Knowledge and practice on invasive arterial pressure monitoring: A study on critical care nurses in order to evaluate the effectiveness of an arterial blood pressure monitoring guideline

Abstract

Background: One of the clips of Critical Care is close monitoring and intensive care for complex issues to Critically ill patients. Monitoring of blood pressure is one of the most fundamental requirements in the ICU and it impacts a lot on understanding patient’s status to take timely decision for any intervention. The cannulation of a peripheral artery to measure Intra-arterial blood pressure (IBP) is often considered the gold standard of blood pressure measurement. Nurses posted in critical care areas and documenting arterial pressure without having much understanding the fundamentals of invasive pressure monitoring often has seen. It becomes challenging when there is a dampened wave or any other trouble shooting status reflected on the hemodynamic monitor. Purpose: The study aimed to determine the existing level knowledge and practice of nurses on arterial pressure monitoring in order to develop a guideline and to validate the same for the purpose of accurate and safe practice while caring patients in Critical care areas by the nurses. Methodology: The quasi experimental research approach was adopted among 100 Nurses posted in two critical care areas with similar set up. Data were collected by using a structured knowledge questionnaire and a structured Practice criterion check list on Arterial Pressure monitoring. All Nurses were included in the study. Both Descriptive and inferential statistics were used to analyze the data. Results: In the research study it was observed that 28 (28%) of Nurses are at the age group of 21 to 25 years, (48%) were 26-30 years and >31 years only 24(24%) Nurses. 76(76%) were female nurses and 24(24%) were male nurses participated for the study. Majority of the nurses were arts back ground joined nursing. 47(47%) of Nurses were having 1-3 years of Nursing experience where as 60% Nurses were having 1-3 years of critical care experience. It means Nurses without experience to other areas directly posted at critical care areas. And Majority (85%) of Nurses have never attended any Hemodynamic monitoring workshop or training before appointed in Critical care. Knowledge of the nurses were assessed by mean percentages and SD which has shown, mean pre-test knowledge score of Nurses is 5.78, ( the knowledge questionnaire carries to total 20 marks)Standard Deviation (SD) 2.42. Mean pre -test practice score is 11.13 and SD 3.18 (The practice observation checklist carries total 15 marks). The Mean post-test knowledge score 19.40 and SD 0.86 after implementation of the guidelines on arterial blood pressure monitoring), and the post-test Practice score is 14.46, with SD 1.22.A paired samples t-test used, which showed that the participant's level of Knowledge on Arterial pressure monitoring after implementation of guidelines increased from pre-test (M = 5.78, SD = 2.24) to post-test (M = 19.4 SD = 0.86,), Paired difference mean 13.62, with SD 2.64 and Pair t test = 51.53, p