Title of the study:

“To assess the effect of planned teaching program on knowledge of staff

nurses regarding infection control measures in IGIMS, Patna.”

ABSTRACT: Infection control is an integral component of nursing care in any setting to

reduce risk for morbidity and mortality in patient and caregivers at all levels. The study is
aimed at evaluating the effectiveness of planned teaching program on knowledge of staff
nurses regarding infection control measures in IGIMS, Patna. Objectives: To assess the
pretest knowledge score of staff nurses working in IGIMS, regarding infection control
measures before the administration of planned teaching program. To assess the posttest
knowledge score of staff nurses working in IGIMS, regarding infection control measures
after the administration of planned teaching program. To compare pre and post knowledge of
staff nurses working in IGIMS regarding the selected methods of infection control measures.
To determine the association between knowledge score with selected demographical
variables. Material & Methods: A pre-experimental study one group pretest- post-test
research design was conducted in IGIMS Hospital, Patna. The study sample consisted 50
staff nurses working in different areas of IGIMS Hospital. Purposive sampling technique was
used to select 50 staff nurses working in specializes areas viz. Emergency, MNICU, SNICU,
Dialysis, KTU, ICU, CCU, CATH lab. Data was collected using self-structure questionnaire
and then administration of planned teaching program post-test data was collected by using the
same tool. The collected data was analyzed by descriptive and inferential statistics and
presented through tables and figures. Results: The result revealed that overall mean
knowledge score was 19.78 in pretest and 22.78 in post-test. It is noted that knowledge level
pretest for 26% of the nurses is moderately adequate, for 74% of the nurses is having
adequate knowledge. After the administration of planned teaching program Post-test
knowledge level, for 4% of the nurses is moderately adequate, and 96% of the nurses is
having adequate knowledge. Paired ‘t’ test showed that there was significant improvement
between pretest and post-test knowledge with ‘t’ value of 7.19, where ‘p’ value is less than
0.01 and hence from the analysis it is concluded that after the administration of planned
teaching program there is highly significant difference was found between the pre and post-
test knowledge score by the pair samples ‘t’ test. Chi square test showed that there was a
significant improvement between pretest and post-test with p value is less than 0.01 for
“source of information” the results are significant at 1%. From the analysis it is concluded
that highly significant association was found between the post-test knowledge level and the
demographic variables. So, it is concluded that the planned teaching program is highly
effective to enhance the knowledge of staff nurses regarding infection control measures.
Conclusion: The overall study findings has shown that there was an improvement of
knowledge after the administration of planned teaching program. As the sample size was
limited to 50 staff nurses, the future study should be replicated on a large sample size to
generalize the findings.

Key words: effectiveness, planned teaching program, staff nurses, knowledge.

Introduction
Microorganisms are tiny living creatures, such as bacteria and viruses.
Microorganisms are present everywhere. Despite their overwhelming abundance, relatively
few of the thousands of species of microorganisms invade, multiply, and cause illness in
animals and people. Many microorganisms live on the skin and in the mouth, upper airways,
and intestines without causing disease. Whether a microorganism lives harmlessly in or on
body, or invades and causes disease depends on both the nature of the microorganism and the
(1)
state of the natural defenses. Infection control refers to policies and procedures used to
minimize the risk of spreading infections, especially in hospital and human or animal health
care facilities. (2)
Infection control is the discipline concerned with preventing nosocomial or
healthcare-associated infection, a practical (rather than academic) sub-discipline
of epidemiology. It is an essential, though often under recognized and under supported, part
of the infrastructure of health care. Infection control and hospital epidemiology are a kin
to public health practice, practiced within the confines of a particular health-care delivery
system rather than directed at society as a whole. Anti-infective agents
include antibiotics, antibacterial, antifungals, antivirals and antiprotozoal.(3)

Standard precautions are meant to reduce the risk of transmission of blood borne and
other pathogens from both recognized and unrecognized sources. They are the basic level of
infection control precautions which are to be used, as a minimum, in the care of all patients.
Hand hygiene is a major component of standard precautions and one of the most effective
methods to prevent transmission of pathogens associated with health care. In addition to hand
hygiene, the use of personal protective equipment should be guided by risk assessment and
the extent of contact anticipated with blood and body fluids, or pathogens. (4)
 Infection is the invasion of an organism’s body tissue by disease causing agents, their
multiplication and the reaction of host tissues to these organisms and the toxins they produce.
(5)
Infectious diseases resulted in 9.2 million deaths in 2015[about 17℅ of all deaths].
Infection annually accounts for 37,000 attributable deaths in Europe and potentially many
more that could be related, and they account for 99,000 deaths in the USA. (6) In USA, the age
adjusted death rate decreased by 1.0% i.e. 724.6 deaths per 1,00,000 standard populations in
2014.(7) The importance of a strong health system is the essential route to achieve
improvement in inpatient care and it also helps in reduction of mortality and morbidity.(8)
To emphasize, in both hospital and non-hospital setting, infection is sometimes
instead called a hospital acquired infection [HAI] when acquired in hospital, nursing home,
rehabilitation facility outpatient clinic or other clinical setting. (9) Hospital acquired infections
are caused by viral, bacterial, and fungal pathogens. The most common types are blood
stream infection [BSI], pneumonia, ventilator associated pneumonia, UTI and surgical site
infection [SSI].(10)

