Effect of Educational Intervention on Knowledge Regarding Patient Safety among Undergraduate Nursing Students of Navi Mumbai.

Mrs. Susan Jacob¹, Mrs. Sindhu Thomas²

¹Associate Professor, Medical Surgical Nursing, MGM New Bombay College of Nursing, Sector 18, kamothe, Navi Mumbai.

²Lecturer, Child Health Nursing, MGM New Bombay College of Nursing, Sector 18, kamothe, Navi Mumbai

*Corresponding Author E-mail: susanninanjacob@gmail.com, SindhuThomas84 @gmail.com

ABSTRACT:

Safety is a basic tenet of high health care quality. Patient safety is the corner stone of high quality health care. Nurses are critical to the surveillance and co-ordinates that reduce such outcomes. Patient safety is an essential and vital component of quality nursing care. However the nation’s health care system is prone to errors, and can be detrimental to safe patient care, as a result of basic system flaws. Patient Safety is a fundamental principle of health care. The simplest definition of patient safety is the prevention of errors and adverse effects to patients association with health care.Doctors are perceived by patients and clinicians as being the captain of the health care team, with good reason. But physicians may spend only 30-45 mts a day with even a critically ill hospitalized patient, whereas nurses are a constant presence at the bed side and regularly interact with physicians, pharmacists, families and all other members of the health care team. of all the members of the health care team, nurses therefore play a critically important role in ensuring patient safety, by monitoring patients for clinical deterioration, detecting errors and near misses, understanding care processes and weaknesses inherent in some system and performing countless other tasks to ensure patient receive a high quality care. Nurses working conditions and patient safety also play a vital role. The Causal relationship between nurse to patient ratio and patient outcomes likely is accounted for both increased workload and increased stress and risk of burn out for nurses. In one British study, missed nursing case episodes were strongly associated with a higher number of patients per nurses. Burnout among clinicians (both nurses and physicians) has consistently been linked to patient safety risks, and some studies show that higher number of patients per nurse is correlated with increased risk of burnout among nurses. The high intensity nature of nurses work means that nurses themselves are at risk of committing errors while providing routine care. Interruptions have been tied to an increased risk of errors, particularly medication administration errors. Need for the study: Furthermore it is recommended that the initial exposure to patient safety should occur early in undergraduate and graduate nursing education programs and be ongoing throughout nursing education. In literature less attention has been paid to the perception of patient safety. Therefore it is important to assess Nursing students knowledge on patient safety to have a base line data and implement a relevant educational intervention on selected aspects of patient safety which included fundamentals of patient safety, emerging challenges, human factors and patient safety, communicating effectively, preventing and managing adverse events and near misses, medication safety and multifaceted approach. Therefore the researcher conducted an educational intervention on patient safety among the undergraduate Nursing students.

Objectives of the study: The objectives of the study were:

1) To assess the knowledge regarding patient safety among undergraduate Nursing Students.

2) To find the effect of educational intervention on Knowledge regarding patient safety among undergraduate Nursing students.

Methods:An evaluative approach with preexperimental one group design was adopted for the study.

Convenient sampling was selected. Permission was obtained from the ethical committee. A structured knowledge questionnaire was used to assess the knowledge regarding patient safety among undergraduate Nursing students. Pretest was done followed by educational intervention and posttest was done on 5^th day with the same tool. Data was analyzed using descriptive and inferential statistics. The findings revealed that overall pretest mean score for knowledge was 6.80, and post test mean score was 8.49. The Computed “t “value was1.702 was greater than the table value. Hence the study concluded that educational intervention on patient safety was effective in improving the knowledge of undergraduate nursing students.

KEYWORDS: Patient safety, educational intervention, knowledge, undergraduate nursing students.

