Effectiveness of an Education Program on Nurses׳ Knowledge at Orthopedic Wards in Ghazi Al-Hariri Martyr Hospital for Surgical Specialties

 

Harith F. Khudhayer¹, Hussein H. Atiyah²

¹College of Nursing, University of Mosul, Iraq

²Adult Nursing Department, College of Nursing, University of Baghdad, Iraq

 

ABSTRACT:

The study aimed to evaluate the effectiveness of an educational program on nurses' knowledge concerning nursing management of patients with skeletal traction. The randomized sample consists of (39) nurses at orthopedic wards in Ghazi Al-Hariri Martyr Hospital from 10^th of January 2018 to 20^th of April 2018, which is divided into two groups, (22) nurses are assigned as study group while (17) nurses were as control group but only the study group were exposed to the educational program. To evaluate nurses׳ knowledge the researcher used a questionnaire composed of (35) multiple choice question and the validity of the questionnaire was determined by a panel of experts. The study indicated that the knowledge score of nursing staff was inadequate for both (study and control) group in the pre-test but the study group knowledge score was highly increased after giving them the educational program. Therefore there were significant differences between study and control group. But the findings indicated that there was no significant relationship between nurses’ knowledge and age, gender, educational level and years of experience of nurses in orthopedic wards. Education and special training programs for these nurses in orthopedic wards should be designed and presented through how to provide nursing care, how to prevent complications and management of complications if present.

 

 

 

INTRODUCTION:

Orthopedic patient is a person who's affected by some defects within the musculoskeletal system and requires a help from the orthopedic staff. The nurse who is specialist in the orthopedic nursing is one of these staff nurse⁽¹⁾

 

Traction is done by both techniques of skin and skeletal methods⁽²⁾. The primary management pattern of fractures is skeletal traction ⁽³⁾.

 

Skeletal traction encompasses any pulling force done by a pin, screw or wire through the fractured bone to do traction; for the tibia, femur, olecranon, os calcis, and metacarpal⁽⁴⁾.

 

However, skeletal traction involves different defects related to pin introduction and infections that due to places of pin at the sites of pin introduction⁽⁵⁾.

 

The nursing staff members who start to provide orthopedic care, they require to understand the correct and efficient nursing skills to practice nursing correctly for themselves and for the patients⁽⁶⁾.

 

Therefore, the study aims to evaluate knowledge of nursing staff at the orthopedic units regarding the existing care of patient with skeletal traction. And to provide an effective educational program to improve and facilitate high quality nursing care for patients undergoing skeletal traction.

 

MATERIALS AND METHODS:

A quasi-experimental design was carried out at orthopedic wards in Ghazi Al-Hariri martyr hospital for surgical specialties from 10/1/2018 to 20/4/2018.

 

The sample involved all the nurses in the orthopedic wards of both morning and night shifts, which is divided into two groups, one is study group (22) nurses and one is control group (17) nurses. A randomized sample (39) nurses was selected through probability sampling technique.

 

The instrument that used is the questionnaire which is composed of (35) multiple choice question concerning nurses׳ knowledge. Reliability of knowledge was determined through collecting the data from 10 nurses and performing test and re-test, the reliability coefficient results are significant for knowledge and validity of questionnaire was determined through the experts.

 

Data were analyzed through the application of descriptive data analysis (frequency, percentage, mean of scores), and the inferential data analysis (t-test, one way analysis of variance, and chi-square.

 

RESULTS:

Table (1): Distribution of the studied groups according to (Socio demographic Characteristics) associated with differences importance.

