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A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED
TEACHING PROGRAMME ON MANAGEMENT OF
BURNS AMONG NURSING STUDENTS IN
SELECTED INSTITUTION OF
RAICHUR.
PROFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION.
HEPSI NATHA.
NAVODAYA COLLEGE OF NURSING
RAICHUR.
NOVEMBER – 2007.
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA.
PROFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION.
1. Name of the candidate
and address
:
HEPSI NATHA
M.Sc. Nursing 1st year,
Navodaya College of Nursing,
P.B.No. 26, Mantralayam Road,
Raichur – 584103.
2. Name of the institution
:
Navodaya college of Nursing.
3. Course of the study and
Subject
:
M.Sc. Nursing 1st year,
Medical and Surgical Nursing.
4. Date of Admission to
the course
:
15/05/2007.
5. Title of the Topic
:
A study to assess the effectiveness of structured teaching programme
on Management of Burns among Nursing Students in selected
Institutions of Raichur.
6. Brief Resume Of The Intended Work:
6.1 Need for The Study:
Throughout the world, burns remain a huge health issue, atleast
in terms of morbidity, especially in the developing countries.1 Injuries
that results from direct contact with exposure to any thermal, chemical or
radiation source are termed as “Burns”. Burn injuries occur when energy
from a heat source is transferred to the tissues of the body. The depth of
injury is related to the temperature and duration of exposure or contact.2
Burns continue to be a leading cause of death in developing
world.3 Approximately 1.25 million people suffer a burn injury in the
U.S. each year. Of this group, 51,000 requires acute hospital admission.
About 5,500 people die from burns and related inhalation injuries
annually. One million work days are lost each year due to burn injury.4
The current statistical data for the year 2007 is 67 burn cases and is found
to the admitted in the civil hospital, Raichur, Karnataka. Among them the
mortality rate is 7.
Most burn injuries occur in the home, usually in the kitchen
while cooking and in the bathroom by means of scalds and by improper
use of electrical appliances around water resources. Burn injuries can also
occur from work accidents. The National Institute for Burn Medicine
which collects statistical data from burn centers throughout the United
States noted that most of the clients (75%) are victims of their own
actions such as scalds in toddlers, playing with matches, electrical injury
in teenage boys and smoking in adults combined with the use of drugs
and alcohol.2
A burn may be so severe that it may cause life threatening
symptoms. The client may stop breathing or go into shock. In such cases,
the first goal of treatment is to save the client’s life not to treat the burns.
Clients
may
require
mouth-to-mouth
resuscitation
or
artificial
respiration.2
Specialized treatment for severe burn cases may also include
installation of a breathing tube if the client’s airway or lungs have been
damaged, administration of fluids through an intravenous tube,
immunization with tetanus vaccine to prevent infection, covering the
burnt area with antibiotic ointment and bandages, debridement or
removal of dead tissue. 2
Burns management has yet to be fully understood by everyone in
our environment. A retrospective study has been conducted regarding the
substances used to treat burns in communities in Nigeria. An analysis of
147 clients in this work shown that 5 per cent of the clients applied one
substance or another. Various substances were used including raw eggs,
gention violet, cassava, engine oil, kerosene, etc. The risk of infection
with most of these substances is obvious.1
The size of burn (percentage of injured skin, excluding first
degree burns) is determined by the rule of 9s and an age specific burn
diagram or chart. Burn size is expressed as percentage of Total Body
Surface Area (TBSA). The basis of the rule is that the body is divided
into anatomic sections, each of which represents 9 per cent of the total
body surface area. The percentage of burns depends on the degree and
severity of the burnt area.2
To prevent burn shock in adults with burn injuries affecting more
than 15 per cent total body surface area, intravenous fluid resuscitation is
generally required. Fluid resuscitation is used to minimize the deleterious
effects of the fluid shifts. The goal of fluid resuscitation is to maintain
vital organ perfusion while avoiding the complication of inadequate or
excessive fluids. Several formulas are used to calculate fluid
requirements. Although each formula is different. The exact amount of
fluid is based on the client’s weight and the extent of injury. Fluid
resuscitation formulas used in burn care are Evans, Brooke, Modified
Brook, Parkland, Hypertonic Saline Solution. Adequacy of fluid
resuscitation is based on urine output when hemodynamic monitoring is
not used. An indwelling urethral catheter connected to a closed drainage
system is placed to measure hourly urine production and to guide
intravenous fluid replacement.2
The prognosis for burns depends on many factors, these factors
include the degree of the burns, the amount of skin affected by the burns
and any additional complications that might have developed.2
As today nursing students are the future care givers throughout
the world, the nurses has to play a vital role in rendering the immediate
care to the client with burns otherwise it may lead to several other
complications. So the Investigator felt the need to assess the knowledge
of B.Sc. Nursing students regarding management of burns. Based on their
knowledge levels the Investigator is interested to prepare structured
teaching programme with the guidance of experts in the field and
intervenes the structured teaching programme. Again, after giving a gap
of 7 days the Investigator will assess their knowledge to see the
effectiveness of structured teaching programme.
