IMPROVING NURSES’ KNOWLEDGE AND CLINICAL PRACTICE IN INTRACRANIAL SURGERY CARE THROUGH PRACTICE IMPLEMENTATION

Abstract

Patients in the post operation phase of intracranial surgery need specialized care to prevent complications and achieve best outcomes. Nurses have an important role in the monitoring of the neurological status of the patient, managing the complications and ensuring patient safety. However, poor knowledge and poor practices may have negative consequences on the outcome of the patient. Thus, it is crucial to adopt evidence-based nursing practices to improve the competency and quality of the nurse’s care in neurosurgical settings.

To evaluate the effect of implementing nursing practices on nurses’ knowledge and clinical practices in the care of patients undergoing intracranial surgery at Punjab Institute of Neuro Sciences Lahore.

The quasi-experimental pretest-posttest study was performed on 64 registered nurses of a Punjab Institute of Neuro Sciences Lahore. Purposive sampling was done to select the participants. A structured questionnaire, comprising 20 items to assess knowledge, 15 items to assess clinical practice, and demographic characteristics was used to collect data. After baseline assessment, all nurses underwent a structured educational intervention based on evidence-based postoperative neurosurgical care, including the aspects of neurological monitoring, infection prevention, medication management, and documentation. Two weeks following the intervention, posttest was administered. The data were analyzed by SPSS 26. The techniques of descriptive statistics, paired sample t-test, Chi-square test and Pearson correlation analysis were used. A p value of <0.05 was used as a cutoff for statistical significance.

The average age of the subjects was 34.80 ± 8.93 years. Prior to the intervention, the moderate knowledge group accounted for 71.9% of the nurses and the poor knowledge group accounted for 28.1%. After practicing the nursing care, 64.1% had good level of knowledge. The mean knowledge score significantly increased from 11.02 ± 2.11 to 15.47 ± 2.42 (t = -31.64, p < 0.001). Concerning clinical practices, 57.8% of the nurses had a moderate practice and 42.2% a poor practice at baseline. The clinical practices of 79.7% were good after the intervention. The mean practice score significantly improved from 8.77 ± 1.79 to 12.84 ± 1.65 (t = -41.68, p < 0.001). Demographic variables such as gender, qualification, total nursing experience and working unit (current) did not correlate with posttest knowledge or practice levels (p>0.05).

The use of structured nursing practices led to a significant increase in the knowledge and actual practice of the nurses about the care of patients receiving intracranial surgery. The results indicate that evidence-based educational programmes and standardised nursing protocols should be embedded in the care of patients in neurosurgical settings to further develop the competence of professionals and improve patient care standards.