Sociodemographic Characteristics.	Groups	Study		Control		C.S. (*) P-value
	Percent	No.	%	No.	%
Age Groups Yrs.	<  30	9	40.9	8	47.1	C.C.=0.179 P=0.523 (NS)
	30 – 39	9	40.9	8	47.1
	40  >	4	18.2	1	5.8
	Total	22	100	17	100
Gender	Male	11	50	12	70.6	C.C.=0.203 P=0.195 (NS)
	Female	11	50	5	29.4
	Total	22	100	17	100
Educational Level	Nursing sessions	1	4.5	0	0	C.C.=0.151 P=0.822 (NS)
	Nursing school	11	50	8	47.1
	Nursing Institute	8	36.4	7	41.1
	Bachelor in nursing and more	2	9.1	2	11.8
	Total	22	100	17	100

^(*)NS: Non Sig. at P>0.05; Testing based on a contingency coefficient (C.C.) test.

 

This table indicated that that studied (Socio Demographic Characteristics) in studied groups had recorded no significant differences at P>0.05, and that is reflecting validity of the selection of study and control subjects due to their similarity in those characteristics.

 

 

Table (2): Distribution of the studied groups according to occupational and developmental characteristics variables with comparisons significant

SDCv.	Groups	Study	Control	C.S. (*) P-value
	Percent	No.	%	No.	%
Years of Employment	< 5	8	36.4	6	35.3	C.C.=0.280 P=0.345 (NS)
	5  -  9	7	31.8	4	23.5
	10 – 14	3	13.6	6	35.3
	15 ≥	4	18.2	1	5.9
	Total	22	100	17	100
Years of Experience in Orthopedic nursing	< 5	13	59.1	10	58.8	C.C.=0.139 P=0.683 (NS)
	5  -  9	6	27.3	6	35.3
	10 – 14	3	13.6	1	5.9
	Total	22	100	17	100
Training sessions in orthopedic nursing	No	6	27.3	7	41.2	C.C.=0.145 P=0.361 (NS)
	Yes	16	72.7	10	58.8
	Total	22	100	17	100
In Iraq Number of sessions	1  -  2	8	50.0	6	60.0	C.C.=0.127 P=0.809 (NS)
	3  -  4	5	31.3	3	30.8
	5 >	3	18.8	1	15.4
	Total	16	100	10	100
Period of training sessions (Per Days)	3 D.	3	18.8	3	30.0	C.C.=0.156 P=0.723 (NS)
	5 D.	10	62.5	6	60.0
	7 D.	3	18.8	1	10.0
	Total	16	100	10	100

^(*)NS: Non Sig. at P>0.05; Testing based on a contingency coefficient (C.C.) test.

 

This table shows that studied groups recorded no significant differences at P>0.05, and that is reflecting validity of the selected study and control subjects due to their similarity concerning of that variables.

 

Table(3): Summary statistics of nurse's knowledge toward skeletal traction questionnaire's items in the studied periods (pre, and post) of applying educational program in the study group, as well as controlled with comparisons significant

Questionnaire's Items	Period	Study					Control					C.S.
		No.	MS	SD	RS%	Ass.	No.	MS	SD	RS%	Ass.
First)): Nurses knowledge toward skeletal traction)))
Skeletal traction usually used for fractures: Before surgery	Pre	22	0.50	0.51	50	M	17	0.18	0.39	18	L	S
	Post	22	1.00	0.00	100	H	17	0.24	0.44	24	L	HS
One of the following sentences is correct about skeletal traction: Done under general anesthesia	Pre	22	0.68	0.48	68	H	17	0.35	0.49	35	M	NS
	Post	22	1.00	0.00	100	H	17	0.35	0.49	35	M	HS
The difference between use of skin and skeletal traction is depending on: Application of pulling force	Pre	22	0.55	0.51	55	M	17	0.47	0.51	47	M	NS
	Post	22	1.00	0.00	100	H	17	0.53	0.51	53	M	HS
Suspended weights should be (10 %) of body weight	Pre	22	0.50	0.51	50	M	17	0.59	0.51	59	M	NS
	Post	22	1.00	0.00	100	H	17	0.59	0.51	59	M	HS
One of the following signs is a sign of pin site infection: Redness	Pre	22	0.45	0.51	45	M	17	0.41	0.51	41	M	NS
	Post	22	0.95	0.21	95	H	17	0.47	0.51	47	M	HS
Second)):  Nurses knowledge concerning risks of skeletal traction)))
Fat embolism is associated with: Femur fracture	Pre	22	0.41	0.50	41	M	17	0.47	0.51	47	M	NS
	Post	22	0.95	0.21	95	H	17	0.53	0.51	53	M	HS
Neurovascular injury in skeletal traction may be caused by: Heavy weights	Pre	22	0.36	0.49	36	M	17	0.65	0.49	65	M	NS
	Post	22	0.86	0.35	86	H	17	0.59	0.51	59	M	NS
Most of arteries at risk of injury in tibia skeletal traction is: Anterior tibial artery	Pre	22	0.64	0.49	64	M	17	0.65	0.49	65	M	NS
	Post	22	0.95	0.21	95	H	17	0.71	0.47	71	H	S
One of the following nerves may be at risk during skeletal traction of lower extremities: Common peroneal nerve	Pre	22	0.36	0.49	36	M	17	0.41	0.51	41	M	NS
	Post	22	0.95	0.21	95	H	17	0.47	0.51	47	M	HS
Thromboembolism occur during skeletal traction due to: Immobility	Pre	22	0.59	0.50	59	M	17	0.29	0.47	29	L	NS
	Post	22	0.95	0.21	95	H	17	0.29	0.47	29	L	HS