INTRODUCTION:

The United States medical errors cost the US economy $19.5 billion in 2008. With the growing recognition of the harm caused by the health care, attention has been made to the importance of teaching about patient safety in graduate medical education.⁴ A report from the Institute of Medicine emphasized that incorporating patient safety education into the clinical training program is a key mechanism for improving patient safety.⁵

Doctors are perceived by patients and clinicians as being the captain of the health care team, with good reason. But physicians may spend only 30-45 mts a day with even a critically ill hospitalized patient, whereas nurses are a constant presence at the bed side and regularly interact with physicians, pharmacists, families and all other members of the health care team.⁶

Of all the members of the health care team, nurses therefore play a critically important role in ensuring patient safety, by monitoring patients for clinical deterioration, detecting errors and near misses, understanding care processes and weaknesses inherent in some system and performing countless other tasks to ensure patient receive a high quality care.⁷

Nurses working conditions and patient safety also play a vital role. The Causal relationship between nurse to patient ratio and patient outcomes likely is accounted for both increased workload and increased stress and risk of burn out for nurses. Missed nursing care – a type of error of omission in which required care elements are not complete is relatively common in patient wards.⁸

In one British study, missed nursing case episodes were strongly associated with a higher number of patients per nurses. Burnout among clinicians (both nurses and physicians) has consistently been linked to patient safety risks, and some studies show that higher number of patients per nurse is correlated with increased risk of burnout among nurses.⁸

The high intensity nature of nurses work means that nurses themselves are at risk of committing errors while providing routine care. Interruptions have been tied to an increased risk of errors, particularly medication administration errors.

Longer shift and working overtime have been linked to increase risk of error, including in one high profile case where an error committed by a nurse working a double shift resulted in the nurse being criminally prosecuted. In their daily work, nurses are also frequently exposed to disruptive or unprofessional behavior, by physician and other health care personnel, and such exposure has been demonstrated to be a key factor in nursing burnout and in nurses leaving their job or the profession entirely.⁹

NEED FOR THE STUDY:

Furthermore it is recommended that the initial exposure to patient safety should occur early in undergraduate and graduate nursing education programs and be ongoing throughout Nursing education. In literature less attention has been paid to the perception of patient safety. Therefore it is important to assess Nursing students knowledge on patient safety to have a base line data and implement a relevant educational intervention and selected aspects of patient safety which included fundamentals of patient safety, emerging challenges, human factors and patient safety, communicating effectively, preventing and managing adverse events and near misses, medication safety and multifaceted approach.

Therefore the researcher conducted an educational intervention on knowledge regarding patient safety among undergraduate nursing students of NaviMumbai.

STATEMENT OF THE PROBLEM:

Effect of educational intervention on knowledge regarding patient safety among undergraduate nursing students of NaviMumbai.

OBJECTIVES:

The objectives of the study were:

3) To assess the knowledge regarding patient safety among undergraduate Nursing Students.

4) To find the effect of educational intervention on Knowledge regarding patient safety among undergraduate Nursing students.

ASSUMPTIONS:

1) Undergraduate students may have some knowledge regarding patient safety.

2) Educational intervention may enhance knowledge.

HYPOTHESIS:

1) H₁ There is significant difference in the knowledge regarding patient safety among undergraduate Nursing students before and after educational intervention.

2) H_oThere is no significant difference in the knowledge regarding patient safety among undergraduate Nursing students before and after educational intervention.

METHODOLOGY:

RESEARCH APPROACH:

Quantitative Approach

RESEARCH DESIGN:

Pre- experimental one group pretest, post-test design was selected.

VARIABLES:

Independent variable: Educational Intervention

Dependent variable:

Knowledge on patient safety among undergraduate Nursing Students.

Setting:

The study was conducted in selected Nursing Colleges of Navi Mumbai.

Population:

B.Sc Nursing 3^rd year and 4^th year students.

Sample size:

55 students participated in the study.

Sampling Technique:

Non-probability convenient sampling technique was used

Sampling Criteria:

Inclusion Criteria:

Undergraduate Nursing Student who: are willing to participate are present at the time of data collection.

Description of the data collection Instrument:

1) Structured Questionnaire to assess the knowledge on patient safety among undergraduate Nursing Students.

The reliability of the tool found to be 0:8 by test-retest method and was statistically significant.

DATA COLLECTION PROCESS:

A formal written administrative permission and ethical clearance was obtained to conduct the study from the authorities. The students were selected based on the inclusion and exclusion criteria and assessed by using the structured Questionnaire.

Informed consent was taken from the participants. Pretest done on the first day followed by educational intervention on patient safety. Post test done on the seventh day on the same participants.

DISCUSSION:

Out of 55 participants, on knowledge regarding burden of care on patient safety 52.77% had given a correct response in the pretest, whereas in the post test was 63.63%.

