NUZHAT SULTANA Online Phd Nursing Student Texila American

NUZHAT SULTANA Online Phd Nursing Student Texila American University

• Introduction: Colostomy care is significant nursing intervention to ensure patient centered care. The assessment of nurses knowledge of colostomy care has not been conducted before at the study hospital. • Purpose: This study was conducted to evaluate the nurses knowledge of colostomy care, and the effect of colostomy care in-service education on the level of competence among nurses working in surgical units. • Method: Participatory Action Research (PAR) approach was selected using pre and post- test to assess the nurses knowledge managing patients with colostomy

• Result: The study results indicates that the nurses working in the surgical units of the study hospital lack the required knowledge related to colostomy care. However, before and after the training session significant difference in knowledge, skills and attitude was noted. • Conclusion: The study findings suggest that there is an intense need to deal with this area and develop the mechanism for regular in-service education sessions on colostomy care for nurses working in surgical units. Moreover, future researches are warranted in this important aspect of nursing care.

• A number of patients undergo colostomy procedure every year to treat and reduce patients’ pain and discomfort. On the other hand, this procedure causes stress and agony for patients, as a result of skin irritation 76%, pouch leakage 62%, unpleasant odor 59%, avoidence of enjoyable activities 54%, and depression/anxiety 53%, cited in (Dabirian, Yaghmaei, Rassouli, & Tafreshi, 2011). • Key professional role of nurses working with colostomy patients is to provide high standard care based on patient's need (Bhzeh, Teleb, Mahmoud, & Soliman, 2013).

• Colostomy is a surgical procedure that takes out one end of large intestine and colon is sidetracked through an incision in the abdominal wall to form a stoma. A stoma is the opening in the skin where a small bag for collecting feces is attached. People with temporary or long-term colostomies have pouches attached to their sides where feaces collect and easily disposed off (Bhzeh, et al. , 2013), (Burch, 2011). • A recent study conducted in Pakistan reported the lack of trained nurses in colostomy care (Zakri, Shah, Khaliq, & Asghar, 2010). • Managing colostomy patient is a complex situation, it is important that time to time nurses knowledge must be up-dated to help the patient to deal with altered health condition (Ardigo & Amante, 2013).

To evaluate the nurses knowledge regarding colostomy care, and the effect of colostomy care in-service education on the level of competence among nurses working in surgical units.

Methodology • Design: Participatory Action Research (PAR) approach was selected using pre and post- test to assess the nurses knowledge managing patients with colostomy with IRB approval. • Sample: The purposive sample of (n=39) Nurses was selected from male and female surgical units at Shifa International Hospital Islamabad, Pakistan a private tertiary hospital.

Cont… Data Collection Data was collected in last week of June 2016, Using selfdeveloped tool based on current literature review in the form of pre-test and post-test. Tool consisted of two parts: Part 1: Demographics characteristics: (age, Gender, academic qualification and job experience). Part 2: Assessment of nurses' knowledge related to colostomy care included five subjective type questions (Each question was allocated 5 marks. Validity of tools was done by two expert nurses. A pilot study was carried out on 10% of sample to test the feasibility of the study)

1. Define colostomy. 2. Name the types of colostomy. 3. List at least 5 teaching needs of colostomy patient. 4. List the food that should be recommended to colostomy patient that makes the stool soft. 5. Name Supplies used for Colostomy Care and also listing 3 competencies required for Colostomy Care.

Results & Discussion

Gender Male (n=26) Female (n=13) 21 -40 (n=33) 41 -60 (n=6) Registered Nurse (n=28) Assistant Head Nurse & Above (n=11) BSc. N (n=8) General Nursing 3 Years Diploma (n=31) *13 One year Specialization Fresh (10) 1 -10 Years (n=23) 11 -40 Years (n=6)

Overall Pre-test & Post-test Score (N=39) Pre-test Score 0 3 4 5 6 7 8 9 10 12 13 Mean Std. Deviation Post-test F 6 2 7 3 2 4 3 4 5 1 2 % 15. 4 5. 1 17. 9 7. 7 5. 1 10. 3 7. 7 10. 3 12. 8 2. 6 5. 1 6. 08 3. 74 P-value (T-test) * = Those who did not attempt the post-test Score 0 20 21 F 2* 3 4 % 5. 1 7. 7 10. 3 22 3 7. 7 23 3 7. 7 24 6 15. 4 25 18 46. 2 Mean Std. Deviation 22. 38 5. 54 0. 000 (Sig. 2 -tailed)

• Overall this study shows that nurses working in surgical wards in study hospital lack the required knowledge and competence related to colostomy care. • Therefore, nurse managers need to develop effective mechanism of regular in-service education for nurses working in surgical units. • Though the sample size was small and study findings cannot be generalized even then study has the implication on nursing practice, education and research.

• Study findings suggest that nurse managers must assess the nurses knowledge regarding colostomy care on regular basis • Develop the effective mechanism for continue education to update nurses with required knowledge and skills to manage colostomy patients in surgical units to ensure patient centered care. • Replication of the study on larger scale in multiple sitting should be conducted for the purpose of generalization.

• Ardigo, F. S. , & Amante, L. N. (2013). Knowledge of the Professional about Nursing Care of People With ostomies and their Families. Text Context Nursing, 22(4), 1064 -1071. doi: https: //dx. doi. org/10. 1590/S 0104 -07072013000400024 • Bhzeh, N. M. , Teleb, S. M. , Mahmoud, M. A. , & Soliman, A. M. (2013). Colostomy: Developing Nursing Care Standards for Patient with Colostomy. The Medical Journal of Cairo University, 81(2), 57 -64. • Burch, J. (2011). Resuming a normal life: holistic care of the person with an ostomy. British Journal of Community Nursing, 16(8), 366 -373. doi: 10. 12968/bjcn. 2011. 16. 8. 366

• Dabirian, A. , Yaghmaei, F. , Rassouli, M. , & Tafreshi, M. Z. (2011). Quality of life in ostomy patients: a qualitative study. Patient preference and adherence, 5, 1 -5. doi: 10. 2147/ppa. s 14508 • Zakri, R. H. , Shah, S. A. , Khaliq, T. , & Asghar, T. (2010). Impact of Ostomy Surgery on Hospitalized Patients at a Tertiary Care Hospital in Pakistan. Ann. Pak. Inst. Med. Sci, 6(1), 36 -39.