A Study to assess the effectiveness of Self Instructional module regarding knowledge and practice related to use of partograph among staff nurses working in labor room of the selected hospitals of Indore

 

Mrs. Yashoda Shrivastava

Associate Professor. HOD, OBG Department, Jabalpur Institute of Health Sciences, Jabalpur, (M.P.)

 

ABSTRACT:

Introduction: The partograph, a graphic recording of progress of labor and salient condition of the mother and fetus, has been used since 1970 to detect labor that is not progressing normally to indicate when augmentation of labor is approximated . abnormally  prolonged labor and its effects are important contributors to maternal and perinatal mortality and morbidity .the use of partgraph will help to identify the complication that can occur in a labor. So knowledge regarding  partograph is very essential to staff nursres working in labor room. Methodology: research approaches adopted for the study was pre-exprimental research design . the research design selected for this study was a pre experimental one group pre – test post test design .non probability  convenient  purposive sampling technique .the study was conducted  on staff nurses working in labor room of selected hospital of Indore  (M.P.).The sample size was 80 staff nurses. Results: The data was analyzed by descriptive and inferential statistics. The knowledge gained through self instructional module was good as it was evidence with a highly significant difference (t=20.99 for knowledge,  p<0.001 two tailed) and( t=6.05 for practice, P<0.001 two tailed) between the mean post-test (X₂=14.50 for knowledge and X₂ =7.64 for practice) and pre-test (X₁=10.55 for knowledge and X₁ =5.51 for practice). There was a significant association between the pre-test knowledge score, practice score and all the taken variable like age of staff nurses,professional education, clinical experiences in labour room,the standard parameter of partograph used in labor room. Conclusion: The self instructional module was found to be an effective strategy for providing information and for improving the knowledge and practices of staff nurses. It was well appreciated and accepted by the staff nurses. The more researches on Partograph will find better outcome for preventing  maternal mortality and morbidity.

 

 

INTRODUCTION:

The Partograph is a simple single page monitoring tool for the first stage of labor. The tool allows the trained birth attendant to monitor the progress of labor, the mother and the fetus, hour by hour and to have a clear means of tracking whether labor is obstructed–with ‘alert’ and ‘action’ lines signaling when a labor has become complicated. In the year 2008 the number of maternal deaths as a result of obstructed labour and/or rupture of the uterus varies between 4% and 70% of all maternal deaths, amounting to a maternal mortality rate as high as 410/100,000 live births. Each year 210 million women become pregnant, of whom 20 million will experience pregnancy-related illness and 500,000 will die as a result of the complications of pregnancy or childbirth. The current WHO initiative is to reduce maternal mortality to 75% of the 1990 level by 2015. If this is to be successful, the problem of obstructed labour will need to be addressed effectively. In India every year, it is estimated that approximately 500,000 women die as a result of pregnancy and child birth, one women dies every minute. An average of 407 women dies every 100,000 live births It is also estimated that 4 million newborns die in the first week of life every year, mostly due to problems during pregnancy and child birth.

 

The Partograph is a vital tool for identifying complication during child birth in a timely manner and refer woman to an appropriate facility for treatment. Prolonged labor is a leading cause of death among mothers and new born in the developing countriesWhen the Partograph will be in practice it helps midwives to identify prolonged labor and know when to take appropriate action. Each year, more than 500,000 women worldwide die from complications related to childbirth. With good quality obstetric care, approximately 90 percent of these deaths could be averted. For this reason all the labours should be monitored closely in order to identify delay at an early stage. The partograph serves as an “Early Warning System” and assists in the early decision on transfer, augmentation and termination of labour. It also increase the quality and regularity of all observations on the fetus and the mother in labour, and aids early of recognition of problems.

 

METHODOLOGY:

The research method adopted for the study was an evaluative approach. Since the study aims at evaluating the effects of a self instructional module regarding knowledge and practice related to use of partograph among staff nurses. the research design selected for this study was a pre-. Experimental, one group pre-test post-test design. the independent variable was the self instructional module on partograph. the dependent variables were knowledge and practice to use pof partograph.the study was conducted at The study was conducted in labor room of District Hospital, Seth Hukumchand Govt. Hospital, Govt. Malharganj Hospital, Govt. Mangilal Churiya Hospital, Govt. Maternity Hospital Pardeshipura,Govt. P.H.C Dakachya Indore, Govt. P.H.C kshipra Indore, Govt. C.H.C Sanver Indor, MadhyaPradesh. The reliability of the test was found out using Karl Pearson’s correlation coefficient formula. The reliability of the structured knowledge questionnaire and observation checklist(schedule) was found to be ‘r =0.834 ’ for knowledge questionnaire and ‘r =.795’ for practice which indicates that the tool was reliable.The sample comprised of 80 staff nurses working in labour room in selected hospital of Indore was taken by Non -probability Convenient Sampling technique.