In regard to safety climate, 9.09% had given correct response in the pretest, whereas in the posttest was 3.63%.

In regard to act carried out during an adverse event 45.45% gave a correct response in the pretest, and 58.18% in the post test.

In regard to adverse event, the pretest knowledge score was 63.63 and post test was 60% respectively.

In regard to highest priority for patient safety the pretest knowledge score was 67.26% with a post test score knowledge of 87.27%.

In regard to ensuring correct site, correct procedure and correct patient surgery the pretest score was 38.17% with a post test score of 38.18%.

With regard to action areas to reduce risk of patient safety, the pretest score was 74.59% with a post test score of 92.72%.

In relation to an unplanned event that threatens human safety the pretest was 12.72% with a post test of 41.81%.

With regard to knowledge on strategies to improve team communication the pretest knowledge score was 52.72% and post test was 65.45%.

Knowledge on technique used by care givers that patient has understood the information the pretest and post test scores were 18.18% and 38.18%.

In relation to the knowledge on best attitude with regard to patient safety the pretest and post test score was60% and 67.27% respectively.

In regard to knowledge on medication error the pretest score was 70% and post test score was 83.63%.

In relation to knowledge on DODAR (Diagnoses, Assign, Review) are the steps to improve, the pretest score was 45.45% and post test score was 61, 81%.

Table 1 Comparison of the pretest and post test score on patient safety. n=55

Sl No	Components on patient safety	Pretest		Post test
		Mean score SD		Mean score SD
1	Fundamentals of patient safety	0.618	0.49	0.67	0.54
2	Emerging Challenges	1.091	0.72	0.089	0.77
3	Human factors and safety	1.05	0.75	1.25	0.58
4	Managing adverse effects	1.47	0.79	2.05	0.73
5	Communicating effectively	1.09	0.77	1.60	0.78
6	Medication safety	0.72	0.44	0.83	0.37
7	Multifaceted approach to create safety culture	0.74	0.64	0.89	0.62

Table: 2-Comparison of the pretest and post test score n=55

Score	Pre test Mean	SD	Post test Mean	SD	T value	Df	Influence
Overall knowledge	6.80	2.48	8.49	2.08	1.702	54	P<0.005

Significant at 0.005 level

Table 1( fig 1) shows that mean score of fundamentals of patient safety was 0.618 and post test was 0.67, where SD was 0.49 and post test was 0.54. Emerging challenges had a mean score of 1.091 and in the post test mean score was 0.089 where pretest SD was 0.72 and post test SD was 0.77.Mean score of Human factors and safety was 1.05 in the pretest and in the post test was 1.25, where SD was 0.75 and 0.58 in the pretest and post test.

Managing adverse effects and near misses, the mean pretest was 1.47 with a mean post test score of 2.05 and SD in the pretest was 0.79 and 0.73 in pre and post test.

In regard to communication, the mean pretest was 1.09 and post test was 1.60, SS 0.77 in the pretest and 0.78 in the post test.

In regard to medication safety, mean pretest score was 0.72 and post test was 0.83, SD in the pretest was 0.44 and 0.37 respectively.

In regard to multifaceted approach to create safety culture the mean score pretest was 0.74 and post test was 0.62 respectively.

Table 2 shows there was a significant difference between the overall knowledge mean pretest score (6.80) and the mean post test score (8.49). The computed “t” value was greater than the table value. So the null hypothesis was rejected and concluded that there was a significant relationship between video assisted teaching and knowledge on patient safety among undergraduate Nurses.

CONCLUSION:

To conclude, the present study explored the importance of patient safety in the curriculum of nursing education and emphasized the concept of medication safety is of high priority which has to be incorporated during the training period.

ACKNOWLEDGMENT:

The author acknowledge the constant support and encouragement from Professor,andDirector, Dr. Mrs. Prabha Dasila of MGM New Bombay College of Nursing and Mrs.BharatiVeer, Vice principal, other fellow workers and students who were willing to spend their valuable time for the study.

REFERENCES:

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Received on 22.08.2017 Modified on 18.09.2017

Int. J. Nur. Edu. and Research. 2018; 6(1): 61-65.

DOI: 10.5958/2454-2660.2018.00015.7