First Month of life is the most vulnerable period for child survival, 2.3 million newborn died in the first 28 days of life in 2022 globally. There are approximately 6500 newborn deaths every day, accounting to 47% of all child deaths

India’s current neonatal mortality rate of 20 per 1000 live birth, the most important causes of neonatal death are premature birth, Birth Complication (Birth Asphyxia / Trauma), neonatal sepsis and congenital anomalies remain the leading cause of neonatal death.

One of the main problem of prematurity and low birth weight is Apnea.¹

Apnea is defined as the cessation of breathing for more than 20 secs or cessation of breathing for less than 20 seconds if it is accompanied by bradycardia or oxygen desaturation.²

Apnea is common problem in preterm infants which may be due to Immaturity of developing brain or an underline Illness or idiopathic apnea of prematurity.

In term infants apnea is always worrisome and demands immediate diagnostic evaluation. Apnea is a feature of many primary diseases that affect neonate such as hypoglycemia, meningitis, haemorrhage, scissors, disturbance in oxygen delivery(Shock, sepsis, Anemia or ventilation defects (Pneumonia, RDS, persistent pulmonary hypertension of the new born, muscle weakness).produce apnea by direct depression of central nervous system.

Apnea is one of the common and serious problems which we come across in N.I.C.U, labour ward and PNC ward. The neonatal nurses have a lot of scope for input into care of newborn in N.I.C.U. One in 10 babies born in India need to spend at least few days in neonatal unit for support. Neonatal nursing is a sub specialty of nursing that works alongside the neonatalogists caring for new born infants with variety of problems like prematurity, birth defects, cardiac malformation and surgical problems. One of the problem of prematurity is apnea.

The nurses are the key personnel whose inputs are in the correction of the problems of neonate in the organizational works is of utmost importance.³

Apnea is one of the prime responsibilities of staff nurses working in NICU to identify the Apnic spells and prompt emergency management steps should be taken as per the protocol because they are the 1st health care givers who are with neonates round the clock.⁴

Background of the study

Sudden Infant death syndrome is the single largest cause of neonatal infant mortality and it’s one of the cause is Chronic hypoxia due to prolonged Apnic episodes.⁵

The care givers must decide which intervention is appropriate as per the severity of neonate’s Apnea.

Example – A Neonate who has an inadequate response to tactile stimulation and O2 administration further requires bag mask ventilation and CPAP therapy^6.

Need for the study

As per the personal experience of the investigator, whenever the staff nurses working in NICU is confronted with the condition like Apnea they are completely dependent on doctors,so Investigator founds the need to research on the knowledge and practices of Staff nurses regarding emergency nursing care of neonate with Apnea.

Problem Statement

Effect of Planned teaching on the knowledge and practices of the staff nurses regarding emergency nursing care of neonate with Apnea in selected hospitals of Mumbai.

OBJECTIVES OF THE STUDY

1. To compare the knowledge of staff nurses regarding emergency nursing care of neonate with Apnea before and after Planned teaching.
2. To explain the practices of staff nurses regarding emergency care of neonate with Apnea before and after Planned teaching.
3. To find the association of knowledge regarding emergency nursing care of neonate with Apnea with selected demographic Variables.

Hypothesis

H01 - There is no difference in knowledge score of staff nurses regarding emergency nursing care of neonate with apnea before and after planned teaching.

H02-There is no association between selected demographic variables and knowledge of staff nurses.

Scope of the study- The study will provide guideline to clinical nurses regarding emergency nursing care of neonate with apnea, also can be used to develop protocol.

Analysis of the study will be helpful to identify the lacuna and evaluate improved area of knowledge and practices of staff nursing regarding emergency nursing care of neonate with Apnea. Planned teaching may help to improve knowledge and practices of staff nurses further it will be beneficial to neonates with Apnea for skilled management and for prevention of complication of Apnea in neonate.

Assumption

Staff nurses have some knowledge regarding emergency nursing care of neonate with apnea. Planned teaching may help to improve and to Adopt self-practices regarding emergency nursing care of neonate with Apnea.

De-Limitations The study was confined to the staff nurses who were working in NICU department. The staff nurses who were willing to participate in the study. The study was confined to selected hospitals of Mumbai. The study was confined to 1 group Pre-Test and Post-test.

Ethical aspects

The research committee and ethical committee approved the study proposal. Written informed consent was taken from the samples which will have full information regarding the purpose of the study. The privacy and confidentiality of the information was ensured. Due permission was obtained from the Authorities of the hospital before conducting the study.

Research approach and research design

Research design - Experimental 1 group Pretest posttest desgin.

Research Approach - Evaluative research approach,

Setting - Selected hospitals of Mumbai.

Sample sizes -30 staff nurses working in NICU.

Sampling technique - Non probablity purposive sampling.

Tool for data collection -

Part-1 -Demo-graphical data comprises of four items regarding age, sex, duration of experience and education.

Part-2 -Structured questionnaire regarding emergency nursing care of neonate with apnea consists of 30 multiple choice questions that covers the meaning,incidences,causes of apnea, types of Apnea, monitoring of neonate with apnea, emergency nursing care with neonate with apnea and general and specific measures of apnea .

