Introduction
Nursing education has a long history that makes students understand how crucial and inevitable moral and ethical responsibilities could be (Karseth, 2004). In the modern world, students have to realise that the roles of nurses vary considerably because they should be ready to cooperate with doctors and patients and never neglect their colleagues, who could also have their personal needs and demands in regards to such influential factors as migration, mass communication, or fast exchange of information (Mill, Astle, Ogilvie, & Gastaldo, 2010).
Besides, nurses have to succeed in managing a lot of tasks that should be performed in hospitals. Wound management is one of the topics that should be discussed. In this project, an education needs assessment will be conducted to understand what nurses have to know about wound management and what improvements could be offered to them in the chosen unit in the form of an educational program with its characteristics and peculiarities.
20 nurses from the Emergency Unit at King Saud General Hospital in Al-Qassim City are chosen as the main participants of this project. Their answers and the assessor’s evaluation of the information will be used to identify the essential education needs and to develop an effective program for these needs with time (Keogh, Fourie, Watson, & Gay, 2010).
Wound management is chosen as the main topic. Three additional topics have to be taken into consideration that includes ischemic wound knowledge, aseptic technique (dressing), and wound assessment. Wound management is an important aspect of an emergency unit of any hospital (Mattu et al., 2012). The possibility to identify and investigate the education needs of nurses at this department should help to contribute to the spheres of education and nursing and provide nurses with knowledge on how they could improve healthcare services.
Background
Any education program should be based on the identification of the gap that could exist between what a learner has already known on a subject and what a learner has to know in regards to the expectations of the chosen organisation (DeSilets, 2007). King Saud General Hospital has about 360-bed capacities and more than 120 nurses working there. The chosen assessment will be focused on the experiences of 20 nurses, who work at this hospital for the period between one and three years (sample of the study). It is expected that the assessment could help to identify the needs of nurses in wound management and understand what kind of instructional needs could be offered.
As Prideaux (2007) explains, medical education is usually characterised by several new challenges. Therefore, it is required to develop medical teaching and learning and consider new requirements and expectations. Nurses should not only to understand what steps they can take in wound management. They should also be ready to identify and comprehend the emergency of their education needs and choose a program that could meet their personal and professional needs. Therefore, it is important to develop an effective education needs assessment and prove its appropriateness for the nurses, who work at the Emergency Unit at King Saud General Hospital in Al-Qassim City.
Data Collection Methods
In many countries, nursing education is identified as a crucial aspect for consideration because of the existing shortage of nurses and the necessity to provide students with a good portion of nursing knowledge (Turner, Davies, Beattie, Vickerstaff, & Wilkinson, 2006). As a result of such needs and challenges, healthcare organisations should take several steps and investigate the areas that have to be improved and explained. To understand what kind of knowledge and skills should be developed by healthcare practitioners, it is necessary to assess the educational needs that could be defined as essential (Dyson, Hedgecock, Tomkins, & Cooke, 2009).
Forbes, While, and Ullman (2005) underline that the modern healthcare environment is complex indeed and not all nurses can identify their learning needs without an additional kind of help. An education or learning need is the gap between what should be known and what is known (Watkins, Meiers, & Visser, 2012). It is hard to understand if a nurse has enough knowledge background to evaluate personal appropriateness for the chosen job.
Therefore, the idea to work with a certain target group helps to succeed in needs assessment and identifying the problems in wound management EU nurses could face. Properly chosen research methods to help to cover the required aspects of human experience and reveal the level of knowledge about the target group of people including the demographic data, personal traits, and personal experience (Bhattacherjee, 2012).
There are many data collection methods and tools that could be used to succeed in a needs assessment. Watkins et al. (2012) introduce more than 20 possible tools for consideration and explain that though the majority of techniques including interviews, SWOT, focus groups, observations, questionnaires, etc. are taken from other disciplines, their application in assessments could be justified and used. Hodges and Videto (2011) say that it is hard to identify what tool is the most appropriate choice; therefore, an assessor should choose such factors as personal skills, time available for research, and the abilities to cooperate with people.
