1. EFFECT OF TRAINING FOR NURSES WORKING IN TEACHING DISTRICT HOSPITALS
Mehta*1 R S, lama*2 S, Parajuli*3 P
B.P. Koirala Institute of Health Sciences
Dharan, Sunsari, Nepal
Abstract:
Introduction:
Knowledge, like muscles, must be nourished-constantly and used frequently to retain function.
Learning like motion, is more easily maintained if it’s momentum has not been interrupted. The
objectives of this study are to discuss the recent trends and development in various fields of
nursing practice and update knowledge and skills in concerned nursing practice areas for nurses
working in these teaching district hospitals.
Research Design and Methodology:
It was single group pre-test post-test education intervention research design conducted among
the nurses working in district and zonal hospitals of eastern Nepal in two slots in 2004 and 2005.
Total 26 nurses (11 in first slot and 15 in 2nd slot) were involved in one-week skill oriented
training programme. After pre-test training programme was taken. The collected data was
analyzed using spss-4 package. The TA, DA and other allowances were provided to the
participants as per WHO policy.
Results:
It was found that in average there is 46% incensement in the score value in posttest. Regarding
the programme evaluation most of the participants evaluated the content, duration, methods,
clinical posting very good.
Conclusions:
The participants were highly appreciated this workshop and requested to continue in future as it
is very useful and practical.
Authors: *1 Mr. Ram Sharan Mehta, (Corresponding author), Asst. Professor, Medical-
Surgical Nursing Department. *2 Ms Sami Lama, Asso. Professsor, Psychatric Nursing
Department, *3 Ms Pushpa Parajuli, Asso. Professor, Medical-Surgical Nursing Department,
B.P.Koirala Institute of Health Sciences, Dharan, Sunsari, Nepal

2. Introduction:
Knowledge, like muscles, must be nourished-constantly and used frequently to retain function.
Learning like motion, is more easily maintained if it’s momentum has not been interrupted. B.P.
Koirala Institute of Health Sciences (BPKIHS) is a only one health sciences university of Nepal,
situated in eastern region of Nepal at Dharan. BPKIHS has the provision to establish teaching
district and facilitate the hospitals of eastern Nepal by providing the health Manpower, and
training for health workers. The objectives of this study are to discuss the recent trends and
development in various fields of nursing practice and update knowledge and skills in concerned
nursing practice areas for nurses working in these teaching district hospitals.
Methodology:
It was single group pre-test post-test education intervention research design conducted among the
nurses working in hospitals of eastern Nepal. One week training programme was arranged for
nurses working in teaching district hospitals of BP Koirala Institute of health Sciences (BPKIHS)
from eastern Nepal. After approval of the project from WHO, the first slot training was arranged
in BPKIHS on 1-7 Dec. 2004 and second slot on 13-19 Nov. 2005. In the first slot 11 Nurses and
in 2nd slot 15 nurses were participated. After obtaining official permission from Eastern regional
health director, the information with all detailed programme was circulated to the concerned
selected participants.
On the first day after inauguration session, the Details of the programme were highlighted to all
participants. In the morning session participants were posted in the specialty clinical areas like:
Emergency, ICU, CCU, Psychiatric, Antenatal, Labour, NICU, PICU, MICU, in rotation from 8
Am-12MD, in rotation. Daily from 2 pm to 5 pm the theoretical and demonstration classes were
arranged in training hall. The availability of refreshment, lunch, and dinner along with residence
facilities was arranged in the institute premises. After the pretest the training was started. At the
end of training post-test was taken. The collected data was analyzed using spss-4 package. The
results obtained and conclusions drawn are presented.
Methods used during the workshop:
Training programme conducted by involving faculty from various departments such as family
medicine, Anesthesiology and Nursing. During the training programme teaching learning
methods used were Structural interactive session, Presentation, Hospital/Field visit,
Demonstration, Simulation, Group discussion and Clinical posting in various supper Specialties
areas. A.V. aids like: OHP, Posters, Pamphlets, Handbooks, Resource materials, multimedia
(LCD), and demonstration were used to facilitate learning.
List of topics covered in training Program: Introduction to Nursing, Nursing Profession &
Hospital, Effective communication, Ethical and legal aspects in nursing, & patient’s right.
Recording reporting and nursing audit, Counseling. Care of patient with HIV/AIDS, hepatitis ‘B’
& STD, Need of hospitalized patient’s and their relatives, Cardio Pulmonary Resuscitation,
Concept of IMCI. Psychological aspects of nursing & IPR, Organizational behaviour. Snake bite,
Legal aspect of abortion. Supervision, Introduction to Reproductive health, Patient assignment
system, Stress and its management, Poisoning. Nosocomial infection/Universal precaution,
Evaluation and monitoring system while students posted in various teaching district hospitals,
Triage/Disaster management, Burn injury and its management, Care of bed ridden/critically ill
patients, Quality assurance in health care and Public relation, NGO/INGO & others organization.

