Quasi-experimental study examining the impact of video-assisted teaching intervention on knowledge concerning aseptic dressing techniques among nursing student interns

Background: Severe infections, or wound infections, are acquired postsurgeries, leading to prolonged hospitalization and increased expenses for patients and hospitals. Aseptic dressings play a role in healing wounds by establishing a clean, moist, and breathable setting that promotes granulation and epithelialization. This method reduces infection risks, accelerates wound recovery, and lessens scarring. The research evaluates how video-guided instruction influences understanding of aseptic dressing methods specifically for infectious surgical wounds. Materials and Methods: A quantitative research method was employed using a preexperimental design known as a one-group pretest posttest approach. The study was conducted among 70 nursing interns selected from specific nursing schools in Dehradun, Uttarakhand, India. Participants were selected through a nonprobability sampling method. Data collection involved gathering demographic information and utilizing a self-structured knowledge questionnaire. The collected data underwent analysis through descriptive and inferential statistical methods for interpretation. Results: The current research demonstrated a notable disparity in nursing interns' pretest and posttest knowledge scores concerning aseptic dressing techniques for surgical infectious wounds (P < 0.05). Conclusion: Video-assisted teaching programs had an impact on enhancing the understanding of aseptic dressing among nursing interns. This study could be a foundation for crafting a protocol or procedural manual for aseptic surgical wound dressing aligned with the institution's policies.

Keywords: Aseptic dressing technique; knowledge; nursing students; video-assisted teaching

INTRODUCTION

The membranes that line the body's orifices are continuous with the skin, which is the outer layer of the human body. According to Takeo et al.[[1]], it serves as a point of entry for microorganisms, and lesions to this system increase the likelihood of wound infection. A wound is an injury that fractures the skin or other body tissues. They consist of skin punctures, scratches, and cuts. Although accidents are the primary cause, wounds can also result from surgery, sutures, and stitches.[[1]]

A 5% drop in the surgical site infection standardized infection ratio connected to all National healthcare safety network (NHSN) operational procedure categories combined compared with the prior year was observed in 2020.[[2]] According to the 2020 hospital acquired infection (HAI) data results released in the NHSN's HAI Progress Report. The Centers for Disease Control and Prevention's national guidelines said that sterile methods and dressings are advised for wound care following surgery for 24–48 h.[[3]],[[4]]

The practice of sterile wound dressing entails the application of tactics in patient care to minimize microbe exposure and preserve microorganism-free areas. Carefully cleaning hands, using a sterile field, applying wound dressing while wearing sterile gloves, using sterile equipment, and avoiding contact with sterile materials on nonsterile surfaces or products are all part of the aseptic wound dressing approach.[[5]],[[6]]Around 4.6%–9.3% of all wound infections are hospital-acquired,[[7]] and the financial burden of these infections falls on hospital healthcare administration. According to "The Burden of Health Care Associated Infection Worldwide, World Health Organization, "surgical site infections are the most common infection in poor nations." In surgical wards, infections occurred 12.5% of the time, with shallow incisions being the most common.[[8]] According to a study conducted in a tertiary care hospital, 4.3% of medical workers did not follow all the protocols for dressing wounds, and superficial surgical infections were common. According to studies,[[9]],[[10]] 5.6% of adult patients in India who had any surgery had SSI.[[11]]A registered nurse is still responsible for procedures since they fall under their purview when they assign duties or other parts of patient care to other medical professionals, family members, or care providers.[[12]]

Several studies have shown that student nurses must increase their understanding of and proficiency with wound dressing to give patients complete nursing care. Knowledge will enhance the student nurse's understanding of wound dressing procedures and encourage their application to enhance patient care and prevent complications. Therefore, the present study evaluated the intervention's effect to enhance nursing interns' knowledge of the aseptic dressing technique.

PRIMARY OBJECTIVE

The primary objective is as follows:

·To evaluate the intervention's effect on enhancing nursing interns' knowledge of aseptic dressing technique.

SECONDARY OBJECTIVES

The secondary objectives are as follows:

·To assess the nursing interns' pre and posttest knowledge scores.

·To find out the association between the pretest knowledge score of nursing interns with selected demographic variables.

MATERIALS AND METHODS

A quantitative research approach was used. A preexperimental research design with one group pre-test and posttest was employed to evaluate the effectiveness of a video-assisted teaching program on knowledge regarding aseptic dressing technique in infectious surgical wounds among intern students of the selected School of Nursing, Dehradun, Uttarakhand, India. Data were collected from 70 intern students from selected nursing schools in Dehradun by convenience sampling techniques. The study was limited to the general nursing and midwifery (GNM) interns of the selected nursing schools, those who were willing to participate, and those who were present during the study. Formal permission was obtained from the Principal of Doon Institute of Medical Science and the Principal and Coordinator of GNM interns of the State School of Nursing, Dehradun, Uttarakhand, India, to conduct the study. The data was collected with the help of a demographic profile and a Knowledge questionnaire. The structured Knowledge Questionnaire consisted of 24 items divided into four areas: aseptic dressing—6 items, wound assessment—4 items, procedure—10 items, and recording and termination—4 items. The range of knowledge score was 0–24. Seven experts validated the knowledge questionnaire and observational checklist. The reliability of the knowledge questionnaire was established by the split-half method (r = 0.93). The study's objectives were explained to the intern students, and confidentiality was assured with consent to participate. After pretesting on the same day, a video-assisted teaching program on knowledge regarding aseptic dressing techniques in infectious surgical wounds was administered among intern students. A test was conducted one week after the pretest and intervention to determine the effectiveness of the video-assisted teaching program.

