INTERNATIONAL JOURNAL OF MULTIDISCIPLINARY EDUCATIONAL RESEARCH

ISSN: 2277-7881; IMPACT FACTOR – 6.014; IC VALUE:5.16; ISI VALUE:2.286

VOLUME 8, ISSUE 10(1), OCTOBER 2019

A DESCRIPTIVE STUDY TO ASSESS THE KNOWLEDGE OF STAFF

NURSES REGARDING FIRST 24 HOURS CARE OF PATIENTS WITH
MYOCARDIAL INFARCTION ADMITTED IN SELECTED
HOSPITALS OF DELHI WITH A VIEW TO DEVELOP SELF
INSTRUCTION MODULE

Ms. Neha Dimri Dr. Sumity Arora

M.Sc Nursing 2nd Year Student Assistant Professor
Holy Family College of Nursing Holy Family College of Nursing
Okhla, New Delhi Okhla, New Delhi

Ms. Giji John

Assistant Professor
Holy Family College of Nursing, Okhla, New Delhi

Abstract

Introduction:

Myocardial infarction (MI) refers to the process by which myocardial tissue is

destroyed in the region of the heart that is deprived of an adequate blood supply
because of reduced coronary artery blood flow. The cause is usually a critical
narrowing of a coronary artery due to atherosclerosis or complete occlusion of
an artery due to the embolus or thrombus.Aim: Aim of the study is to assess the
knowledge of staff nurses regarding first 24 hours care of patients with
myocardial infarction admitted in selected hospital of Delhi with a view to
develop self-instructional module. Setting and Design: The quantitative
research approach was used. It was a descriptive ,cross-sectional study and
study was conducted in Holy Family College of Nursing, Okhla, New Delhi and
National Heart Institute, East of Kailash , New Delhi. Sample and Sampling:
200 samples were taken using convenience sampling technique. Methods: The
tool used in the study was knowledge questionnaire. It had two parts: part A:
consisted of socio demographical profile which had 10 items. Part B: consisted
of knowledge questionnaire it consisted of 30 multiple choice questions Result:
The result of the study showed that majority78.5% of staff nurses had average
knowledge, 13.5% of staff nurses had poor knowledge and only 8% of staff
nurses had good knowledge. There was a significant association between
knowledge of staff nurses regarding 24 hours care of the patient with
myocardial infarction and age, clinical experience at p ≤ 0.05 level of
significance. There was no significant association between knowledge of staff
nurses regarding 24 hours care of the patient with myocardial infarction and

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INTERNATIONAL JOURNAL OF MULTIDISCIPLINARY EDUCATIONAL RESEARCH
ISSN: 2277-7881; IMPACT FACTOR – 6.014; IC VALUE:5.16; ISI VALUE:2.286
VOLUME 8, ISSUE 10(1), OCTOBER 2019

professional education, institution and working area at p≤ 0.05 level of

significance. Conclusion: The study concluded that staff nurses had average
knowledge regarding first 24 hours care of patients with myocardial infarction.
There is a need to plan special training and education session to enhance their
knowledge.

Key Words: Myocardial Infarction, First 24 hours care of patients with

Myocardial Infarction, self-instructional module.

Introduction

Coronary artery disease (CAD) is a type of blood vessel disorder that is

included in the general category of atherosclerosis. Atherosclerosis is often
referred to as “hardening of the arteries” which is an abnormal accumulation of
lipid or fatty substances and fibrous tissue in the vessel wall. These deposits,
called atheroma may rupture and forms “the thrombus” that obstruct blood flow,
leading to sudden cardiac death or an acute myocardial infarction (MI) which is
the death of heart tissues. Coronary Artery Disease is the most common cause of
heart disease and approximately one in eight women and one in five men die
from the disease. Myocardial infarction (MI) refers to the process by which
myocardial tissue is destroyed in the region of the heart that is deprived of an
adequate blood supply because of reduced coronary artery blood flow. The
cause is usually a critical narrowing of a coronary artery due to atherosclerosis
or complete occlusion of an artery due to the embolus or thrombus.

