Presentation of dissertation about TPN in ICU

Dissertation topic about TPN in ICU

1.   Effectiveness of an Interventional Program on Nurses’ Knowledge and Practice toward Parenteral Nutrition in Critical Care Units A Dissertation submitted by Asmaa Jumaa Falih To Department of Adult Nursing College of Nursing- University of Baghdad in Partial Fulfillment of the Requirements For the Degree of Doctor of Philosophy in Nursing Supervised by: Assist Prof . Dr. Aqeel Habeeb Jasim

2.   بسم الله الرحمن الرحيم   ﴿وَيَسْأَلُونَكَ عَنِ الرُّوحِ ۖ قُلِ الرُّوحُ مِنْ أَمْرِ رَبِّي وَمَا أُوتِيتُم مِّنَ الْعِلْمِ إِلَّا قَلِيلًا﴾  صدق الله العلي العظيم سورة الاسراء الاية 85

3. Effectiveness of an Interventional Program on Nurses' Knowledge and Practice toward Parenteral Nutrition in Critical Care Units Title

4. 1.To assess nurses' knowledge toward parenteral nutrition in critical care units. 2.To evaluate nurses' practice toward parenteral nutrition in critical care units. 3.To determine the effectiveness of an interventional program on nurses' knowledge and practice toward parenteral nutrition in critical care units. 4.To find out the relationship between nurses' knowledge and practice and their demographic data Aims of the Study

5. Introduction Nutrition is one of the primary and physiological needs of human beings and is essential for the maintenance of life, growth, development, tissue repair, and the function of limbs and organs then cells changed when a person is hospitalized [1]. When individuals fall ill, nutrition becomes a key factor in their healing and recovery. Poor nutrition is closely linked to delayed or impaired recovery from illness or surgery. For effective wound healing, tissue maintenance, and quicker recovery, patients require optimal nutritional intake[2].

6. TPN is primarily used for patients in critical care units due to the severity of their conditions. Critical care nurses have a significant responsibility in caring for these patients. As licensed professionals, they ensure optimal care for acutely and critically ill patients and their families. Critical care nurses are responsible for assessing critically ill patients' nutritional status, initiating and managing enteral or parenteral nutrition, monitoring potential complications, and evaluating and revising nutrition goals [4]. Introduction

7. Methodology Study design A quantitative, quasi-experimental design was carried out through the pre-test and post-test approach that includes (a pretest and post-test I, then post-test II); application for both study group and control group. The period of the study between 2 nd January 2023 to 4 th March 2024

8. Setting of the study The study was conducted in the Medical City Complex , Critical Care Units department, which includes :( Ghazi Al-Hariri Teaching Hospital , Baghdad Teaching Hospital and Private Nursing Home)

9. Study sample A non - probability purposive sample was selected from nurses working in ICU at a Teaching Hospitals in Baghdad city. The sample consist of (80) nurses, which are divided into two groups (40) nurses considered as study group, and (40) nurses are considered as a (control group).

10. Study Instrument Part-1: This part included a covering letter to obtain the nurses’ agreements (written and oral consents) to participate in this study Part-2: Socio-Demographic Data Sheet : This part dealt with socio- demographic nurses’ characteristics (age, gender, educational level, Marital Status, years of nursing experience, years of ICU experience)

11. Study Instrument Part- 3: Questionnaire to assess nurses’ knowledge about Parenteral Nutrition: Questionnaire to assess nurses’ knowledge about Parenteral Nutrition designed by (Rupawaththa, et al.,2016) : In this section, a set of multiple-choice questions (MCQs) and true/false statements were employed to assess nurses' knowledge of Total Parenteral Nutrition (TPN). ). The knowledge assessment test comprised 50 questions in total Part- 4: Questionnaire to Assess Nurses’ Practice regarding TPN. Questionnaire to assess nurses’ practice regarding TPN designed by (Rupawaththa, et al.,2016): The observational checklist for assessing nurses' practices regarding Total Parenteral Nutrition (TPN) administration is structured into three observations and subdivided into four distinct parts: equipment (5 items), preparation (5 items), performance (20 items), and evaluation (2 items).