6.2 Review Of Literature:
A review of literature on the research topic makes the researcher
familiar will the existing studies and provides information which helps to
focus on a particular problem, lay a foundation upon which to base new
knowledge. It creates accurate picture of the information found on the
subject.
A study has been conducted to assess the impact if advanced burn
life support educational programmes (ALBS) on the knowledge among
experienced burn nurses in USA. A convenience sampling technique was
used to select the sample. The sample size taken was 6 clinical experts
with in the 21 bed southeastern burn center who had never taken
advanced burn life support educational programme. The tool used for
data collection was semi-structured questionnaire. The study results
shown that the nurses with high levels of experience had an increase in
knowledge and expressed value in continuing education in curriculum.
Hence, the study recommended that there is necessity of educational
programmes for nurses with significant specialized experience.5
A study has been conducted to understand the cultural meaning
which attribute to burn pain among nursing team and burn patients in
Portuguese and participant observation were carried out during one year
at a burn unit. The sample size taken was four nurses, five auxillaries and
twelve clients. The tool used for data collection was semi-structured
interview. The study results shown that burn pain was understood by
nurses as physical and emotional pain where as for professionals bath and
dressing changes were stressful and for patients, burn pain was terrible. 6
An experimental study was conducted to assess the effectiveness
of the advanced burn life support course on military physicians and
nurses in USA. The study sample taken was 1035 military health care
providers. The advanced burn life support and combat burn life support
course programmes were given to the study sample. The tool used for
data collection was structured questionnaire. The study results shown
that the students feed back was largely positive and was being used for
further course intended not only for military audience, but also in the
casualty situations.7
A descriptive study was conducted to assess the knowledge
regarding different aspects of the treatment of burn clients among
physicians, nurses and other burn team members in Israel. The study
sample taken were
70
health care professionals involved in the
treatment of burns. The tool used for data collection was questionnaire
comprised of 30 questions. The study results shown that 77 per cent of
subjects responded that most local wound care is essential in burns
management, where as 23 per cent of subjects responded to dressing
changes, Edinborough University Solution of Lime (EUSOL) even
though it is unsuitable due to its toxic effects and hydrotherapy which has
been proposed as a source of infection and contamination.8
An experimental study was conducted to assess the knowledge
and practice regarding care of the clients with burn injuries among home
care nurses in USA. The study samples taken were 40 home care nurses.
An educational programme was given to them to develop the knowledge
and skills to care for the clients with burn injuries at home. The tool used
for data collection was semi-structured questionnaire. The study results
shown that there was marked improvement of knowledge and practice
and the client outcome was improved by application of all nursing
measures at home. Hence, the study concluded that this educational
programme improved the knowledge of home care nurses and it also
helped the home care nurses to give a well integrated continuity of care
to the clients.9
An experimental study was conducted to assess the impact of a
Burn Wound Education Programme and implementations of a clinical
pathway on client outcomes among home care nurses in USA. The
sample size taken was 60 home care nurses. The tool used for data
collection was semi-structured interview. The data were collected from
54 clients’ records from the first two periods and the entire samples of 12
records from the third period were reviewed. The study results shown the
positive impact of education in combination with the use of a burn home
care clinical pathway.10
6.3 Statement of the problem
A study to assess the effectiveness of structured teaching programme
on Management of Burns among Nursing Students in selected
Institution of Raichur
6.4 Objectives of the study
 To assess the knowledge of nursing students regarding
management of burns.
