Hebron university - Nursing faculty

Prepared by

Tasneem waleed Tarayrah

Supervised by

Dr. Hussein Jabareen

2012

Seminar about: Educate the women about the benefits and harms associated with cesarean section (pre and post cesarean section)

Outline:
1- Introduction.

2-Reaserch question & Hypothesis

3- Aims & objectives.

4- Methodology.
5- Results.

6-Discussion & Recommendations

7- Conclusions.

Introduction:o A cesarean birth happens through an incision in the abdominal wall and uterus rather than through the vagina. The origin of the term (caesarean) is not entirely clear.. It is a common surgical procedure performed on women worldwide.

Research question:

1-Is nurse give teaching about several benefits and harms associated with women undergoing CS? 2-What is the factors prevent nurses from giving sufficient amount of education for women undergoing CS?

Aims & objectives

To establish data of what kind of teaching the nurse give to women undergoing CS.

To examine which topics that nurse focus on during teaching.

To identify factors which limit or prevent sufficient teaching to women undergoing CS.

 The main aim is to initiate the nurses and midwifes how to educate the women about several benefits and harms associated with women undergoing CS. The benefits are safety, no labor pain, Dignity and Privacy, no trauma for child, schedules the delivery. While the harms like bleeding need for blood transfusion, infection, damage to the bladder and bowel, and deep venous thrombosis.

Methodology:
Study design:
This study used prospective cross sectional study. I used Questionnaires design.

Study population
The study population consisted of all the nurses work with women under going to CS in hospitals.

Sampling of the study

The study sample will be chosen randomly , 120 questionnaire distributed.

Methodology
Location: Al Ahli hospital
Alia hospital Red crescent hospital Al Mezan hospital Mohammad ali-almohtaseb hospital

Timing:
2 weeks from 19/3/2011 -1/4/2011

Analysis:
By using the SPSS windows program.

Result
The response rate is 92% My questionnaires consisted of 3 parts: 1. Demographic Data 2. question to test nursing teaching to women about several benefits and harms associated with women undergoing CS. 3. Question to test abesticles of give teaching.

age
Age 20-30 years 31-40 years 41-50 years More than 50 years Frequency 50 33 7 1 Percentage 5% 36% 8% 1%

Type of Nursing Specialization

Frequency General Nurse Midwife 44 47 Percentage 48% 52%

Questions
I think mothers feel more safe during cesarean section

agree
Freq (percent)

disagree
Frequency (percentage)

I dont know
Frequency (percentage)

53 (58%)

23 (25%)

15 (17%)

Nurses educate mothers how to manage infection post cesarean section

All nurses at my department have enough knowledge about how to manage the complications during cesarean section

27 (79%)
66 (73%)

10 (11%)
14 (15%)

9 (10%)
11 (12%)

Nurses give mothers all knowledge they need post delivery.

Mothers who go through CS for the first time has less knowledge than multiple ones

76 (83%)
77 (85%)

9 (10%)
7 (8%)

6 (7%)
7(8%)

questions
Nurses at my department involve the family as support group for mother undergoing CS Nurses focus on teaching the women about infection of the incision site

agree
Frequency (percentage)

disagree
Frequency (percentage)

I dont know
Frequency (percentage)

66 (73%)

14 (15%)

11 (12%)

63 (69%)

12 (13%)

16 (18%)

Nurses educate mothers that CS has more complications than normal delivery
Nurses educate mothers that the delivery by CS has more risk for the baby than normal delivery Nurses teach mothers about balanced nutrition they needs for quick recovery

75 (82%)
59 (65%)

8 (9%)
11 (12%)

8 (9%)
21 (23%)

69 (76%)

13 (14%)

9 (10%)

Which of the following factors prevent nurses from giving sufficient amount of education for mothers? questions
Work pressure Vague instruction to be followed Un-cooperated mothers

agree
Frequency (percentage)

disagree
Frequency (percentage)

I dont know
Frequency (percentage)

78 (86%) 64 (70) 61 (67%)

3 (3%) 12 (13%) 14 (15%)

10 (11%) 15 (17%) 16 (18%)

Lack of lows and regulations by the hospital forcing the nurse to provide education
Nurses dont consider educations of mothers pre & post CS as part of theirtherapeutic program

60 (66%)
45 (50%)

12 (13%)
15 (16%)

19 (21%)
31 (34%)

Which of the following factors prevent nurses from giving sufficient amount of education for mothers? questions agree
Frequency (percentage)

disagree
Frequency (percentage)

I dont know
Frequency (percentage)

Nurses don't have skills in how to communicate with mothers There is no adequate incentives by the hospital to encourage mothers education

29 (32%)

22 (24%)

40 (44%)

48 (53%)

13 (14%)

30 (33%)