A breach in infection control practices facilitates transmission of infection from

patients to health care workers, other patients and attendants. It is therefore important for all
health care workers, patients, their family members friends, significant others and close
contacts to other to infection control guidelines. It is also imperative for health care
administrator to ensure implementation of the infection control program in health care
facilities. (11)

Infection control is an integral component of nursing care in any setting to reduce risk
for morbidity and mortality in patient and care givers at all levels. (12) Infection control is a
quality standard of patient’s care and is essential for the wellbeing of not only the patients but
also required for the safety of staff to accomplish a reduction in the infection rates for which
an infection control program has to be given.(13) Standard precaution of infection control
refers to the prevention of contact with blood, all body fluids, secretions and excretion from
the body. It is necessary to ensure the safety of not only the patients but also all the health
care personnel, as well as those who visits the health care setting, coming in contact with the
hospital environment. (13)

Standard precautions include hand washing making use of personal protective

equipment’s when likely to come into contact with bodily substances, as well as correct and
safe disposal of sharps and management of biomedical wastes. Guidelines about infection
control measures are one of the strategies used to prevent the spread of infectious diseases.
The primary aim of the guidelines in any setting is to prevent people from acquiring
avoidable infection. Hence, achieving this aim requires the willingness of all health care
staffs to maintain the highest possible standards of clinical practice following sound infection
control principles. (13)

Statement of the Problem:-

“To assess the effect of planned teaching program on knowledge of staff nurses regarding
infection control measures in IGIMS, Patna.”

Objectives: -

1. To assess the pretest knowledge score of staff nurses working in IGIMS, regarding
infection control measures before the administration of planned teaching program.

2. To assess the posttest knowledge score of staff nurses working in IGIMS, regarding
infection control measures after the administration of planned teaching program.

3. To compare pre and post knowledge of staff nurses working in IGIMS regarding the
selected methods of infection control measures.

4. To determine the association between knowledge score with selected demographical

variables.

Assumptions: -

1. Staff nurses may have some knowledge regarding infection control measures.

2. Staff nurses may desire to learn in order to upgrade their knowledge regarding the
infection control measures.

Inclusion Criteria: -

1. All staff nurses working in specialized areas of IGIMS hospital, Patna.

2. All staff nurses of IGIMS hospital irrespective of diploma and degree program,
undergraduate and postgraduate program.

3. All staff nurses of IGIMS irrespective of cadre.

4. Staff nurses present only in the day shift.

Exclusion Criteria: -

1. Staff nurses who are unable to attend or who refuse for the consent to participate.
2. Staff nurses who are in night shift.

Research Approach
For the present study, quantitative evaluative research approach and pre-experimental
one–group pretest-post-test research design was used to assess the effect of planned teaching
program on knowledge regarding infection control measures among staff nurse.
Research design
The research design selected for the study, was Pre-experimental one-group pretest-
post-test design. The information and the data of the samples were collected by distributing
the staff nurse’s self –administered questionnaires. Single group of staff nurses were assessed
through self-reporting knowledge questionnaire consisting of 29 questions regarding
infection control measures.
Setting of the Study
The setting of the present study was at specialized areas :- Emergency, MNICU,
SNICU, Dialysis, KTU, ICU, CCU, Cath Lab of IGIMS Hospital, Patna.
Sample size: Sample in the present study are 50 staff nurses of IGIMS Hospital, Patna.
Variables
In this study, variables are Age, Professional qualification, Designation, Total year of
experience working in specialized area, Previous information and sources of information on
infection control measures.
Population
In this study, we have to measure the population of staff nurses working in IGIMS
Hospital, Patna.
Sample technique
Purposive Sampling Technique was adopted in this study. The samples were selected
from staff nurses working in specialized areas viz. Emergency, MNICU, SNICU, Dialysis,
KTU, ICU, CCU, CATH lab of IGIMS Hospital, Patna.
Description of the tool
The tools consisted of: -Self Structured questionnaire for knowledge assessment.
Data collection instrument: Self Structured Knowledge questionnaire
Self Structured Knowledge Questionnaire which consisted of sociodemographic
variables and knowledge questionnaire on infection control.

