A Descriptive Study to Assess the Knowledge and Practice on ECG Skills among Emergency Nurses at Selected Hospitals, Chennai

Sasikala.A¹, Latha Venkatesan², Sasikala. D³

¹Lecturer, Apollo College of Nursing, Chennai.

²Principal, Apollo College of Nursing, Chennai.

³Reader- Apollo College of Nursing, Chennai.

*Corresponding Author E-mail: sasikalaarumugam1005@gmail.com

ABSTRACT:

Background: Electrocardiogram (ECG) plays a crucial role in helping to diagnose, follow-up, and detect any abnormalities in a patient’s condition. Nurses are usually the first to conduct an ECG and therefore need to know how to interpret them. The present study aims to examine the emergency nurse’s knowledge and practice about ECG skills. Objective: The objective of the study is to assess the knowledge and practice on ECG skills among emergency nurses. Methodology: A descriptive correlative design was adopted for conducting this study among 30 Nurses by purposive sampling technique at selected hospitals in Chennai. An extensive review of literature and experts opinion laid foundation for the development of demographic variable proforma of nurses, structured knowledge questionnaire on ECG skills and observation checklist on ECG. A pilot study was conducted to establish feasibility and researchability of the study after obtaining setting permission, participants consent and brief introduction about the study was given to participants. The data regarding demographic variable proforma of nurses, structured knowledge questionnaire on ECG skills among nurses was collected by self reporting method. The practice was assessed by using observation checklist on ECG skills. The collect data were organized and analysed using descriptive and inferential statistics. Results: More than half of nurses had moderately adequate knowledge (53.3%) and 46.6% of nurses have inadequate knowledge regarding ECG skills. Conclusion: There was no association between demographic variables such as gender, education status, years of experience in emergency ward and knowledge on ECG skills.

KEYWORDS: ECG skills, Emergency Nurses, Knowledge, Practice

INTRODUCTION:

Life threatening cardiac arrhythmias that cause sudden cardiac death claim more than a thousand lives a day. Worldwide, cardiovascular disease is estimated to be leading cause of death in the world 2020. Electrocardiogram (ECG) continues to be the most commonly used laboratory procedure for the diagnosis of heart disease.¹

Electrocardiogram (ECG) plays a crucial role in helping to diagnose, follow-up, and detect any abnormalities in a patient’s condition. Nurses are usually the first to conduct an ECG and therefore need to know how to interpret them. This is because a failure to detect abnormalities means that physicians will not be notified which will affect patients’ care.²

Nurses plays a vital role in linking with the rhythm strip and the clinical status of the patient and the nurses identification and recognition of cardiac rhythm in the initiation of appropriate nursing and medical response. Knowledge about the categorization of cardiac rhythm and subsequent validation of nurses’ competency are critical knowledge safe effective practice^3,4. Therefore understanding the nurses’ perception of cardiac rhythm knowledge and ultimately, developing tools to evaluate this knowledge, and competence in the recognition of ECG rhythms, are of critical importance to nursing.⁵

Purpose:

The purpose of the study is to assess the Knowledge and Practice on ECG skills among Emergency Nurses at Selected Hospital, Chennai.

Null Hypotheses:

H01 There will be no significant association between selected demographic variables and knowledge regarding ECG skills among Emergency nurses.

H02 There will be no significant correlation between the knowledge and practice scores regarding ECG skills among Emergency nurses.

MATERIALS AND METHODS:

A descriptive correlative design was adopted for conducting this study among 30 Nurses by purposive sampling technique at selected hospitals in Chennai. An extensive review of literature and experts opinion laid foundation for the development of demographic variable proforma of nurses, structured knowledge questionnaire on ECG skills and observation checklist on ECG^6,7. A pilot study was conducted to establish feasibility and researchability of the study after obtaining setting permission, participants consent and brief introduction about the study was given to participants. The data regarding demographic variable proforma of nurses, structured knowledge questionnaire on ECG skills among nurses was collected by self reporting method. The practice was assessed by using observation checklist on ECG skills⁸. The collect data were organized and analysed using descriptive and inferential statistics

RESULTS AND DISCUSSION:

The data were analyzed after completion of data collection in Apollo Hospitals, Chennai. Analysis was done according to the objectives and hypothesis of the study. Majority of the participants were belongs to the age group of 21-25 years (70%), had completed B.SC (N) (72%), females (73%) and had 1-3 years of experience (80%).

