Study on Knowledge, Attitude and Practice of Cardiac Resuscitation Among Nursing Professionals at Dessie Referal hospital, North East Ethiopia

Kirubel Dagnew¹, Lehulu Tilahun²

¹Wollo University, Department of Comprehensive health Nursing, Dessie, Ethiopia

²Wollo University, Department of Emergency and Ophthalmic Health, Dessie, Ethiopia

*Corresponding Author E-mail: lehulut333@gmail.com

ABSTRACT:

Background: Cardiac Resuscitation is an important medical procedure which is performed in an effort to manually preserve intact brain function until further measures are taken to restore normal spontaneous blood circulation and breathing in a person with cardiac arrest. Objective: To assess knowledge, attitude and practice towards cardiac resuscitation among Nursing professionals at Dessie Referral Hospital. Methods: Institutional based cross sectional study was conducted among 182 nursing professionals at Dessie Referral Hospital to assess their Knowledge Attitude and practice towards cardiac resuscitation. And the participant was selected from each Strata by systematic random sampling as a whole, with proportional allocation to each department in its respective ward to fill self-administered questionnaire. The data that we gathered from April 1-5/2018 was analyzed by SPSS statistical software and presented by using frequency table. Results: Among 182 respondents 59.9% have good knowledge; degree nursing professionals also had good knowledge as high as 68.8%. 84.6 % have good attitude among all respondents and only 31% of nursing professionals have good performance of cardiopulmonary resuscitation. Significantly academic qualification has association with knowledge and attitude at p=0.04 and 0.00 respectively. Discussion: Based on the results discussions were made. Conclusion: Generally majority of respondents had good knowledge and attitude and poor performance on Cardiac Resuscitation.

KEYWORDS: Cardiac resuscitation, knowledge, attitude and practice.

INTRODUCTION:

Cardiac Resuscitation is an important medical procedure which is performed in an effort to manually preserved intact brain function until further measures are taken to restore normal Spontaneous blood circulation and breathing in a person in cardiac arrest.

It is a combination of rescue breathing and chest compression, which is delivered to the victims who are thought to be in cardiac arrest. Being important members of the health care team; medical students are deemed to passes the basic skills and expertise which are needed to perform it (1,2).

The ability to respond quickly and effectively to cardiac arrest situation rests on health care team and medical students being competent in emergency lifesaving procedure of cardiac resuscitation Resuscitation. The American Heart Association (AHA) resuscitation guidelines recommend that all under graduated students who are in contact with the patients should have regular resuscitation training (1,3).

Early initiation of Cardiac Resuscitation can improve patient survival and neurologic outcome. Targeted education on Cardiac Resuscitation for emergency care providers and the public has increased survival rate of the patients. Cardiac arrest continues to be a major cause of premature death in much of the world today. Although the epidemiology of cardiac arrest has been well studied in many developed countries, there are still no studies done on assessments of knowledge, attitude and practice on Cardiac Resuscitation. Besides this, it initiates responsible bodies to treat cardiac arrest patients in order to take action and further increment of awareness. (2,3,4).

In developing countries including Ethiopia, health care facilities differ widely in terms of equipment, staff and resources and vary enormously in their capacity to provide emergency care. It is evident that the management of any serious illness such as cardiac arrest is challenge to the health care system. Nursing professionals’ competencies, the characteristics of the patients and inefficiency of the health care system may compromise the health and wellbeing of the patients. Nursing professionals are usually the first, and often the only, point of healthcare contact for patients. In spite of the heavy burden of health care that rests on the shoulders of nursing professionals in Ethiopia, the delivery of emergency care is still limited by the lack of specialized Cardiac Resuscitation training for nursing professionals. Therefore, the hospitals have to have a well skilled and experienced Nursing professionals and modern medical tools and equipment’s to provide lifesaving treatment of Cardiac Resuscitation (5, 6, 7).

METHODS AND MATERIALS:

Institutional based cross sectional study was conducted among nursing professionals at Dessie Referral Hospital from April 1-5/ 2018 G.C.

All Nursing professionals who are working at Dessie Referral Hospital were considered as source population. Selected Nursing professionals working at Dessie Referral Hospital considered as study population.

All Nursing professionals who are working at study site and available during the study period were included under the study. Nursing professionals who are on annual leave and those with recently employed were excluded from the study.

The data collected by using structured self-administered questionnaires. It includes four parts; the first section containing socio demographic characteristics such as age, sex, educational status and department. The second part elicits about knowledge, the third part includes questions concerning attitude and the last part includes practice assessment checklist towards cardiopulmonary resuscitation.

Sample size is determined using single population proportion formula by considering the 50% proportion, 95%convidence level and 5% margin of error. The sample of 182 subjects were included in the study.

Respondents had been stratified based on their department. From each stratum, sample respondents will be selected through systematic random (lottery system) sampling technique First all department from the hospital are taken. The sample are stratified based on their department and from each stratum members is draw by using systematic random sampling technique. In General the size of the sample in each ward is taken in proportion to the size of the ward.