Section I: Demographic profile of staff nurses consisting of age, professional qualification,

designation, total year of experience working in specialized areas, previous information and
sources of information on infection control measures.
Section II: Self structured multiple-choice questions regarding different aspects of infection
control measures to assess the knowledge of staff nurses. This questionnaire consisted of 29
questions regarding different aspects of infection control measures to assess the knowledge of
staff nurses. Each correct answer was awarded ‘1’ mark and wrong answer or left questions
was awarded ‘0’. The level of knowledge was classified and scored as poor (0-9), Average
(10-19), Good (above–20).
Content validity
The initial draft was given to 10 experts. They were requested to validate the
questionnaire based on the criteria and to give suggestion on the adequacy and relevance of
the content. After obtaining their opinion the tools were modified accordingly.
SECTION A: Description of socio-demographic variables of staff nurses
regarding infection control measures.
In this section analysis of socio-demographic variables of the staff nurses is
described regarding “Age, Professional Qualification, Designation, Working
Experience, Previous Information, Source of Information”.
Table No. 1: Frequency and percentage distribution of the study subjects as per
socio-demographic variables. N=50

Age (years) Frequency %

20 – 30 31 62.0
30 – 40 18 36.0
40 – 50 1 2.0
Total 50 100.0
Professional
Frequency %
Qualification
 DGNM 40 80.0
BSc 5 10.0
Post Basic BSc. Nursing 4 8.0
MSc. Nursing 1 2.0
Total 50 100.0
Designation Frequency %
Sr. Grade I 10 20.0
Sr. Grade II 40 80.0
Total 50 100.0
Working Experience Frequency %
<4 28 56.0
4–7 17 34.0
7 – 10 3 6.0
> 10 2 4.0
Total 50 100.0
Previous Information Frequency %
Yes 43 86.0
No 7 14.0
Total 50 100.0
Source of Information Frequency %
Book 24 48.0
Friend 3 6.0
Print Media 2 4.0
Channel Media 11 22.0
Conference
10 20.0
/Seminar/Workshop
Total 50 100.0

Regarding the Age the distribution shows that 62% of staff nurses were in the
age group 20 – 30 years, 36% of them between 30 – 40 years and 2% of staff nurses
were in the age group 40 – 50 years. Thus, it can be interpreted that highest percentage
age group of 20 – 30 years.
Regarding the Professional Qualification, the distribution shows 80% of the
staff nurses were DGNM, 10% of the them were BSc, 8% of the staff nurses had Post
Basic BSc. Nursing education and 2% of them were MSc. Nursing. Thus, it can be
interpreted that highest percentage of staff nurses were DGNM.

Regarding the Designation, the distribution shows 20% of the staff nurses were
Sr. Grade I and 80% of them were Sr. Grade II. Thus, it can be interpreted that highest
percentage were Sr. Grade II.
Regarding the Working Experience, the distribution shows that 56% of the
staff nurses had Experience below 4 years, 34% of the staff nurses had Experience
between 4 – 7 years, 6% of them had Experience of 7 – 10 years and 4% of them had
Experience of above 10 years. Thus, it can be interpreted that highest percentage of
Working experience of staff nurses were 4 – 7 years.
Regarding the Previous Information, the distribution shows that 86% of the
nurses said yes for Previous Information and 14% of them said that no Previous
Information. Thus, it can be interpreted that highest percentage of staff nurses had
Previous Information on infection control.
Regarding the Source of Information, the distribution shows 48% of the staff
nurses had Books as the source of information, 6% of them had Friends, 4% of them
had Print media. Twenty two percent of the staff nurses had Channel media & 20% of
the staff nurses had Conference/Seminar/Workshop. Thus, it can be interpreted that
highest percentage of staff nurses had Book as the source of information.
SECTION B: To assess the effect of planned teaching program on knowledge of staff
nurses regarding infection control measures in IGIMS, Patna

Knowledge level– Pre-test

Table No.2: Describes the distribution of Knowledge level Pre-test with respect to the
demographic variables “Age (years), Professional Qualification, Designation, Working
Experience, Previous Information, Source of Information”.
Table No. 2: Knowledge level- Pre-test

