SR20518111615

International Journal of Science and Research (IJSR)
ISSN: 2319-7064
ResearchGate Impact Factor (2018): 0.28 | SJIF (2019): 7.583
A Descriptive Study on Knowledge and Practice of

Staff Nurses towards Nursing Initial Assessment in
Selected Hospital at Mangaluru
Ramyashree S
Abstract: The initial nursing assessment is the initial step of the nursing process. It involves the systematic and continuous collecti on,
analyzing and organizing the data. Documentation and communication of the data collected, critical thinking skills are applied during
the nursing process. This provides decision making and a framework to develop a plan of care for the patient incorporating evidence-
based practice study was conducted to assess the knowledge and practice of the staff nurses towards nursing initial assessment in a
selected hospital at Mangaluru. The sample consists of 170 staff nurses. The data was obtained by using a Questionnaire and a checklist
method. The data were analyzed by using descriptive statistics such as mean, standard deviation, mean %, median, frequencies, and
inferential statistics such as χ2 for finding the association between the knowledge score, practice, and demographic variable. The study
revealed that 69.47 % of staff nurses had good knowledge of initial assessment whereas 28.8 % of staff nurses had average knowledge
and 1.78 % of staff had poor knowledge. The study also revealed that 76.55 staff nurses are having good nursing initial assessment
practice and 23.5 % are having average nursing initial assessment practice.
Keywords: Nursing initial assessment, Practice, Knowledge
1. Introduction of the nursing process, involves the systematic and

continuous collection of data; sorting, analyzing, and
Assessment is the first step to determine health status. It is organizing that data; and the documentation and
the gathering of information to have all the “necessary communication of the data collected. Critical thinking skills
puzzle pieces” to make a clear picture of the person‟s health applied during the nursing process provide a decision-
status. The entire plan of care is based on the data collected making framework to develop and guide a plan of care for
during this initial phase, so it is mandatory to ensure that the the patient incorporating evidence-based practice concepts.
information collected is correct, complete and organized in This concept of precision education to tailor care based on
a way that you will begin to sense a pattern of health or an individual's unique cultural, spiritual, and physical needs,
illness. According to Carpentino, “Assessment is the rather than a trial by error, one size fits all approach results
deliberate and systematic collection of data to determine a in a more favorable outcome.3
client‟s current and past health status, functional status and
to determine the clients present coping patterns”1. Part of the assessment includes data collection by obtaining
vital signs such as temperature, respiratory rate, heart rate,
The initial nursing assessment is the initial step of the blood pressure, and pain level using an age or condition
nursing process .It involves the systematic and continuous appropriate pain scale. The assessment identifies current and
collection, analyzing and organizing the data. future care needs of the patient by allowing the formation of
Documentation and communication of the data collected, a nursing diagnosis. The nurse recognizes normal and
critical thinking skills are applied during the nursing abnormal patient physiology and helps prioritize
process. This provides decision making and framework to interventions and care. 3
develop a plan of care for the patient incorporating evidence
based practice2. Before assessment can begin the nurse must establish a
professional and therapeutic mode of communication. This
The nursing assessment includes gathering information of develops rapport and lays the foundation of a trusting, non-
the patients individual physiological, psychological, social judgmental relationship. This will also assure that the
and spiritual needs. Subjective and objective data collection person will be as comfortable as possible when revealing
are an integral part of this process. The part of the personal information. A common method of initiating
assessment includes data collection by obtaining vital signs therapeutic communication by the nurse is to have the nurse
such as temperature, respiratory rate, heart rate, blood introduce herself or himself. The interview proceeds to
pressure and pain level using an age or condition asking the client how they wish to be addressed and the
appropriate to pain scale . The assessment identifies current general nature of the topics that will be included in the
and future care needs of the patient by allowing the interview.4
formation of a nursing diagnosis .the nurse recognizes
normal and abnormal patients physiology and helps The therapeutic communication methods of nursing
prioritize interventions and care. The function of the initial assessment takes into account developmental stage (toddler
nursing is to identify the assessment parameters and vs. the elderly), privacy, distractions, age-related
responsibility is needed to plan and deliver appropriate impediments to communication such as sensory deficits and
individualized care to the patient.2 language, place, time, non-verbal cues. Therapeutic
communication is also facilitated by avoiding the use of
The initial nursing assessment, the first step in the five steps medical jargon and instead using common terms used by the
Volume 9 Issue 5, May 2020
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Licensed Under Creative Commons Attribution CC BY
Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1317
ISSN: 2319-7064
patient4. GCS. This finding raises concerns on the importance
knowledge and skill in assessing GCS. Education and age
During the first part of the personal interview, the nurse have a correlation with satisfaction towards nurses‟
carries out an analysis of the patient needs. In many cases, knowledge in GCS. This indicates that mid age nurses with
the client requires a focused assessment rather than a lower education level has higher skill and experience on
comprehensive nursing assessment of the entire bodily using the GCS tool.2
systems. In the focused assessment, the major complaint is
assessed4. It is observed that even though the staff nurses have enough
knowledge regarding the initial assessment they are unable
The patient history and interview is considered to be to practice it in their daily because of their busy schedule.
subjective but still of high importance when combined with Sometimes staff nurses have to handle so many patients at a
objective measurements. High quality interviewing time and they usually tend to rush during assessment. But
strategies include the use open ended questions. Open-ended nursing initial assessment should be practiced by the nurses
questions are those that cannot be answered with a simple properly because it helps the nurses to plan further in patient
"yes" or "no" response. If the person is unable to respond, care. It also helps the nurse build a rapport and maintain a
then family or caregivers will be given the opportunity to good therapeutic relationship between the patients and the
answer the questions4. nurses.2
2. Need for the Study Objectives