Indians are at increased risk of myocardial infarction at a younger age

(<40 years)i.In the year 2014, the incidence of myocardial infarction in coastal
regions of India was 64.37/1000 people. Approximately 31.75% of deaths occur
due to myocardial infarction in India. Acute myocardial infarction can have
unique manifestations in individual patient includes chest pain, shortness of
breath (35%), fainting or dizziness (21%), sweating (21%), indigestion, nausea,
and anxiety. Typical chest pain (75%) in acute MI has the following
characteristics Intense and unremitting for 30-60 minutes. Chest pain often
radiates up to the neck, shoulder, and jaw and down to the ulnar aspect of the
left arm (40%) and usually described as a substernal pressure sensation that also
may be characterized as squeezing, aching, burning, or even sharp.

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ISSN: 2277-7881; IMPACT FACTOR – 6.014; IC VALUE:5.16; ISI VALUE:2.286
VOLUME 8, ISSUE 10(1), OCTOBER 2019

Results:
Table 1 Frequency and Percentage Distribution of Demographic
Characteristics. (n= 200)
S.no. Variables Frequency Percentage
1. Age (in years):
a) 22-26 years 146 73%
b) 27-31 years 40 20%
c) 32-36 years 13 6.5%
d) 37 years & above 1 0.5%

2. Gender:
a) Male 13 6.5%
b) Female 187 93.5%

3. Institution:
a) Government institute 11 5.5%
b) Private institute 189 94.5%

4. Professional Education Status:

a) General nursing and midwifery 84 42%
b) Post Basic B.Sc. Nursing 15 7.5%
c) B.Sc. nursing 101 50.5%
d) M. Sc nursing 0 0%

5. Clinical experience (in years):

a) 1- 4 years 154 77%
b) 5 - 8 years 39 19.5%
c) 9 - 12 years 3 1.5%
d) > 12 years 4 2%

6. Working area:
a) Emergency 19 9.5%
b) Intensive Care Unit 111 55.5%
c) Semi-intensive care unit 8 4%
d) Catheterization lab 8 4%
e) Medical Ward 35 17.5%
f) Surgical ward 19 9.5%

7. Personal monthlyincome in rupees:

a) 15,000 – 20,000 95 47.5%
b) 21,000 – 26,000 64 32%
c) 27,000 – 32,000 26 13%
d) >33,000 15 7.5%

8. Prior working experience in cardiac unit. 12 6%

a)Yes 188 94%
b) No
Attended any work shop or continuing nursing
9. education on management of myocardial infarction.
a) Yes 0 0%
b) No 200 100%
Member of any cardiac organization
a) Yes 0 0%
10. b) No 200 100%

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ISSN: 2277-7881; IMPACT FACTOR – 6.014; IC VALUE:5.16; ISI VALUE:2.286
VOLUME 8, ISSUE 10(1), OCTOBER 2019

The Table 1 Revealed that out Majority of the staff nurses 146 (73%) were in
the age group of 22-26 years. Majority187 (93.5%) of staff nurses were female.
Majority 189 (94.5%) of staff nurses were from the private institute. Majority
101(50.5%) were B.Sc. degree holders. Majority 154 (77%) of staff nurses had
1 – 4 years of clinical experience. Majority 95 (47.5%) of the nurses were
earning between (15,000 – 20,000).
Table - 2
Section wise Mean Score, mean percentage, standard Deviation of the
learning needs of the staff nurses regarding 24 hours care of patient with
myocardial infarction.( n=200)

Table 2 shows that the highest learning need of staff nurses as the mean score in
sign Diagnostic measures in myocardial infarction was 5.255 (17.52%) followed
by ,drug therapy i.e. 8.01 (26.7%), invasive and non-invasive management i.e.
1.145 (3.82%), dietary management i.e. 0.94 (3.13%).

Figure 1: Pie Diagram Showing Percentage Distribution of Staff Nurses

According to their knowledge score regarding 24 hours care of the patient
with the myocardial infarction.

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ISSN: 2277-7881; IMPACT FACTOR – 6.014; IC VALUE:5.16; ISI VALUE:2.286
VOLUME 8, ISSUE 10(1), OCTOBER 2019

Data in figure 1 reveal that highest (78.5) percentage of staff nurses had
an average knowledge and 8% had good knowledge and 13.5 % of staff nurses
had poor knowledge on first 24 hours care of the patient with myocardial
infarction. This interpreted that the staff nurses had inadequate knowledge on
first 24 hours care of the patient with myocardial infarction.

Table 3
Mean, Mean percentage and Standard Deviation of staff nurses in terms of
knowledge regarding first 24 hours care of patients with myocardial
infarction. n=200
Mean Mean percentage Standard deviation

Knowledge
Score 15.35 51.167% 0.4998

Data in table 3 reveals that the overall mean score (15.35±0.4998)

which was 51.167% of total mean score shows that the nurses had average
knowledge regarding24 hours care of the patient with myocardial infarction.

Table 4
Chi-square Showing significance of the association between knowledge
scores of staff nurses with selected demographic variables
( n=200)
s.no. Sample characteristics Frequency of subjects df Chi P
square value
value
Good Average Poor
1. Age (in years):
a) 22-27 years
b) 28 and above 7 122 21 2 7.380* 0.0250
8 34 8
2. Professional Education
Status:

a) General nursing and 6 66 11 4 3.87NS 0.4241

midwifery
b) Post basic B.Sc. 3 10 3
nursing 6 80 15
c) B.Sc. nursing
3. Institutions

a) Government institute 1 9 1 2 0.256NS 0.8799

b) Private institute 14 148 27

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4. Clinical experience (in

years):

a) 4 years 6 124 24 2 10.106* 0.006

b) 5 years and above 8 33 5 4

5. Working area:

a)Emergency, Intensive 10 113 15 2 3.804NS 0.1493

Care Unit, Semi-intensive
care unit
b) Catheterization lab and 5 44 13
Medical Ward, Surgical
ward

Data in table 4 shows that there was no significant association between

knowledge of staff nurses regarding first 24 hours care of the patient with
myocardial infarction and professional education, institution and working area
at p≤ 0.05 level of significance.
There was a significant association between knowledge of staff nurses regarding
first 24 hours care of the patient with myocardial infarction and age, clinical
experience at p ≤ 0.05 level of significance.

Discussion
The present study showed that the staff nurses had average knowledge regarding
24 hours care of the patient with myocardial infarction. The present study
showed that the staff nurses had average knowledge regarding emergency
management of myocardial infarction.. Where staff nurses had poor levels of
knowledge related to the drugs used for initial management of acute myocardial
infarction. Also showed that the staff nurses had a poor level of knowledge
about the emergency care of patients with acute myocardial infarction.

The Self- Instructional Module was effective on emergency management of the

patient with myocardial infarction. The findings of these studies concluded that
the Self-Instructional Module was a useful tool for further nurse education.

Conclusion
On the basis of above findings of the present study, the following conclusions
can be drawn.
There was average knowledge (78.5%) among staff nurses regarding first 24
hours care of patient’s myocardial infarction. There was a significant
association between knowledge of staff nurse and demographic characteristics
of staff nurses like age and clinical experience. There was no significant
association of knowledge among staff nurses and demographic characteristics of
staff nurses like professional education, institution and working area.

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INTERNATIONAL JOURNAL OF MULTIDISCIPLINARY EDUCATIONAL RESEARCH
ISSN: 2277-7881; IMPACT FACTOR – 6.014; IC VALUE:5.16; ISI VALUE:2.286
VOLUME 8, ISSUE 10(1), OCTOBER 2019

Conflict of Interest: There is no conflict of interest.

Source of Funding: Self

References

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Philadelphia, Lippincott Williams and Wilkins Company; 2004.
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3. Johnson JY. Text book of medical surgical nursing. 11th edition, India;
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4. Chauhan S, Aeri BT. Prevalence of cardiovascular disease in India and its
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paper-1013/ijsrp-p2234.pdf
5. Rao V, Rao P, Carvalho N. Risk factors for acute myocardial infarction in
coastal region of India: A case-control study. Heart India. 2014 Jul 1;2(3):
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