Knowledge level_Pre

Moderately Total
Adequate
adequate

N % N %

20 – 30 6 12 25 50 31

Age (years) 30 – 40 6 12 12 24 18

40 – 50 1 2 - - 1

DGNM 11 22 29 58 40

Professional BSc 1 2 4 8 5
Qualification Post Basic BSc. Nursing 1 2 3 6 4

MSc. Nursing - - 1 2 1

Sr. Grade I 4 8 6 12 10
Designation
Sr. Grade II 9 18 31 62 40

<4 6 12 22 44 28

Working 4–7 4 8 13 26 17
Experience 7 – 10 1 2 2 4 3

> 10 2 4 - - 2

Previous Yes 11 22 32 64 43
Information No 2 4 5 10 7

Book 6 12 18 36 24

Friend - - 3 6 3
Source of
Print Media - - 2 4 2
Information
Channel Media 4 8 7 14 11

Conference /Seminar/Workshop 3 6 7 14 10

Total 13 26 37 74 50

The Table No. 2: Shows that 26% of the staff nurses Knowledge level during Pre-test
is moderately adequate and 74% of the staff nurses Knowledge level during Pre-test is
Adequate. Hence, Majority of Knowledge level during Pre-test is Adequate.
 Further in order to find the association between the demographic variables and their
Opinion about the Knowledge level during Pre-test the chi-square test was used and result of
the test is shown in table.4.3.1a.

Knowledge level- Post-tests

The Table No:3 describes the distribution of Knowledge level during Post-test with
respect to the demographic variables “Age (years), Professional Qualification, Designation,
Working Experience, Previous Information & Source of Information”.

Table No: 3 Knowledge Level-Post-test

Knowledge level Post test

Moderately
Adequate Total
adequate

N % N %

20 – 30 1 2 30 60 31

Age (years) 30 – 40 1 2 17 34 18

40 – 50 - - 1 2 1

DGNM 2 4 38 76 40

Professional BSc - - 5 10 5
Qualification Post Basic BSc. Nursing - - 4 8 4

MSc. Nursing - - 1 2 1

Sr. Grade I - - 10 20 10
Designation
Sr. Grade II 2 4 38 76 40

<4 2 4 26 52 28

Working 4–7 - - 17 34 17
Experience 7 – 10 - - 3 6 3

> 10 - - 2 4 2

Previous Yes 2 4 41 82 43
Information
No - - 7 14 7

Source of Book - - 24 48 24
 Friend - - 3 6 3

Print Media 1 2 1 2 2
Information
Channel Media - - 11 22 11

Conference /Seminar/Workshop 1 2 9 18 10

Total 2 4 48 96 50

The Table No: 3 shows that 4% of the Knowledge level during Post-test is Moderately
adequate and remaining 96% of the Knowledge level is Adequate. Hence, Majority of
Knowledge level during Post-test is Adequate.

Table No 4: Comparison of pre and post-test of knowledge scores

Moderately adequate Adequate

Knowledge level Total
N % N %

Pre -Test 13 26 37 74 50

Post Test 2 4 48 96 50

96
100
90
74
80
70
Percentage

60
Moderatly adequate
50
Adequate
40
26
30
20
4
10
0
Pre Test Post Test

Figure No 1:
 It is noted from the Table No 4 that knowledge Level Pre-test for 26% of the staff

nurses is Moderately adequate, for 74% of the staff nurses is Adequate knowledge. Post-test

for 4% of the staff nurses is Moderately adequate, for 96% of the staff nurses is Adequate

knowledge.

Table No. 5: Overall Knowledge Comparison

Paired Samples Statistics

N Mean SD Paired t P

Pre 50 19.78 2.06

Overall Knowledge 7.19 0.001**
Post 50 22.78 2.57

**

The overall mean Knowledge score (19.78± 2.06) was obtained during pre-test and
during post-test the mean score (22.78± 2.57) was obtained.

It is noted from the above table that the ‘p’ value is less than 0.01 and hence from the
analysis it is concluded that there is highly significant difference was found between the pre
and post-test knowledge score by the Paired Samples t test.

Table No .6: Chi square Test - Knowledge level Post-test

Profile of the staff Chi

df P Significant
nurses square

Age (years) 0.20 2 0.903 Not Significant

Professional Qualification 0.52 3 0.914 Not Significant

Designation 0.52 1 0.470 Not Significant

Working Experience 1.64 3 0.651 Not Significant

Previous Information 0.34 1 0.560 Not Significant

Source of Information 13.54 4 0.009 Highly Significant

 Further in order to find the association between the demographic variables and their
Opinion about the Knowledge level Post the chi-square test was used and result of the test is
shown in Table No. 6.

