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Evaluation and Improvement of Knowledge of Medical Staff on Pulse Oximetry in Educational Hospitals

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Evaluation and Improvement of Knowledge of Medical Staff on Pulse Oximetry in Educational Hospitals International Journal of Children and Adolescents Brief Communication IJCA, Vol. 4, No. 1, Feb. 2018.11-17. Evaluation and Improvement of Knowledge of Medical Staff on Pulse Oximetry in Educational Hospitals Nastaran Khosravi: Neonatologist, Ali-Asghar Hospital, Tehran University of medical sciences, Tehran, Iran Nasrin Khalesi, Ali-Asghar Hospital, Tehran University of medical sciences, Tehran, Iran Behnam Sobouti: Pediatrics infectious diseases, Ali-Asghar hospital, Iran University of Medical Sciences, Tehran, Iran Samira Hasankhani: General Practitioners, Iran University of medical sciences, Tehran, Iran Yaser Ghavami: (*Corresponding Author), General Practitioners, Iran University of medical sciences, Tehran, Iran. [email protected] Hossain Ghjaeimi: Pediatrician, Ali-Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran Received: 22 Jul 2017 Accepted: 20 Jan 2018 __________________________________________________________________________________________ Abstract Background: Pulse Oximeter monitoring has become so common over previous decades that in some health care units, blood oxygen level is now considered as the fifth vital sign. However, it seems there is still some lack of knowledge and/or experience among medical staff operating pulse oximeter and interpreting its results. The aim of this study was to investigate and compare the knowledge on Pulse Oximetry among medical staffs working with these devices. Methods: A standardized questionnaire on the performance of pulse oximetry and influencing factors was provided to a group consisting of nurses, pediatric residents, respiratory therapists and anesthetic technicians before and after an educational program on pulse oximetry. Responses to the questionnaires before and after the course were analyzed and compared. Results: A total number of 101 participants completed the questionnaires which constituted 31 pediatric residents (31%), 51 nurses (50%), 7 respiratory therapists (7%) and 12 anesthetic technicians (12%). Pre course and post course mean knowledge score on pulse oximetry in participants were 10.93 ± 4.55 and 14.07 ± 1.98, respectively (p< 0.001). Implementing educational program on pulse oximetry, increased the percentage of mean knowledge score on pulse oximetry significantly from 74% to 93% (p<0.001). Conclusion: Educational course for pulse oximetry, significantly improved the knowledge scores among participants in our study. Continuing medical education (CME) and adequate training programs to improve the lack of knowledge on pulse oximetry is highly recommended. Downloaded from ijca.iums.ac.ir at 13:15 IRST on Wednesday October 6th 2021 Keywords: Pulse oximetry, Medical staff, Nurse, Pediatric resident, Physical therapist, Anesthetic technician, Medical knowledge Copyright© Iran University of Medical Sciences Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors Cite this article as: Khosravi N, Khalesi N, Sobouti B, Hasankhani S, Ghavami Y, Ghjaeimi H. Evaluation and Improvement of Knowledge of Medical staff on Pulse Oximetry in Educational Hospital. 2018(10 Feb);4(1):11-17. _______________________________________________________________________________________ Background Most of the initial assessment and treatment of Pulse oximetry is considered an important and acutely ill patients is provided by trainee doctors frequently used device for non-invasive and nurses working at hospitals. Previous studies monitoring and assessment of arterial blood have shown that there is a lack of knowledge on oxygenation (1). It is imperative for medical staff, pulse oximetry in trainees and other medical staff especially those who work in emergency rooms, who are usually measuring vital signs in patients ICUs and CCUs, to know the functions of the (2-8); and this lack of knowledge has the potential pulse oximetry device and more importantly how to influence patients’ outcome and contribute to to accurately explain and interpret the obtained the high level of clinical errors. It may result in data to better evaluate and take care of critically ill the failure to detect clinical deterioration, to patients (2, 3). perform timely intervention, and to commence 11 Knowledge of Medical Staff on Pulse Oximetry simple supportive care leading to cardiac arrest, bilingual English-Farsi (native English) speaker, intensive care unit admission, or death. not familiar with the original questionnaire. Then Frequently, there is poor management of the a pilot study was performed on 10 subjects and patient’s airway, breathing, circulation, oxygen finally the questionnaire was validated by 3 