The objectives include obtaining answers to research
Nursing assessment is the first and important step in nursing questions or testing research hypothesis by conducting the
process that plays vital aspects in dealing with the patient study6. A researcher identifies several research aims and
health assessment. The assessment includes an interview objectives- the specific accomplishments the researcher
together with an observation of a patient throughout the hopes to achieve by conducting the study. The
assessment implementation, medical practices are required objectives include obtaining answers to research
Nursing assessment includes emotional and mental questions or testing research hypothesis but may also
assessment, physical, environmental and social issues that encompass some broader aims like developing
affects the patients health.5 recommendations for changes in the knowledge and
practices based on the study results. The objectives should
Clear accurate and accessible documentation is an essential be specific and achievable. It will provide reader with a
element of safe, quality, evidence based nursing practice. clear criterion against which the proposed research
Nurses practice across settings of position levels from the methods can be assessed7. The present study is aimed at
bedside to the administrative office. The registered nurse assessing knowledge and practice of staff nurses towards
and the advanced practice registered nurse are responsible nursing initial assessment in selected hospital at Mangaluru.
and accountable for the nursing documentation that is used
throughout an organization. 5 Problem Statement
A descriptive study on knowledge and practice of staff
Documentation of nurses work is critical as well as effective nurses towards nursing initial assessment in selected
communication with each other and with other discipline .it hospital at Mangaluru.
is how nurses create a record of their services for use by
payers the legal system, government agencies , accrediting Objectives of the Study
bodies, researchers and other group and individuals directly 1) To assess the knowledge of the staff nurses towards
or indirectly involved with health care .Documentation is nursing initial assessment in a selected hospital at
sometimes viewed as burden and even as a distraction from Mangaluru.
patient care high quality documentation however is 2) To assess the practice of staff nurses towards nursing
necessary and integral aspects of the work of registered initial assessment in a selected hospital at Mangaluru.
nurses in all roll roles and settings. It is particularly 3) To find the correlation between knowledge and practice
important to effective documentation of nursing services. of staff nurses towards nursing initial assessment in a
Nurses and other health care provides aim to share selected hospital at Mangaluru.
information about the patient and organizational function 4) To find the association between the knowledge with
that is accurately, contemporaneous, concise, through selected demographic variables
organized and confidential. Information is communicated 5) To find the association between the practice with
verbally and is written and electronic format across all selected demographic variables.
settings. Written and electronic documentation are formats
that provide durable and retrievable records. 5 Operational Definition
A study was done regarding the assessing nurses‟ Assess: Assess means evaluate or estimate the nature,
knowledge of glass cow coma scale in emergency and ability, or quality of7. In this study it refers to the knowledge
outpatient department. This study was conducted in the of staff nurses regarding nursing initial assessment in
emergency and outpatient department of tertiary medical selected hospital at Mangaluru.
Centre. 135 questionnaires were distributed, and all were
returned culminating in a 100% respond rate. This study Knowledge: Knowledge is acquaintance with facts, truths,
found that only 2.96% of nurses have good knowledge in or principles, as from study or investigation; general
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Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1318
ISSN: 2319-7064
erudition.7 In this study it refers to the score obtained by the literature it gives a theoretical base for research and helps to
staff nurses regarding nursing initial assessment in selected determine the nature of the study. The main purpose of
hospital Mangaluru. literature review is to convey to the readers about the work
already done and the knowledge and ideas that have been
Practice: Practice is habitual or customary performance; already been established on a particular topic of research.7
operation7. In this study it refers to do or perform nursing
assessment by staff nurses working in a selected hospital at The investigator conducted and extensive review of research
Mangaluru. and non-research literature through reports, thesis, journals,
textbooks, training guides, manuals, electronic database
Staff Nurses: Staff nurses are a qualified nurse ranking (pubmed, CINHAL etc) and educational material.
immediately below a sister. 7In this study it refers to a
person educated and trained in nursing which includes The chapter deals with the review of literature which is the
GNM staff and graduate nursing staff. essential step in the development of research project. It
helps to develop insight into the area of investigation and
Nursing assessment: In this study it refers to a structured directs the researcher to develop a plan.
physical examination allows the nurse to obtain a complete
assessment of the patient .Observation / inspection , A descriptive study was conducted among staff nurses
palpation , percussion , auscultation are the techniques used regarding knowledge, attitude and practices regarding pain
to gather information . assessment among patients with cancer in Uganda Cancer
Institute. Total 67 nurses were selected to participate in the
Assumptions study, and they all fully completed the study, yielding a
The study is based on the following assumptions response rate of 100%. The majority of subjects were aged
1) Staff nurses have some knowledge and skills regarding between 20-40 years (67.2%) with a mean age of 26 and
initial nursing assessment of the patients standard deviation (SD) compared to men (38.8%), and the
2) Knowledge and practice on nursing initial assessment of least had either 1-2 years or more than 20 years of
patient is measurable experiences (19.4%). Regarding duty shifts most nurses
3) Accurate knowledge and practice of staff nurses preferred day shifts (34.3%) while the least worked evening
regarding initial nursing assessment will help them only shifts (19.4%). Majority of nurses reported that they
identify patients conditions and have proper diagnosis had received formal training on pain assessment (89.6%)5.
Hypothesis A cross sectional descriptive survey was conducted in 2007