3. Results:
Total 26 nurses were participated in this training programme from various district and Zonal
hositals of eastern Nepal like: Dhankuta, Ilam, Bhadrapur, Inruwa, Biratnagar, Ithari and
Sagarmatha Zonal hospitals. It was found that in average there is 46% increasement in the score
value. The details of the findings are dipcted in table I & II.
Strengths of workshop:
1. Well Planned/ Managed training =54 %
2. Interactive T/L Process = 45 %
3. Contents covered useful = 33%
4. Well selected topics = 18%
5. Clear Language = 18 %
6. Conducive Environment Maintained = 18 %
7. Good IPR between Teachers and participants = 13 %
8. Clinical posting is very useful = 13 %
9. Discussion & demonstration =9%
10. Allowances provided beneficial =7 %
11. Accommodation provided =7%
Weakness of workshop:
1. No responses/ No complains – 73.2 %
2. Duration of training needs to increases – 13 %
3. Needs more group work – 13 %
4. Visual materials needs to added –7%
Suggestions/ Recommendations for further improvement:
• No responses (No suggestion) = 86.5 %
• Continue in future = 27 %
• Increase duration of training = 18 %
• Focus on disease process =9%
• Involve More nurses =9%
• Group work to be added =9%
Discussion and Conclusion: Overall it was very interesting and interactive training programme.
All participants were actively participated in theory as well as clinical areas. All the set
objectives were met. As suggested by participants they would like to have this type of training
programme on regular basis. This training is helpful to improve professional knowledge and skill
in the field of nursing. Nursing faculty also strongly recommended having this type of training
programme in future.
Plan for follow-up mechanism: Faculties from college of nursing would visit time to time to all
districts hospitals, when the students are posted. Faculty would take suggestions and feedback
from the nurses working in teaching district hospitals for the future improvement of the training
programmes. Nursing faculty also willing to organize next training programme in future as per
need of the teaching district hospitals.
Acknowledgement: This training was completed with the financial assistance of WHO and
technical support from BPKIHS. Hence, we heartily express our sincere thanks to WHO and
BPKIHS authorities for their support and cooperation.

4. Refrences:
1. Lotka F. The importance of worker, staff and patient participation in hospital
evolution. Work hospitals and health services. 35(3): 20-23.
2. Sharma S, copra S. Hospitalized patients need for information. NJI 1997,98(11): 247-
248.
3. Bhaskaran VP, Satyashankar P, Patankar RP. Study of the utilization Pattern of
hospital based health Insurance plan targeted towards lower socio-economic group.
JAHA. 16(1): 5-9.
4. Bedi S, Arya S, Sharma RK. Patent expectation survey – A relevant marketing tool
for hospitals. JAHA.16 (1): 15-24.
5. Amin TS, Qadri GJ. Cost Evaluation of construction at 500 Bedded Tertiary care
teaching hospital. Journal of Academy of Hospital Administration 1999; 11(2): 13-19.
6. Kumar R. Medical documentation- patient satisfaction document. JAHA: 15 (1): 54-
56.
7. Oconnel BO, Warelow PJ. Challenges of measuring and linking patient outcomes to
nursing interventions in acute care settings. Nursing health science. 2001, 3(3): 113-7.
Table – I
Pre Test/ Post Test Score Analysis
N= 26
PRE- TEST POST –TEST
Full Marks 60 60
Marks obtained
18.5 (30%) 46 (76%)
Av (mean)
Minimum 4 (6.6%) 41 (68%)
Maximum 43 (71.6%) 60 (100%)
Range 4-43 41-60
Table – II
Program Evaluation by the participants
N= 26
Particular Responses
F/G/E* P.A.G* N.P*
Content 100 00 00
Duration of Training 100 00 00
T/L Methods used 80.0 6.7 13.3
Clinical posting 80 20 00
Use of T/L Materials 66.7 33.3 0
Language 33.3 60.0 6.7
Environment 53.3 47.7 00
Refreshment 73.3 26.7 00
Accommodation 26.7 60.0 13.3
Key: * F/G/E= fully satisfied/good/Excellent.,
PAG= Partially / Average//Good,
NP= Not good / Partially satisfied