Effect of Basic Life Support Training Programme on Knowledge and Practice among Administrative Employees of Health Institutes, Navi Mumbai.

 

Ms. Kshama Ravindra Sansare¹, Mrs. Susan Jacob²

MGM Institutes University Department of Nursing, Kamothe, Navi Mumbai.

 

ABSTRACT:

Basic Life Support (BLS) competency is considered a fundamental skill not only for health care workers but also for other non-medical personnel such as administrative employees. Administrative employees are the people who are working for 24 hours in the hospital along with health care professionals. Patients who are visiting hospitals first come to the enquiry desk for enquiry and meet the non-medical personnel, such as administrative staffs; In case any person falls there with cardiac arrest the administrative staff should have some knowledge and practice regarding BLS to save the life of that person before medical team arrives. Objectives- To assess the knowledge regarding Basic Life Support among administrative employees before and after the training programme. To assess the practice regarding Basic Life Support among administrative employees before and after the training programme. Quantitative research approach and quasi experimental one group pre test post design was used. Non probability convenient sampling method was used to select 60 administrative employees as a study subject. The mean knowledge score of subjects in pre test was 4.90 and in post test was 9.78 and overall mean practice score of subjects in pre test was 3 and in post test 16.15. There is no significant association between pre test knowledge and practice score in relation to BLS and selected aspects of socio demographic variables. Conclusion- Equal positive response to the demonstration and teaching was found really useful to administrative employees which will help them to take prompt decisions, perform cardiopulmonary resuscitation and save many lives of cardiac arrest victims.

 

 

INTRODUCTION:

Basic Life Support (BLS) refers to the service healthcare providers and public safety professionals provide to patients who are experiencing respiratory arrest, cardiac arrest or airway obstruction.

 

 

BLS includes psychomotor skills for performing high-quality cardiopulmonary resuscitation (CPR), using an automated external defibrillator (AED) and relieving an obstructed airway for patients of all ages¹

 

Basic Life Support (BLS) is the provision of treatment designed to maintain adequate circulation and ventilation to the patient in cardiac arrest, without the use of drugs or specialist equipment. Basic Life Support (BLS) includes recognition of signs of sudden cardiac arrest (SCA), heart attack, stroke, and foreign-body airway obstruction (FBAO); and cardiopulmonary resuscitation (CPR)².

About 92% cardiac arrest victims die before reaching the hospital, but statistics prove that if more people knew CPR, more lives could be saved. Immediate CPR can double or even triple a victim’s chance of survival³. Today basic CPR not only includes the traditional skills of chest compressions and rescue ventilation, but also, when indicated, rapid on-scene defibrillation through the availability and use of an automated external defibrillator (AED). The main issue, however, is how to better facilitate and ensure that all potential rescuers will be trained and ready to perform this life-saving actions.⁴

 

Tim Piepho, et.al⁶ (2011) conducted a study on Lay basic life support: the current situation in a medium-sized German town. The study investigates BLS skill and knowledge of German laypersons in a public community place and examines the effect of the interval between the last BLS course and present skills in cardiopulmonary resuscitation (CPR). It was verified that Lay persons who attended a BLS course more than 10 years ago showed a significant lack of BLS knowledge and failed more often to deliver chest compressions and rescue breathing. The study demonstrates that current CPR guidelines for BLS are not followed by lay persons in a medium-sized town in Germany. These data suggest that CPR refresher courses as well as implication of BLS guidelines in daily life are warranted.

 

Cardiovascular disease is the world’s leading killer. According to world Health Organization (WHO) estimates, 16.7 million people around the globe, die of cardiovascular disease each year. This is over 29% of all deaths globally. Cardiovascular diseases are now more prevalent in India and China than in all economically developing countries if the world combined. Cardiovascular disease in India quadrupled in the last 40 years. WHO estimates that by 2020 close to 60% of cardiac patients worldwide will be Indian.⁷

 

In India, statistics relate to mortality attributable to Cardiovascular Disease. Cardiovascular disease was expected to rise by 103% in men and by 90% in women from 1985 to 2015. Rapid urbanization and industrialization together with the adoption of modern lifestyles have tremendously increased the burden of non-communicable disease in developing countries like India.⁸

 

Participation in both successful and unsuccessful cardiopulmonary resuscitation and Basic Life Support is one of the most stressful situations that the administrative employees have to deal with after joining duties in a hospital set up.⁹ A thorough knowledge and competency (skill) help them to perform Basic Life Support on patient whenever needed in absence of medical personnel.

 

NEED FOR THE STUDY:

We should keep in mind that CPR’s main objective is to promote an artificial circulation of oxygen throughout the body, especially the brain and heart, until the spontaneous return of all vital functions.⁵

 

The study conducted by The International Liaison Committee on Resuscitation (ILCOR) recommends that strategies should be implemented that promote cardiopulmonary resuscitation (CPR) training in the workplace. Sim M S¹⁰ (2009) conducted a study on Non-medical employees at a hospital who were trained to conduct basic life support (BLS). Subject background information, test results and survey findings were examined and factors affecting BLS skill acquisition were studied. According to total checklist scores, subjects achieved a mean (SD) score of 8.66 (3.57). 22.3% performed all 13 skills. Based on 5-point overall competency ratings, 43.7% of subjects were rated as “competent”, “very good” or “outstanding”. Age (<40 years and ⩾40 years) was the only factor that significantly affected skill acquisition (skill acquisition by those ⩾40 years of age was poorer than by those aged <40 years). It was verified that Traditional BLS training is less effective in individuals aged ⩾40 years.

 

Basic Life Support competency is considered a fundamental skill not only for health care workers but also for other non-medicos such as administrative employees. Administrative employees are the people who are working for 24 hours in the hospital along with health care professionals. Patients who are visiting hospitals first come to the enquiry desk for enquiry and meet the non-medical personnel, such as administrative staffs, In case any person falls there with cardiac arrest the administrative staff should have some knowledge and practice regarding BLS to save the life of that person before medical team arrives.

 

Taking into account the importance of such activity, the present study intended to check the knowledge and practice on BLS among administrative employees working in health institutes.¹¹ Therefore, in the light of the above facts and experience of the researcher, this research was designed to investigate knowledge and practice regarding Basic Life Support among Administrative employees.

 

STATEMENT OF THE PROBLEM:

“Effect of Basic Life Support training programme on knowledge and practice among administrative employees of health institutes, Navi Mumbai.”

 

OBJECTIVES OF THE STUDY:

·        To assess the knowledge  regarding  Basic Life Support among administrative employees before and after the training programme

·        To assess the practice regarding Basic Life Support among administrative employees before and after the training programme.

 

ASSUMPTIONS:

1)     Administrative employees may have some knowledge regarding Basic Life Support

2)     Knowledge may influence practice

3)     Training programme may enhance knowledge and improve practice.

 

HYPOTHESIS:

H₀₁ - There will be no significant difference in the knowledge regarding BLS among Administrative employees before and after training programme.

H₀₂ – There will be no significant difference in the practice regarding BLS among Administrative employees before and after training programme.

 

METHODOLOGY:

Research Approach:

A quantitative research approach

 

Research Design:

Quasi experimental one group pre-test post-test design was selected

 

Variables:

Independent variable - Training programme regarding Basic Life Support Dependent variable - Knowledge and Practice regarding Basic Life Support among administrative employees.

 

Setting:

The study was conducted in selected hospital and educational institutes of Kamothe which include colleges of Nursing, Dental and Physiotherapy.

 

Sample:

Administrative employees

 

Sampling technique:

Non probability convenient sampling technique.

 

Sample size:

60 administrative employees participated in the study.

 

Sampling Criteria:

Administrative employees who:

·        are willing to participate

·        are present at the time of data collection

·        have a minimum educational qualification of 12^th Standard

 

TOOL:

The tool used for this study was

1) Structured knowledge questionnaire

2) Observation check list

 

Structured knowledge questionnaire contained 15 statements and observation checklist contained 20 statements. The scale was administered among the subjects before and after the training programme regarding Basic Life Support.

 

Description of the Tool:

The objective of structured questionnaire was to assess the knowledge score of policemen on the following aspects.

 

Tool I – Structured knowledge questionnaire:

Section A- Demographic data

Section B – Questionnaire. Structured multiple choice questionnaire was used.

 

Tool II- Observation check list:

It had 20 items with two responses i.e. yes and no. With every action performed, was given a score of one (1) and zero (0) for not performing the desired action.

 

DATA COLLECTION PROCESS:

Prior to data collection, the investigator took permission from the respective authorities and study subjects. The Investigator selected subjects who met the inclusion criteria. A pre-test in the form of questionnaire and observation check-list was administered. The investigator carried out a training programme with the help of CPR manikin on the same day as intervention. The post-test was given on the eighth day using the same tool.

 

FINDINGS AND DISCUSSIONS:

1)     DEMOGRAPHIC DATA OF THE SUBJECTS

 

Distribution of administrative employees based on Age

 

 

 

Distribution of administrative employees based on Source of Information

 

 

 

 

 

 

 

 

 

2)     ASSESSMENT OF THE KNOWLEDGE AND PRACTICE OF SUBJECTS REGARDING BLS:

Table 2 Overall knowledge scores regarding Basic Life Support n = 60

Knowledge	Pre test		Post test
	f	%	F	%
Good	0	0	17	28.3
Average	21	35	42	70
Poor	39	65	1	1.7

Table 2 shows that 21 (35%) of sample had an average knowledge and 39 (65%) had poor knowledge during pre test while majority of sample 42 (70%) had an average knowledge and 17 (28.3%) had good knowledge during post test.

 

Table 3 Overall Practice scores regarding Basic Life Support  n = 60

Practice	Pre test		Post test
	f	%	F	%
Good	0	0	56	93.3
Average	0	0	4	6.7
Poor	60	100	0	0

 

Table 3 depicts that out of 60 samples (100%) had a poor practice score on Basic Life Support in the  pre test  and in the post test  majority of sample 56 (93.3%) had  good practice score and 4 (6.7%) had an average score on Basic Life Support in the post test.

 

 

3)     EFFECTIVENESS OF TRAINING PROGRAMME ON KNOWLEDGE AND PRACTICE OF SUBJECTS REGARDING BLS

Table 4 Distribution of Sample based on Significance of difference in pre test and post test mean knowledge scores regarding Basic Life Support among administrative employees before and after the Training programme.  n = 60

Knowledge	Mean	SD	Difference Mean	Wilcoxon signed rank test	p value	Level of significance
Pre test	4.90	1.782
			4.88	6.700	0.000	p < 0.05
Post test	9.78	2.164

 

The mean pre test knowledge was 4.90 with a standard deviation of 1.782 where as the post test mean was 9.78 with a standard deviation of 2.164. Since the data does not follow Normal distribution, a non-parametric equivalent of student t-test, Wilcoxon Signed Rank test was applied to find whether there is any significance difference between the Pre and Post Knowledge test. A p-value of 0.00(<0.05) indicates that there is statistically significant difference between the Pre and Post test in Knowledge. Hence the null hypothesis H₀ is rejected and research hypothesis (H₁) is accepted. The educational intervention was found to be effective in improving the knowledge of study participants regarding Basic Life Support.

 

The mean pre test practice was 3.00 with a standard deviation of 1.010 where as the post test mean was 16.15 with a standard deviation of 2.110. Since the data does not follow Normal distribution, a non-parametric equivalent of student t-test, Wilcoxon Signed Rank test was applied to find whether there is any significance difference between the Pre and Post practice test. A p-value of 0.00(<0.05) indicates that there is statistically significant difference between the Pre and Post test in practice. Hence the null hypothesis H₀ is rejected and research hypothesis (H₁) is accepted. The educational intervention was found to be effective in improving the practice of study participants regarding Basic Life Support.