The quality of data assured by properly designing the data collection instrument for its simplicity and clearness for collecting data using carefully designed structured questionnaire which was prepared in English and it has been pre-tested on 10 Nursing professionals at Boru Meda Hospital. One of us assigned as supervisor and other two as data collector. During data collection, each and every activity have been monitored and evaluated for its correctness, completeness, timeliness and clarity from the beginning until completion.

The data was analyzed by SPSS version 20 and described by using frequency table, bar graph and the significance have been tested using logistic regression statistical significance for variable was set at p- value less than 0.05.

RESULTS:

Socio demographic characteristics of respondents:

A total of 182 Nursing professionals filled out knowledge, attitude, and practice assessment questions on cardiac resuscitation. The overall response rate in this study was 100%.

The majority (54.9%) of participants were females, 159 (87.4%) of respondents were aged above 25 years, 100 (54.9%) had five and less than five years of working experience and 154 (84.6%) were BSC Nursing professionals (Table 1).

Table 1: Socio-demographic characteristics of the study participants (n=182) in Dessie Referral Hospital April, 2018.

(n=182)

Variables	Category	Frequency	Percentage
Sex	Male	82	45.1
Sex	Female	100	54.9
Age	<=25 years	23	12.6
Age	>25 years	159	87.4
Educational status	Diploma	28	15.4
	First degree	154	84.6
	<=5 years	100	54.9
Work experience	>5 years	82	45.1

Majority of the Respondents’ were from the following departments: OR (29), Pediatrics ward (18), adult OPD (22), medical ward (17), and 13 were from surgical ward.

Knowledge status of respondents on Cardiac Resuscitation:

Table 2: Respondents status of knowledge towards Cardiac Resuscitation at Dessie referral hospital April 2018 (n=182).

Variable	Category	Knowledge Status
		Good		Poor		COR	AOR	95%CI	P-value
		No	%	No	%
Sex	Male	48	60	34	41.5	0.9	0.9	0.49 -1.63	0.85
	female	61	61	39	39
Age	<=25	10	44	13	56.5	0.46	0.5	0.19 -1.13	0.13
	>25	99	62	60	37.8
	Diploma	3	11	25	89.3	0.05	2.2	0.01- 0.18	0.001
Educational status	First degree	106	6 8.8	48	31.2
	<=5 years	50	50	50	50	0.3	2.8	0.20 - 0.72	0.004
Work experience	>5years	59	72	23	28

Table 3: Respondents status of attitude towards Cardiac Resuscitation at Dessie referral hospital April 2018 (n=182).

Variable	Category	Attitude status
		Poor		Good		COR	AOR	(95% CI)	P-value
		No	%	No	%
Sex	Male	11	13.4	71	86.6	1.32	0.3	0.58-3.00	0.65
	female	17	17	83	83
Age	<=25years	3	13	20	87	1.24	0.08	0.34-4.50	0.98
	>25years	25	15.7	134	84.3
	Diploma	14	50	14	50	0.1	3.34	0.04-0.25	0
Educational status	First degree	14	9.1	140	90.9
	<=5 years	17	17	83	83	0.75	1.6	0.33-1.72	0.65
Work experience	>5 years	11	13.4	71	86.6

Table 4: Respondents status of performance towards Cardiac Resuscitation at Dessie referral hospital November 2018 (n=182)

Variable	Category	Performance status
		Good		Poor		COR	AOR	(95% CI)	P-value
		No	%	No	%
Sex	Male	19	23.2	63	66.8	0.49	0.39	0.25-0.94	0
	female	38	38	62	62
Age	<=25years	10	43.5	13	56.5	1.83		0.75-4.47	0.3
	>25 years	47	29.6	112	70.4		1.79
	Diploma	5	17.9	23	82.1	0.42	3.23	0.13-1.19	0.1
Educational status	First degree	52	33.8	102	66.2
Work experience	<=5 years	34	34	66	66	1.32		0.70-2.49	0.5
	>5years	23	28	59	72		0.91

DISCUSSION:

Cardiac Resuscitation is an important medical procedure which is performed in an effort to manually preserve intact brain function until further measures are taken to restore normal spontaneous blood circulation and breathing in a person in cardiac arrest. It is a combination of rescue breathing and chest compression, which is delivered to the victims who are thought to be in cardiac arrest. Being important members of the health care team; Nursing professionals are deemed to passes the basic skills and expertise which are needed to perform. The primary objective of this study was to have a baseline evaluation of the current Cardiac Resuscitation knowledge, attitude and practice at Dessie referral hospital in order to develop appropriate and targeted interventions for improving their gap (1).