 

Questionnaire's Items	Period	Study					Control					C.S.
		No.	MS	SD	RS%	Ass.	No.	MS	SD	RS%	Ass.
(Third)): Nurses knowledge regarding procedure of skeletal traction)
We should pay attention in insertion of Steinman pin into tibia because of the common peroneal nerve is located	Pre	22	0.41	0.50	41	M	17	0.59	0.51	59	M	NS
	Post	22	1.00	0.00	100	H	17	0.65	0.49	65	M	HS
One of the principles of effective skeletal traction is	Pre	22	0.41	0.50	41	M	17	0.65	0.49	65	M	NS
	Post	22	0.95	0.21	95	H	17	0.65	0.49	65	M	S
Thomas splint is used in skeletal traction to	Pre	22	0.45	0.51	45	M	17	0.41	0.51	41	M	NS
	Post	22	1.00	0.00	100	H	17	0.41	0.51	41	M	HS
The best technique for insertion of Steinman pin into tibia is	Pre	22	0.45	0.51	45	M	17	0.47	0.51	47	M	NS
	Post	22	0.91	0.29	91	H	17	0.41	0.51	41	M	HS
Local anesthesia is injected to decease pin prior to insertion of pin into	Pre	22	0.50	0.51	50	M	17	0.35	0.49	35	M	NS
	Post	22	0.91	0.29	91	H	17	0.29	0.47	29	M	HS
((Fourth)):  Nurses knowledge concerning nursing management of skeletal traction
The nurse should prevent thromboembolism during skeletal traction by	Pre	22	0.41	0.50	41	M	17	0.41	0.51	41	M	NS
	Post	22	1.00	0.00	100	H	17	0.41	0.51	41	M	HS
The nurse should try to prevent constipation during skeletal traction by giving	Pre	22	0.36	0.49	36	M	17	0.41	0.51	41	M	NS
	Post	22	0.95	0.21	95	H	17	0.41	0.51	41	M	HS
The nurse can Prevent bedsore during skeletal traction by	Pre	22	0.41	0.50	41	M	17	0.47	0.51	47	M	NS
	Post	22	0.91	0.29	91	H	17	0.53	0.51	53	M	HS
The nurse should teach the patient deep breathing during traction to decrease	Pre	22	0.36	0.49	36	M	17	0.29	0.47	29	L	NS
	Post	22	0.86	0.35	86	H	17	0.41	0.51	41	M	HS
One of the following interventions  is an necessary nursing care during traction	Pre	22	0.64	0.49	64	M	17	0.35	0.49	35	M	NS
	Post	22	0.91	0.29	91	H	17	0.41	0.51	41	M	HS
The nurse should monitor pin site for redness and discharge during	Pre	22	0.50	0.51	50	M	17	0.41	0.51	41	M	NS
	Post	22	0.86	0.35	86	H	17	0.41	0.51	41	M	HS
The nurse should teach the patients some home instructions like	Pre	22	0.36	0.49	36	M	17	0.47	0.51	47	M	NS
	Post	22	0.95	0.21	95	M	17	0.47	0.51	47	M	HS
One of the following is the best during pin site dressing	Pre	22	0.32	0.48	32	L	17	0.53	0.51	53	M	NS
	Post	22	0.95	0.21	95	H	17	0.53	0.51	53	M	HS