12. Validity and Reliability Validity of the questionnaire is determined through the: Panel of (15) experts Reliability of the Instrument Consistency of the questionnaire is stated through use the test- retest and split half approach. The correlation coefficient for the reliability of the assessment was (r = 0.908) for nurses’ knowledge and (r= 0.860) for nurses’ practice

13. Statistical Analysis For this study, data are analyzed through the application of statistical procedures and by using (SPSS) version (26). A. Descriptive Statistical Measures B. Inferential Statistical Measures

14. Results

15. Table 1. Participants' Socio-demographic characteristics

16. Table 1. Participants' Socio-demographic characteristics

17. Levels of knowledge Study Group (N=40) Control Group (N=40) Pre-test Post-test 1 Post-test 2 Pre-test Post-test 1 Post-test 2 F % M S.D F % M S.D F % M S.D F % M S.D F % M S.D F % M S.D Low 37 92.5 60.30 3.14 94.47 2.29 96.40 2.07 37 92.5 60.27 5.56 34 85.0 63.15 5.44 32 80.5 65.90 6.61 Moderate 3 7.5 3 7.5 6 15.0 8 19.5 High 40 100 40 100 Total 40 100 40 100 40 100 40 100 40 100 40 100 Table (2): Overall Assessment of Nurses’ Knowledge about Parenteral Nutrition among Study and Control Group f : Frequency, %: Percentage, M: Mean of total score, SD Standard deviation of total score, Total Mean: Low: 50-66.66, Moderate: 66.67-83.33, High: 83.34-100  

18. Table (3): Statistical Comparison between Nurses’ Knowledge about Parenteral Nutrition among Study and Control Group Study Group (N=40)     Control Group (N=40) T-test Items M.S   SD ASS Items M.S SD ASS. Value df P-value Sig. Pre-test 60.30 3.14 L Pre-test 60.27 5.56 L 0.02 39 0.632 NS Post-test1 94.47 2.29 H Post-test1 63.15 5.44 L 35.824 39 0.000 HS Post-test 2 96.40 2.07 H Post-test2 65.90 6.61 L 28.813 39 0.000 HS M : Mean of total score, SD Standard 'deviation of total score, ASS: Assess: T-test, df: Degree of freedom, P-Value: Probability value, sig.: Significant, NS: Nonsignificant, HS: Highly significant, L: low, M: Moderate, H: High, Low: 50-66.66, Moderate: 66.67-83.33, High: 83.34-100

19.   Table (4): Overall Assessment of Nurses’ Practice about Parenteral Nutrition among Study and Control Group Levels of knowledge Study Group (N=40) Control Group (N=40) Pre-test Post-test 1 Post-test 2 Pre-test Post-test 1 Post-test 2 F % M S.D F % M S.D F % M S.D F % M S.D F % M S.D F % M S.D Low 37 92.5 20.85 4.56 61.25 7.82 62.57 7.91 37 92.5 19.7 4.43 38 95.0 19.35 4.39 34 85.0 18.87 4.34 Moderate 3 7.5 3 7.5 2 5.0 6 15.0 High 40 100 40 100 Total 40 100 40 100 40 100 40 100 40 100 40 100 M.S: Mean of total score, SD Standard deviation of total score, Total mean (Low: 0-21.3, Moderate: 21.4-42.6, High: 42.7-64 )

20. Table (5): Statistical Comparison between Nurses’ Practice about Parenteral Nutrition among Study and Control Group Study Group (N=40)     Control Group (N=40) T-test Items M.S   SD ASS. Items M.S SD ASS. Value df P-value Sig. Pre-test 20.85 4.56 L Pre-test 19.7 4.43 L 1.213 39 0.445 NS Post-test1 61.25 7.82 H Post-test1 19.35 4.39 L 54.752 39 0.000 HS Post-test 2 62.57 7.91 H Post-test2 18.87 4.34 L 71.155 39 0.000 HS M : Mean of total score, SD Standard 'deviation of total score, ASS: Assess: T-test, df: Degree of freedom, P-Value: Probability value, sig.: Significant, NS: Nonsignificant, HS: Highly significant, L: low, M: Moderate, H: High, Low:0-21.3, Moderate:21.4-42.6, High: 42.7-64.  

21. Conclusions 1.The findings showed that there was positive effect of interventional program on the study group in the improvement of the nursing staffs' knowledge and practice toward parenteral nutrition in critical care units 2. The findings of the study indicate that there were no significant relationships between nurses' knowledge and their demographic characteristics (Age, gender, marital status, total number of years' experience in nursing, number of years' experience in ICU). In addition, there was a significant relationship between the level of education and their nurses' knowledge toward parenteral nutrition. 3. The findings of the study indicate that there were no significant relationships between nurses' practice and their demographic characteristics (Age, gender, level of education, marital status, total number of years' experience in nursing, number of years' experience in ICU).    

22. Recommendations Emphasize nutrition as a therapy for critically ill patients because of its importance in improving their outcomes. Developing the educational program toward parenteral nutrition during academic stages for nursing students. Special and continuing educational program should be established and applied for nurses who are working in intensive care units concerning parenteral nutrition . 4 . Designing and distributing a booklet to all nurses, those who are working in intensive care units about parenteral nutrition

23. THANKS