الفهرس 
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Abstract
Mechanical ventilation is a mechanical device which supports ventilation to the lungs. It is a vital, life-saving therapy for patients with dangerous illness and respiratory disorder. MV is a common procedure used to treat patients with respiratory failure and indicated when the patient’s spontaneous ventilation is inadequate to maintain life. Although it is life-saving, it is invasive, expensive and associated with some serious potential risks such as VAP, ventilator-induced lung injury, hemo-dynamic problems and prolonged intensive care unit (ICU) stay, Therefore, SLP is a new method of education which can help nurses to develop their knowledge and practice for the delivery of safe, evidence-based, high-quality care for patients and to achieve their goals (ANCCC 2015 and Majeed, 2017).
Aim of the Study
This study aims to evaluate the effect of self-learning package on nurses’ performance caring for patients on ventilators through:
Assess knowledge of nurses regarding caring for patients on ventilators.
Assess practice of nurses regarding caring for patients on ventilators.
Research hypothesis:
There will be a positive change in nurses’ performance post the implementation of self-learning package (SLP) through improvement of nurses’ knowledge and practice for caring for patients on ventilators.
Subjects and Methods
Technical Design:
The technical design includes the study design, setting, subjects, and tools for data collection.
1) Research design:
A quasi-experimental design study was utilized to meet the aim of this study.
2) Research Setting:
This study was conducted in critical care units: ICU; RICU and CTICU at Ain-Shams University Hospitals
3) Subjects:
A sample of convenience of forty (40) nurses was recruited from the previously mentioned settings for those available nurses (20) from ICU, (10) nurses from RICU and (10) nurses from CTICU from both sexes, different age, and different qualifications.
4) Tools for data collection:
three tools were used to collect data:
I. Self-administered nurses’ questionnaire.
II. Nurses’ observational checklists.
III. Nurses’ opinions questionnaire regarding SLP and problems facing nurses during management of the patient on MV.
I. Self-administered nurses’ questionnaire: It was used to assess nurses’ knowledge regarding caring for patients on ventilators pre, post & follow up phases. This tool It was designed by the researcher after reviewing the related literature and was used at pre, post and follow up phases.
II. Nurses’ observational checklists: about caring for patients on ventilators and preventing complications and VAP, it was adopted from Bird et al., 2010; Smeltzer, et al., 2010; Gattinoni, et al., 2012; Parker, 2012; Ali, 2013; Silva, et al., 2013 and Hinkle, & Cheever, 2014 and Lynn, 2014 and used to assess nurses’ practice regarding caring for patients on MV and preventing complications associated with ETT & tracheostomy regarding and prevention of VAP at pre, post and follow-up phases.
III. Nurses’ opinions regarding SLP: It was adapted from Khalil, 2013 and used to assess nurses’ opinions regarding using SLP and problems facing nurses during management of the patient on MV.
Fieldwork:
Data collection of this study was accomplished through 19 months, in the period from the beginning of the December 2015 to June 2017, during morning and afternoon shift three days/week.
The observation checklist was carried out to assess practice of the nurse caring for patients on ventilators that were filled in by the researcher by direct observation while the questionnaire was carried out to assess knowledge of the nurses caring for patients on ventilators, Both the questionnaire and the observation checklist were carried out before delivering SLP (pre-phase), after one month from studying SLP (post phase), and finally after three months (follow up phase).
Self learning package:
It was designed by the researcher and included: an overview about MV and nursing intervention for management of patients on ventilators booklet and CD.
Results:
The important findings that were obtained from the study can be summarized as follows:
The present study revealed that the mean age for nurses under study was 31.38 ± 6.88 and the majority of them (85.0%) didn’t attend any training courses about MV.
The present study revealed that the majority of the study nurses had satisfactory knowledge related to overview about MV and nursing intervention for management of patients on ventilators at post and follow up phases of the implementation of SLP.
The study result showed that there were highly statistically significant differences between total score of nurses’ level of knowledge related to overview about MV pre/post implementation of self-learning package, and post/follow up phase at (p<0.001**) as post more better.
The present study revealed that the majority of the study nurses had competent practices regarding nursing management for patients on ventilators at post and follow up phases of implementation.
The study result showed that there were highly statistically significance differences between total score of nurses’ practice pre/post implementation of SLP, pre/ follow up phase at (p< 0.001) as post more better.
The present study revealed that the majority of the study nurses (80.0%) had competent practice regarding preventing complications associated with ETT & tracheostomy tubes and prevention of VAP at post and follow up phases of implementation of SLP.
The present study revealed that their three-quarters of the studied nurses (75.0%) had competent practice regarding documentation at post and follow up phases of implementation of SLP.
The results in this study revealed that all of the sample (100%) stated that the subject is important, the objectives were met, the content of the subject was comprehensive, organized, and integrated, and the presentation of the subject is interesting and self-explanatory.
The results in this study revealed that the majority of the study nurses (97.5%, 87.5% & 82.0% respectively) were facing problems during management of patient on MV shortage of nurses, lack of equipment and lack of knowledge & training
Conclusion:
Based on the findings of the present study, it can be concluded that:
There was the statistically significant positive effect of SLP implementation on nurses’ level of knowledge and practice as regards caring for patients on MV at post implementation and follow up phases.
Also, all of the studied nurses’ opinions regarding the content of SLP for nurses’ caring for patients on ventilators were satisfactory.
Recommendations:
On the light of the current study findings, the following recommendations are suggested.
The importance of conducting the SLP in a wider field including all hospitals to raise the efficiency of nursing care provided.
Critical care units in hospitals should be supplied by Arabic SLP for nurses’ performance caring for patients on ventilators to improve the quality of patient’s care and consequently decrease the complications for these patients.
Multiple SLP should be designed and performed to facilitate the learning process on other subjects such as preventing complications of MV and nurses’ performance caring for patients on ventilators.
A further study to be carried out in different settings on a larger sample for a wider utilization of the SLP, in order to achieve generalization of the results.
Solve conflict between different nurses categories by dissemination and availability of job description.
Availability of supplies and equipment needed for MV care in critical care units.