Ethical considerations

The official authorization was secured through administrative channels. The chosen participants were duly informed about the study's objectives and significance, with an assurance of the confidentiality of their responses. Each participant provided written consent before their involvement in the study. The Government Doon Medical College Hospital, Dehradun, Uttarakhand, India, granted ethical clearance for this research. They were referenced by letter no. GDMC/Paramedical/2021/6080 dated 27th September 2021.

Data analysis

The study's analysis was done with the help of the IBM Statistical Package for the Social Sciences (SPSS, Chicago, IL, USA) version 25 based on descriptive (mean, median, and standard deviation) and inferential statistics (paired t tests and chi-square test).

RESULTS

[Table 1] highlights that most respondents were between 20 and 22 years of age with a percentage of 62.9%, 4.3% are less than 20 years, followed by 30%of students between 23 and 25 years, then 2.9% of students are more than 26 years. The majority of respondents who have performed aseptic dressing more than five times were 52.9%, followed by 41.4% who have performed aseptic dressing less than five times and 5.7% who have not performed aseptic dressing. Most respondents were females, with a percentage distribution of 82.9%, and males were 17.1%. The number of respondents who attended the demonstration was 80%, followed by 20% who had not attended any demonstration. Most respondent's sources were clinical teaching and class teaching, with a percentage distribution of 57.1%, followed by 14.3% whose sources were only class teaching, and 28.6% of students learned through only clinical teaching.{Table 1}

[Table 2] reveals nursing intern students' pretest and posttest mean knowledge scores regarding the aseptic dressing technique. The pretest and posttest mean knowledge scores were between 12.33 ± 3.326 and 16.36 ± 2.973 [Figure 1].{Table 2} {Figure 1}

[Table 3] explores the pretest knowledge score, 16 (22.9%) had poor knowledge, 44 (62.9%) had average knowledge, and 10 (14.3%) had good knowledge. While during posttest knowledge scores, 2 (2.9%) had poor knowledge, 27 (38.6%) had average knowledge, and 41 (58.6%) had good knowledge.{Table 3}

[Table 4] depicts the pretest and posttest mean knowledge scores were 12.33 ± 3.326 and 16.36 ± 2.973, respectively. The difference between the pretest and posttest mean knowledge score was significant (P = <0.0001). The finding highlighted that the video-assisted teaching program significantly impacted the knowledge of nursing intern students regarding aseptic dressing technique.{Table 4}

[Table 5] reveals the association of pretest knowledge score with the socio-demographic variables with the help of chi-square with Yates correction. The findings stated that variables like age (P = 0.771), gender (P = 0.810), attended demonstration (P = 0.681), the number of times aseptic dressing performed (P = 0.288), and source of learning (P = 0.478) have no statistically significant association with levels of knowledge of the students.{Table 5}

DISCUSSION

The present study evaluated the intervention's effect on enhancing nursing interns' knowledge about aseptic dressing techniques. The present study's findings showed that 44 (62.9%) participants had average knowledge in the pretest knowledge score. In context to our findings, Jarelnape[[13]] expressed that nearly two-thirds of subjects (66.3%) had average knowledge of the aseptic technique. A systematic review by Hawker et al.[[14]] revealed that nursing students expressed confidence in their abilities to perform aseptic techniques, but their knowledge, comprehension, and skill were frequently lacking. It was felt by both students and licensed nurses that aseptic technique instruction and training might be enhanced.[[14]] Another study by Gasaba E et al.[[15]] stated that nurses have poor knowledge of reading implementation of the principles of asepsis. This finding was nearly similar to our findings.[[15]] According to the evaluation, a sizable percentage of participants believed that their unit did not have enough resources or training for aseptic procedures. The participants reported several obstacles in sustaining aseptic techniques, including inadequate training, limited resources, time constraints, and inadequate support. The present study explored that the mean pretest knowledge score was 12.33. In this regard, Jarelnape[[13]] expressed that the mean knowledge score was 14.12, which is nearly similar to our findings.

Furthermore, the findings revealed that the difference between pretest and posttest mean knowledge scores was significant (P = <0.0001). The finding highlighted that the video-assisted teaching program significantly impacted the knowledge of nursing intern students regarding aseptic dressing technique. In this reference, Kumar and Pareek[[16]] revealed that the video-assisted teaching program effectively enhanced the nurses' knowledge about hand hygiene, as the present study highlighted that the educational intervention was significantly effective in upgrading the knowledge levels of the participants. Mall et al.,[[17]] Pareek et al.,[[18]] and Kumar et al.[[19]] also revealed similar findings while assessing the effectiveness of the learning package. Such interventions contribute to upgrading the awareness of healthcare professionals.

CONCLUSION

The latest research found that nursing students possess a restricted understanding of aseptic dressing methods for infectious surgical wounds. However, following the implementation of a video-assisted teaching program, there was a noticeable enhancement in the students' knowledge levels. Consequently, the intervention significantly improved nursing interns' understanding of aseptic dressing techniques for infectious surgical wounds. The ongoing trend seeks to furnish students with comprehensive knowledge, clinical expertise, positive attitudes, and ethical values essential for assuming professional nursing roles. This approach aims to foster competencies among students, with the acquired knowledge contributing to reducing disease progression and lessening the burden of illness.

Financial support and sponsorship

Nil

Conflicts of interest

There are no conflicts of interest.