Effectiveness of Educational Intervention Programme on Knowledge and Behavioral Competence of Methicillin Resistance Staphylococcus Aureus among Nursing Officers

 

K. Kavipriya¹, Dr. A. Maria Therese², Dr. A. Felicia Chitra³

¹Post Graduate Nursing Student, Department of Medical Surgical Nursing, Mother Theresa Post Graduate and Research Institute of Health Sciences, Puducherry, India

²Professor, Mother Theresa Post Graduate and Research Institute of Health Sciences, Puducherry, India

³Prinicpal, Mother Theresa Post Graduate and Research Institute of Health Sciences, Puducherry, India

 

ABSTRACT:

Methicillin-Resistant Staphylococcus Aureus (MRSA) is a serious strain of Staphylococcus Aureas that causes life threatening pneumonia, bloodstream infections and surgical site infections in medical facilities. The transition to colonization or infection of even low risk populations places the Nursing Officers in a vulnerable position as they provide care to the patient with unsuspected MRSA colonization or Infection. The aim of the study is to assess the Knowledge and Behavioral Competence on Methicillin Resistance Staphylococcus aureus (MRSA) among Nursing Officers. So Pre Experimental Time series research design was used for this study. The sample comprised of 50 Nursing Officers. Data was collected by using self administered structured questionnaire before and after Educational Interventional programme. The study result shows that 42 [84%] of Nursing Officers having Inadequate knowledge and 6[12%] of them have Moderate adequate knowledge and 2(4%) of them have adequate knowledge and 50(100%) had Poor Competence and no one had fair and good Competence on MRSA before intervention. Before the Educational Interventional programme, the mean score of Knowledge was 8.32 and mean score of Behavioral Competence was 47.70 and there was a marked gain in Knowledge and Behavioral Competence mean score after the Educational Interventional programme were 19.54 and 98.00. The difference in knowledge and Behavioral competence score were statistically significant at 0.001 level which indicates that Educational Interventional Programme was effective in terms of gaining Knowledge and Behavioral Competence. The findings of this study support the need for conducting CNE on MRSA to increase the Knowledge and Behavioral Competence about MRSA among Nursing Officers and recommended to follow Infection control measures and standard precautions to prevent the spread of MRSA infections.

 

 

 

 

 

INTRODUCTION:

Methicillin-Resistant Staphylococcus Aureas (MRSA) is a type of staphylococcus bacteria that is resistant to antibiotics called Beta-lactams antibiotics and other more common antibiotics such as oxacillin, penicillin and amoxicillin [Center for Disease Prevention and Control, CDC (2006)]. MRSA is one of the most dangerous and feared strains of Staphylococcus Aureas because of its resistance to Methicillin which is one of the most recent and strongest antibiotics. Due to such resistance it is of clinical and economic burden to most healthcare institutions around the world.

 

NEED FOR THE STUDY:

Methicillin-Resistant Staphylococcus Aureus (MRSA) is a serious strain of Staphylococcus Aureas that causes life threatening pneumonia, bloodstream infections and surgical site infections in medical facilities (CDC, 2015). Health Care Workers have an essential role in the prevention of MRSA transmission in different health care settings. The Knowledge gained and perceived by Health Care Workers about MRSA has a tremendous effect on their attitude to continuously take preventive measures towards decreasing Healthcare associated MRSA (Seibert et al., 2014). MRSA infections are known to be associated with significant morbidity, increased length of Hospital stays, higher cost of treatment and high mortality (Shibabaw et al., 2013).

 

Additionally, researchers have provided evidence that MRSA and other resistant bacteria are transmitted by the Nursing Officers Hands, Clothing, and Equipment to the patient, other Nursing Officers, and even Family Members. Snyder and colleagues (2008) reported 17.5% of Nursing Officers acquired the MRSA on their gloves, gown, or both after caring for patients colonized or infected with these bacteria. Each Nursing Officers must become aware of their role and consequences for non adherence to practices such as Hand Hygiene and wearing gowns and gloves to prevent transmission of MRSA.

 

OBJECTIVES OF THE STUDY:

·       To Assess the Existing Knowledge and Behavioral Competence of MRSA among Nursing officers

·       To Evaluate the Effectiveness of Educational Interventional programme on MRSA among Nursing Officers

·       To Find out the association between Post test Knowledge and Behavioral Competence scores of Nursing Officers with their selected demographic variables.

 

HYPOTHESES:

·         H1: There will be a significant difference between pre and post-test Knowledge and Behavioral Competence scores of Nursing Officers about MRSA.

·         H2: There will be a significant association between the post-test Knowledge and Behavioral Competence scores of Nursing Officers with their demographic variables

 

MATERIAL AND METHOD:

·       The Health centre was selected by simple random sampling and samples were selected by Convenience sampling technique.

·       The sample comprised of 50 Nursing Officers who were working in selected Health Centers.

·       Before starting Data collection, researcher obtained permission from the Medical officers from the selected Health centres.

·       Data were collected using 25 items self administered structured questionnaire for assessing their Knowledge and 25 items five point rating scale to assess their Behavioral Competence. Educational Intervention Programme on MRSA was given for 30 minutes with the help of power point presentation (45 slides) and a booklet was given at the end of intervention to each sample.

·       Pre test was done using a self administered structured questionnaire and 5 point rating scale on 1^st day.

·       Post test was conducted on 8^th day, 15^th day and 22^nd day following intervention to assess the level of Knowledge and Behavioral Competence about MRSA by using the same tool.