 To evaluate the effectiveness of structured teaching
programme in management of burns.
 To find out the relationship between knowledge of the
nursing student regarding management of burns with
selected socio-demographic variables.
6.5 Hypothesis
 There will be a significant relationship between the
knowledge of the nursing students on management of
burns with the selected socio demographic variables.
 There will be a significant relationship between pre test
and post test knowledge scores.
6.6 Operational Definition
Effectiveness :
It is the extent to which the knowledge of nursing students
improved with regard to management of burns after the implementation
of structured teaching programme as evidenced by the differences in the
pretest and post test scores.
Structured teaching programme:
It refers to systematically developed instrument designed for a
group of nursing students to provide information regarding management
of burns.
Nursing students:
Students who are studying in II year B.Sc.Nursing at Navodaya
College of Nursing, Raichur.
Management:
It is the art of securing maximum results by planning, organizing
and implementing the comprehensive nursing care by the nursing
students for managing the burns client.
Burns:
Injuries that result from direct contact with any thermal or
chemical or radiation or inhalation source.
7 Materials and Methods:
7.1 Sources of Data:
Design:
The research approach adapted is one group pre and post test
experimental study.
Setting of the study:
Study will be conducted in a selected nursing institution at
Raichur. In Raichur 3 nursing institutions are functioning. Among them
Navodaya College of Nursing has been selected for the present study.
Navodaya Institution emerged in 1992. It was affiliated to Gulbarga
university from 1992-1995. In 1996 it got affiliated to Rajiv Gandhi
University of Health Sciences, Bangalore.
The institution initiated nursing education with diploma in
general nursing and midwifery and added basic B.Sc. Nursing in 1993,
post Basic Nursing in 2003 and M.Sc.Nursing course in 2001. Navodaya
Institution is having total strength of five hundred and eighty five GNM
students, thirteen post basic B.Sc. Nursing students, three hundred and
eleven B.Sc. Nursing students and twenty five M.Sc.Nursing students.
Population:
The population included in the study are those who are studying
in II year B.Sc. Nursing in Navodaya College of Nursing, Raichur. There
are 28 boys and 64 girls comprising a total of 92 students in B.Sc.
Nursing IInd year, 2007-08 batch.
Sample size:
Simple size for the study consists of 92 B.Sc. Nursing II year,
2007-08 students studying at Navodaya College of Nursing, Raichur.
Sampling technique:
Purposive sampling technique will be used to select the nursing
institution and simple random technique will be used to select the sample
by using lottery method.
Inclusion Criteria:
The study includes nursing students who are
 studying in B.Sc. nursing II year at Navodaya College Of Nursing,
Raichur.
 willing to participate in the study.
 available at the time of data collection.
Exclusion Criteria:
The study excludes the nursing students, who are not
 studying in B.Sc. Nursing II year at Navodaya College Of Nursing,
Raichur.
 willing to participate in the study.
 available at the time of data collection.
Selected Variables:
Dependent Variables:
Knowledge of the nursing students regarding management of
burns.
Independent Variables:
Structured teaching programme regarding management of burns.
Extraneous Variables:
1. Age:
Age of the sample is categorized as.
 19-21 years
 22-24 years
 25 years and above
2. Gender:
Gender of the sample is categorized as
 Male
 Female
3. Religion:
Religion of the sample is categorized as
 Hindu
 Muslim
 Christian
4. Educational Background:
It refers to previous education of the subjects. It is categorized as
 Intermediate
 Intermediate with vocational nursing
 General graduation or above
5. Clinical Exposure:
It refers to experience of the sample in burn care unit. It is
categorized as
 3 week.
 4 weeks.
 5 weeks.
 6 weeks.
7.2 Methods of collecting data:
Data collection instrument:
A structured questionnaire will be developed and used for
collecting the data. It consists of 2 parts namely part I and part II. Part I
deals with sociodemographic data and Part II represents the knowledge
related items on management of burns.