More than half of nurses had moderately adequate knowledge (53.3%) and 46.6% of nurses have inadequate knowledge regarding ECG skills. Mean score of normal ECG was 2.37 and SD was 1.03, Atrial fibrillation mean score and SD was 2.50, 1.36, Ventricular Fibrillation mean score and SD was 2.47,1.11, Heart Block mean score and SD was 2.27,1.14, Management of Dysrrhythmias ⁹mean score and SD was 2.23, 1.19 and the over all mean and SD of Knowledge regarding ECG skills was 11.7 and 3.14.

Majority of nurses (70%) had average practice Scores and 30% poor practice scores regarding ECG skills. Mean and Standard Deviation of Practice Scores of Nurses on ECG Skills was 10.7 and 2.74. There was no association between demographic variables such as gender, education status, years of experience in emergency and knowledge on ECG skills. Hence the null hypothesis Ho1 “There was no significant association between demographic variables and knowledge on ECG skills” was retained. There was a mild positive correlation between knowledge and practice on ECG skills and interpretation among nurses working in emergency care unit with r value of 0.342 at p<0.001. Hence the null hypothesis H02 “There will be no significant correlation between the knowledge and practice scores regarding ECG skills among nurses working in emergency care unit” was rejected.

Following study also supporting the current study conducted by Ahmed, (2015) among 102 nurses who was worked in CCU, ICU, Emergency Unit and assessed their knowledge and practices with ECG by using Self-administered questionnaire sheet related to demographic characteristics of the nurses, and observational checklist for nurses' practice regarding. The study showed that the percentage of successful Knowledge about electrocardiogram is 74.5 %, While the proportion of failures 25.5%. For the practical part of questionnaire the number of successful was 93.1%. While the proportion of failures 6.9%. There is no significant association of knowledge and Practices with demographic data¹¹.

CONCLUSION:

The finding of study revealed that nurses in Emergency nurses had moderate level of knowledge in ECG due to the level of experience and their exposure to the specific conditions. The study concluded saying that Electrocardiographic monitoring is a cornerstone of the emergency care units. The quick response of the nurses to life threatening arrhythmias plays a central role in the prevention of sudden death in the hospital.

ACKNOWLEDGEMENT:

I would like to thank all the participants for supporting me to conduct this study. I would like to thank my research guide and clinical guide who helped me throughout the study. I would like to extend my heartfelt thanks for all who has directly or indirectly helped me during my study period.

CONFLICT OF INTEREST:

The author declares no conflict of interest.

IMPLICATIONS:

· Strategies/policies can be formed for the nurses to provide a better nursing care for patient with arrhythmias by various continuing education programs can be conducted to increase and update knowledge of nurses

· Demonstration of proper technique and conducting skill stations programs help the students to acquire an adequate knowledge and incorporate it in their practice.

· The nurse administrators must periodically organize formal training programs to the nurses for ECG monitoring in Emergency Care Unit¹⁰.

· The professionals and the students can conduct further studies on ECG monitoring and its interpretation.

RECOMMENDATIONS:

· An experimental study can be conducted to assess effectiveness of structured teaching program in knowledge level among Emergency nurses regarding ECG.

· A Comparative study can be conducted on level of knowledge among Emergency nurses in different clinical settings.

Fig.1: Percentage Distribution of Male and Female Nurses in Emergency Unit.

Table 2: Frequency and Percentage Distribution of Knowledge Scores regarding ECG Skills among Emergency Nurses

Level of Knowledge

Frequency (f)

Inadequate (<13)

Moderately Adequate (13-18)

Adequate (19-25)

46.66

53.3

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Received on 21.12.2020 Modified on 26.06.2021

Int. J. Nur. Edu. and Research. 2022; 10(1):53-55.

DOI: 10.52711/2454-2660.2022.00012