Nurses' knowledge of positioning of the acute-stroke patient for the prevention of contractures
Creators: name: Benson, Bonnie Eakle
Publisher: name: University of Utah
Year: 2012
Subjects: Manpower
Nurses
Cerbrovascular Disease
Patients

description: The purpose of this study was to assess the knowledge of a sampling of  baccalaureate and associated degree registered nurses concerning position of the acute stroke patient for the prevention of contractures.  Two data instruments were developed: (1) a checklist of joint positions for the examiner's use as nurse positioned a model patient and (2) a questionnaire containing 29 multiple-choice items on prevention and significance of contractures.  The instruments were evaluated by a panel of 10 rehabilitation experts for validity and technical accuracy, then were revised as suggested.  Ease and reliability of scoring of the checklist were tested.  The sample included 15 baccalaureate and 15 associated degree nurses in staff or head nurse positions, employed on medical, neurological, and surgical intensive care units of the Latter-day Saints Hospital and University Hospital in Salt Lake City.  The sample was selected on the basis of availability and willingness to participate.  Of the 30 nurses, 22 were full-time employees.  Length of professional experience ranged from .1 to 12 years; the mean was 3.1 years.  Length of experience with stroke patients ranged from 0 to 12 years; the mean was 2.2 years.  Positioning demonstrations with a model patient were conducted under standard condition on the units.  Questionnaires were completed following the demonstrations.  Scores for the checklist ( possible 24 points) included a range of 9 to 21, a mean and median of 17, and a standard deviation of 2.86.  Scores for the questionnaire (possible 20 points) included a range of 14 to 24, a mean and median of 18, and a standard deviation of 3.08.  Independent t test were not significant.  The Pearson r for checklist scores and length of professional experience was -.476; the r for checklist scores and length of experience with stroke patients was -.668.  Both values, with 28 degrees of freedom, were significant at p &lt; .01.  Pearson r correlations were not significant for questionnaire scores and length of experience,  nor for questionnaire scores and checklist scores.  Chi-square tests  for checklist scores and questionnaire subscores also were not significant.  Item analysis of the questionnaire revealed positive discrimination power of 28 of the 29 items, indicating internal consistency of the questionnaire.  The Pearson r for significance ratings and the number of correct responses to items was not significant.  Frequency distributions of joint positions and of positioning aids used during the demonstrations plus the scores on the checklist and the questionnaire indicated that the sample significantly lacked knowledge of the purpose of positioning, of functional positions, of the use of a variety of positions, and the use of positioning aids.  Beginning validity of the two instruments was established.  A repeat of this study and an enlargement of the study to include a sample baccalaureate, diploma, and associate degrees nurses; licensed practical nurses; and aides were indicated.