All hypothesis is tested at 0.05 level of significance to determine the knowledge and attitude and practice of
H0: There is no significant relationship between knowledge physicians and nurses towards nursing initial care in
and practice of staff nurses regarding nursing initial Lebanon and to assess the need and a model for service
assessment. delivery using self- administer questionnaire. 1873 nurses
H1: There will be significant relationship between the and 1884 physicians participated in the study. The response
knowledge and practice of staff nurses regarding nursing rate was 51% for nurses and 13% for physicians. Around
initial assessment. 93% of nurses and 69% of physicians were able to identify
H2: There will be significant association of knowledge of the goals of initial care. The majority (94% -99%) believed
that terminally ill patients and their families should be
staff nurses regarding nursing initial assessment with
informed of the diagnosis and prognosis. Only 19% of
selected demographic variables.
physicians routinely informed terminally ill patients about
H3: There will be significant association of practice of staff
their diagnosis.8
nurses regarding nursing initial assessment with selected
demographic variables. A study regarding knowledge, attitude and practice of
nurses toward palliative care was conducted in eastern
Delimitation Ethiopia in the year 2015. The study used a cross sectional
1) The study is delimited to staff nurses who are having day descriptive survey and data was collected with the self-
duty. administered questionnaire from 197 nurses. The study
2) Data collection period is limited to 30days received that 56%had good knowledge and 88.3% of them
had favorable attitude towards palliative care. The study
Summary showed that there is no significant association between
This chapter includes problem statement, objectives, knowledge of palliative care and age, sex, and experiences
operational definition, assumptions, hypothesis, conceptual of the nurses (P value> 0.05).9
framework, delimitation of the study and scope of the study.
The next chapter deals about the extensive review of An observational study was done in the year 2014 to
literature done to form the basis of the study. identify the nurses‟ knowledge regarding nursing
documentation. Sample consisted of 150 nurses working in
3. Review of Literature two main teaching hospitals Nineveh government. More
than half of items (53.97%) concerning principles, and
A literature review is an evaluative report of information (28.57%) of items of purposes were got level of knowledge
found in the literature relayed to selected area of study. The < while the other items got moderate level of knowledge,
review describes, summarizes, evaluates and clarifies this but none of them got high level of knowledge. Educational
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Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1319
ISSN: 2319-7064
level of nurses had significant associations with aspects 2016 to assess the knowledge regarding assessment of high-
documentation.10 risk neonates among staff nurses and nursing student in
selected hospital at Nellore, AP. With regards to level of
A descriptive study conducted to explore perceptions of knowledge of staff nurses, 8(53.3%) of them had adequate
pain and pain management by nurses and physicians who knowledge, whereas in nursing students 10(66.7%) of them
care for pediatric emergency room patients in the year 1994. had moderately adequate knowledge. hence the study
A descriptive survey design using the adapted Klein concluded that staff nurses have adequate knowledge
premedication questionnaire explored the attitude and regarding assessment of high-risk neonates. therefore, there
practices of 24 nurses and 21 physicians about children‟s was a lack of aware of practicing of identification and
pain in the emergency setting. The majority of nurses and assessment of high-risk neonates among student nurses in
physicians who care for pediatric emergency room patients selected hospitals at Nellore. Hence the study concluded that
would medicate children experiencing pain. Both the groups with the regards to age of staff nurses, majority 13(86.6%)
perceived pain in children the same way. There was a lack of them are between 20-25 years whereas in nursing
of knowledge in both groups regarding the appropriate students 15 (100%) of them are between 18-19 years. With
dosages of pain medications. Nurses and physician need a regards to gender of staff nurses, 15(100%) of them are
stronger base regarding pain management practices11. females. With regards to level of knowledge of staff nurses,
8(53.3%) of them had adequate knowledge whereas in
A descriptive study was conducted on the year 2003 to nursing students 10(66.7%) of them had moderate adequate
compare the knowledge and attitude about cancer pain knowledge.15
management among oncology and non-oncology nurses at
Utah, USA. 44 oncology nurses and 303 non oncology A cross sectional study was conducted in the year 2018
nurses completed the study. Ferrell‟s Nurses‟ knowledge regarding the routine, knowledge and attitude towards
and attitudes survey method was used. Attitudes of oncology nutrition and documentation of nursing staff in primary
nurses were more in line with recommended practices health care. The questionnaire were distributed to 1391
(principles) of cancer pain management that dose of non- eligible registered nurses social and health service assistants
oncology nurses. Oncology nurses had a better and social health service helpers in a municipality in
understanding of recommended practices of cancer pain Denmark. The overall response rate was 32% living a total
management than oncology nurses but still struggled with number of 449 respondents. The total of 54% eligible
understanding the pharmacology of medications used to registered nurses, 47% of eligible social and health service
manage cancer pain. Nurses do not use evidence-based assistants and 26% of eligible social and health service
practice in pain management consistently. Continuing helpers responded to the questionnaire. Employees from all
education regarding cancer pain management remains four districts were represented among the respondents and
important for oncology and non-oncology nurses12. district third was strongly represented by 57% of
respondents. It is however, also by far the largest district in
A quantitative assessment of patient and nurse outcomes of terms of number of employees. The respond rate in nursing
bedside nursing report implementation was done in the year home was equivalent to the response rate in home care/
2014. The study used Quasi-experimental pre-and post- home nursing 52% and 48% respectively. 16
implementation design. Seven medical-surgical units in a
large university hospital implemented a blend of recorded A descriptive retrospective study was conducted by Setz V
and bedside nursing report. Outcomes monitored included Get al67 et al to evaluate the quality of nursing records of
patient and nursing satisfaction, patient falls and nursing patients treated in the medical surgical units of university of
overtime and medication errors. It was found statistically Sao Paulo. Four hundred and twenty-four records of
significant improvements post-implementation in four discharged (56.1%) and expired patients (43.9%) were
patient survey items specifically impacted by the change to reviewed between November 2006 to January 2007 using
bedside report. However, there was a decline in nurse three audit tools. The review mainly pertained to;
perception that report took a reasonable amount of time after demographic and background information; operation room
bedside report implementation; contrary to these flow sheet; nursing diagnoses, orders and progress notes;
perceptions, there was no significant increase in nurse implementation of the nursing orders; medical orders;
overtime13. discharge and death documentation. Findings revealed that
64.7% of nursing documentation was acceptable. However,
A study was done in the year 2016 to introduce and evaluate only 8.7% of nursing documentation was of good quality
the compliance to documentation of situation, background, and 26.7% of nursing documentation was of poor quality.
assessment, recommendation (SBAR) form. 20 nurses These findings suggested deviation of nursing practice from
involved in active bedside care were selected by simple recommended standards. It was concluded that as there are
random sampling. Majority of nurses were females (65%) in flaws pertaining to adequacy of formal language, grammar,
the age group 21-30years (80%). There was a significant accuracy, clarity, brevity, identification and technical
association between overall audit scores and graduate terminology, there is need for standardization of nursing
nurses. Only 70% of nurses had documented plan of care. records.17
Most (76%) of nurses expressed that SBAR form was
useful, but 24% nurses felt SBAR documentation was time A qualitative study was conducted to develop an instrument
consuming.14 for initial nursing assessment. complex health care needs
focus on accountability and necessity of inclusion of nurses
A descriptive cross-sectional design was adopted in the year in documenting and monitoring clinical care plan have
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Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1320
ISSN: 2319-7064
brought in the concept of initial nurse assessment and were undertaken and a new, more comprehensive
nursing process. a focus group design was utilized to assessment framework was developed titled „HIRAID‟.
explore and conceptualize an initial nurse assessment from HIRAID is informed by current evidence, comprising of
that may be utilized by service hospital the study is of seven assessment components: History, Identification,
descriptive design with a qualitative approach and study Assessment, Intervention, Diagnostics; Reassessment and
participants were 8 clinical female nurses with professional Communication.23
service ranging from 1-18 years, with a median service of
7.5 years. The qualitative analysis led to the emergence of A qualitative descriptive study using the person-centered
various important themes from the focus group data18. nursing framework as the context through which nursing
assessments and care plans were explored. Person centered
The quantitative correlation study was conducted in a care is a approach to care that is underpinned by the mutual
university -affiliated, teaching hospital to examine ward respect and the development of the therapeutic relationship
nurses knowledge regarding the importance of nutritional between the patient and the nurses. Findings indicated that
assessment, their knowledge and perceived quality many nursing records were incomplete and information
nutritional care provided in their wards. Data was collected regarding psychological aspects pf care was infrequent.
from 415 nurses and analyzed by frequency. Most nurses There was evidence that nurses engaged with residents and
appreciated the importance of nutritional assessment and worked with their beliefs and values. However, the nursing
recognized common misconception of nutrition care. documentation was not completed in consultation with the
Factors associated with lower scores on these variables patients were there was little suggest that patients were
included male gender, type of department and country of involved in decision relating their care24.
origin. 19
A study was conducted based on evidenced based practice.
The study was conducted on a medical surgical unit at the Based on the quality and safety education for nurse‟s
Midwest academic medical center. It was observed nursing competencies, the thirty seven item appraisal of nursing
activities, such as hand off, direct patient care, indirect practice covers person-centered care, team-work and
patient care, inter professional communication and charting. collaboration, evidence-based practice, safety, informatics,
Total of 79 observations with 15 registered nurses. professionalism, and overall satisfaction. Interrater
Observation was done where nurses were seen to be reliability and internal consistency reliability were generally
multitasking as they engaged in communication and hands acceptable. Scores increased significantly for nurses as they
on tasks simultaneously It was found average nurses were moved through a nurse residency programme25.
multitasking. Nurses communicating with patients during
medication administration, patient assessment and charting A study was conducted to assess the capability of the risk
were common multi tasks: nurses also often communicated assessment and prediction tool and other pre-operative
with other nurses while charting.20 variables to determine expected disposition prior to surgery
in heterogeneous neurosurgical cohort through observational
The qualitative study was conducted to explore clinical study. Patient above 50 years or above undergoing elective
nurse‟s experiences and perspectives of patient advocacy. neurosurgery were enrolled. Higher risk assessment and
Qualitative research was suitable for the studies on prediction tool score significantly predicted home
relatively new areas of knowledge. 15 nurses selected disposition (p<0.001). A grading scale utilizing this variable
throughout purposeful sampling to participate in the study. had superior discriminatory power between skilled nursing
15 clinical nurses with an average work experience of 8 facility and home rehab discharge when compared with risk
years and 3 months and mean age of 32.25 years were assessment and prediction tool score alone (p=0.004).26
selected from the selected wards suitable to the larger study.
The participants were selected from educational and non- 4. Methodology
educational hospitals in different provinces of Iran to gain
an adequate variation in experiences and perspectives of Research methodology is the systematic way of doing the
nurses regarding patient advocacy in nursing. 21 research to solve the problem. The research methodology
organizes the components of the study in a way that is most
The study was conducted to check the consequences of falls likely to lead to valid answers to the sub problems that has
among hospital patient are a great problem, for the patient, been posted. Research methodology is the specific
family and society. In Sweden almost one third of all hip procedures or techniques used to identify, select, process,
fracture occurs in the hospital population. Despite this very and analyze information about a topic. In a research paper,
few prevention strategies have been developed and tested. In the methodology section allows the reader to critically
this study, a risk assessment and recording program in evaluate a study‟s overall validity and reliability. It also
relation to the risk of failing among the patients in geriatric indicates the general pattern for organizing procedures for
department recording of falls was found more often in the the development of the tool, pilot study and the procedure
study group but the proportion of injuries in relation to falls for data collection and plan for data analysis.7
was higher in the control group.22
A thorough study was conducted to inform the re In this chapter the methodology adopted for the study such
development of emergency nursing assessment framework as research approach, research designs, variables, setting of
at Sydney nursing school, to provide emergency nurses with the study, population, samples and sampling technique,
a systematic approach to initial patient assessment. sampling criteria, development and description of the tool,
Modification to emergency nursing assessment framework content validity and reliability of the tool, pilot study, data
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Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1321
ISSN: 2319-7064
collection procedures and plan for data analysis. researchers adopt to develop evidence that is accurate and
interpretable. The investigator has used the non-
Research approach experimental descriptive correlational research design in
Research approach indicates the problem for conducting order to study the variables in the research study7. The non-
the study, the choice of appropriate approach depends on experimental descriptive correlational research design was
the purpose of the study.6 The research approach use by the used to observe, describe and document aspects of a
investigators for this study was quantitative approach as the situation as it naturally occurs and sometimes to serve as a
main objectives of the study was to determine the point for the hypothesis generation or theory development.7
knowledge and practice of staff nurses regarding the
nursing initial assessment and it usually involves collecting The study designs comprised of identifying the level of
and converting data into numerical form so that statistical knowledge and practice of staff nurses on nursing initial
calculations can be drawn. assessment by administering a structured knowledge
questionnaire and self- rated practice rating scale and
Research design finding out the relationship between the knowledge and
Research design is the framework of the methods and practice on nursing initial assessment.
techniques chosen by the researcher to combine various
components of research in a reasonably logical manner so The schematic representation of the design is depicted in fig:
that the research problem is efficiently handled. Research
design of the study spells out the basic strategies that
Variables under the study Medical College Hospital at Mangalore. It is a

