A Pre-Experimental Study To Assess The Effectiveness Of Structured Teaching Programme On Knowledge Regarding Trauma Care Among The Students At Selected Nursing Colleges Of District Mohali, Punjab.

Trauma is defined as a tissue injury that is accountable for initiating hypothalamic-pituitary-adrenal axis and immunological and metabolic responses responsible for restoring haemostasis.¹.²According to World Health Organization, it consists of a coordinated system of pre-hospital care, acute treatment at emergency facilities, surgical and critical care interventions, and long-term rehabilitation to guarantee a continuum of care from the time of injury until achievement of their maximum level of health.⁴

In 2019, 4.4 million lives were lost due to injuries, globally. Among the people aged 5 to 29, injuries are the three of five major causes of death. The major reason of these deaths include road injury, suicides and violent crimes.⁶The World Health Organization states that injuries can either be self-inflicted or caused by road traffic events, disasters, interpersonal violence, drowning, fires, wars, poisonings, and falls ⁹Trauma can lead to a variety of medical conditions such as broken bones, collapsed lung, compartment syndrome, deep cuts, flail chest, traumatic brain injuries, haemorrhage, hypovolemic shock, spinal cord injuries, traumatic abdominal injuries, amputations, and ruptured aorta.⁷

 When a trauma patient arrives at the emergency department, an immediate assessment of their condition is necessary. Along with gathering the history of events from the rescue team or witnesses, most patients are immediately connected to a cardiac monitor, pulse oximeter, and blood pressure monitor while taking the vital signs.

NEED OF THE STUDY:

Trauma is one of the leading causes of death and disability across the globe. The World Health Organization (WHO, 2022) reports that injuries lead to around 4.4 million deaths every year, contributing to nearly 8% of the deaths worldwide.⁹ Road traffic accidents alone are responsible for over 1.3 million deaths every year and over 50 million people suffer non-fatal injuries, many of which result in long-term disability¹⁰.Studies have shown a lack knowledge about trauma care in healthcare workers. For instance, a study among anesthesia trainees reported that only 45% demonstrated satisfactory knowledge, while more than half showed inadequate understanding of airway, breathing, circulation, and primary survey principles.¹¹ Similarly, a multicenter study among pediatric emergency nurses found that less than 40% could correctly apply standardized trauma triage protocols, with over half scoring below the acceptable knowledge level. ¹²

During clinical postings in various hospitals, we observed that there is a lack of knowledge about trauma care in the nursing students. Most of the students are not well aware of the guidelines, protocols and essential role nurses play in the management of trauma patients. This gap in knowledge can reduce their confidence and effectiveness in handling emergencies. A Structured Teaching Programme (STP) gives a clear and organized way to improve this gap.

REVIEW OF LITERATURE:

Hassan (2024) Carried out a quasi-experimental study in Egypt with the aim of assessing the effect of a structured teaching program on emergency nursing interns. The study recruited 85 participants and applied a pre-test–post-test design to evaluate trauma knowledge and preparedness. Findings demonstrated a substantial improvement in participants’ trauma knowledge, with the pre-test mean score of 42.7 (SD = 11.3) rising significantly to 78.5 (SD = 9.8) in the post-test (t = 21.6, p < .001), demonstrating the effectiveness of structured teaching interventions in strengthening clinical preparedness.¹³

OBJECTIVES:

1. To develop tool to assess the pre-test knowledge score regarding trauma care.
2. To develop and implement structured teaching programme regarding trauma care.
3. To conduct post test knowledge score regarding trauma care.
4. To assess the effectiveness of the structured teaching programme by comparing pre –test and post –test knowledge scores.
5. To determine the association between pre- test knowledge scores with selected demographic variables.
6. To disseminate the findings of the study.

HYPOTHESIS:

H0: The structured teaching programme was not effective in improving the knowledge of

+students regarding trauma care at 0.05 level of significance.

H1: The structured teaching programme was effective in improving the knowledge of students regarding trauma care at 0.05 level of significance.

