الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 193 |  |  |
| | | from | 193 | | |
Abstract
SUMMARY
Agriculture is a major source of income for a high percentage of the rural population and pesticides are the most frequent causes of poisoning among them. Aluminum phosphide is a highly efficient agent for preserving grains against rodents and insects. It accounts for a large number of poisoning cases. Aluminum phosphide poisoning has a high mortality rate of about 90%. It releases phosphine gas after exposure to moisture, and this reaction is catalyzed by the acidity of the stomach. Phosphine is then absorbed throughout the respiratory or gastrointestinal tracts and causes toxicity through inhibition of cytochrome c oxidase and formation of highly reactive free radicals. Treatment of patients with aluminum phosphide poisoning is supportive, including mechanical ventilation and vasopressors (Anbalagan et al., 2023).
Nurses play a core role to deal with acute poisoning patient. In Tanta, there is a lack of studies to improve nursing performance about acute poisoning. (Allam etal., 2021).
Aim of the study:
This study aims to assess nurses’ performance regarding care of patients with aluminum phosphide poisoning through the following:
1. Assess nurses’ level of knowledge regarding care of patient with aluminum phosphide poisoning
2. Assess nurses’ practice level regarding care of patient with aluminum phosphide poisoning
3. Assess nurses’ attitude regarding care of patient with aluminum phosphide poisoning
Research questions
1. What is nurses’ level of knowledge regarding care of patient with aluminum phosphide poisoning?
2. What is nurses’ practice level regarding care of patients with aluminum phosphide poisoning?
3. What is nurses’ attitude regarding care of patient with aluminum phosphide poisoning?
operational definition
performance: In this study performance means knowledge, practice and attitude.
Aluminum phosphide poisoning: Ingestion or inhalation of aluminum phosphide tablets which used for preserving grains from insects and pests, may be intentional or accidental.
Methodology
Research design:
A descriptive exploratory design was applied to achieve the aim of this study.
Exploratory research means a research conducted for formulating a problem for more clear investigation. Descriptive research is a research that explore and explain an individual, group or a situation. (Swedberg, 2020).
Setting:
The study was conducted at three units (5 nurses from surgical intensive care unit, 32 nurses from poison ICU unit, 3 nurses from emergency unit), surgical intensive care unit at fifth floor; which consists of 3 rooms (16 beds), poison ICU unit at second floor; which consisted of one room (10 beds), emergency unit at ground floor which consisted of two rooms 3beds at Tanta University Hospital, Tanta city -Egypt.
Subjects:
A convenient sample included all available nurses (40 nurses) who working in the previously mentioned settings at Tanta university hospital. The nurses had different qualifications and years of experience.
Convenient sample: It is a form of non-probability sampling commonly used for population and clinical research (Andrade, 2021).
Tools of data collection:
Three tools were used for data collection as follows:
1- Self-Administrated nurses’ knowledge questionnaire
2- Observational Checklist for nurses caring of patients with aluminum phosphide poisoning
3- Nurse’s attitudes Likert scale toward aluminum phosphide poisoning
Tool I: Self-Administrated nurses’ knowledge questionnaire
It was used to assess nurses’ level of knowledge regarding patient with acute aluminum phosphide poisoning, it was composed of two parts:
• Part 1: Demographic data sheet: it was used to assess the nurses’ demographic characteristics including age, gender, level of education, social status, work place, years of experience and previous training courses; it composed of 7 closed ended questions.
• Part 2: Nurses’ knowledge regarding aluminum phosphide poisoning:
It was developed by the investigator based on review of relevant recent literature in Arabic language, it was designed to assess nurses’ level of knowledge about aluminum phosphide poisoning. (Hussein et al., 2020; Abdullah et al., 2018; Rutto et al., 2012).
Tool II: Observational Checklist for nurses caring of patients with aluminum phosphide poisoning
It was developed by the investigator based on the recent and relevant literature (Hussein et al., 2020; Rutto et al., 2012; Sasirekha et al., 2011), it was used to assess nurses’ practice for patients with aluminum phosphide poisoning.
Tool III: Nurse’s attitudes Likert scale toward aluminum phosphide poisoning
It was adapted from (Hussein et al.,2020, Rutto et al., 2012) and modified by the investigator. It was used to assess nurses’ attitude toward caring for patient with aluminum phosphide poisoning.
Result of the study:
The main results of this study revealed that:
The current study results findings reveal that 40% of the studied nurses, were ranged from 30 to less than 40 years old, 62.5% of the studied nurses were males, 42.5% were married, 80% worked at poison ICU unit, also 40% had bachelor degree. While 45 % had more than 10 years of experience.
Regarding to training courses about 2.5% had basic life support courses, also 40% had management of crises course, 32.5% had first aid course and 80% had other courses.
Revealed that 82.5% of the studied nurses had unsatisfactory level of knowledge concerning aluminum phosphide poisoning.
Revealed that 42.5 % of the studied nurses had incompetent level of practice concerning aluminum phosphide poisoning.
Clarified that 37.5 % had negative attitude toward care of patients with aluminium phosphide poisoning.
There was highly statistically relation between total knowledge and demographic characteristics (age, gender, marital status and occupation. On the other hand, there was statistically significant between experience and total knowledge.
There were no statistically significant relations between studied nurses ’demographic characteristics and total practice and attitude.
there was statistically significant relation between studied nurses’ total knowledge and practice. Furthermore, there was statistically significant relation between total knowledge and attitude.
There was moderate positive correlation between total knowledge, attitudes& practice. In the same line, there was weak positive correlation between total practice and total attitude.
Conclusion:
Based on the findings of the current study, it can be concluded that nearly three quarters of the studied nurses had unsatisfactory knowledge and more than half of them had competent level of practice regarding patient care with aluminum phosphide poisoning. Meanwhile, more than one third had negative attitude regarding patient care with aluminum phosphide poisoning.
As well as there is statistically significant difference between the nurses’ knowledge, level of practice and attitude and their demographic characteristics: (age, gender, level of education, unit and years of experience). Regarding patient care with aluminum phosphide poisoning statistically significant difference between the nurses’ performance three domain (knowledge, practice and attitude).
Recommendations:
Based on the findings of the present study, the following are recommended in nursing education, practice and further research:
Nursing Education:
• On-going and regular in-service educational programs regarding evidence-based guidelines should include aluminum phosphide poisoning.
• Nursing educators and clinical facilitators must incorporate strategies regarding management aluminum phosphide poisoning into the intensive care unit and use learning opportunities to raise awareness of nursing staff about this problem.
• Developing simplified and comprehensive booklet including basic information about aluminum phosphide poisoning: as definition, causes, mechanism of action, complication and nursing role towards this type of poisoning.
• The ministry of agriculture must prevent usage of aluminum phosphide tablets in the markets.
Nursing practice:
• On-going and regular in-service training regarding basic procedures which applied for aluminum phosphide poisoning patients as: first aid, giving medications and decontamination (gastric, skin).
• Unit protocols regarding aluminum phosphide poisoning management should be developed and reviewed regularly as updates and new evidence for best practice are constantly emerging and ICU nurses should be educated on updated protocols.
Further nursing research:
• The study should be replicated on large sample and in different hospital setting in order to generalize the results.
• Further research should be conducted to evaluate the effect of education regarding care of patient with aluminum phosphide poisoning on ICU nurses’ knowledge, practice and attitude.