A variable is any aspect of a theory that can vary or change multispecialty hospital with 1250 beds. It is a teaching
as part of the interaction within the theory. A variable is a institute with a research Centre that offers both under
concept that has measurable changing attributes. Variables graduate and post graduate courses in various specialties.
are qualities, properties or characteristics of person, things, The hospital has a well-equipped wards, ICUs and
or situation that change or vary7. specialties where there are good amount of nurses available
Independent variables with good knowledge and skills.
In this study the key variables are the knowledge and
practice of staff nurses regarding nursing initial assessment. Population
Population refers to the entire set of individuals or objects
Extraneous variables that possesses specific characteristics that the researcher is
Extraneous variables are the factors that are not the part of interested in the study27.
the study but may affect the measurement of the of the study
variables27. The extraneous variables in the current study are The population in this study comprises of the staff nurses
age, religion, type of family, marital status , educational working at Father Muller Medical College Hospital,
qualification, place of work, year of clinical experience. Mangaluru at the time of data collection.
Setting of the study Sample and sample size

The study setting can be seen as the physical, social, and A smaller part of the population selected in such a way that
cultural site in which the researcher conducts the study6. The the individual in the sample represents (as nearly as
setting is where the population or the portion of it that is possible) the characteristics of the population27.
being studied is located and where the study is carried out.
The present study was conducted in the Father Muller In this study 170 staff nurses fulfilled the sampling criteria
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Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1322
ISSN: 2319-7064
were selected for the study. 4) Knowledge on clinical parameters – 23.3%
5) Knowledge on procedures – 16.8%
Sampling technique
Sampling is the process of selecting a portion of the Development of the tool:
population to obtain data regarding a problem. 27 A purposive In order to conduct this study, three tools were prepared.
sampling was used to select the samples for the study.
Baseline proforma:
In purposive sampling the researcher based on the The baseline proforma consisted of the data such as age,
knowledge and expertise of the subjects, selects and gender, educational qualification, year of experience. Place
handpicks the elements of the study that are thought to best of work and year of working in the particular ward. The
represent the phenomenon being studied. The researcher respondents had to tick against the given option below.
intended to select the subjects who fulfilled the sampling
criteria. Development of the structured knowledge questionnaire
on nursing initial assessment:
Criteria for sample selection Inclusion criteria The knowledge questionnaire consisted of 30 questions with
 Staff nurses who are present during the data collection the 4 options given to each questions. The respondents are
 Staff Nurses willing to participate in the study instructed to place a tick mark against the appropriate
answer. The right answer will be allotted with 1 mark and the
Exclusion criteria wrong answer will be allotted with 0 mark.
 Staff nurses who are not present during the data collection
 Staff Nurses who are working in critical care units and Development of self-rated practice checklist:
operation theatre. The practice checklist consisted of 30 questions listed with
 Staff nurses who are on night duty. the yes or no. The respondents were instructed to place a tick
mark in the appropriate in the column. The yes answer is
Data collection instruments allotted with 2 mark and the no answer will be allotted with 1
Data collection tools or instruments are devices used by the mark.
researcher to collect data to understand the variables or
phenomena in the study.6 In this study, the investigator has Testing of the tool
prepared and used the baseline proforma, structured
knowledge questionnaire, self-rated practice rating scale to Developing the criteria for the checklist:
collect the information pertaining to the staff nurses. A criteria for the checklist was prepared by the investigator
for establishing the content validity for each item regarding
Selection and development of the tool its accuracy, relevance and appropriateness. The checklist
Tools are procedure or the instruments used by the was developed with agree, disagree and remarks.
researcher to measure the key variables in the research
problem. The tool was prepared on the basis of the objectives Content validity
of the study. The following steps were adopted prior to the Validity refers to the degree to which an instrument
development of the tool: measures what is supposed to be measuring6. To ensure the
 Review of literature from – books, journals, magazines, content validity, the prepared instrument along with the
research studies- this provided adequate content area for problem statement, objectives, hypotheses, operational
the tool development. definition, blueprint and criteria were submitted to 7 experts
 Internet search such as pubmed, CINAHL, COCHRANE, in the different fields of nursing. Based on their suggestions
MEDLINE. the tool was modified. The first draft of the baseline
proforma consisted of 7 questions after the suggestion the
 Consultation and discussion with research guide, nursing
questions were reduced to 5 questions.
experts.
 Personal experience and discussion with acquaintances.
The first draft of the structured knowledge questionnaire had
 Development of the blueprint. 30 questions. The experts suggested to change system wise
 Preparation of the first draft. questions and frame them according to knowledge and
 Construction of the baseline proforma, structured practice of initial assessment only. It was suggested to
knowledge questionnaire, self-rated rating scale. change some grammatical errors. It was also suggested to
 Content validation keep the questions either in the question form or in the
 Checking for the reliability. statement form. The extra questions were asked to delete
 Pre testing of the tool. because questions were repeated. The suggestions were
 Preparation of the final draft. accepted, and some items were deleted. Thus, the final
questionnaire consisted of 20 questions. The first draft of the
Preparation of the first draft of the tool Preparation of self-rated practice checklist consisted of 30 questions. The
the blueprint: experts suggested to keep the questions either as positive
A blueprint was prepared which showed the distribution of statements or as negative statements. It was also suggested to
items according to the content areas. include only the items which were appropriate to our
1) General identification of patient problems -23.3% problem statement and objectives. It was suggested to
2) Initial assessment on cardiac system – 10% change the grammatical error. It was also suggested to
3) Initial assessment on respiratory system -26.6% change the checklist into the rating scale. The suggestion was
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Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1323
ISSN: 2319-7064
accepted, and changes were made. The checklist was Pilot study
changed into the rating scale. Some of the questions were Pilot study is the small version or trial run of the major
removed. Thus, the final tool consisted of 15 questions. study. Its function is to obtain information for improving the
projects for assessing its feasibility. The principal focus is
Reliability of the tool the assessment of the adequacy of measurements.
The reliability of an instrument is the degree of consistency
with which it measures the attribute it is supposed to be The investigator conducted the pilot study in the Father
measuring6. In order to establish the reliability of the tool, Muller Medical College Hospital. Investigator explained the
the investigator administered the structured knowledge need of study and obtained a formal permission from the
questionnaire and self-rated practice rating scale to 17 of the director of the Father Muller Medical College Hospital. The
staff nurses working in a particular ward at Father Muller pilot study was conducted on 17 staff nurses working in the
Medical College Hospital, Mangaluru. To find the internal wards in the hospital. The sample were selected using
consistency of the structured knowledge questionnaire, split purposive sampling and those who met the sampling criteria.
half method was used, and it was found to be 0.70. Hence the The investigator explained the purpose of the study and
structured Knowledge questionnaire was found to be reliable. assured them that confidentiality will be maintained. A
written consent was obtained from them prior to the
The internal consistency of the self-rated practice rating scale administration of the tool. The respondents had taken 30
