الفهرس | Only 14 pages are availabe for public view |
Abstract The study was conducted in General Surgery Department (units A, B and C) at Assiut University Hospital. Data were collected from all nurses (60 nurses) in addition to adult patients who had performed cholecystectomy. through 12 month period (January 2012 to December 2012); 4 months for teaching nurses the developed postoperative nursing care standards, 8 months for assessment nurses knowledge and practice and making patient assessment pre and post implementing postoperative nursing care standards. The following tools were utilized for data collection: Tool I: Post-operative assessment sheet for nurses (Annex A): To measure the exact knowledge and practice level of nurses regarding care of cholecystectomy patients. Part (one): This part is concerned with socio-demographic characteristics for nurses. Part (two): Level of nurses` knowledge about the postoperative nursing care of cholecystectomy patients. Part (three): Assessment of Nurses practice observation checklist about postoperative care of cholecystectomy. Tool II: Post-operative competencies sheet for nurses Opinionnaire (Annex-B): It was developed by the researcher based on current national and international literature in order to nurse’s opinions as regard to the basic nursing competencies for post-operative cholecystectomy patients. This tool covered 11 major broad competencies which were further subdivided into sub competencies. Tool III: Patient`s assessment sheet (Annex C): This part includes three parts which are: Part (one): This part is concerned with socio-demographic characteristics of patients who had performed open cholecystectomy. This part is concerned with general assessment including history taking and vital signs recording chart for three days. Part (four): Assessment of postoperative complications. Tool IV: Construction of postoperative nursing care standards booklet (Annex D): After passing through an extensive and relevant literature review. It was written in Arabic using simple language with illustrations and it was concerning knowledge about: - Brief illustration of the anatomy and physiology of the gallbladder. - Definition of cholecystectomy. - Types of cholecystectomy. - Technique of cholecystectomy. - Complications of cholecystectomy. - Developed nursing care standards: Total score of the questionnaire sheet was 50 degrees: - Less than 50% (less than 25 degree) was regarded as poor level of knowledge. - 50%-70% (25- 35 degree) was regarded as satisfactory level of knowledge. - More than 70% (More than 35 degree) was regarded as good level of knowledge. Total score of the observation checklist sheet was 512 degrees: - Less than 60% (Less than 307 degree) was regarded as inadequate level of practice. - 60% and above (307 degree and above) was regarded as adequate level of practice. Data was collected and analyzed by computer- programmed SPSS (ver.17). Using; number, percentage, mean, chi-square test and T. test. Statistical significance was considered at P-value < 0.05. Main findings of the present study were as the following: For nurses: • There was a great progress in the level of nurses’ knowledge post implementing nursing care standards and all of nurses had a good level of knowledge. • There was a great improvement in the nurses practice scores and they had adequate level of practice after the implementation of the designed nursing care standards. • There was a positive correlation between total nurses` knowledge and practice scores post implementing nursing care standards. For patients: • As regard postoperative anesthesia complications(nausea and vomiting) it was found that there was a statistical significant difference between postoperative complications as regard pre and post implementing postoperative nursing care standards (P<0.001). • Also, the incidence of other postoperative complications decreased after implementation of nursing care standards than that found in pre implementing nursing care standards but not reach to a statistical significant difference. The 1st hypothesis was supported as a good improvement in the mean knowledge scores immediately after the implementation of the developed postoperative care standards The 2nd hypothesis was supported as a good improvement in the mean practice scores immediately after the implementation of the developed postoperative nursing care standards. The 3rd hypothesis was supported The incidence of postoperative complications for patients cared by nurses after standard care implementation is lesser than that developed pre standard care implementation The 4th hypothesis was supported as a positive relationship was found between nurses` knowledge and practice scores immediately after application of the developed postoperative nursing care standards. |