Date of Award

12-7-2022

Degree Type

Thesis

Degree Name

Master of Science in Nursing (MScN)

First Advisor

Dr. Salma Rattani

Second Advisor

Ms. Nimira Asif

Third Advisor

Mr. Hussain Maqbool

Department

School of Nursing and Midwifery, Pakistan

Abstract

Background: Protective lung strategies are not implemented within ICU despite strong evidence-based recommendations and dedicated professionals. Nurses’ adherence plays a crucial role in implementing recommended guidelines, eventually improving patient outcomes. Understanding the factors responsible for non-adherence and behavior change to protective lung strategies among nurses is, therefore, important.
Purpose: To identify the barriers and to explore the knowledge, attitude, and behavior of ICU nurses regarding the implementation of protective lung strategies.
Method: A descriptive, cross-sectional study design was used. Participants were nurses working in the six intensive care units of a pediatric tertiary care hospital in Lahore, Pakistan. Purposive sampling was used with randomization to recruit the study participant, and the total sample size was 137 nurses. A previously validated tool was used to assess the perceived barriers (attitude, behavior, and perceived knowledge) and actual knowledge about protective lung strategies. A summative rating scale was used to identify the barriers to the implementation of protective lung strategies, and Robust regression analysis was added to assess the predictors of barriers.
Findings: A high degree of overall nurses’ barriers was observed, with a mean score of 66.77 ± 5.36. Across all the barriers subscales, the attitude subscale was the most significant barrier (35.74 ± 3.57). Knowledge related barriers were also significantly higher, approximately only 4% of participants knew about the recommended guidelines, whereas the mean knowledge score was 0.61. Nurses with more than ten years of experience reported higher overall (68 ± 3) and attitude (37± 3) level barriers. The barriers are high in nurses working in the MICU (68 ± 3), and lowest in CSICU (65 ±5). All the barrier scales and knowledge scores were not significant for observing any difference with a year of experience, work hours spent in ICU, and type of the ICU.
Conclusion: Important nurses’ barriers, including attitude and knowledge deficit, were reported regarding the implementation of the protective lung strategies. Interventions planned according to these barriers may help to increase the level of adherence of low tidal volume ventilation and improve patient outcomes.

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1

Last Page

73

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