was obtained by test retest method. Karl Pearson‟s minutes to complete the structured knowledge questionnaire
correlation coefficient formula was used to check the and self-rated practice rating scale. The result of showed
reliability of the tool and the r value was found to be 0.7. 77% of the staff nurses had good knowledge regarding the
Hence the self-rated practice rating scale was found reliable. nursing initial assessment and about 85% of staff nurses had
well skilled practice on nursing initial assessment. There is a
Pretesting of the tool weak positive correlation between the knowledge and
Pretesting is the trial administration of a newly developed practice of the staff nurses regarding the nursing initial
instrument to identify the flaws or to assess time assessment (r=0.174). The Fischer exact test was done to
requirements. The investigator administered the structured show the association between the demographic variables and
knowledge questionnaire, self-rated practice rating scale to knowledge and practice and it was found there is association
17 staff nurses working at father muller medical college between the demographic variables and practice but there is
hospital. They took 30 minutes to read and complete the set no association between demographic variables and
of questions given to them. It was found that staff nurses knowledge. The data was collected was analyzed using
were able to answer all the questions given to them. descriptive and inferential statistics. Thus, the study was
found to be feasible and practical. After the pilot study the
Description of the final tool investigator proceeded with the main study.
The final consisted of:
Data collection process Data collection
Baseline proforma Ethical clearance was obtained from the ethical committee of
father muller medical college hospital before conducting the
The baseline proforma consisted of data such as age, gender, study. The investigator obtained written permission from the
educational qualification, place of work and years of hospital administrator. The main study was conducted at
experience. father muller medical college hospital, Mangaluru. The data
collection was carried in the general, semiprivate and private
Tool 1: Structured knowledge questionnaire to assess the wards. The purpose of the study was to know the knowledge
knowledge of staff nurses towards nursing initial and practice of the nurses in the hospital. A written consent
assessment: was obtained, and confidentiality was assured. The staff
nurses were available in the hospitals. The staff nurses were
This tool consisted of 20 questions covering the following given the baseline proforma, knowledge questionnaire and
areas: the self-rated practice rating scale. The average time taken to
1) Baseline proforma– 30 % complete the tool was 30 minutes. The obtained data was
2) Clinical parameters – 35 % compiled and analyzed in the SPSS version 16.
3) Obstetrics and gynecology - 20 %
4) Mini mental status examination – 15 %- Plan for analysis
Analysis is a process of organizing and synthesizing the data
The items had options where the respondents were instructed in such a way the research questions can be answered and
to place a tick mark below the options which was appropriate hypothesis tested. The data obtained will be entered in the
to them. Each correct answer scored 1 and a wrong answer master sheet and analyzed using both descriptive and
scored 0 mark. The maximum score was 20. inferential statistics in SPSS 16.
Tool 2: Self-rated rating scale: The data will be presented in figures and tables:
Practice was categorized into admission and initial Section 1: Baseline characteristics.
assessment practices. The items had responses as always, Section 2: The knowledge regarding nursing initial
sometimes and never. Always was allotted with the marks 3, assessment among staff nurses. Section 3: The practice
sometimes was allotted as 2 and never was allotted as 1. The regarding nursing initial assessment among staff nurses.
maximum score was 45 and the minimum score was 15. Section 4: Correlation between knowledge and practice
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Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1324
ISSN: 2319-7064
regarding nursing initial assessment among staff nurses. assessment with selected demographic variables.
Section 5: Association of knowledge on nursing initial
assessment with selected demographic variables. Section I: Baseline characteristics
Section 6: Association of practice on nursing initial The section deals with the description of baseline
assessment with selected demographic variables. characteristics of subjects and is explained in frequency and
percentage using table 1.
Summary
This chapter has dealt with the research approach and design, Table 1: Frequency and percentage distribution of subjects
variables, setting, population, sample and sample size, according to their baseline characteristics, n=170
sampling technique, data collection instruments and S. No Variable (f) (%) Mean±SD
development of the tool, reliability of the tool, testing of the Age in years
tool, description of the final tool, pilot study, data collection 20-25 111 65.29 25.07±3.1
process and plan for data analysis. 1 26-30 50 29.41
31-35 7 4.11
>35 2 1.17
5. Results Gender
2 a) Male 8 4.7
This chapter presents the data collected from 170 staff nurses b) Female 162 95.29
regarding their knowledge and practices of nursing initial Educational qualification
assessment in a selected hospital Mangaluru. The collected a) GNM 40 23.52
data is tabulated in the master sheet and analyzed and 3 b) BSc nursing 115 67.64
interpreted in the light of the objectives and hypotheses of c) PBBSc nursing 14 8.23
the study using descriptive and inferential statistics. d) MSc nursing 1 0.5
Place of work
Objectives of the Study a) General ward 138 81.17
4
1) To assess the knowledge of the staff nurses towards b) High density unit 3 1.76
nursing initial assessment. c) Private ward 29 17.05
2) To assess the practice of staff nurses towards nursing Year of clinical experience
initial assessment. a) Less than 1 year 58 34.11
3) To find the correlation between knowledge and practice 5 b) 2-5 years 99 58.23
c) 6-10 years 11 6.47
of staff nurses towards nursing initial assessment.
d) Above 11 years 2 1.17
4) To find the association between the knowledge with
selected demographic variables
The data presented in Table 1 reveals the following findings:
5) To find the association between the practice with selected
demographic variables.
Hypothesis
All hypothesis is tested at 0.05 level of significance
H0: There is no significant relationship between the
knowledge and practice of staff nurses regarding nursing
initial assessment.
H1: There will be significant relationship between the
knowledge and practice of staff nurses regarding nursing
initial assessment.
H2: There will be significant association of knowledge of
staff nurses regarding nursing initial assessment with
selected demographic variables.
H3: There will be significant association of practice of staff
nurses regarding nursing initial assessment with selected
demographic variables. Figure 2: Bar Diagram Representing Distribution of
Subjects According to Age
Organization of findings
The analysis and interpretation of data are organized and
presented under the following headings Most of the staff nurses 111(46%) are in the age group 20-25
Section 1: Baseline characteristics. years and very few (1.17%) are of the age group 30 years
Section 2: Knowledge regarding nursing initial assessment above.
among staff nurses. Section 3: Practice regarding nursing
initial assessment among staff nurses.
Section 4: Correlation between knowledge and practice
regarding nursing initial assessment among staff nurses.
Section 5: Association of knowledge on nursing initial
assessment with selected demographic variables.
Section 6: Association of practice on nursing initial

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Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1325
ISSN: 2319-7064
Gender Majority of subjects 138(81.17%) were working in general
ward whereas 3(1.76%) are working in high density units.
Year of clinical experience
Figure 6: Pie Diagram That Shows Subjects According to

Year of Clinical Experience
Figure 3: Pie Diagram That Shows the Subjects
According to Gender Majority of staff nurses 162(95.29%) Majority of staff nurses are having 99(58.23%) 2-5 years of
are female and only 8(4.70%) are males. Educational clinical experience and 2(1.17%) are having above 11 years.
qualification
Section 2: Knowledge towards nursing initial assessment
among staff nurses.
A structured knowledge questionnaire was constructed by
the investigator to determine the knowledge level of 170
staff nurses regarding nursing initial assessment.
Table 2: Grading the knowledge of the staff nurses, n=170

Knowledge score Grading Frequency Percentage
0-9 Poor 3 1.78
10-14 Average 49 28.82
15-20 Good 118 69.41
Max score=20
Data in table 2 reveals that 118(69.47%) staff nurses had

good knowledge on initial assessment whereas few had
3(1.78%) poor knowledge on initial assessment
Table 3: Mean, Standard Deviation and Mean Percentage of