There was a significant difference between pre-test and post-test mean knowledge score i.e., 8.560 regarding trauma care among the nursing students after the implementation of structured teaching programme.

Hence, the alternative hypothesis was accepted and null hypothesis was rejected.

Materials and methods:

RESEARCH APPROACH

A quantitative approach was used to evaluate the effectiveness of structured teaching programme on knowledge regarding trauma care among students at selected Nursing Colleges of District Mohali , Punjab.

RESEARCH DESIGN

The design for the present study was pre-experimental design (one group pre - test post –test design).

RESEARCH SETTING

The study was conducted at selected Nursing Colleges of District Mohali , Punjab.

TARGET POPULATION

In the present study the population consists of nursing students of selected Nursing Colleges of District Mohali , Punjab.

SAMPLE SIZE

The total sample size of the present study was 100 Nursing students of selected Nursing College of District Mohali , Punjab .

SAMPLING TECHNIQUE

Purposive sampling technique

SAMPLING CRITERIA

Inclusion  criteria

• Nursing colleges of District Mohali , Punjab.
• Students of 1^st year ( B.Sc. Nuring and GNM )

Exclusion criteria

• Students from non – nursing courses.
• Students were not in  1^st year (B.Sc. Nuring and GNM )

DESCRIPTION OF TOOL

Section A:- Socio Demographic Profile

This  data sheet deals with demographic variables such as age, gender, Religion, year/semester of the study, educational course , location , type of family, occupation of father, occupation of mother , family income, and source of information.

Section B ;- Self Administered  Questionnaire

The data was collected through well prepared multiple choices questionnaire. Its consists of 40 Questions and total score will be 40.

Section–C :- Structured Teaching Programme

This part consists of teaching on introduction, Definition, Golden hour, trauma care team members, triage, process of trauma care , Endotracheal intubation , tracheostomy, and nasogastric tube insertion to enhance the knowledge regarding trauma care among the students. Teaching was given with use of AV aids such as power point presentations , charts and flash cards.

PILOT STUDY:-

It was conducted on 10% of the total sample size i.e.10 samples. The pilot study was conducted at Rayat Bahra College of Nursing, Mohali .

RESULTS:-

The data was analyzed according to the plan of data analysis, which includes both descriptive and inferential statistics ,and the finding are presented below :

Figure no.1: Knowledge level of nursing students in Pre-Test

TABLE1: Knowledge Regarding Trauma Care Among Nursing Students In Pre-Test. N=100                                                                                                                                          

Before administering the structure teaching programme knowledge among the nursing students regarding trauma care was assessed and the result has been in table 1.

The table 1 and bar graph chart in figure 1 show that 72 (72%) nursing students had average knowledge as compared to 23 (23%) who had poor knowledge and only 5(5%) had good knowledge.

Figure no. 2: Knowledge level of nursing students in Post – test

TABLE 2: Knowledge Regarding Trauma Care Among Nursing Students In Post-Test:N=100

After administering the Structure teaching programme Knowledge among the Nursing students regarding trauma care was assessed and the result has been in table 2.

The table 2and bar graph chat in figure2 show that the post test result illustrates that 48 (48%) nursing students had good knowledge as compared to 46 (46%) who had average knowledge and only 6 (6%) had poor knowledge.

Figure no.3 Mean comparison of Pre- test and Post- test knowledge  score

TABLE 3: Mean Comparison Of Knowledge Score In Pre-Test And Post-Test. N=100

The mean comparison of knowledge score in pre-test and post-test shown in figure 3 demonstrates the effectiveness of structured teaching programme. The knowledge score increased from 17.88±5.258 in pre-test to 26.44±6.631 in post-test making a mean difference of 8.560. The result of intervention proved that statistically significantly higher knowledge (8.560-1.98, p= .001) (p<0.001) was acquired by the students at selected nursing colleges of District Mohali, Punjab regarding trauma care as shown in figure.3.

Table 4: Association Of Knowledge With Age, Gender, Educational Course, Domicile ,Type Of Family              N=100