 

Questionnaire's Items	Period	Study					Control					C.S.
		No.	MS	SD	RS%	Ass.	No.	MS	SD	RS%	Ass.
The nurse should monitor suspended weights to be	Pre	22	0.41	0.50	41	M	17	0.41	0.51	41	M	NS
	Post	22	0.91	0.29	91	H	17	0.41	0.51	41	M	HS
If the patient suffers from any chest pain or other complications the nurse should	Pre	22	0.41	0.50	41	M	17	0.35	0.49	35	M	NS
	Post	22	1.00	0.00	100	H	17	0.29	0.47	29	L	HS
The nurse should keep the line of pulling or traction	Pre	22	0.50	0.51	50	M	17	0.53	0.51	53	M	NS
	Post	22	0.91	0.29	91	H	17	0.53	0.51	53	M	HS
One of the following sentences is unnecessary for patients in skeletal traction	Pre	22	0.36	0.49	36	M	17	0.53	0.51	53	M	NS
	Post	22	0.95	0.21	95	H	17	0.53	0.51	53	M	HS
The nurse should monitor movement of the effected extremity to ensure there is no	Pre	22	0.36	0.49	36	M	17	0.35	0.49	35	M	NS
	Post	22	0.91	0.29	91	H	17	0.35	0.49	35	M	HS
The nurse should encourage the patient to eat diet that contains	Pre	22	0.50	0.51	50	M	17	0.24	0.44	24	L	NS
	Post	22	0.95	0.21	95	H	17	0.24	0.44	24	L	HS
The nurse can decrease pain of skeletal traction patients	Pre	22	0.23	0.43	23	L	17	0.59	0.51	59	M	S
	Post	22	0.86	0.35	86	H	17	0.53	0.51	53	M	HS
The nurse can decrease edema of the fractured part	Pre	22	0.50	0.51	50	M	17	0.59	0.51	59	M	NS
	Post	22	1.00	0.00	100	H	17	0.59	0.51	59	M	HS
When the nurse clean pin site he should notice	Pre	22	0.50	0.51	50	M	17	0.35	0.49	35	M	NS
	Post	22	1.00	0.00	100	H	17	0.35	0.49	35	M	HS
One of the following is nursing intervention during skeletal traction	Pre	22	0.50	0.51	50	M	17	0.35	0.49	35	M	NS
	Post	22	0.91	0.29	91	H	17	0.35	0.49	35	M	HS
To keep the pulling force and patient's body force the nurse should ask  the patient to	Pre	22	0.50	0.51	50	M	17	0.24	0.44	24	L	NS
	Post	22	0.91	0.29	91	H	17	0.24	0.44	24	L	HS
Encourage the patent to increase fluids and eat highly fibers diet to decrease	Pre	22	0.36	0.49	36	M	17	0.53	0.51	53	M	NS
	Post	22	0.86	0.35	86	H	17	0.53	0.51	53	M	S

HS: Highly Sig. at P<0.01; S: Sig. at P<0.05; NS: Non Sig. at P>0.05; Testing based on a contingency coefficient (C.C.) test.