 

Table 1: Mean and Standard deviation of Knowledge score on MRSA among Nursing Officers. N=50

Knowledge	Mean	S. D	Mean Diff.	ANOVA- Ftest
Pretest	8.32	2.44	11.22	F = 160.64 p = 0.001, S***
Post Test1	17.16	4.32
Post test 2	18.72	3.31
Post test 3	19.54	3.87

***p<0.001, S - Significant

 

Table 2: Mean and Standard deviation of Behavioral Competence score on MRSA among Nursing Officers. N = 50

Behavioral Competence	Mean	S. D	Mean Diff.	ANOVA- ‘F’test
Pretest	47.70	3.18	50.30	F = 890.12 p = 0.001, S***
Post Test 1	82.68	7.83
Post test 2	93.14	4.58
Post test 3	98.00	5.94

***p<0.001, S – Significant

 

Table 3: Association between level of Knowledge with Age and Working Experience

Sample Characteristics		X2 value	P value
Knowledge	Age	4.61	P=0.03, S*
	Working Experience	5.13	P=0.02, S*
Behavioral Competence	Age	3.94	P=0.04, S*
	Working Experience	4.02	P=0.04, S*

*p<0.001

 

RESULTS:

The significant findings of the study were: The majority of the Nursing Officers 38(76%) were belongs to the Age group of above 35 years, 50(100%) were Female, 40(80%) were GNM, 40(80%) had more than 10 years of working experience, 42(84%) do not have previous source of Knowledge and 47(94%) have not nursed patients with MRSA infection. The study findings revealed that 42(84.0%) had Inadequate level of Knowledge, 6(12.0%) had Moderate level of Knowledge, 2(4.0%) had Adequate Knowledge and 50(100%) had Poor Competence and no one had fair and good Competence on MRSA before intervention

 

Table 1 and 2 revealed that in the pretest, the mean score of knowledge was 8.32±2.44 and in post test1, the mean score was 17.16±4.32, in post test 2, the mean score was 18.72±3.31, in post test 3, the mean score was 19054±3.87. The mean difference was 11.22.  The calculated ANOVA ‘F’ value of F = 160.64 was found to be statistically significant at p<0.001 level. In the pretest, the mean score of Behavioral Competence was 47.70±3.18 and in post test 1, the mean score was 82.68±7.83, in post test 2, the mean score was 93.14±4.58, in post test 3, the mean score was 98±5.94. The mean difference was 50.30.  The calculated repeated measures ANOVA ‘F’ value of F = 890.12 was found to be statistically significant at p<0.001 level. This clearly indicates that Educational Interventional Programme on Behavioral Competence regarding MRSA imparted to Nursing Officers had significant effect and their level of Behavioral Competence was increased in the post test.

 

DISCUSSION:

·       The calculated ANOVA ‘F’ value of F = 160.64 in Knowledge and F = 890.12 in Behavioral Competence was found to be statistically significant at p<0.001 level

·       Thus, the hypothesis H1 which stated that there will be significant difference between the pre and post test scores of Knowledge and Behavioral Competence about MRSA among Nursing Officers working in selected Health Centers was accepted.

·       This Study is consisted with the similar study conducted by Shrithi. M. T. et al (2015) to find the Effectiveness of Teaching programme in increasing the Knowledge level of Nurses on prevention of transmission of MRSA and the findings of the study had shown that the level of knowledge on MRSA and preventive measures before Planned Health teaching was M= 10.62, SD = 4.43 and after Health Education M= 20.46, SD = 2.94 at p< 0.0001 level. Thus the study revealed that the intervention of Planned Health teaching was effective in improving the knowledge and preventive practices.

·       The data in table 3 shows that there was statistically significant association with post test level of Knowledge and Behavioral Competence about MRSA among Nursing Officers with Age and Working Experience.

·       Thus, the hypothesis H2 which stated that there will be significant association between the post test scores of Knowledge and Behavioral competence of MRSA among Nursing Officers with the selected demographic variables was accepted with regard to Demographic variables in terms of Age and Experience.

CONCLUSION:

This study revealed that Educational program definitely improves the Knowledge and Behavioral Competence among the Nursing Officers. Hence regular awareness creating/ teaching programme must be conducted to prevent the spread of MRSA.Small sample size and convenience sampling used limits the generalizability of study findings. The duration of the study was short 4 weeks therefore the long term effectiveness of Educational Intervention Programme could not be assessed.

 

REFERENCES:

1.      Barton E et al (2009) “Future treatment options for Gram-positive infections--looking ahead”, Clinical Microbiol Infection, 15 Suppl 6:17–25.

2.      Dr. Santhosh V. “Essentials of Medical Micro Biology”, Bangalore: G S Publication Ltd:75-77

3.      Burton DC et al (2007) “Methicillin-resistant Staphylococcus aureus central line-associated bloodstream infections in US intensive care units”, JAMA. 2009; 727–736.

4.      Herold BC, et al. (1998) “Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk” JAMA. 1998; 279: 593–598.

5.      Kallen AJ et al (2008) “Health care-associated invasive MRSA infections”, JAMA. 2010;304: 641–648

6.      Klevens RM, Morrison MA, Nadle J, et al. (2007) “Invasive Methicillin-Resistant Staphylococcus aureus Infections in the United States. JAMA., 298:63–71.

7.      Maree CL et al (2007) “Community-associated methicillin-resistant Staphylococcus aureus isolates causing healthcare-associated infection”. 2007; 13: 236–242.

8.      Whitlock EP et al (2010) “Identifying, selecting, and refining topics for comparative effectiveness systematic review”. 2010; 63:491–501. 

 

 

 

 

 

 

Received on 04.05.2019          Modified on 18.05.2019

Accepted on 01.06.2019     © A&V Publications all right reserved