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Effect of a self-directed learning package on emergency nurses' knowledge of assessment of oxygenation and use of supplemental oxygen.

Emergency nurses frequently and independently make decisions regarding supplemental oxygen. The importance of these decisions for patients is highlighted by the well documented association between respiratory dysfunction and adverse events. This study aimed to: (i) examine the effect of educational preparation on emergency nurses' knowledge of assessment of oxygenation, and the use of supplemental oxygen; (ii) explore the impact of existing knowledge on decisions related to the implementation of supplemental oxygen; and (iii) explore nurses' characteristics that were associated with effectiveness of the educational preparation. A pretest/post-test, controlled, quasi-experimental design was used in this study. Educational preparation was effective in increasing emergency nurses' knowledge. Baseline level of knowledge was predictive of reports of independent decisions regarding the implementation of oxygen. There was a significant positive relationship between postgraduate qualification in emergency nursing and the effect of education, and significant negative relationships between effect of education and baseline level of knowledge and daily decisions to implement supplemental oxygen.

Clinical Competence↗

The effects of specific educational preparation on emergency nurses' clinical decisions regarding supplemental oxygen administration.

The use of supplemental oxygen by emergency nurses has important implications for patient outcomes, yet there is significant variability in oxygen administration practises. Specific education related to oxygen administration increases factual knowledge in this domain; however, the impact of knowledge acquisition on nurses' clinical decisions is poorly understood. This study aimed to examine the effect of educational preparation on 20 emergency nurses' decisions regarding the assessment of oxygenation and the use of supplemental oxygen. A pre-test/post-test, quasi-experimental design was used. The intervention was a written, self-directed learning package. The major effects of the completion of the learning package included no change in the number or types of parameters used by nurses to assess oxygenation, a significant decrease in the selection of simple masks, a significant increase in the selection of air entrainment masks, fewer hypothetical outcomes of unresolved respiratory distress and more hypothetical outcomes of decreased respiratory distress. As many nursing education programs are aimed at increasing factual knowledge, while experience remains relatively constant, a greater understanding of the relationship between factual knowledge and clinical decisions is needed if educational interventions are to improve patient outcomes.

Adult↗

Effectiveness of a genetics self-instructional module for nurses involved in egg donor screening.

OBJECTIVE: To evaluate the effectiveness of a self-instructional module in increasing nurses' knowledge of genetics. DESIGN: Pretest/posttest study design. Participants completed a pretest questionnaire used to measure baseline knowledge of basic human genetic concepts and risk assessment and collect descriptive data. Participants then reviewed a self-instructional module and completed a posttest questionnaire. SETTING: Study materials were mailed to 262 registered nurses involved in screening egg donors at 177 reproductive health centers in the United States from July to September 2000. PARTICIPANTS: Sixty-five registered nurses working at reproductive health centers. One hundred of 262 eligible nurses completed the pretest (38% return rate) and 65 of these 100 nurses also completed the posttest (65% retention rate). INTERVENTION: A 22-page self-instructional booklet on genetic risk assessment. MAIN OUTCOME MEASURES: Pretest and posttest responses. RESULTS: There was a significant increase of 20.8% in participants' mean knowledge score on the posttest (M = 89.0%, SD = 8%, range = 67%-100%) as compared with the pretest (M = 69.0%, SD = 12%, range = 42%-92%), based on paired t-test analysis (t = 11.74, SE = 0.426, p < .0001). CONCLUSION: A genetics self-instructional module for registered nurses was effective in increasing knowledge of basic human genetic concepts and risk assessment. More in-depth independent study programs in genetics for nurses are recommended.

Curriculum↗

Oral cleanliness and gingival health following oral hygiene instruction by self-educational programs.

