A Quasi Experimental Study to Assess the Effectiveness of Selected Psychiatric Emergency Management (SPEM) Programme upon the Competency in Managing the Psychiatric Emergencies among Nurses at Selected Hospitals, Chennai.

Statement of the Problem

A Quasi Experimental Study to Assess the Effectiveness of Selected Psychiatric Emergency Management (SPEM) Programme upon the Competency in Managing the Psychiatric Emergencies among Nurses at Selected Hospitals, Chennai.

Objectives

Primary Objectives

1.  To assess the level of competency in managing the Psychiatric Emergencies by the nurses before and after the Selected Psychiatric Emergency Management (SPEM) Programme in experiment and control group.

2.  .   To assess the effectiveness of Selected Psychiatric Emergency Management (SPEM) Programme upon the competency in managing the Psychiatric Emergencies among nurses by comparing the pre and posttests scores in experiment and control group.

Secondary Objectives

3.  To find out the correlation between knowledge, confidence and skills of nurses in managing the Psychiatric Emergencies in experiment and control group.

4.  To find out the association between selected background variables and competency managing the Psychiatric Emergencies among nurses in experiment and control group.

5.  To determine the level of acceptability among experimental group of nurses regarding the Selected Psychiatric Emergency Management (SPEM) Programme.

Research Hypotheses

H1: There will be a significant difference in competency between control and experimental group of nurses before and after Selected Psychiatric Emergency Management (SPEM) Programme.

H2: There will be a significant association between selected background variables and level of competency in control and experimental group of nurses before and after Selected Psychiatric Emergency Management (SPEM) Programme.

H3: There will be a significant correlation between posttest level of knowledge, confidence and skills in managing the Psychiatric Emergencies in experiment and control group of nurses.

Operational Definitions Effectiveness

It is the result of Selected Psychiatric Emergency Management (SPEM) programme on improving the competency of nurses working in hospitals as evidenced by increased post test scores measured by comparing the competency scores of nurses before and after administration of Selected Psychiatric Emergency Management (SPEM) Programme**.**

Selected Psychiatric Emergency Management (SPEM) ProgrammeIt is a module designed using techniques such as lectures, demonstrations and simulation learning programmes for empowering the nurse’s competency in managing the psychiatric emergency conditions such as patients with suicide attempt, delirium and aggression in hospitals. So that it will help to enhance the nurses competency especially in assessment areas including the risk assessment of selected psychiatric emergencies for actual and potential patients admitted in hospitals. This programme will be conducted for 8 hours in one week on every alternative day (2 hours/day) as per the convenience of the hospital and nursing authorities. Ice breaking sessions will be conducted to prevent the monotony of the programme.

CompetencyIt refers to the capacity / ability of nurses working in hospitals, which includes the knowledge, confidence and skills on Selected Psychiatric Emergency Management (SPEM).

Knowledge: It is the awareness and understanding about Selected Psychiatric Emergency Management among nurses as measured by structured knowledge questionnaire on Selected Psychiatric Emergency Management developed by the investigator.

Confidence:It refers to feeling of nurses about trusting in own abilities of self-power and judgement in  managing the psychiatric emergencies as measured by using  rating scale on confidence tool developed by investigator for Selected Psychiatric Emergency Management (SPEM) Programme.

Skills: It is the ability of nurses to perform the Selected Psychiatric Emergency Management as measured by using Objective Structured Clinical Examination (OSCE) skill stations, with observational checklists developed by the investigator for Selected Psychiatric Emergency Management (SPEM) Programme.Psychiatric EmergenciesIt refers to Selected Psychiatric Emergencies such as suicide attempt, delirium and aggression.

NursesIt refers to the registered staff nurses with qualification of GNM, B.Sc.(N), P.B.B.Sc(N) and M.Sc (N) working in selected hospitals in Chennai.

HospitalsIt refers to the selected multi-specialty tertiary care hospitals in Chennai.

Research Methodology

Research approach

Evaluative approach

Research Design

Quasi Experimental –research design

O1      -     O2 - O3

O1     X    O2 - O3

Variables

**Independent Variable:**Selected Psychiatric Emergency Management (SPEM) Programme.

Dependent Variables:

Competency (knowledge, confidence and skills)of nurses.

Research SettingTwo Apollo Hospitals will be selected based on feasibility and accessibility of samples (Nurses). Among two hospitals, 1 will be assigned to control group and 1 will be assigned to experimental group randomly which includes:

1. Apollo Specialty Hospitals, Vanagaram, Chennai.

2. Apollo Hospitals, Greams road, Chennai.

PopulationTarget PopulationStaff Nurses working in hospitals who satisfy the inclusion criteria.

Accessible PopulationThe accessible population in the study will be the staff nurses working in selected hospitals in Chennai.

SampleSample includes nurses working in selected hospitals who meet the inclusion criteria.

Sample SizeSample size is estimated based on the previous study findings using power analysis. Two hundred and twenty samples (110 in control group and 110 in experimental group) will be included in the study.

Sampling Technique                        From each wards of selected hospitals, the control and experimental group of nurses will be allotted proportionately by using simple random technique as per inclusion criteria.

Sampling Criteria Inclusion criteria:

1.Nurses who are available at the time of data collection.

2.Nurses working in inpatient units such as critical care units, post-operative wards, cardio thoracic ICUs, emergency units, neuro, medical and surgical wards in the selected hospitals.

Exclusion criteria:

1.Nurses with qualification of M.Sc(N) in Psychiatric nursing specialty.

2.Nurses who had training on Psychiatric Emergencies Management (SPEM) Program within last three years.

3.Nurses who are working in the out Patient Department, operation theatre, endoscopic procedures and catheterization labs.

Development and Description of Tools

1.  Background Variables Proforma to assess the Background Characteristics of nurses.

2.  Structured questionnaire to assess the knowledge of nurses in managing the selected psychiatric emergencies.

3.  Rating scale to assess the confidence of nurses in managing the Selected Psychiatric Emergencies Management

4.  OSCE skills stations with observational checklists to assess the level of skills of nurses in managing the selected psychiatric emergencies.

5.  Rating scale to assess the level of acceptability of nurses regarding the Selected Psychiatric Emergency Management (SPEM) Programme.

Pilot Study

Pilot study will be conducted with 10% of the total population Permission will be obtained from the concerned authorities. Pilot study will be conducted using the same tools and procedures planned for the main study.

Data Collection

Data on knowledge and confidence will be collected using predetermined, validated and pretested tools through self administration method and data on skills of nurses will be collected by Objective Structured Clinical Examination (OSCE) skill stations with observational checklists with help from trained simulated patients and trained evaluators. Intervention- SPEM programme will be administered to the experimental group of nurses and control group will receive only their continuing education program done on the job in their hospital. First post test will be conducted after 1 week after intervention and post test 2 will be conducted after 1 month of SPEM programme**.**

Data Analyses

Descriptive statistics

The descriptive statistical analysis includes frequencies, percentages, means and Standard deviation.

Inferential statistics

Inferential statistics measured like independent "T’ tests, Pearson correlation coefficient and Repeated measures ANOVA with Post Hoc Analysis will be used to test the hypotheses.

The chi-square test will be used to find the association between the background characteristics of nurses.