Assessments Intervals Scales: [L: Low (0.00 – 33.33)]; [M: Moderate (3.34 – 66.66)];[H: High (66.67 – 100)

 

Table (4): Descriptive statistics and testing significant of studied nurse's knowledge toward skeletal traction main domains in pre and post periods

Groups Statistics (Pre X Pre)
Grand Main Domains		Group	No.	GMS	SD	SE	t-test	P-value
Pre	Nurses knowledge toward skeletal traction	Study	22	53.64	27.87	5.94	1.62	0.114 NS
		Control	17	40.00	23.45	5.69
	Nurses knowledge concerning risks of skeletal traction -	Study	22	47.27	25.11	5.35	-0.28	0.784 NS
		Control	17	49.41	22.49	5.46
	Nurses knowledge regarding procedure of skeletal traction	Study	22	44.55	21.32	4.55	-0.74	0.462 NS
		Control	17	49.41	18.86	4.58
	Nurses knowledge concerning nursing management of skeletal traction	Study	22	44.55	17.38	3.71	0.500	0.617 NS
		Control	17	42.06	12.00	2.91
Post	Nurses knowledge toward skeletal traction	Study	22	99.1	4.3	0.91	10.26	0.000 HS
		Control	17	40.0	23.5	5.69
	Nurses knowledge concerning risks of skeletal traction -	Study	22	93.6	11.4	2.42	7.34	0.000 HS
		Control	17	51.8	21.3	5.16
	Nurses knowledge regarding procedure of skeletal traction	Study	22	95.5	8.6	1.83	9.50	0.000 HS
		Control	17	51.8	17.4	4.22
	Nurses knowledge concerning nursing management of skeletal traction	Study	22	93.0	7.0	1.50	15.54	0.000 HS
		Control	17	40.0	12.6	3.06
Overall Assessment (((Pre )))		Study	22	47.50	14.78	3.15	0.536	0.595 NS
		Control	17	45.22	10.71	2.60
Overall Assessment (((Post )))		Study	22	95.3	4.7	1.01	18.35	0.000 HS
		Control	17	45.9	10.3	2.50

HS: Highly Sig. at P<0.01; NS: Non Sig. at P>0.05; Testing based on two independent t - test.

GMS: Grand Mean of Score/ or Global Mean of Score

 

This table shows that along pre-post periods studied main domains, as well as an overall assessment are accounted highly significant differences at P<0.01 in the study group, and no significances at P>0.05 are accounted in controlled group.

For summarizes preceding results, it could be conclude that proposed educational program has been highly successful by improving the quality of nurse's knowledge concerning nursing management of patients with skeletal traction at orthopedic wards.

Table (5): Descriptive Statistics and testing significant of studied main domains a long (Pre – Post) periods in study and Control groups

Sub & Main Domains		Period	No.	GMS	SD	SE	MP t-test	C.S.
Study	Nurses knowledge toward skeletal traction	Pre	22	53.6	27.9	5.9	-7.5	0.000 HS
		Post	22	99.1	4.3	0.9
	Nurses knowledge concerning risks of skeletal traction -	Pre	22	47.3	25.1	5.4	-8.0	0.000 HS
		Post	22	93.6	11.4	2.4
	Nurses knowledge regarding procedure of skeletal traction	Pre	22	44.6	21.3	4.6	-12.4	0.000 HS
		Post	22	95.5	8.6	1.8
	Nurses knowledge concerning nursing management of skeletal traction	Pre	22	44.6	17.4	3.7	-12.9	0.000 HS
		Post	22	93.0	7.0	1.5
	Overall Assessment	Pre	22	47.5	14.8	3.2	-15.6	0.000 HS
		Post	22	95.3	4.7	1.0
Control	Nurses knowledge toward skeletal traction	Pre	17	40.0	23.5	5.7	0.00	1.000 NS
		Post	17	40.0	23.5	5.7
	Nurses knowledge concerning risks of skeletal traction -	Pre	17	49.4	22.5	5.5	-0.31	0.762 NS
		Post	17	51.8	21.3	5.2
	Nurses knowledge regarding procedure of skeletal traction	Pre	17	49.4	18.9	4.6	-0.38	0.707 NS
		Post	17	51.8	17.4	4.2
	Nurses knowledge concerning nursing management of skeletal traction	Pre	17	42.1	12.0	2.9	0.69	0.498NS
		Post	17	40.0	12.6	3.1
	Overall Assessment	Pre	17	45.2	10.7	2.6	-0.20	0.841 NS
		Post	17	45.9	10.3	2.5

