DEVELOPMENT OF PROBLEM-SOLVING ABILITY

PROBLEM SOLVING PROCESS

Problem solving approach is a meaningful, development, sequential, based on the discovery
of generalization. It involves the thought process that result from doubt, perplexity of the
problem. Problem solving requires critical ability to identify problems, find out possible
solutions and implement the best solution.

Definition-
 It is a systematic process of solving simple or complex, short term or long term
problem, by applying certain observational thoughts and action process in scientific
way.
 It is a process of proceeding from a state of dissatisfaction to a state of satisfaction,
which is the attainment of desired objectives or goals.
 It is a scientific process that provides a theoretical framework utilized in attaining the
solution to complex problem.

PROBLEM SOLVING PROCESS

Defining the problem

Collection of data

Data analysis

Evaluation of alternatives

Implementation & Review

IDENTIFICATION OF THE PROBLEM IS DONE BY:

 Discussion with the NS, DNS, Nursing educator, Sister-in charge, Nursing officers
and Doctors who were posted in different units.
 Observation of the Nursing officers working in different unit related to infection
control and nursing care.
 Reviewing the patient’s records.
 Discussion with the experts of the health team members.
  Review of literature.
 Reviewing from previous experience.
 Observing the problems of the patients with which they come for follow up in the
OPD.

STATEMENT OF THE PROBLEMS

“Knowledge deficit among regarding fluid therapy in children and medication error.”

OBJECTIVES OF THE STUDY

1. To assess the knowledge of the Nursing officers regarding fluid therapy in children
and medication error.
2. To help the Nursing officers to become aware of the importance fluid therapy in
children and medication error.
3. To plan and implement appropriate intervention to solve the problem.
4. To assess the amount of knowledge retained after the intervention or to assess the
effectiveness of the intervention.

METHODOLOGY
Approach:
Evaluative approach was considered appropriate because the primary objective of study was
to determine the knowledge deficit of the Nursing officers regarding care of fluid therapy in
children and medication error.

Single group design with pre and post-test 01 X 02.

Method of Data Collection:

Structured questionnaire.

Tool:
Structured knowledge questionnaire.
It contained 15 items to judge the knowledge of the Nursing officers about care of fluid
therapy in children and medication error.

Sample: Nursing officers of different Unit

Setting: CNE Room ground floor new building.

Sample Size: 12

Sampling Criteria
1. Nursing officers working in Medicine Ward, Surgery ward, NN ward, PICU and
causality.
2. Nursing officers who are willing to participate.
3. Availability.
Assessment of the Problem
A pre-test structured questionnaire was prepared to assess the knowledge of the nursing
officers about care of fluid therapy in children and medication error.

Criteria for Selection of Solution of Problem

The above-mentioned solution was implemented depending upon:
a) Availability of the sample group.
b) Practicability
c) Utility
d) Resources available
e) Availability of time and money

Alternative Solutions Planned

o Arrange for a group discussion.
o Plan for teaching programme.
o Planned teaching program using power point presentation.

Selection of Best Alternative

Considering the feasibility, time, and resource economy planned teaching program was
implemented.

Implementation of the Program

Educational material was prepared and information regarding the teaching program was
given in CNE room on 20-02-20 to a group of 12 Nursing officers. The Nursing officers were
informed about the time and place of group teaching.
 Administered pre-test Questionnaire to assess the existing knowledge.
 Conducted a planned teaching program through power point presentation for 1 hour.
 The participants appreciated the class taken.

EVALUATION
o The same questionnaire was administered after teaching programme. Analyzing mean of
pre-test score and post-test score did evaluation of teaching program. The mean pre-test
score was 5.47 and the mean post-test score was 9.53 with a mean difference of 4.06.
o Hence the teaching program was found to be effective in improving the knowledge of the
Nursing officers.

RESULT:
The mean pre- test score was 5.47& mean post test score was 9.53with a mean difference of
4.06
Hence the teaching programme was found to be effective in improving the knowledge of the
Nursing officers.

TABLE - I
Pre Teaching& Post Teaching knowledge scores of samples on knowledge items care of
fluid therapy in children and medication errors.

TOTAL ITEMS: 15

MAXIMUM SCORE: 15

CODE Pre teaching Scores Post teaching Scores

NO OF
SAMPLE
1. 7 12
2. 7 11
3. 10 15
4. 9 15
5. 6 12
6. 15 15
7. 6 12
8. 3 13
9. 2 11
10. 9 13
11. 4 7
12. 4 7

TOTAL SCORE: 82 143

TABLE II

Mean difference of pre teaching knowledge & post teaching knowledge score of the
sample on items regarding fluid therapy in children and medication error.

TYPE OF PRACTICE SCORE MEAN MEAN DIFFERENCE

Pre Teaching 5.47

4.06
Post Teaching 9.53
Data given shown that mean Post Teaching Scores is higher than mean Pre Teaching Scores
by a mean difference of 4.06 indicating that the planned teaching programme was effective to
increase knowledge among staff nurses

MEAN

10
9
8
7 MEAN
6
5
4
3
2
1
0
Pre Teaching Post Teaching

CONCLUSION:

On the basis of the finding of study the following conclusion were drawn:

 Knowledge deficit existed in staff nurses regarding care of fluid therapy in children
and medication error.
 The planned teaching program was found to be effective in increasing the knowledge
of the staff nurses

APPENDICES
 PRE TEST/ POST TEST
CODE:

SECTION A: SOCIO-DEMOGRAPHIC PROFILE

1. Department:

2. Years of experiences:

3. Educational Qualification:

4. Post:

SECTION B: Tick mark the right option.

1. Infants are more vulnerable to fluid deficit due to:

a. High metabolic rate b. Small surface area
c. Ability to concentrate urine

2. Fluid lose in infants occur through:

a. Urine and feces b. Skin c. Both a and b
3. Electrolytes required with IV fluid in first 48 hrs. of life are:
a. Sodium b. Potassium c. None

4. Glucose in maintenance fluid prevents from:

a. Dehydration b. Ketoacidosis
c. Electrolyte imbalance

5. Hemolysis is caused by:

a. Hypotonic solution b. Isotonic Solution
c. Hypertonic Solution

6. Daily fluid requirement of a neonate weighing 1600g at 1st day of life is:
a. 30 ml/kg b. 40 ml/kg c. 60 ml/kg

7. Maximum fluid rate that can be administered in children is:

a. 50 ml/hr. b. 100 ml/hr. c. 150 ml/hr.

8. Cause of increase water needs is:

a. Incubator b. Oliguria c. Phototherapy

9. Replacement fluid therapy is given to:

a. Correct existing water lose
b. Replace ongoing water lose
c. Both a and b

10. Assessment during fluid therapy includes:

a. Weight b. Urine output c. Both a and b

11. Calculate the drop rate for infusing 30 ml fluid over 30 min with drop factor 60.
a. 30ml/min b. 40ml/min c. 60ml/min

12. Lack of knowledge about medication comes under which type of issues?
a. Personnel issues
b. Systemic issues
c. Skill based error

13. After a medication error a nurse should file it in a incident report within
a.1 day b. ½ hrs. c. 1 week

14. What should be the immediate step after medication error?

a. Informing the senior nursing officers b. Assessment
c. Notifying the physician

15. What type of error does similar name drugs cause?

a. Dispensing error b. Prescription error c. Knowledge based error

ANSWER KEY:
QUESTION NO. ANSWER

1 A

2 C

3 C

4 B

5 A

6 C

7 B

8 C

9 A

10 C

11 C

12 A

13 A

14 B

15 A