Figure 4: Bar Diagram Representing Subjects According Knowledge Score of staff nurses towards nursing initial
to Educational Qualification assessment, n=170
Mean± Standard Deviation Mean percentage (%)
The data on educational status shows that 115(67.64%) 15.32±2.44 76.6
subjects had basic BSc nursing and 1(0.5%) are having MSc Max. Score: 20
nursing.
Table 4: Area wise mean, mean percentage, SD and
Place of work maximum score of knowledge score of staff nurses towards
nursing initial assessment, n=170
Maximum Mean
S. No. Area Mean ±SD
Score %
1. Baseline Proforma 6 3.88±1.29 64.67
Clinical
2. 7 6.02±1.314 86.0
parameters
Obstetric
3. 4 3.51±0.73 87.75
gynecology
Mini mental status
4. 3 1.9±0.98 63.33
examination
Section 3: Practice towards nursing initial assessment

among staff nurses.
A self-reported checklist constructed by the investigator to
determine the practice of 170 staff nurses regarding nursing
Figure 5: Bar Diagram Representing Distribution of initial assessment, n=170
Subjects According to Place of Work

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Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1326
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Practice score Grading Frequency Percentage Table 7:
Poor 15-25 0 0 n=170
Average 26-35 40 23.5 Knowledge
S.
Good 36-45 130 76.5
NO
Variable level Df 𝒙𝟐 P
Min score=15 <16 ≥16
max score=45 1 Age in years
20-25 56 55 3 0.795 0.072
Data in the table reveals that 130(76.5%) of staff nurses are 26-30 24 26 (fisher exact)
having good practice and 40(23.5%) are having average 31-35 2 5
practice. >35 1 1
2 Gender
a) Male 5 3 1 0.489 0.21
Table 5: Mean, Standard Deviation and Mean Percentage of
b) Female 78 84 (fisher exact)
practice Score of staff nurses towards nursing initial 3 Educational qualification
assessment, n=170 a) GNM 21 19 3 0.649 0.105
Mean± Standard Deviation Mean percentage (%) b) BSc nursing 6 2 (fisher exact)
38.10±3.66 84.66 c) PBBSc nursing 8 6
Min. Score: 15 d) MSc nursing 1 0
Max. Score: 45 4 Place of work
a) General ward 63 75 2 0.229 0.021
Table 6: Area wise mean, mean percentage, SD and b) High density unit 2 1 (fisher exact)
maximum score of practice score of staff nurses towards c) Private ward 18 11
nursing initial assessment, n=170 5 Year of clinical experience
S Maximum Mean a) Less than 1 year 28 30 3 0.145 0.075
Area Mean ±SD
No. Score % b) 2-5 years 52 47 (fisher exact)
Admission procedure c) 6-10 years 2 9
1. 15 13.41±1.6 29.8
practice d) Above 11 years 1 1
2. Basic procedure practice 40 24.6±2.79 54.66
Summary: The table shows that there is no association
Section 4: Correlation between knowledge and practice between knowledge on nursing initial assessment with
towards nursing initial assessment among staff nurses. selected demographic variables of the staff nurses. Thus, null
hypothesis is accepted, and research hypothesis is rejected.
This section deals with the correlation between knowledge
and practice on nursing initial assessment among staff Section 6: Association of practice on nursing initial
nurses. assessment with selected demographic variables.
n=170 This section deals with the finding of association between
practice on nursing initial assessment with selected
Variables r value P value demographic variables. The number of subjects who had
Knowledge Practice 0.173 0.024 good and average score were identified and grouped
according to the demographic variables such as age, gender,
Data from the above table reveals that the calculated r value educational qualification, place of work, and year of clinical
is 0.173 and p value is 0.024 which is significant at 0.05 experience.
level of significant. There is a weak positive correlation To test the association of practice on nursing initial
between the knowledge and practice of staff nurses regarding assessment with the selected demographic variables the
nursing initial assessment. Thus, research hypothesis is following null hypotheses were formulated.
accepted, and null hypothesis is rejected.
H3: There is no significant association of practice on nursing
Section 5: Association of knowledge on nursing initial initial assessment with selected demographic variables.
assessment with selected demographic variables.
This section deals with the findings of association between Table 8: Chi-square test showing the association between
knowledge score on nursing initial assessment with selected practice on nursing initial assessment with selected
demographic variables. The number of subjects who had demographic variables, n=170
high and low knowledge score were identified and grouped Practice on
according to the demographic variables such as age, gender, S. nursing initial
educational qualification, place of work and year of clinical NO
Variable
assessment
Df 𝒙𝟐 P
experience. <=38 ≥38
1 Age in years
To test the association between knowledge on nursing initial 20-25 58 53 3 0.184 0.11
assessment with selected demographic variables the 26-30 30 20 (fisher exact)
following null hypotheses were formulated. 31-35 6 1
>35 2 0
H0: There is no significant association of knowledge on 2 Gender
a) Male 5 3 1 1.00 0.271
nursing initial assessment with selected demographic
b) Female 91 71 (fisher exact)
variables. 3 Educational qualification

