Impact of a Structured Training Program Regarding Care of Patients with Chest Tube Drainage in Terms of Knowledge and Practices of Nurses Working in a Tertiary Care Cancer Center in North India

Abstract

Introduction: A chest tube (hollow, flexible drainage tube) placement is a procedure in which a tube is inserted by an aseptic technique through the side of the chest wall into the pleural space. The complication rate in patients with ICD has been found high, resulting from inadequate knowledge of thoracic anatomy or/and insufficient clinical training and experience. Objective: Assessing the efficacy of a structured Clinical training program regarding the care of patients with chest tube drainage, assessing existing and gained knowledge and practices level, and finding the association between the sociodemographic variables and knowledge and practices. Material and Methods: In this Prospective study, 200 nurses participated in the study; pre-test and Post-test research designs were applied in this study. Data collection was done by using of probability random sampling technique. Result: The Pre-test Mean knowledge score was 8.77 with a standard deviation of 2.08 and the Mean practical knowledge score was 7.6 with a standard deviation of 2. When participants' knowledge and practices were checked before the training program, 58 % (116) subjects had Good Knowledge, 22.5 % (45) had average knowledge, 17.5 % (35) had excellent knowledge, and 2 % (4) had poor knowledge scores. When participants' practical knowledge was checked before the training program, 49 % (98) subjects had good practice scores, 43 % (86) had average practice scores, 5.5 % (11) had excellent practice scores, and 2.5 % (5) had poor practice scores. Posttest mean knowledge score was 10.56 with a standard deviation of 1.86. Posttest mean Practical knowledge score was 10.57 with a standard deviation of 2.26. After the structured clinical training program, 57.5 % (23) had an adequate knowledge score, 40 % (16) had a moderate level of knowledge score, and 2.5 % (1) had inadequate knowledge. After the structured clinical training program, 50 % (100) had an excellent practice score and 42 % (84) had a good practice score, and 8 % (16) had an average practice score. An association was found between existing knowledge score and marital status, between post-test knowledge and Religion as calculated p-values of the Fisher Exact test that is 0.036, 0.017 is smaller than the alpha value 0.05. In the Practical Knowledge score, an association between pre-test practice scores and the number of previous ICD training was found, as the calculated p-value of the fisher Exact test 0.04 was smaller than the alpha value of 0.05. Conclusions: In the care of a patient who has an Inter-costal chest tube, need much attention as comparing other, because the handling of the ICD tube and bag, emptying of a bag, and transportation of the ICD patient need careful action. In our study, we found that existing knowledge and Practice of ICD care procedures are not satisfactory with the traditional teaching approach, bedside clinical training is a beneficial approach that will significantly improve the Knowledge and Knowledge in practice. Keywords: ICD Care, Intercostal drainage, Chest tube care, Thoracic tube care