Knowledge of respiratory dysfunction among nurses working in surgical wards at Universitas Academic Hospital

Abstract

Background: Clinical deterioration in ward patients leading to adverse events such as cardiac arrest, intensive care unit (ICU) admission and death is often preceded by respiratory dysfunction. Monitoring of ward patients is nurse-led; therefore, their knowledge and skill are crucial to identifying the deteriorating patient and to make decisions on escalating patient care. Although knowledge is a prerequisite for quality of nursing care, performing well on test is not an indicator of the quality of care. The design of a reliable knowledge test involves the structured development of the task to be carried out, and methods for each with their underlying theoretical basis which is often in psychology, psychometry and education. Objectives: This study assesses the performance of the surgical ward nurses on a single best answer knowledge test based on respiratory dysfunction. Method: Nurses working at an academic hospital surgical wards participated in this cross-sectional study from 20th to 26th April 2018. Data collection was done using a self-administered questionnaire with two sections: one section for demographic data and the second section consisted of nine (9) single best answer multiple-choice questions. Results: Out of 95 ward staff, 78 were eligible to take part in the study. Of these, 50/78 (64%) agreed to take part and responded to the questionnaire and test. A desirable score of no more than two incorrect answers was set (77%), and this was achieved by 16 % of study participants. The lowest mark achieved was one correct out of 9 (11%), and the highest score was 8 out of 9 (89%), with a median mark of 5.0 and interquartile range 4.0-6.0. Conclusion: There was a wide range of performance on the knowledge test by all grades of nurses, with only 16% scoring correctly on seven or more questions. Respiratory deterioration in surgical patients is poorly understood, and failure to diagnose it may be an important factor in the development of surgical complications leading to delayed intervention, morbidity and mortality. Although nurses are the first-line caregivers, the interventions are doctor-led, requiring a communication and action loop that involves a team and systems approach.