Data collection method:
After obtaining the prior permission from the significant
authorities and consent from the subjects the Investigator will assess the
knowledge of nursing students regarding management of burns by using
a structured questionnaire and then intervenes structured teaching
programme. Again the Investigator will assess the effectiveness of
structured teaching programme by post test after a gap of 7 days
depending on time convenience of the sample.
Plan for data analysis:
Numerical data obtained from the sample will be organized and
summarized with the help of descriptive statistics.
Testing the level of significance of hypothesis will be done with
the help of inferential statistics like chi-square tests and coefficient
correlation to identity the relationship between knowledge to nursing
students regarding management of burns with selected demographic
variables.
Projected Outcomes:
The result of the study throws light on effectiveness of structured
teaching programme on management of burns among nursing students.
There by helps the future researchers to adopt modified strategies to
enhance the knowledge of nursing students.
7.3 Does the study require any investigation or intervention to be
conducted on patients or other human or animals? If so please
describe briefly.
Since, it is one group pretest and post test experimental design,
the study requires intervention. The Investigator will assess the
knowledge of nursing students on management of burns and administers
structured teaching programme and again tests the knowledge of nursing
students to assess the effectiveness of structured teaching programme.
7.4Has ethical clearance been obtained from your institution in case
of 7.3?
 Permission will be obtained from institutional ethical committee,
Navodaya College of Nursing, Raichur.
 Consent will be obtained from all the participants.
8. LIST OF REFERENCES:
1. Olaitin P.B, Lyidobi E.C. ANNALS OF BURNS AND FIRE
DISASTERS. Volume XVII – 2004 June.
2. Joyce. M.Black. MEDICAL AND SURGICAL NURSING. 7th
edition, Volume – 2; 1433, 1442-1446.
3. Aoron
J.
PERIOPERATIVE
MANAGEMENT
OF
BURN
PATIENTS. 1999 June; 69(6): 1211-22.
4. Brunner and Suddarth. TEXT BOOK OF MEDICAL- SURGICAL
NURSING. Philadelphia. Lippincot Company. 8th edition; 1223-30.
5. Wolak E, Klish K. EDUCATIONAL OPPORTUNITIES FOR
EXPERIENCED STAFF. 2006 Jul-Aug; 22(4): 181-6.
6. Rossi LA, Casagrande LD. THE NURSING PROCESS AT A
BURNS UNIT. Lat Am Enfermagem. 2001 Sep-Oct; 9(5) :39-46.
7. Barillo DJ, Cancio LC. COMBAT BURN LIFE SUPPORT: A
MILITARY BURN-EDUCATION PROGRAM. J Burn Care
Rehabil. 2005 Mar-Apr; 26 (2): 162-5.
8. Haik J, Ashkenazy O. BURN CARE STANDARDS IN ISRAIL.
Burns. 2005 Nov; 31(7): 845-9. Epub 2005 Jun 20.
9. Dattolo J, Trout S. HOME HEALTH CARE AND BURN CARE:
AN EDUCATIONAL AND ECONOMICAL PROGRAM. J Burn
Care Rehabil. 1996 Mar-Apr; 17(2): 180-7.
10. Momolem NL, Brenner PS. THE IMPACT OF A BURN WOUND
EDUCATION PROGRAM AND IMPLEMENTATION OF A
CLINICAL PATHWAY ON PATIENT OUTCOMES. J Burn Care
Rehabil. 2000 Sep-Oct; 21(5): 440-5.
9. Signature of the Candidate
:
10. Remarks of the Guide
:
11. Name & the Designation of
:
11.1 Guide
: Miss Annapoorna. S
Asst. Professor,
DEPT. OF MEDICAL SURGICAL NURSING
11.2 Signature
:
11.3 Co-guide
:
11.4 Signature
:
11.5 Head of the department : Miss Annapoorna. S
Asst. Professor,
DEPT. OF MEDICAL SURGICAL NURSING
11.6 Signature
:
12.1 Remark of the Chairman
& Principal
12.2 Signature
: