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Effect of Planned Teaching on Knowledge and Practices among Staff Nurses Working in a Selected Hospital Regarding Prevention of Selected Cardiopulmonary Complications in Post-Operative CABG Patients
Coronary Artery Bypass Graft (CABG) surgeryis a surgical procedure performed to relieve angina and reduce the risk of death from coronary artery disease. Arteries or veins from elsewhere in the patient’s body are grafted to the coronary arteries to bypass atherosclerotic narrowing’s and improve the blood supply to the coronary circulation supplying the myocardium. A study conducted to assess the incidence of post-operative respiratory complications after CABG revealed that thoracic surgery is responsible for majority of pulmonary complications. The diaphragmatic dysfunction, post-operative pain and alveolar collapse resulted in a 50% to 60% decrease in vital capacity and a 30% decrease in residual functional capacity. The use of opioids and other anesthetic agents that are used during surgery make client more prone for development of pulmonary and cardiac complication. The National Surgical Quality Improvement Program (NSQIP) compared hospitalization costs and length of stay among patients with various postoperative complications. Among infectious, cardiovascular, venous thromboembolic, and pulmonary complications, pulmonary complications were by far the most costly and, along with venous thromboembolic complications, required the longest mean hospital stay. For these reasons, identifying patients at risk for pulmonary complications and developing a strategy to reduce the risk is clearly worthwhile. Methodology-Research approach adopted for the study was Descriptive evaluative approach with one group pretest- posttest design. Structured questionnaire and observation checklist were used to collect the data. The reliability of the questionnaire was calculated by test retest method. The tool was administered at two different occasions and the score was compared and calculated using formula of correlation co-efficient. The reliability coefficient for knowledge and practice score was 0.847. Structured questionnaire was used to assess the knowledge and observation checklist was used to assess the practice of staff nurses regarding prevention of selected complications in post-operative CABG patients. The data was analyzed in terms of objectives and hypothesisusing descriptive and inferential statistics. Result- In pretest 22(55%) sample had average knowledge followed by 18(45%) were in good category. The post test score reveals that29(72.5%) sample had excellent knowledge followed by 9(22.5%) samples with good knowledge, very few samples 2(5%) were in average category. In pretest most 27(67.5%) sample had good practices level followed by 12(30%) were in average category and minimum1(2.5%) sample had excellent practices. The post test score reveals that majority 37(92.5%) sample had excellent practice followed by 3(7.5%) samples with good practice. The calculated ‘t’ value for knowledge and practice was found to be 13.43 and 20.54. This suggest that planned teaching programme is effective in improving knowledge and practice regarding prevention of selected cardiopulmonary complications in post-operative CABG patients among staff nurses working in a selected hospital. Conclusion-Staff nurses working in cardiac care units had inadequate knowledge regarding prevention of selected cardiopulmonary complications in post-operative CABG patients, planned teaching programme was found to be effective in improving the knowledge and practices of staff nurses regarding prevention of selected cardiopulmonary complications in post-operative CABG patients thus improving patient care.
Coronary Artery Bypass Graft, Planned Teaching Programme, Effectiveness, Knowledge, Practice, Staff Nurses.
- Williams SM, Wilkins J S. Pathophysiology 2 in one reference for the nurses. 1st ed. Philadelphia : Lippincott; 2005. p.143
- Lewis SM, Heitkemper MM, Dirksen SR, o’brien RC, Giddens GS, Bucher S. Medical surgical nursing:Nursing management of clinical problems. 7th ed. St.Luis: Mosby; 2007.p.744-84.
- Dadielkulickshiel. By pass surgery overview. 2007 Sep. Available from:URL:http://www/ncbi/nlm/nch.gov/pubmed
- Fredric S, Ibrahim S, Puri R. Coronary artery bypass graft surgery patient education [serialonline].2008; 1(1). Available from: URL: http://www/ncbi/nlm/ nch.gov/pubmed.
- Baskett RJF, Buth KJ, Collicott C, Ross DB. Preoperative cardiovascular risk factor control in elective coronary artery bypass graft patients: A failure of present management. Can J Cardiol.2002; 18(4): 397-402. Available from www.ncbi.nlm.nih.gov/pubmed/11992133
- Wikimedia foundation. Coronary artery bypass surgery. June. 2010. Available from http://en.wikipedia.org/wiki/Coronary_artery_bypass_surgery
- Rochelle W. Preoperative and postoperative management of patients undergoing coronary artery by pass grafts. World J Surg.1978; 2: 829-842. Available from www.springerlink.com/content/h60715241n57t514
- Dimick JB, Chen SL, Taheri PA. Hospital costs associated with surgical complications: a report from the private-sector National Surgical Quality Improvement Program. J Am Coll Surg .2004; 199:531-537.
- Hulzebos, EHJ Smit Y; Helders PPJM; van Meeteren NLU (14 November 2012). "Preoperative physical therapy for elective cardiac surgery patients". Cochrane Database o f Systematic Reviews (11). doi:10.1002/14651858.CD010118.pub2. Retrieved 27 June 2013.
- Chunta K S. Using focus groups to explore expectations of open heart patients. South Onlin J Nsg Rsrch.2010, 9(1). Available from www.snrs.org/publication/SOJNR-articles2.html
- Kaul U, Bhatia V. Perspective on coronary interventions & cardiac surgeries in India. Indian J Med Res. Nov 2010; 132(5):543-548
- Kaivan B. Measures of Electrolyte imbalances in CABG patients. World J surg: 2013; 56:667-669
- Bergsland J, Kabil E, Mujanovic E, Terzic I. Training of cardiac surgeons and nurses for Bosnia and Herzegovina: Outcomes in coronary bypass grafting surgery. Ann Thorac Surg . 2007; 83:462-467. Available from indmed.nic.in/imcwebij.html.
- Oxford dictionary [internet]: Oxford university Press 2015. Available from http://oxforddictionaries.com/definition/english/study.
- Black JM, Hawks JH. Medical Surgical Nursing, clinical management for positive outcomes. 8th ed. India: Elsevier; 2009.p.1421.vol 2.
- Basvanthappa BT. Nursing Research.1st edition. India: Jaypee Brothers Medical Publications; 1998
- Ji Q, Mei Y, Wang X, Feng J, Cai J, Ding W. Risk Factors for Pulmonary Complications Following Cardiac Surgery with Cardiopulmonary Bypass. Int J Med Sci 2013; 10(11):1578-1583. Available from http://www.medsci.org/v10p1578.htm
- Gale GD, Teasdale SJ, Sanders DE, Bradwell PJ, Russell A, Solaric B, York JE.Pulmonary atelectasis and other respiratory complications after cardiopulmonary bypass and investigation of aetiological factors.CanAnaesth Soc J 1979, 26(1): 15-21
- Stelzner TJ, King TE Jr, Antony VB. The pleuropulmonary manifestations of the postcardiac injury syndrome. Chest 1983; 84:383-387
- Ali IM, Lau P, Kinley CE. Opening the pleura during internal mammary artery harvesting: advantages and disadvantages. Can J Surg2006; 39:42-45
- Topal, A., &Eren, M. (2012). Risk factors for the development of pneumonia post cardiac surgery. Cardiovascular Journal of Africa, 23(4), 212-215. Available from http://doi.org/10.5830/CVJA-2012-005
- Ali A, Milapchand Bhora, Lilibeth Pineda, RajwinderDhillo. Nosocomial pneumonia in elderly patients following cardiac surgery. Respiratory MedicineVolume 100, Issue 4, April 2006, Pages 729-736
- Kees H Polderman, Armand RJ Girbes. Severe electrolyte disorders following cardiac surgery: a prospective controlled observational study. World J surg: 2013;56: 667-669. Available from http://www.ccforum.com/content/8/6/R459
- Goldstein J, Vincent JL, Leclerc JL, Vanderhoeft P, Kahn RJ: Hypophosphataemia after cardiothoracic surgery. Intensive Care Med 1985, 11:144-148
- J Almeida, F Galas, J Fukushima, E Almeida, A Gerent, E Osawa, C Park, R Nakamura, A Leme, M Sundin, R Kalil Filho, F Jatene and L Hajjar. Risk factors for severe vasodilatory shock after cardiac surgery.Critical Care 2015, 19 (Suppl 1): P149. Available fromhttp://www.ccforum.com/content/19/S1/P149
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