In this project, it is decided to use a questionnaire as the main data collection tool. The rationale for this choice is the possibility to gather enough qualitative and quantitative facts, to identify the attitudes of nurses to the importance of wound management, to clarify if nurses are interested in the idea of the improve their knowledge, and to start developing a program that could help nurses in emergency units. Questionnaires are characterised by certain boundaries. Still, they help the interviewees to narrow down their answers and share the required portion of information. At the same time, questionnaires are not difficult to create (Stufflebeam, McCormick, Brinkerhoff, & Nelson, 2012).
The only challenge is to make sure that there are enough participants for the study and that people give clear and true answers. Besides, questionnaires are effective for research projects because it is possible to modify the answers, interpret them in the ways that are convenient for researchers, and promote confidentiality that could be important for some participants (Rattray & Jones, 2005). Questionnaires also help to touch upon the ethical aspects of the study and follow the ethical guidelines that are important for cooperation with people (Gupta, 2011).
Some authors suggest using specially developed checklists and forms to create an effective questionnaire (Reviere, 2013). However, a researcher is also able to develop a questionnaire form independently regarding the requirements of the study offered by professional researchers. Therefore, it is suggested to focus on the information that could be gathered from different literary sources at first (Buckley, Wheeler, & Halbesleben, 2015). The data has to be credible and relevant. The information gathered from the employees of the King Saud General Hospital should also be critically evaluated and free from judgements and prejudices. In other words, all instruments of the study have to be culturally sensitive but unbiased (Anderson, 2013).
To introduce a strong questionnaire, Sleezer, Russ-Eft, and Gupta (2014) offer to develop a pilot test. The pilot-test survey should be properly organised including such stages as the selection of the participants, observation of the participants, the introduction of the main goals of the survey, the analysis of the data that could be gathered from the test, and the modification of the results according to the requirements given by the experts.
The rationale for the pilot study is the necessity to introduce the participants and identify the research boundaries in the study. The researcher needs to understand what types of workers (in these cases, they are nurses) could be appropriate for the investigation and clarify what kind of answers they could give. It is not enough to create questions and pose them to anyone. Therefore, the pilot test helps to underline the importance of the boundaries in this research.
There are three types of tasks the participants have to deal with. The first part includes the demographic information about the participants and some general facts that help to get a clear idea of the experience of the participants. The possible form is described in Appendix One.
In this project, a list of topics for discussion will be given, and a Likert-type form of the answer will be offered to comprehend what nurses know about wound management and if they need an additional portion of knowledge on this subject (Mitchell & Jolley, 2012). The table offered in Appendix Two could be offered to the participants as a part of the questionnaire (a pilot test).
The approval for the possibility to develop questionnaires with nurses should be got from a certain leader. In this project, the coordination with the head nurse plays an important role. It is important to discuss all aspects of the study with the head nurse, provide the head nurse with the examples of the questions (this activity is possible via e-mail), and get the approval and the permission to contact with other nurses.
The participants of the survey should be provided with one sheet of paper and a pencil. Certain time frames have to be established (30 minutes should be enough). A researcher has to make sure that all participants understand their duties and are ready to cooperate without any problems and misunderstandings.
As soon as the answers to these tasks are given, it is necessary to provide the participants with another form of questionnaires that are divided into three sections regarding the wound management topics mentioned above. The examples of questionnaires are given in Appendix Three. Nurses have to evaluate the conditions under which they have to work and the level of knowledge they have and want to have and share their opinions about the urgency of topics.
Data Analysis
Though the majority of questionnaires have a low rate of response (Gupta, 2011), the researcher must contact with the participants before the questionnaires and provide the required portion of information about the goals of the study and their roles as the participants. Such face-to-face communication can help to attract the attention of the participants to the study and increase their commitment to all answers given (Buckley, Wheeler, & Halbesleben, 2015). The participants have to understand that the identification of the educational needs is the priority in the project.