A total of 182 Nursing professionals filled out knowledge, attitude, and practice assessment questions on Cardiac Resuscitation at Dessie Refferal Hospital. The overall response rate in this study is 100%. The majority (54.9%) of participants were females, 159(87.4%) of respondents were aged above 25 years, 100(54.9%) had five and less than five years of working experience and 154 (84.6%) were BSC Nursing professionals. It is like that of study conducted at Sains university and Raja Perempuan hospital in Malaysia as majority (60%) of respondents were female and 77% were BSc Nursing professionals, but the response rate of this study is 70% unlike that of our current study which is 100%, it is due to simplicity and precision of our questionnaire and punctuality of data collectors and supervisor (11).

Nursing Professionals knowledge on Cardiac Resuscitation have been evaluated by using structured knowledge assessment questionnaire, majority 109(59.9%) had good knowledge, 73(40.1%) had poor knowledge. Educational status (OR 0.05, p-value 0.00 and CI 0.01-0.18) and experience (OR 0.46, p-value 0.032 and CI 0.24-0.89) had significant association with knowledge as degree Nursing professionals 106(69.4%) have good knowledge. similarly with study conducted at Jimma university among nurses there was significant association between academic year, source of information of Cardiac Resuscitation and knowledge of Cardiac Resuscitation as p value is less than 0.05 and No significant associated indicated among sex, age distribution and knowledge of Cardiac Resuscitation of students as p value is ≥0.05 about 95.7% of the respondents had good knowledge about Cardiac Resuscitation it gives clue that education is the main influential event in the cognitive development and awareness (8).

Majority of Nursing professionals 154(84.6%) have good attitude and the remaining 28(15.4%) have poor attitude. Among participants degree Nursing professionals were have good attitude significantly 140(90.9%) than that of diploma Nursing professionals 14(50%) with (p-value=0.04, odds ratio = 0.10 and confidence interval = 0.04-0.25), which is less than finding at study conducted among nurse students at Ethiopian university hospitals in 2014, 93.8% of the respondents found to have positive attitude as compared to 7.4% of respondents noticed with negative attitude. Attitude level among all, academic year found to be statistically significant (as p value is less than 0.05), so in our study academic qualification had significant association with the attitude of Nursing professionals like that of study at Ethiopian University hospitals it may be due to the probability of Nursing professionals to have good attitude if they have awareness on ascertain issue (8).

As participants respond to practice assessment questions. Lowest score of good performance among each independent variable was seen and performance of nursing professionals towards Cardiac Resuscitation had not significant association with these variables unlike knowledge and attitude. Female participants 38(38%) had good performance while males only 19(23.2%). degree Nursing professionals also had good performance than diploma Nursing professionals 52(33.8%) and 5(17.5%) respectively similarly Nursing professionals had low performance (41%) on Cardiac Resuscitation relative to knowledge and attitude with study at Malaysia the reality behind good knowledge and attitude with poor performance may be negligence, understaffing and shortage equipment (10).

Generally the overall performance of participants towards Cardiac Resuscitation is 57(31%) relatively low as majority have good knowledge and attitude. the performance is less than finding at Vijayawada in 2017 which is 52%. The reason behind low performance of Nursing professionals towards Cardiac Resuscitation globally may be due to shortage of educational opportunity, as many educated Nursing professionals available, the nurse patient ratio will increase and Nursing professionals will have enough time to demonstrate Cardiac Resuscitation and this increase quality of Nursing professionals to do that perfectly (9).

CONCLUSIONS:

A total of 182 nursing professionals were participated in the study, most of respondents were from emergency, operation room and medical wards. Majority of nursing professionals 109 (59.9%) have good knowledge concerning Cardiac Resuscitation and educational status has significant association with knowledge as degree nursing professionals had better knowledge at p-value 0.04, and with attitude at p-value 0.00. Majority of participants (83.2%) have good attitude towards Cardiac Resuscitation and majority of respondents have poor performance unlike knowledge and attitude as only 31% have good performance. Generally majority of respondents had good knowledge and attitude and poor performance on Cardiac Resuscitation.

DECLARATIONS:

Ethics approval and consent to Participate:

Ethical clearance was obtained from WU, Medicine and Health Sciences College, Research and Community Service (RCS) office. After gaining permission from the hospital data collection commenced.

CONSENT FOR PUBLICATION:

“Not applicable”

COMPETING INTERESTS:

The authors declare that they have no competing interests

FUNDING:

We did not get any funds from anyone.

AUTHOR CONTRIBUTION:

KD brought the original idea and drafted and revised the work. KD and LT also supervised data collection, analyzed and interpreted the finding. Finally LT wrote the manuscript

ACKNOWLEDGEMENT:

We want to say thanks to Wollo University for creating an opportunity to run this research paper.

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10. Med J Malaysia Vol 66 No 1 March 2011

Received on 10.05.2020 Modified on 01.07.2020

Int. J. Nur. Edu. and Research. 2020; 8(4):478-482.

DOI: 10.5958/2454-2660.2020.00105.2