It is noted from the Table No:6 that the p value is less than 0.01 for “Source of
Information” the results are significant at 1%. From the analysis it is concluded that there is
highly significant association was found between the Knowledge level Post and these
demographic variables.

Conclusion: The present study deals with assessing the effect of planned teaching program
regarding infection control measures of staff nurses in IGIMS Hospital, Patna, Bihar. Self-
structured knowledge questionnaire was used to collect data. The obtained was analysed in
terms of objectives of the study using descriptive and inferential statistics. The data presented
in the form of tables and figures.

Limitations:

1. The study was limited only to staff nurses who are working in specialized area of
IGIMS, Patna.

2. Study was limited only to assessing the effectiveness of PTP in terms of knowledge
gain and lacked the analysis of awareness and practice levels.

3. The study was limited only to a section of group with no control groups; reducing the
level of comparative effectiveness of the study.

Implication of The Study

The findings of the study have the following implications in nursing practice, nursing
research, nursing administration and nursing education. Nursing practice

 Nurses are the back bone of the health care set up of any country.

 Increasing rate of Nosocomial Infection needs more attention.

 The expanded role of professional nurse emphasizes the activities, which includes
promotive, preventive, curative and rehabilitative aspects.

 Nurses play an important role in prevention of disease and promotion of health.

  In service education program should be organized to encourage Staff Nurses
regarding prevention of Nosocomial Infection.

 Health information and knowledge on prevention of Nosocomial Infection can be

imparted through various methods like mass media, lecture and Planned Teaching
Programme.

Nursing Research

 Large scale studies can be conducted.

 The study creates awareness for further study about Nosocomial Infection.

Nursing Administration

 Nursing personnel should accept the responsibility of creating

awareness among other health personnel regarding prevention of
Nosocomial Infection.
 Nursing personnel should take the initiative to organize in-service
education programme on prevention of Nosocomial Infection.
 Administrators should encourage the Staff Nurses to participate in
conferences, workshops, symposium and seminars regarding
prevention of Nosocomial Infection.
 Administrator must ensure that nursing personnel are adapting the
ways which can help to prevent spread of Nosocomial Infection.
 Guidelines related to prevention of Nosocomial Infection should be
displayed in all the units of the hospitals.

Nursing Education

 Nurse educator should educate the nursing students and other health care
personnel about transmission causes and prevention of Nosocomial Infection.
 One of leading functions of nursing is to impart education with newer
knowledge regarding prevention of Nosocomial Infection.
 Nurse educators can make use of teaching programme, to orient their new
recruits.

Recommendations: On the basis of the findings of the study, it is recommended that,

  This similar study can be conducted in other areas of Indira Gandhi Medical
College and Hospital on a large group.
 A comparative study can be conducted on the Staff Nurses working in State
Hospital and District Hospital.
 Similar study can be conducted with the help of video assisted devices.
 Study can be conducted using various design.

References

1. Introduction to infections. 2018 Cited 2018 June 16

2. Infection Control Definitions by Medical Dictionary. [Online]. 2018
3. Infection Control. [Online]. 2018 [Cited 2018 June 16]
4. Infection control standard precautions in health care. [Online]. 2018
5. Infection. [Online]. 2018 [Cited 2018 May 28]
6. World Health Organization. Patient Safety. Save Lives clean your hand. [Online].
2018 [Cited 2018 May 28];
7. National Vital Statistics Reports. [Online]. 2016 June 30 [Cited 2017 May 28]; 65, 4.
8. Koshy Siju, Patel Rinku. A study to assess the effectiveness of Planned Teaching
Programme on knowledge Regarding the Infection Control Measures in Labour Room
among the staff Nurses working in Maternity Unit in selected Hospital of Panchmahal
District. IJIRD[Online]. 2015 April [Cited 2017 May 28]; 4(4): 180-185.
9. Hospital Acquired Infection. [Online]. 2018 [Cited 2018 May 28].
10. Custodio Haidee T. Steele W Russell etal. Hospital Acquired Infections. 2018 Dec
11. World Health Organization. Practical Guidelines for infection Control in Health care
facilities. 2004, 2017 May 28]. 1-103
12. Joy Nija (2017) A study to evaluate the effectiveness of structured Teaching
Programme on infection Control in isolation wards among the staff nurses in a
selected government Hospital, Bengaluru. [Online]. [Cited 2017 May 28].
13. Sulaiman Ali Al (2014) Effect of Nursing Guidelines Regarding Infection Control
Measures on Performance of Internship Students in Applied Medical Science College
at Hafr Al-Bation, Saudi Arabia. IOSR – JNHS 2014 Jul – Aug; 3(4): 37-46.