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Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1327
ISSN: 2319-7064
a) GNM 19 21 3 0.243 0.051 Study on knowledge and practice of staff nurses towards
b) BSc nursing 67 48 (fisher exact) nursing initial assessment among 170 subjects, the study
c) PBBSc nursing 10 4 result reveals that [65.29%] of subject belongs 20-25.
d) MSc nursing 0 1
4 Place of work Section 2: Knowledge regarding nursing initial
a) General ward 85 53 2 0.001 0.001* assessment among staff nurses.
b) High density unit 3 0 (fisher exact)
c) Private ward 8 21
Knowledge score grading frequency percentage: 0-9 poor,
5 Year of clinical experience
a) Less than 1 year 32 26 3 0.520 0.057
10-14 average, 15-20 good [69.41%] belongs to good
b) 2-5 years 54 45 (fisher exact) category.
c) 6-10 years 11 3
d) Above 11 years 2 0 Areas were
a) Baseline proforma
Data in the table shows that there is no association between b) Clinical parameters
practices on nursing initial assessment with the selected c) Obstetric gynecology
demographic variables (age of staff nurses, gender, d) Mini mental status
educational qualification, place of work, year of clinical
experiences).Hence the null hypotheses (H03) was accepted Section 3: Practice regarding nursing initial assessment
research hypotheses (H3) was rejected and we conclude that among staff nurses
In the present study shows mean percentage was high in the
there is no significant association between practice on
practice score [76.5] was good that is grading 36-45 and the
nursing initial assessment with selected baseline variables. least [0] practice score was poor that is grading 15-25 and
[23.5] practice score was average that grading 26-35
Summary: The table shows that there is no association .minimum score was 15 and maximum score 45.
between practice on nursing initial assessment with the Documentation of practice is an essential component of
selected demographic variables but there is an association of nursing process. It is the tangible evidence of the cognition
practice with area of working (0.001). Hence the null and skill of the professional nurse practicing nursing. It is a
hypothesis was rejected, and research hypothesis was statement of accountability and responsibility by the nurse.
accepted. The legalistic environment in which today's nurse practices
nursing emphasizes the importance of good documentation
6. Discussion in the patients' medical records.
This chapter presents major findings of the study discussed Section 4: Correlation between knowledge and practice
with reference and in relation to similar studies conducted by towards nursing initial assessment among staff nurses
other researchers. The aim of the study was on knowledge In the present study shows There were variables that is
and practice of staff nurses towards nursing initial knowledge and practice r value is 0.173 and p value is 0.024
assessment in selected hospital Mangalore. Quality which is significant at 0.05 level of significant there is a
assessment tool was conducted to collect data and the weak correlation between knowledge and practice of staff
obtained data was analyzed using descriptive and inferential nurses regarding nursing initial assessment. Compared to a
statistics. study related to study motives and career choices of dental
students, this study found that more students had become
Objectives of the Study familiar with the concept of through community courses and
1) To assess the knowledge of the staff nurses towards had more knowledge in this field. Since the community
nursing initial assessment in a selected hospital at dentistry department provides the issue related in the form of
Mangaluru. theoretical classes and workshops in the Isfahan Dental
2) To assess the practice of staff nurses towards nursing School, the higher knowledge of students in Isfahan
initial assessment in a selected hospital at Mangaluru. compared to other colleges is justifiable. It seems that
3) To find the correlation between knowledge and practice students more familiar with the use of evidenced based
of staff nurses towards nursing initial assessment in a practice in their educational curriculum can be effective in
selected hospital at Mangaluru. enhancing knowledge, attitude, and evidence-based
4) To find the association between the knowledge with practices. The results of the present study showed a
selected demographic variables significant correlation between the four assessed domains
5) To find the association between the practice with selected that seem perfectly logical because an increase in a person's
demographic variables. knowledge of evidenced based practice will be accompanied
by increased levels of his skill and practice.
Major Findings of the study Section 1: Baseline
characteristics Section 5: Association of knowledge on nursing initial
The study shows that age in years [65.29%] were with age assessment with selected demographic variables.
group 20-25, Gender [95.29%] were females, educational In the present study shows that there is no association
qualification [67.64%] were P.B.BSc, place of work between knowledge on nursing initial assessment with
[81.17%] were from general ward and year of clinical selected demographic variables of the staff nurses. Thus, null
experience [58.23%] were 2-5 years. hypothesis is accepted, and research hypothesis is rejected.
The aim of the study was to determine nurse‟s knowledge
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Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1328
ISSN: 2319-7064
and practice on the initial management of acute poisoning setting and larger population.
among adult casualties seen at automated external
defibrillator, knowledge and practice on the initial 8. Limitations of the Study
Management of Poisoning. The mean general knowledge
score for nurses according to their professional  The present study was limited to a relatively small sample
qualifications, trainings on courses related to emergency care size that limited the generalization of the result.
and automated external defibrillator experience was  The study is confined to knowledge and practice among
measured. Those nurses with higher qualifications had higher the staff nurses regarding initial assessment form.
mean scores than the ones with lower professional
qualifications. Further, those who had done courses or
trainings related to emergency care like basic life support,
9. Recommendations and Suggestions
advanced cardiac life support, advanced trauma life support,
nursing and certified clinical nurse scored higher than those  A similar study can be replicated on larger samples for
who had not done these courses. making broader generalization.
 A similar study can be carried out in different settings.
 A descriptive study can be conducted on initial assessment
7. Conclusion and other methods of assessment.
The main purpose of the study was to assess the knowledge
and practice among the staff nurses regarding initial 10. Summary
assessment form. This chapter deals with the conclusion
based with conclusions based on findings of the study. The This chapter was dealt with various nursing implications of
conclusions drawn were the study the limitations which the investigator experienced
in the study the experience of investigators during the study
Implications to Nursing helped to give suggestions and recommendations for further
The investigator has drawn the following implications from studies. Obtaining a concise and effective health history and
the study which was of vital concern for nursing practice physical exam takes practice. It is not enough to simply ask
nursing administration nursing education and questions and perform a physical exam. As the patient‟s
recommendations for nursing research. nurse, you must critically analyze all of the data you have
obtained, synthesize the data into relevant problem focuses,
Nursing Education and identify a plan of care for your patient based upon this
The health care delivery system at present puts more synthesis. As the plan of care is being carried out,
emphasis on knowledge and practice regarding the initial reassessments must occur on a periodic basis. The frequency
assessment of client through holistic approach based on of reassessments is unique to each patient based upon their
mutual respect and cooperation the nurses should be well diagnosis. The ability of the nurse to efficiently and
educated regarding initial assessment. So that the nurses will effectively obtain the health history and physical exam will
improve their knowledge and practice and skills. ensure that appropriate plan of care will be enacted for all
patients.
Nursing Pratice
Nurses play a vital and major role in the health care delivery Objectives
system. Nurses have great responsibilities for the assessing 1) To assess the knowledge of the staff nurses towards
the client so the initial assessment of the client should be nursing initial assessment in a selected hospital at
done it can be used to provide holistic care and health Mangaluru.
promotion of the clients in the hospital. 2) To assess the practice of staff nurses towards nursing
initial assessment in a selected hospital at Mangaluru.
Nursing Administration 3) To find the correlation between knowledge and practice
Today there is increase in demand for quality care policies of staff nurses towards nursing initial assessment in a
and its execution of quality nursing care based on research selected hospital at Mangaluru.
findings they can take initiatives in conducting health 4) To find the association between the knowledge with
education regarding different coping strategies and the selected demographic variables
various relaxation techniques in the wards and clinics. 5) To find the association between the practice with selected
demographic variables.
Administration can recommend for availability of structured
set up in hospital to enhance the relaxation techniques Hypotheses
emotional support counseling section etc. H0: There will be no significant relationship between the
knowledge and practice of staff nurses towards nursing
Nursing Research initial assessment.
The finding of this study can be disseminated to clinical H1: There will be significant relationship between the
nursing student nurses through websites, literature, journals knowledge and practice of staff nurses towards nursing
etc. Emphasis should be laid on research in the area of non- initial assessment.
pharmacological measures of pain management, reducing H2: There will be significant association of knowledge of
stress and promote sleep and improve psychological physical staff nurses towards nursing initial assessment with selected
and social wellbeing the generalization of the study result demographic variables.
can be made by further replication of the study in various H3: There will be significant association of practice of staff
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Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1329
ISSN: 2319-7064
nurses towards nursing initial assessment with selected investigator. The respondents were very cooperative for the
demographic variables. study. The present study was a new learning experience for
the investigator. The constant directions, Encouragement,
Assumptions Suggestions and valuable corrections, Hospital management
The study is based on the following assumptions: contributed their maximum for the fruitful completion of the
1) Staff nurses have some knowledge and skills regarding study
initial nursing assessment of the patients.
2) Knowledge and practice on nursing initial assessment of References
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[15] Prasanna K. Assess the knowledge regarding assessment 6267(15)00026- 9/fulltext
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medicine.2016;9:5 9

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Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1331
ISSN: 2319-7064
Annexure-1
Letter Requesting Permission To Conduct The Pretesting Reliability Pilot Study And Main Study
From,
IIIrd yr. B.Sc Nursing students Group no- 10
Father Muller College of Nursing Kankanady, Mangaluru
To,
The Administrator
Father Muller Charitable Institution Mangalore-575002
Subject: Request for permission to conduct research study Respected Rev Father,
I have selected the below mentioned topic for my dissertation to be submitted in Rajiv Gandhi University of Health Sciences,
Bangalore, Karnataka, as a requirement for the award of Bachelor of science in degree in nursing. Topic: “A descriptive
study on knowledge and practice of staff nurses towards nursing initial assessment in selected hospital at Mangaluru”.
I am interested in conducting this study in general ward, private ward, high density units of your esteemed Institutions. I
assured that this study will not cause any inconvenience to the normal routine of the wards purpose.
Kindly permit me to conduct the study and do the needful. Thanking you
Place: Mangalore Yours sincerely,

Date: Ms. Litty Thomas
Ms. Littymol John Ms.Lolita Dsouza
Ms. Loycee Lolita Mascarenhas Ms. Maria Jyothi Mascarenhas
Annexure 2
Letter granting ethical clearance

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Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1332
ISSN: 2319-7064
Annexure 3
Letter granting permission to conduct research study

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Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1333
ISSN: 2319-7064
Annexure 4
Letter requesting opinion of experts to validate the tool
From,
Ms. Loycee Lolita Mascarenhas IIIrd year B.Sc (N)