 

RESULT:

Section I–The Effectiveness of Self Instructional Module (Sim) In Terms of Gain In Knowledge And Practice Scores:

The section-I deals with Statistical analysis and interpretation of data in order to evaluate the effectiveness of self instructional module (SIM) in term of gain in knowledge as well as in their practices of studied subject’s i. e. staff nurses.

 

KNOWLEDGE:

Table.1- Pre-test knowledge score distribution of selected samples in terms of frequency and percentage

Category/Scores	Frequency, (N=80)	Frequency Percentage (%)
Poor (0-5)	1	1.3
Average (6-10)	36	45.0
Good (11-15)	43	53.7
Excellent (16-20)	0	0.0
TOTAL	80	100.0

 

 

Table: 2-Post-test knowledge score distribution of selected samples in terms of frequency and percentage

Category/Scores	Frequency, (N=80)	Frequency, Percentage (%)
Poor (0-5)	0	0.0
Average (6-10)	4	5.0
Good (11-15)	49	61.3
Excellent (16-20)	27	33.8
TOTAL	80	100.0

 

PRACTICES:

Table.3- Practices pre-test score distribution of selected samples in terms of frequency and percentage

Category/Scores	Frequency, (N=80)	Frequency Percentage (%)
Poor (0-4)	22	27.5
Average (5-8)	44	55.0
Good (9-12)	14	17.5
Excellent (13-16)	0	0.0
TOTAL	80	100.0

 

 

Table 4-Practices post-test score distribution of selected samples in terms of frequency and percentage

Scores	Frequency (N=80)	Frequency Percentage (%)
Poor (0-4)	0	0.0
Average (5-8)	39	43.8
Good (9-12)	35	48.8
Excellent (13-16)	6	7.5
TOTAL	80	100.0

 

The Comparison Between Mean Score of Pre and Post-Test of Knowledge and Practices:

 

Table 5-Mean () and Standard Deviation (s) of Knowledge and practice Scores

Variable	Test	Mean ()	S D ()
Knowledge	Pre	10.55	1.999
	Post	14.50	2.000
Practice	Pre	5.51	1.786
	Post	7.64	2.383

 

Table. 6-Comparison of knowledge and practice scores between pre and post-test

Knowledge	Mean ()	Std. Error of Mean	D. F.	t-Value	p-Value
Pre-test	10.55	0.188	79	20.99	0.001
Post-test	14.50

 

Practice	Mean ()	Std. Error of Mean	D. F.	t-value	p-value
Pre-test	5.51	0.351	79	6.05	0.001
Post-test	7.64

Indicates highly significant.

 

CONCLUSION:

This study shows that there is a significant increase in knowledge of staff nurses after giving the self Instructional module. There was significant association between knowledge on Partograph and age, professional education, clinical experience in labour room, the standard Parameters of Partograph used in labor room.

 

REFERRENCES:

1.          Holmes P, Oppenheimer LW, Wen SW. (2001) The relationship between cervical dilatation at initial presentation in labour and subsequent intervention, BJOG.;108(11):1120–1124

2.          Neal JL, Lowe NK, Ahijevych KL, Patrick TE, Cabbage LA, Corwin EJ. 2010 “Active labor” duration and dilation rates among low-risk, nulliparous women with spontaneous labor onset: a systematic review. Journal of Midwifery Womens Health.;55(4):308–318

3.          Dilkason, (1992) Maternal and Infant Nursing Care, 1st Edition, Library of Congress Cataloging in Publication Data USA, page No. 212-214.

4.          F. Gary Aenningham, Norman F. Gant, Kennethj Leveno, Larry C. Gilstrap, Williams, (2001) Obstetrics, Edition 21st International, M.C. Graw Hill, Medical Publication Division New York. Page No.124-128

5.          www.ncbi.nlm.nih.gov/pubmed/7712898

 

 

 

 

 

Received on 29.06.2019          Modified on 21.07.2019

Accepted on 08.08.2019     © A&V Publications all right reserved