ventilated patients in the critical care units to ensure that ventilated patients can breathe on their own to maintain adequate oxygenation after the removal of an artificial airway and prevent liberation failure. The study aimed to describe the effect of an educational intervention on professional nurses’ knowledge concerning the liberation of ventilated adult patients in public critical care units. The research study described how an educational intervention increased the knowledge of professional nurses working in five public adult critical care units with a total of 54 beds for medical and surgical adult patients who are mechanically ventilated across the Eastern Cape Province. The objectives were first; to investigate the knowledge of professional nurses, concerning the liberation of ventilated adult patients. Secondly, to implement the evidence-based guidelines on liberation using an educational intervention. Thirdly, to describe the effect of an educational intervention on professional nurses’ knowledge concerning the liberation of ventilated adult patients in five public critical care units across the Eastern Cape Province. The researcher conducted an intervention research study using a quantitative, quasi-experimental pre-test/post-test with a control group design. The researcher recruited 150 participants who were professional nurses working in the five adult critical care units in academic hospitals. The five public adult critical care units were purposively divided into three sample groups, which consisted of two experimental groups and a control group. While considering the geographical location and proximity of the academic hospitals the groups were divided into Experimental Group 1 (comprised of 57 professional nurses from two critical care units) and Experimental Group 2 (comprised of 59 professional nurses from two critical care units), plus a Control Group (comprised of 34 professional nurses from one critical care unit). To achieve a large sample, all the professional nurses working in the five academic hospitals across the Eastern Cape Province were included in this study. The research study was conducted in three phases. In Phase One of the study, a pre-test questionnaire was administered to the professional nurses to investigate their current knowledge of the liberation of ventilated adult patients. Subsequently, in Phase Two, an educational intervention that was based on the liberation of ventilated adult patients used a PowerPoint in-service presentation in the form of a formal lecture, printed copies of the evidence-based guidelines on liberation and colour printed posters attached to the notice boards and strategic places such as the tea room and corridor of the critical care units in Experimental Group 1. Equally, Experimental Group 2 received only printed copies of the evidence-based guidelines. In the Control Group, the researcher did not implement the evidence-based guidelines. Three months after the implementation of the evidence-based guidelines, Phase Three was conducted, and a post-test questionnaire was administered to describe the effect of the educational intervention on the professional nurses’ knowledge. With the assistance of the statistician, data were analysed through descriptive analysis using the measure of frequency, central tendency, dispersion/variation and position. In addition to that, an inferential analysis used Analysis of Variance, Chi-square test, t-statistic (t-test), Cohen’s d, Cramér’s V, and Scheffe’s post-hoc test. Since there was no existing questionnaire, the researcher developed the questionnaires that were used in this study. The researcher ensured reliability and validity throughout the study. The ethical clearance reference number, H17-HEA-NUR-019 was obtained for the study from the Nelson Mandela University. A letter of permission was granted by the Provincial’s Department of Health, Bhisho, the Eastern Cape Province, with reference number, EC_201712_017. Other ethical principles were taking into consideration. The implementation of evidence-based guidelines on liberation using an educational intervention in the form of PowerPoint presentation, complemented with printed copies of the evidence-based guidelines and coloured posters as reminders showed an increase (Mean = 65,22; S.D = 12,08) in the mean knowledge score of professional nurses in Experimental Group 1. Contrary, the use of printed copies of the evidence-based guidelines on liberation showed a significant decrease (Mean = 53,41; S.D = 15,44; p = 0.033; Cohen's d = 0.49 small effect) in the mean knowledge score of professional nurses in Experimental Group 2. A single educational intervention method did not affect knowledge increase compared to a combined educational intervention method. Imparting knowledge in the public critical care units across the Eastern Cape Province is still very important. Further recommendations for practice, research and education were provided.
- Full Text:
- Date Issued: 2019
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