^(*) HS: Highly Sig. at P<0.01; NS: Non Sig. at P>0.05; Testing based on two independent t - test. GMS: Grand Mean of Score/ or Global Mean of MP t-test: Matched Paired t-test.

 

Table (6): Analysis of covariance concerning nurse's knowledge with skeletal traction at orthopedic wards in study group according to SDCv.

Source	Type III Sum of Squares	d.f.	Mean Square	F Statistic	Sig. Levels	C.S. (*)
Intercept	58498	1	58498.2	2387	0.000	HS
Age Groups	14.3	2	7.2	0.293	0.751	NS
Gender	14.4	1	14.4	0.586	0.458	NS
Education level	52.3	3	17.4	0.711	0.563	NS
Years of Experience	71.2	2	35.6	1.452	0.270	NS
Error	318.6	13	24.5
Total	200208	22
Corrected Total	468.5	21

^(*) HS: Highly Sig. at P<0.01; Non Sig. at P>0.05; Statistical hypothesis based on Analysis of Covariance (ANCOVA).

 

In this table results shows that weak relationships are proved with (SDCv.), since no significant relationships are accounted at P>0.05, and accordance with the that, it could be concludes studied questionnaire of studying assessments of nurse's knowledge improvements through applying suggested educational program concerning nursing management patients with skeletal traction at orthopedic wards could be generalize on the studied population even though differences within socio-demographical characteristics variables of studied subjects would be in the study group.

 

Table (7): Analysis of Covariance (ANCOVA) concerning nursing management of skeletal traction improvements in control group according to Sociodemoghraphic AQ characteristics.

Source	Type III Sum of Squares	d.f.	Mean Square	F Statistic	Sig. Levels	C.S. (*)
Intercept	6436	1	6436	49.23	0.000	HS
Age Groups	19.4	1	19.4	0.148	0.708	NS
Gender	191.8	1	191.8	1.467	0.254	NS
Education level	95.6	2	47.8	0.366	0.703	NS
Occupation status	104.9	1	104.9	0.802	0.391	NS
Error	1307	10	130.7
Total	37484	17
Corrected Total	1696	16

(*) HS: Highly Sig. at P<0.01; Sig. at P<0.05; No Sig. at P>0.05; Statistical hypothesis based on Analysis of Covariance (ANCOVA).

 

Results shows that weak relationships are proved with (SDCv.), since no significant relationships are accounted at P>0.05, and accordance with the that, it could be concludes studied questionnaire of studying assessments of nurse's knowledge improvements without applying suggested educational program concerning nursing management patients with skeletal traction at orthopedic wards could be generalize on the studied population even though differences within socio-demographical characteristics variables of studied subjects would be in control group.

 

DISCUSSION:

This study confirmed that the majority of nurses' age in both the study and control groups was less than 39 years with percentage of (40.9%) in study group and (47.1%) in the control group. This study confirmed that the majority of nurses in orthopedic wards were male with (70.6%) in the control group but equal gender of nurses in the study group with (50%) for both male and female. The present study has revealed the majority of nurses in the study group (50%) and (47.1%) in the control group were nursing school graduated related to educational level (Table 1). 

 

Al-Aboudy stated that the highest percentage (30%) of nurses at (25-29) age, regarding to the gender the highest percentage (70%) of nurses male and for the level of education the highest percentage (42%) are nursing institute graduated⁽⁶⁾.