therapy, fluid balance, and monitoring. Although clinicians familiar with questionnaire and pulse the cause of such insufficient care is inevitably oximetry. multi-factorial, basic education in acute care and From January to December 2014, the the preparation of staff for clinical practice seems questionnaire was distributed to a convenience to be important determinants (9). During the sample of health care professionals who were departments' meetings and grand rounds, we involved in pediatric care. Residents and nurses received significant amounts of reports from our were enrolled in the study when they had colleagues and attending physicians about completed their first year of training or practice. misinterpretation and misunderstanding of pulse The participants were from 3 tertiary care teaching oximetry among medical staff working in neonatal hospitals (Rasoul Akram, Akbar Abadi and Ali- and pediatric wards. In order to address this issue, Asghar). The questionnaires were distributed we decided to evaluate the knowledge of our staff unexpectedly among participants; and they who are actively interacting with the patients' vital completed the forms voluntarily on site within 20 signs in pediatric hospitals; and also provide an minutes from the distribution. One of the opportunity for the medical staff to participate in investigators or a physician who did not educational courses for learning and updating participate in the study proctored the entire their knowledge on critical care issues such as process at all locations. After filling out the pulse oximetry. questionnaire, the subjects were asked to participate in an educational course for pulse Methods and Materials oximetry. Most of them agreed to participate in In this cross-sectional study, we evaluated the the course and completed the course. The time of knowledge of our medical staff consisted of the course was flexible and included 5 hours of nurses, pediatric residents, anesthetic technicians education which was executed mostly at the and respiratory physiotherapist who worked in weekends. Post-course evaluation was performed intensive care units in pediatric Centers in 3 3 to 6 weeks after educational course by giving training hospitals of Iran University of medical the same questionnaires to the subjects. Correctly sciences (Tehran, Iran). To obtain a high response answered questions were summed to measure the rate and decrease missing data, we tried to use a knowledge score of each participant. Unanswered short-in-length questionnaire, which could be items were considered as false. Chi-square test easily and rapidly answered. We preferred to was used for categorical variables between choose a standardized questionnaire which groups. We found that all continuous variables Downloaded from ijca.iums.ac.ir at 13:15 IRST on Wednesday October 6th 2021 includes only closed format and true/false were normally distributed using Kolmogorov - questions. A standardized questionnaire which Smirnov test. Thereafter, one-way analysis of was developed by Attin et.al. (4) was used for variance (ANOVA) was used to compare the data collection that consisted of 3 sections: (1) mean scores between groups with unequal sample demographic data (occupational status, record of size and student t-test used for comparison service in pediatric unit, experience of using Pulse between pre- and post-course scores in each Oximetry, basic knowledge about Pulse Oximetry, group. Because multiple comparisons were made and its educational program type); (2) fifteen short on the same data for the comparison of the answer questions to determine the knowledge of knowledge scores, the Bonferroni correction was participant about Pulse Oximetry (Table 1). (As applied to reduce the occurrence of type I errors. our study was conducted for neonatal intensive Therefore, a p-value less than 0.02 was considered care units, 2 questions were omitted from original statistically significance. Statistical analysis was questionnaire due to irrelevancy to neonatal care performed using Statistical Package for Social and (3) evaluating knowledge of participant after Sciences v.18 (SPSS Inc., Chicago, IL, USA). a session about pulse oximetry in clinical cases. The study was approved by the ethics The questionnaire was translated into Farsi committee of the Iran University of Medical language and then the translation was evaluated Sciences (Tehran, Iran). by 3 bilingual (English-Farsi) experts for evaluating and proofreading it. The reconciled Farsi version was then back-translated by a IJCA, Vol. 4, No. 1, Feb, 2018.11-17. 12 Nastaran Khosravi et al. Table 1. Demographics of subjects participated in the study ED N-ICU P-ICU P-Ward Total P-value Age ≥ 40 9 3 8 28 51 0.15 < 40 16 13 15 25 71 Gender Male 15 9 11 27 62 0.86 Female 10 12 12 26 60 Educational Lev- el 12 8 11 34 65 0.04 Nurse 8
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