Investigating the relationship between knowledge and performance of nurses working in neonatal wards in the field of venipuncture in hospitals affiliated to Tabriz University of Medical Sciences in 2012

Dissertation to receive a master's degree in neonatal special care

Abstract

Title: Investigating the relationship between the awareness and performance of nurses working in neonatal wards in the field of venipuncture in hospitals affiliated to Tabriz University of Medical Sciences in 2013

Introduction: venipuncture is the most important therapeutic procedure among patients It is hospitalized and due to its invasive nature, this procedure is associated with many and common complications. The purpose of the present study is to investigate the relationship between the knowledge and performance of nurses working in neonatal wards in the field of neonatal venipuncture in hospitals affiliated to Tabriz University of Medical Sciences affiliated to Tabriz Medical Sciences

Methodology: The present study is a descriptive correlational study that was conducted on 65 nurses working in neonatal wards in Tabriz hospitals. The tools used are the knowledge questionnaire and the nurses' performance checklist in the field of neonatal venipuncture. After collecting the data using SPSS/13 software, descriptive and analytical statistical methods including percentage, mean and standard deviation were used. Pearson correlation coefficient tests were used for the relationship between demographic variables with the level of awareness and performance. Findings: The results of the present study showed that the awareness and performance of nurses in the field of venipuncture is average. The average knowledge score is 7.37 and the average performance score of nurses is 57.71. The results of the Pearson correlation test showed that there is no statistically significant relationship between the knowledge and performance of nurses (p=0.142), but there is a direct relationship (r=0.11) and the performance of nurses increases with increasing awareness.

Conclusion: The total findings of the study showed that the knowledge and performance of nurses working in neonatal wards in The range is moderate and there is no significant statistical relationship between them, but there is a direct relationship. Therefore, it is suggested to improve the knowledge and practical skills of nurses about blood sampling of babies.

Key words: awareness, performance, blood sampling of babies, nurses

Introduction of research

Research title: Investigating the relationship between the knowledge and performance of nurses working in the neonatal wards in the field of venipuncture in hospitals affiliated to Tabriz University of Medical Sciences in 2012

Research context:

Hospitalized infants include about 10% of live births and are subjected to several procedures, the most important and common of which is venipuncture. Annually, more than 450 million cases of venipuncture are performed on 150 million patients (1). More than 80 percent of the patients referred to the hospital undergo venous treatment and venipuncture, and about half of them are exposed to its complications. The average number of venipunctures during hospitalization for each hospitalized infant is 3.8 cases, and the rate of failure in each procedure is estimated at 30-40 percent (2, 3). Venipuncture is a procedure in which the skin is pierced in order to insert a plastic cannula into the vein, and its purpose is to administer drugs, fluids, blood products, and intravenous nutrition (2, 4).

Venipuncture is the most important treatment procedure among hospitalized patients and is often life-saving for patients, and at the same time, it is one of the most challenging and important issues in caring for infants because it can lead to injury and stress in patients and nurses. be made Venipuncture has many complications, which include pain, damage to nerves, arteries and organs, blood loss, misplaced placement in the artery, necrosis in the skin and organs, hematoma, anemia, and impaired blood supply to the organs. All visible vessels can be used for venipuncture in infants, but due to the possibility of damage to arteries, nerves and other organs, it should not be done in a deep and random manner.Due to the ease of access, superficial vessels are usually used for this purpose, and the lack of accuracy in the selection of vessels can increase the probability of failure, increase the patient's discomfort, the risk of injury and infection, as well as stress in the medical personnel, but the correct selection of the location and the performance of vasodilation techniques can lead to an increase in the probability of success in venipuncture (5). It is one of the most common problems in babies. Despite the start of oral feeding, many of these babies need a reliable venous access for a long time. Repeated attempts to achieve peripheral venous access with angioket have disturbed the health of the baby's very sensitive skin, which is considered as the first line of defense against systemic infections, and exposes the baby to more damage (6).

Complications such as vascular phlebitis due to chemical or mechanical factors and damage to the endothelium of the vessels, extravascular leakage with dangerous complications such as skin necrosis, compartment syndrome and delayed deformity in the organs, the occurrence of delayed thrombosis due to damage to the endothelium of the vessels by the cannula wall, injectable substances and microbial colonization, inflammation and infection in the vein path due to the loss of skin integrity during vein grafting and the proliferation of microbial agents in the vein path, causing bacteremia and Sepsis is caused by the entry of infectious agents into the blood circulation system through the cannula, and each of the above complications can have significant effects on the patient's health, and many of them can be prevented to some extent. Several risk factors are involved in the process of complications caused by venipuncture, which include: factors related to caregivers such as experience and skill and applying the correct standard method, drug-related factors such as drugs with low pH and hyperosmolar, factors related to the type of catheter such as gender and size, factors related to the patient (patients with vascular and blood problems). Some other factors, such as the place of insertion and the equipment used, such as glue and splints, can also cause changes in the complications of venipuncture, and these complications can be prevented by using the correct technique of implantation and proper care (7).

Although venous catheter insertion is the most widely used among invasive procedures, despite the wide use of peripheral venous catheters, studies on the serious complications caused by it are very limited, and the amount of complications reported due to venipuncture in different studies are very different (4-80 percent), which is caused by the difference in personal and non-scientific definitions of the desired complications (1).

It is one of the necessary qualifications for all medical personnel, and nurses must be responsible for complications caused by nurses' performance (including phlebitis as the most common complication of venipuncture) (3).

The most important issue regarding the prevention of infections related to intravenous catheters is washing hands and observing aseptic technique before inserting the catheter, and studies have shown that nurses are less aware of the importance of hand washing and wearing gloves. and the time required to wash hands and wear gloves before contacting the patient is less observed. Catheter insertion is considered an invasive surgical procedure and can be done by using proper antiseptics, inserting the catheter in the right place, maintaining the safety of the catheter, choosing the right vessel, and so on. It reduced the rate of complications and infections caused by venous catheters and prevented the growth and proliferation of microorganisms. The optimal level of knowledge of nurses about venipuncture is the basis for correct venous treatment, and with proper preparation, correct procedure, sensitivity to venous catheter insertion, care of the inserted catheter, and monitoring of its side effects can lead to improving the health and safety of infants. Nurses need extensive information about the types of catheters and how to care for, prevent, and treat local and systemic infections caused by venous catheters, and their information on this matter must be constantly evaluated and updated if necessary (3).