 

Table 5 Distribution of Sample based on Significance of difference in pre test and post test mean practice scores regarding Basic Life Support among administrative employees before and after the Training programme.  n = 60

Practice	Mean	SD	Difference Mean	Wilcoxon signed rank test	p value	Level of significance
Pre test	3.00	1.010
			13.15	6.769	0.000	p < 0.05
Post test	16.15	2.110

 

 

 

4)     COMPARISON OF OVERALL ITEM WISE MEAN SCORES ON KNOWLEDGE AND PRACTICE:

Table 6 n=60

Item wise total Mean Score for Knowledge	Pre test Mean	Post test Mean
Assessment and Activation Adult Compressions Adult Breath Automated External Defibrillator (AED)	1.33 1.20 0.35 1.53	2.68 2.35 1.15 3.17

 

Table 7 n=60

Item wise total Mean Score for Practice	Pre test Mean	Post test Mean
Assessment and Activation Adult Compressions Adult Breath Automated External Defibrillator (AED) Resume Compressions	2.50 0.30 0.12 0.05 0	3.77 3.23 4.08 4.13 0.92

 

5)     AN ANALYSIS OF DATA RELATED TO ASSOCIATION BETWEEN SELECTED VARIABLES AND PRE-TEST KNOWLEDGE OF SUBJECTS REGARDING BLS

 

Table 8                                                                                               n = 60

Demographic Variable	Df	X2 cal	X2 tab	p-value
Education 12 and above Graduate Post Graduate	2	0.216	5.99	0.897
Working Department Hospital Employee Nursing College Dental College Physiotherapy College	3	2.979	7.82	0.395

 

In order to find the relationship between knowledge and selected demographic variables, Chi square test used. The study shows that there was no significant association between pre-test knowledge score in relation to education and working departments that is calculated value is 0.216 and 2.979 respectively.

 

CONCLUSION:

During the study it was observed that, all the subjects were very conscious and interested to learn. The results of pre test of the study revealed that there is low level of knowledge and practice about BLS. In post test there is significant gain in knowledge and practice is seen. The results indicated that equal positive response to the training programme was found really useful to them.

 

REFERENCES:

1.       American Red Cross, Basic Life Support for healthcare provider’s handbook, published by Stay Well, 2011, ISBN 978-1-58480-646-2.

2.       Chandrasekaran et al. awareness of Basic Life Support among medical, dental, nursing students, and doctors, Indian Journal of Anaesthesia 2010, 54:121-6.

3.       Jayalaxmi Pillai, Effectiveness of American Heart Association (AHA) certified Basic Life Support training among the nurses working in selected hospitals of Pune city, Symbiosis College of Nursing, National Digital Library of India, Inflibnet Shodhganga.,pdf.

4.       Lynn P. Roppolo, Timothy Saunders, Paul E. Pepe and Ahamed H. Idris, Layperson training for cardiopulmonary resuscitation: when less is better 2007 Lippincott Williams and Wilkins 1070-5295.

5.       Perqola AM et al, Lay people and Basic Life Support, PubMed, NCBI, Rev Esc Enferm USP, 2009 June, 43(2); 335-42.

6.       Piepho Tim et al, lay Basic Life Support: the current situation in a medium sized German town, Emerg Med Journal, 2011 Sep, 28(9); 786-9. 

7.       World Health Organization Statistical Information System (WHOSIS).Cardiovascular Disease Statistics.

8.       Tanmay Nag et al, Cardiovascular disease risk factors in Asian Indian population: A systematic review, Journal of Cardiovascular Disease Research, 2013 Dec; 4(4): 222-228.

9.       Basil K et al, a study on progressive improvement in knowledge and skill of administering Basic Life Support among student nurses in a selected college of nursing, International Journal of Clinical Anesthesiology, 2015 August, ISSN: 2333-6641

10.     Sim M S et al, basic cardiac life support,Emerg Med Journal 2009 May, 26:327-330,2008.

11.     Polit and Beck, D F Beck, CT. Nursing Research. Generating and Assessing for Evidence for Nursing Practice, 8^th edition, Lipincott Williams and Wilkins; 2008.

 

 

 

 

Received on 06.09.2017           Modified on 14.10.2017

Accepted on 02.02.2018     © A&V Publications all right reserved