The process of gathering information did not take much time because several nurses wanted to evaluate their level of knowledge and support the idea of additional training and improvement of knowledge among nurses. First types of questions were given to all nurses, who want to participate in the study (N=50). 20 nurses were chosen for the questionnaires regarding their age and experience. The completion rate is 40%.
Number of participants (overall) | Male participants | Female participants | Total |
Agreed to participate | 12 | 28 | 40 |
Appropriate for the study | 8 | 16 | 24 |
Rate | 66% | 57% | 60% |
The second part of the questions helped to identify the topics, which seem to be urgent for discussion with nurses and the knowledge of which should be improved.
Topics | Rate |
Ischemic wound knowledge | 35% |
Aseptic technique | 20% |
Wound assessment | 45% |
These results prove that nurses want to improve their knowledge about the ways of how wound assessment should be organised. Then, they also find it necessary to have a good portion of knowledge about ischemic wounds and their pathologies. Finally, some nurses want to learn aseptic techniques and understand the conditions under which medical help could be given.
Finally, the answers to the third part of the questionnaire demonstrated nurses’ interests in different spheres of wound management. The questions were divided into three main groups that covered the themes of ischemic wound knowledge, aseptic techniques, and wound assessment. Nurses had to share their personal opinions about the importance of different topics and their interests in the improvement of the level of knowledge. The peculiar feature of this method was the possibility to understand that the majority of nurses did want to improve their level of knowledge regardless of their qualifications and their working experiences.
Findings
The results of the questionnaires and the direct communication with nurses helped to comprehend that not all nurses were confident in the level of knowledge they gained at the moment of the questions (Prideaux, 2007). Some nurses wanted to pay more attention to additional training and courses that could help to improve their services and provide them with confidence to help patients in the most effective ways. Wound assessment is a very important area for investigations. Nurses underlined the necessity to study this topic and consider the conditions under which patients with wounds could be provided with help.
Wound assessment is the primary educational need. Poor ischemic wound knowledge is another crucial area for the analysis. Nurses have to learn the nature of ischemic wounds deeply to understand what is expected of them and what kind of help the patients with such wounds could expect. Aseptic techniques cannot be ignored by nurses because they cover the process of sterilising all settings nurses have to work in. Still, not many nurses understand how crucial this area of knowledge is. Regarding the answers got from the nurses of the Emergency Unit at King Saud General Hospital in Al-Qassim City, it is possible to develop a program that touches upon the following issues:
Duration | Topic | Instructions |
3 weeks (2-3 hours per day) | Wound management | Nature of wounds Important devices Further recommendations for patients |
2 weeks (1-2 hours per day) | Ischemic wound | Common symptoms of a wound First aid techniques Patients at risk |
1 week (1 hour per day) | Aseptic technique | Dressing of nurses and the staff Conditions under which aid is given Alternatives to infection prevention |
1 week (1 hour per day) | Additional questions | Nurses roles in the ED Communication between nurses, patients, and doctors |
Conclusion
The topic of wound management cannot be ignored among nurses of the ED. Nurses have to understand how crucial their roles in the healthcare system. Still, some nurses seem to have poor confidence in their knowledge and cannot work to their full extent. The assessment of the educational needs of nurses helped to define the topic Wound Assessment as the main need for consideration.
Therefore, the program should be focused on the importance of wound assessment. At the same time, nurses also want to gain a better understanding of other issues of wound management. They have to improve their knowledge in ischemic wounds and understand why aseptic techniques cannot be neglected. Many ways could be offered to nurses to improve their level of knowledge. In this project, an educational program is offered. In general, the program should help to improve nurses’ knowledge in all three topics and explain how high-quality healthcare services should be offered at the Emergency Department.
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