The aim of the present study was to determine the motivational effect of using a periodontal self-examination manual prior to a self-instructional manual in oral hygiene and to examine whether instruction provided at a later time than the scaling procedure improves the effect of the instruction. 74 patients with periodontal disease were divided into 3 groups: (1) A group of 23 patients who performed a self-examination of their periodontal condition prior to self-instruction in oral hygiene; (2) a control group of 27 patients who used only the self-instructional oral hygiene manual; and (3) a group of 24 patients who were not given the self-instructional oral hygiene manual before 6 weeks after the baseline examination. All these patients had their teeth scaled at the start of the study and after 3 and 7 months. The effect of the various modes of instruction was evaluated by assessments of plaque and gingival bleeding scores. These parameters were determined at the baseline and after 2 and 6 weeks and 3 and 7 months. The results demonstrated a significant improvement in plaque and gingival bleeding scores following the use of the self-instructional manual in oral hygiene. The use of the periodontal self-examination manual or a delay of the instruction had no additional effect on oral cleanliness. The level of oral hygiene and gingival health achieved at 3 months was maintained in all 3 groups for an additional period of 4 months. After that time, they were divided into 2 other groups depending on whether or not their plaque score was less than 20%. A total of 26 in the group who had a plaque score higher than 20% demonstrated a plaque score of than 20% after having performed the tooth brushing test. 10 of the remaining patients, who still had a plaque score of more than 20% after the tooth brushing test, received additional instruction in oral hygiene which subsequently resulted in improved oral cleanliness after 6 months.

Adult↗

Comparison of modes of oral hygiene instruction in improving gingival health.

195 Hong Kong Chinese employees from a single company participated in a 10-month longitudinal study on the effects of various modes of delivery of oral hygiene messages on their gingival health. Subjects were allocated to one of the following modes of oral hygiene education: (1) personal instruction; (2) self-education manual; (3) video; (4) a combination of 2 or more of these modes of instruction. Scaling or any other form of periodontal treatment was not given throughout the study period. Full mouth clinical examinations were carried out using a Williams Periodontal probe to examine for the presence or absence of plaque and bleeding on probing from the gingival sulcus. At 2 weeks, 4 months and 10 months, results showed significant reductions in the mean % of plaque and bleeding when compared with baseline. No significant differences were found between the groups given the various modes of oral hygiene education. The study does confirm the effectiveness of oral hygiene alone in improving gingival health, but the lack of difference in the outcome of various oral hygiene education approaches indicates that the mode of instruction is not crucially important to the end result. However, it has to be acknowledged that improvement in oral hygiene may be related to factors other than the oral hygiene programme itself. The findings have significant implications in oral health promotion programmes to improve the periodontal status of the local community.

Adult↗

Oral hygiene instruction using a self inspection plaque index.

The need for proper oral hygiene requires large amounts of time and manpower, and relapse is still common. This paper describes a self instructional manual and self inspection plaque index that was tested in a periodontal recall population. The program was tested on 18 periodontal recall patients over a period of 6 weeks. Questionnaires were completed at the start, at 2 weeks, and at the end of the experimental period to evaluate patient opinions. Presence of plaque near the gingival margin was recorded at the start, at 2 weeks, and at 6 weeks. Patients were provided with a self instructional manual which taught them to recognize plaque on six teeth. Also, they were given a lighted mouth mirror, a toothbrush, and disclosing wafers. Initial, before-brushing plaque scores of 47% decreased to 18% during the 6 weeks of the study. After-brushing plaque scores also were significantly improved during the study. Patients were able to perform the plaque index without guidance to a high level of agreement with a dental hygienist (r = 0.72). Furthermore, the program was well accepted by the patients according to their answers on the questionnaire.

Adult↗

A portable, self-instructional stress management program for college students.

This article describes the process used to develop a stress management program for college students and the program that resulted. Based on a needs assessment and piloting of the program, a portable, modular self-instructional program was developed. The program consists of five instructional stations: Assessment; The Nature of Stress and the Skill of Cognitive Restructuring; The Effects and Consequences of Stress and Time Management Skills; Relaxation Skills; and Planning For Stress Control. Feasibility in administering the program was of particular importance, so the program was portable. It can be transported to residence halls, student unions, or other gathering places, and it does not require a trained professional to be present. Included are two videotapes and two slide/audiotapes produced by the program's developers, one relaxation tape (guided imagery), and handout materials.

Adult↗