 

The findings demonstrated that the majority of nurses who work in the orthopedic wards were having less than 5 years employment with percentage (36.4%) in the study group and (35.3%) in the control group. This study revealed that the majority of nurses who work in the orthopedic wards with less than 5 years of experience in the orthopedic nursing with percentage (59.1%) in the study group and (58.8%) in the control group (Table 2).

 

El Enein et al., (2012) reported that the highest percentage of nurses had 1 to 5 years of experience (52.5%) ⁽⁷⁾. Samira and Rajaa, (2005) conducted in their study in Baghdad found that (54%) of the nurses had (1-5) years of experience in orthopedic wards ⁽⁸⁾.

 

The finding of the present study proved that nurses 'knowledge scores were poor in all knowledge items in pre-test which has been strongly increased immediately after the program implementation .This may be due to that nurses lacked the motivation to review the handout which has been given to them in the implementation phase, and the retention of knowledge quickly deteriorates if it is not used or updated regularly , the assessment intervals that used were ( L: Low 0.00-33.33); ( M: Moderate 3.34-66.66);(H: High 66.67-100) (Table 3). 

 

Results showed that the two groups in the light of the main domains had a highly congruent status, as there no significant differences at P>0.05 are accounted, and that assigned studied domains are reflecting an objectives behavior that differs in response from one person to another, which means that the subject of congruence is not based on chance (Table 4).

 

 

 

The present study showed that along pre-post periods studied main domains, as well as an overall assessment are accounted highly significant differences at P<0.01 in the study group, and no significances at P>0.05 are accounted in controlled group (Table 5).

 

Results shows that weak relationships are proved with (SDCv.), since no significant relationships are accounted at P>0.05, and accordance with the that, it could be concludes studied questionnaire of studying assessments of nurse's knowledge improvements without applying suggested educational program concerning nursing management patients with skeletal traction at orthopedic wards could be generalize on the studied population even though differences within socio-demographical characteristics variables of studied subjects would be in control group.

 

The findings indicated that there was no significant relationship between nurses’ knowledge and age, gender, educational level and years of experience of nurses in orthopedic wards (Table 6, 7).

 

Al-Aboudy mentioned in his study that the nurses in orthopedic ward must take in services education to motivate them and increasing their knowledge regarding nursing management of the orthopedic ward ⁽⁶⁾.

 

RECOMMENDATIONS:

Based on the discussion and interpretation of the findings, the study recommends a further education and training programs should be planned and implemented for nurses in the orthopedic wards concerning nursing management of patients with skeletal traction.

 

REFERENCES:

1.      Wang and Zhen,: Fundamental and advanced nursing skills, Thomson Palmar Learning.

2.      Foster, K. (2006): A brief review of the effects of preoperative skin traction on hip fractures, Journal of Orthopedic Nursing, 10(3);2002: 138-143.

3.      Museru, L. M, and Mcharo, C. N.: the dilemma of fracture treatment in developing countries, International Orthopedic Journal, 26; 2002: 324–327.

4.      Fred, R., Nelson, M., FAAOS, C., A Manual of Orthopedic Terminology, 8th Edition), 2015:121-123.

5.      Overly, M. Frank, W, Steele. Common Pediatric Fractures and Dislocations, Clinical J Ped Emergency Med, 3(2); 2002: 12-14.

6.      Al-Aboudy, R. Evaluation of knowledge and practices of nurses in orthopedic wards concerning femur fractures care, a master thesis, College of Nursing, University of Baghdad. 2002.

7.      El Enein, Nagwa Younes Abou, Azza Saad Abd El Ghany, and Ashraf Ahmad Zaghloul. "Knowledge and performance among nurses before and after a training program on patient falls." 2012: 358-364.

8.      Samira, A. Rajaa, I. Evaluation of Knowledge and Practices of Nurses in Orthopedic wards concerning femur Fractures, A master thesis, College of Nursing, University of Baghdad, Sci. J. Nursing/ Baghdad, 18(2); 2005:25-31.

 

 

 

 

 

Received on 08.09.2018           Modified on 18.10.2018

Accepted on 19.02.2019         © RJPT All right reserved