Observation checklist - consists of 30 steps which includes, preparation, assessment and emergency nursing care of neonate with apnea.

Part-3 - Development of planned teaching regarding emergency nursing care of neonate with apnea.

In this study the researcher used experimental one group design. One group Pre-test, Post-test design is where a single group is observed at 2 points before and after the introduction of the independent variables.

Reliability of study

For the Reliability of the observation checklist inter-rater method was used. Reliability of the questionnaire was calculated by Test, Retest method. Pilot Study The investigator has done pilot study to access the feasibility in a similar setting of the actual research work. The pilot study was performed on 5 staff nurses working in NICU department

 METHOD OF DATA COLLECTION

Stage-1 - The pretest questionnaire was administered to the group of staff nurses working in NICU regarding emergency nursing are of neonate with apnea.

The response received through questionnaire were assessed and based on their correct responses, the gaps in their knowledge were identified by the investigator.

Stage -2 - Teaching plan was prepaid with attractive visual aids.

Stage-3 - Planned teaching was given to the samples according to their conveyance during break hours.

Stage-4 - The questionnaire was then administered after 7 days to collect post test data from the group, so as to assist the change in knowledge and also observed the practices by using the observation checklist to collect the post test data from the group and assess the change in their practices.

Data analytics

The data collected from the samples was grouped and analysed with the help of statistical measures.

Part-1 consists of demographic data.

Part-2 consists of Multiple choice questions.

Each correct answer were carrying ‘1’ mark and each incorrect answer was carrying ‘0’ mark. Part-3 Consists of observation checklist, each correct step carried ‘1’ mark and incorrect steps was carrying ‘0’ mark. Collected data was transformed to master sheet for compilation and analysis.

Descriptive statistics: - Frequency and Percentage distribution was used to analyse the demographic data. Knowledge of staff nurses before and after providing planned teaching was analyzed by frequency and percentage. Explaining the practices of staff nurses regarding emergency nursing care of neonate with Apnea.

Inferential statistics - Comparison of knowledge between pre-test and post-test of staff nurses in groups according to demographic charachteristics analysed by T-test.

 Analysis of association of knowledge scores with the demographic variables by using Chi-Square.

Major finding

Part-1 Deals with demographic data presented in terms of             Frequency and Percentage.

Age – In a group of 30 samples,

53.33 %(16 samples) from the age group of 21 to 30 years . 30% (9 samples) from the age group of 31 to 40 years.

16.67% (5 samples) from the Age group of 41 to 50 years.

 0% (0 samples) from the age group above 50 years were Nil.

Sex – In a group of 30 samples, 90%(27 samples) were  female. 10% (3 samples) were Male.

Duration of Experience – In a group of 30 samples,

26.67 %(8 samples) were having experience 1 – 5years. 50 %(15 samples) were having experience 5-10 years. 13.34 %( 4 samples) were having experience 10-15 years. 10% (3 samples) were having experience 15-20 years.

Education – In a group of 30 samples,

80 %( 24 samples) completed GNM course.

20% (6 samples) completed Basic BSc Nursing course.

Part-2 Deals with Pre and Post knowledge scores in terms of Frequency and Percentage Scores section wise & overall knowledge.

Overall from the group of 30 samples.

20% (6 samples) gave correct answers in pre-test whereas 96.67% (29 samples) gave correct answers in post-test.

In a group of 30 samples of NICU staff nurses scores are obtained on same before and after planned teaching, Paired t-test was used IN Pre-Test mean percentage was 13 and post -test percentage was 27.2.

The overall t value |t cal | =30.978 is greater score than the Table value t_29,0.05=1.70 at 0.05 level of significance which revealed that planned teaching was effective in increasing the knowledge of staff nurses working in NICU.

Part-3 Deals with comparison of Pre & Post knowledge scores with the help of paired T Test.

The mean knowledge score of the sample in each area in pretest was found to be less than post-test, which shows that there was marked increase in post-test mean knowledge score which indicates significant improvement in the knowledge.

Part-4 Consists observations of Pre and Post Planned teaching. Result concluded that collected data was not useful for statistical analysis.

Part-5 Deals with association of knowledge scores with the selected variables in the study that is Age, Sex, Education and duration of experience of staff nurses.

For Age X²Cal =0.430 < X²_2,0.05 = 5.99. Hence H0 is accepted.

For sex X²Cal =2.91 < X²_2,0.05 = 3.84. Hence H01 is accepted.

For Duration of experience

X²Cal =0.804 < X²_3,0.05 = 7.81 hence H02 is accepted.

For Education

 X²Cal =0.536 < X²_1,0.05 = 3.84.hence H03 is accepted.

It was concluded that there is no association of knowledge score with the selected varaibles.

The study conclusively demonstrates that planned teaching significantly improves the knowledge of NICU staff nurses, as evidenced by the substantial increase in post-test scores. However, the improvement in knowledge was not influenced by demographic factors such as age, sex, education, or duration of experience. This suggests that the planned teaching intervention was universally effective across the sample population, regardless of individual differences. Future studies could explore additional variables or larger sample sizes to further validate these findings.

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