I think mothers feel more safe during cesarean section

I think mothers feel more safe during cesarean section

Frequency 53

percentage 58%

I dont know
never

15
23

17%
25%

Nurses educate mothers how to manage infection post cesarean section

frequency always I dont know 72 9

percentage 79% 10%

never

10

11%

All nurses at my department have enough knowledge about how to manage the complications during cesarean section

frequency always I dont know never 66 14 11

percentage 73% 15% 12%

Nurses give mothers all knowledge they need post delivery

frequency
always I dont know never 76 9 6

percentage
83% 10% 7%

Mothers who go through CS for the first time has less knowledge than multiple ones

frequency always 77

percentage 85%

I dont know never

7 7

8% 8%

Nurses at my department involve the family as support group for mother undergoing CS

frequency

percentage

always
I dont know never

66
14 11

73%
16% 12%

Nurses focus on teaching the women about infection of the incision site

frequency always 63 12 16

percentage 69% 13% 18%

I dont know never

Nurses educate mothers that CS has more complications than normal delivery

frequency

percentage 82% 9%

always
I dont know never

75 8

9%

Nurses educate mothers that the delivery by CS has more risk for the baby than normal delivery

frequency always 59 11 21

percentage 65% 12% 23%

I dont know never

Nurses teach mothers about balanced nutrition they needs for quick recovery

frequency

percentage 76% 14%

always
I dont know never

69 13

10%

Which of the following factors prevent nurses from giving sufficient amount of education for mothers?

Work pressure Agree I do not know Disagree

frequency 78 3 10

percentage 86% 3% 11%

Vague instruction to be followed

frequency Agree I do not know Disagree 64 12 15

percentage 70% 13% 17%

Un-cooperated mothers frequency Agree 61 percentage 67%

I do not know Disagree

14 16

15% 18%

Lack of lows and regulations by the hospital forcing the nurse to provide education

frequency Agree I do not know Disagree 45 15 31

percentage 49% 17% 34%

Nurses dont consider educations of mothers pre & post CS as part of their therapeutic program

frequency Agree 39

percentage 43%

I do not know Disagree

17 35

19% 38%

Nurses don't have skills in how to communicate with mothers

frequency Agree I do not know Disagree 29 22 40

percentage 32% 24% 44%

Type of Nursing Specialization * All nurses at my department have enough knowledge about how to manage the complications during cesarean section Cross tabulation
40 35 30 25 20 15 10 5 0 general nurse midwife l yes I dont know no

Place of work * Lack of lows and regulations by the hospital forcing the nurse to provide education Cross tabulation
25 20 15 yes 10 5 0 Governmental Hospital NonGovernmental Hospital Private hospital I dont know no

Type of Nursing Specialization * Nurses don't have skills in how to communicate with mothers Cross tabulation
25 20 15 10 5 0 general nurse midwife

agree I dont know disagree

Place of work * There is no adequate incentives by the hospital to encourage mothers education Cross tabulation

Age: * Nurses give mothers all knowledge they need post delivery Cross tabulation

Type of Nursing Specialization * Nurses don't have skills in how to communicate with mothers Cross tabulation

Discussion
The evidence from this study lends support for the research hypothesis that there are nursing role in teaching and nurse give teaching in good level. The level of teaching to women undergoing CS were given in high level and Rate. Nurses focus on most of my topics included in my research about women undergoing CS teaching.

Discussion Cont.
There are many factors affect health education program the main work overload and Un-cooperated mothers

Training Recommendation Offer courses to health teams about how to deal with patients pre and post operative to decrease the harms and increase the benefits associated with CS.

Policies Recommendation
Flow sheet paper for could be supplement in the patients files to evaluate harm process. Universities and schools who educate health team (doctors, midwives, and nurses) offer topics that directly deal with this subject.

Management Recommendation
Encourage preoperative and post operative education for patients who do CS. Encourage companion for psychological support, and health team support. Encourage health team to give more attention especially to gestures. Encourage a decrease in the use of pharmacological agents and used nonpharmacological agents instead.

Recommendation for future researches

Although many more issues remain to be investigated: Examining differences between spinal and general anesthesia in governmental hospitals is essential to decrease the harm and increase the benefits. Replication studies should identify the factors that play a role in the harms and benefits associated with CS in Hebron hospital and analyze the impact of these on patients satisfaction

 This study aimed to assess the education impact of women undergoes C-section (pre and post cesarean section) about the benefits and harms on their health related quality of life, baby's health. This study was a prospective study. A sample of nurses educated women undergoes C-section included in this study. Full stratified questionnaire developed for the purpose of data collection in the Hebron The data analyzed using SPSS and the result discussed with whom have specialty about the problem. The most achievable output is that 70% of women will get the knowledge about the benefits and harms pre and post cesarean section.