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Pacemakers are used to treat arrhythmias. Arrhythmias are the problems with the rate or rhythm of the heartbeat. During an arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm. The placement of pacemakers in general is safe. However, as with any procedure, complications can occur. These include: infection, excessive bleeding, perforation of the heart muscle, stroke or myocardial infarction (heart attack), punctured lung, formation of hematoma (blood clot) inside the skin pocket. Also there are long-term risks of; dislodging of the pacemaker electrodes, fracture of an electrode tip, broken insulation on a pacemaker lead, a loose connection between a pacemaker lead and the pulse generator, in appropriate firing of the pacemaker and erosion (Wearing a way of the skin) of the skin pocket (Linda,Kathleen, Mary, 2014).
Aim of the study:-
This study aims to:-
• Assess the Nurses’ Performance Regarding Patient with Permanent Pacemaker In Intensive Care Unit through the following:
1- Assess nurses’ level of knowledge regarding Patient with Permanent Pacemaker.
2- Assess nurses’ practice regarding Patient with Permanent Pacemaker.
• What are the nurses’ levels of knowledge regarding Patient with Permanent Pacemaker?
• What are the nurses’ levels of practice regarding Patient with Permanent Pacemaker?
Subject and methods:
The study was portrayed under the four main designs as follows:
• Technical design
• Operational design
• Administrative design
• Statistical design
3- Technical design
The technical design included research design, setting, subject and tools for data collection.
A descriptive exploratory design was used to conduct this study.
This study was conducted in the intensive care unit at Benha University Hospital.
All available nurses working in intensive care unit at Benha University Hospital who were caring for patient with permanent pacemaker in Benha University Hospital studied nurses were different gender with different ages and educational level.
Tools of data collection:-
2- Self-administered questionnaire tool.
It was developed by the researcher based on related literature, it was written in simple Arabic language. It was divided in to two parts:
Part I: Demographic data characteristics: It was used to assess demographic characteristics such as (age, level of gender, marital status, education, years of experience and old training programs)
Part II: This part was developed to assess nurses’ knowledge regarding pacemaker and the nursing management for those patients
It was developed by the researcher based on the related literature. It was used to assess Nurses’ practice for Patient with Permanent Pacemaker it include:
A. Vital signs monitoring (pulse, blood pressure, respiration)
B. Care of closed wound
D. Permanent pacemaker
The results of this study have shown the following:-
• About (67.5%) of studied nurses their age between 18 to 25 years. And (47.5%) of them were having from 5 to 10 years of experiences. (90%) of studied nurses were female and(45%) of them were married , (65%) of studied nurses were graduated from technical institute, and (80%) of them didn’t have previous training courses.
• Total knowledge about pacemaker and its complication, there is about (78%) of studied nurses were had unsatisfactory level of total knowledge regarding permanent pacemaker.
• About half of studied nurses had unsatisfactory level about measuring pulse,
• About (57.5%) of studied nurses had unsatisfactory level about measuring respiration
• There is (82.5%) of studied nurses had satisfactory level about measuring blood pressure
• (70%) of studied nurses had unsatisfactory level regarding caring of closed wound.
• (85%) of studied nurses had satisfactory level regarding practice of Electrocardiogram.
• (67.5%) of studied nurses had unsatisfactory level regarding caring for patients with permanent pacemaker.
Based on findings of the current study, it can be concluded that: three quarter of study nurses had unsatisfactory level of knowledge and practice regarding patients with permanent pacemaker.
Based on the findings of the present study, the following recommendations are suggested:
• On-going and regular in service educational programs regarding permanent pacemaker
• Nursing educators and clinical facilitators must incorporate strategies regarding permanent pacemaker into the ICU and use learning opportunities to raise awareness of nursing staff about the topic.
• Developing a simplified and comprehensive booklet including guidelines about nursing care of patients with permanent pacemaker in ICU.
• Learning resources such as articles, journals and electronic resources such as computers and internet should be made accessible in the units for nursing staff members. Continuing professional development programs should include skills updates.
• In-service training and educational program prior to the work in the critical care unit.
• Nurse supervisors should also verify that permanent pacemaker checklists appropriately followed by all nursing staff to prevent any complication
• Increase number of nurses in ICU units based on international nurse patient ratio to improve quality of care
• The study should be replicated on large sample and different hospitals setting in order to generalize the results.
• Further study to evaluate the reflection of educational program regarding nurses’ perception.