Father Muller College of Nursing To,
Subject: Request for experts opinion and suggestions to establish content validity of the research tool.
Respected Sir/Madam,
I Ms. Loycee Lolita Mascarenhas and group from III year B.Sc (N) students of Father Muller college of nursing have selected
the following topic for our dissertation to be submitted to Rajiv Gandhi university in the partial fulfilment for the requirement
for award of bachelor of science in nursing.
TOPIC: A DESCRIPTIVE STUDY ON KNOWLEDGE AND PRACTICE OF STAFF NURSES TOWARDS

NURSING INITIAL ASSESSMENT IN SELECTED HOSPITAL AT MANGALURU.
Objective of the study

1) Socio demographic proforma
2) Questionnaire
3) Checklist
We humbly request you to go through the items and give your suggestions and opinions to develop the content validity of the
tool. Kindly suggest modification, additions and deletions, if any in the remark column.
Thanking you in anticipation.
Place: Mangalore Yours faithfully,
Date: Loycee Mascarenhas and Group
Annexure 5
Letter of acceptance form for tool validation
Name:
Designation:
Name of the Institute:
Statement of acceptance/non acceptance
I give my acceptance/ non acceptance to validate the tool.
Topic: a descriptive study on knowledge and pracitice and pracitice of staff nurses towards nursing initial assessment
in selected hospital at mangaluru.
Place:
Signature
Date:
Annexure 6
Content validation certificate
I hereby certify that I have validated the tool of Ms. Loycee Lolita Mascarenhas and group, III year B.Sc (N)
students, Father Muller College of Nursing who is undertaking the following study
TOPIC: “A DESCRIPTIVE STUDY ON KNOWLEDGE AND PRACTICE OF STAFF NURSES TOWARDS

NURSING INITIAL ASSESSMENT AT SELECTED HOSPITAL AT MANGALURU”.
Signature of the expert Designation and Address
Place: Date:

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Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1334
ISSN: 2319-7064
Annexure 7
Criteria checklist for validation of the tool
Instruction: Review the items in the tool and give your valuable suggestions regarding accuracy, relevance and
appropriateness of the content. Kindly place the tick mark the appropriate column. If there are any suggestions
or comments please mention in the remark column.
Tooli: Socio Demograhic Proforma
Question no : Agree Disagree Remarks

1
2
3
4
5
6
7
Tool 2: Questionnaire
Question no Agree Disagree remark
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Tool III: Checklist

Question no Agree Disagree Remark
1
2
3
4
5
6
7
8
9
10
11
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Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1335
ISSN: 2319-7064
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Annexure 8
List of validators
1) Ms. Darryl Aranha

Deputy chief nursing officer Father Muller college of nursing
2) Mrs. Victoria D‟Almeida

Prof, HOD of MSN dept & vice principal Father muller college of nursing
3) Sr. Deepa
Associate prof & HOD of nursing foundation Father muller college of nursing
4) Mrs. Preethi Fernandes

Assistant prof , dept of MSN Father muller college of nursing
5) Mrs. Sandra Saldanha Lecturer , dept of CHN

Father muller college of nursing
6) Mrs. Precilla D‟silva Lecturer , dept of OBG

Father muller college of nursing
Annexure 9
Subject Information Sheet and Informed Consent Form
Title of the Study: A descriptive study on knowledge and practice of staff nurses towards nursing initial assessment in
selected hospital at Mangalore.
Names of Researchers/Investigators:
Ms. Litty Thomas Ms. Littymol John Ms. Lolita Dsouza
Ms. Loycee Lolita Mascarenhas Ms. Maria Jyothi Mascarenhas
Name of Organization:
Father Muller College of Nursing, Kankanady, Mangalore
Name of Sponsor (Grant agency):

This Research is a Self-funded study.
Name of Project and Version:

A descriptive study on knowledge and practice of staff nurses towards nursing initial assessment in selected hospital at
Mangalore. This study is Undergraduate study of Father Muller College of Nursing
This Informed Consent Form has two parts:

 Information Sheet (to share information about the study with you)
 Certificate of Consent (for signatures if you agree to participate) You will be given a copy of the full Informed Consent
www.ijsr.net
Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1336
ISSN: 2319-7064
Form
Introduction
We, Ms. Litty Thomas, Ms. Littymol John, Ms. Lolita Dsouza, Ms. Loycee Lolita Mascarenhas, Ms. Maria Jyothi
Mascarenhas the third year students of Father Muller College of Nursing are conducting a study on knowledge and practice
of staff nurses towards nursing initial assessment in selected hospital at Mangalore inviting you to participate in our research.
If you do not understand some of the words and concepts, we will explain them as we go and you may ask questions now or
later. You can talk to anyone whom you feel comfortable about the research and you can take time to reflect on whether you
want to participate.
Purpose:
By doing this study we will come to know the knowledge and practice of the staff nurses regarding the initial assessment.
Type of Research Intervention:

The researcher will administer knowledge questionnaire on nursing initial assessment among staff nurses and information
will be collected from the subjects.
Selection of Participants:
Staff nurses will be selected as the participants for this study.
Voluntary Participation:
Your participation in this research is entirely voluntary .it is your choice whether to participate or not. You are free to
discontinue the study at any time and for any reason. You can ask any doubts related to the study at any time to the
researcher.
Procedure
 This study will include demographic proforma, to elicit the personal information about the subjects.
 Structured knowledge questionnaire and checklist is used to assess the knowledge and practice of the staff nurses regarding
nursing initial assessment.
 Ethical clearance will be obtained from father muller college institutional ethics committee.
 Written permission will be obtained from Chief Nursing officer and administrator of Father Muller Medical College
Hospital.
 Written information sheets will be produced before the subjects and all queries regarding the study will be explained before
obtaining the consent from them.
Duration:
Minimum of 45minutes of time is given to each participant.
Risks and Discomforts:
The study does not involve any actual/ potential risks to you. Privacy and confidentiality of the study participants will be
ensured. The result of the study may be published for scientific purpose or to scientific groups and confidentially will be
maintained.
Benefits:
The study helps to improve the knowledge and practice of staff nurses regarding initial nursing assessment.
Reimbursements:
During the study the participants will not be entitled to any compensation or reimbursements.
Confidentiality:
Privacy and confidentiality of the study participants will be ensured. The result of the study may be published for scientific
purpose or to scientific groups. However, you will not be identified and confidentially will be maintained.
Sharing of Research Findings:

The data obtained from you will be combined with the data from the other subjects who are in this study. The published
results will not include your name or any other information that would personally identify you in any way.
Right to refuse or withdraw:

You have the right to withdraw from the study.
Whom to Contact
www.ijsr.net
Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1337
ISSN: 2319-7064
Ms. Loycee Lolita Mascarenhas 9980688891/8310695639

Email: angel.llm0298@gmail.com
Mrs. Ramyashree S
7349426322
Email:ramyaashwath@fathermuller.in
This research project is reviewed and approved by Father Muller Charitable Institutions Ethics Committee, Kankanady,
Mangalore. This is a committee whose task it is to make sure that research participants are protected from harm.
The contact details of ethics committee are as follows:
Dr. Shivashankara A.R, Member Secretary,

Father Muller Charitable Institutional Ethics Committee, Kankanady, MANGALORE-02.
Phone : 08242238399; 9880146133.Mail : FMCIIEC@FATHERMULLER.IN; ARSHIVA72@GMAIL.COM.
Dr. Shalini Shenoy,

Chairperson of Father Muller Charitable Institutional Ethics Committee, Professor of Microbiology,
Kasturba Medical College, Mangalore -01. Phone:9845497072. Mail: shenoyshalini@gmail.com
Informed Consent
I have read and understood the information/ it has been read to me and explained in an understandable language about the
research project: A Descriptive study on knowledge and practice of staff nurses towards nursing initial assessment in a
selected hospital at Mangalore. I have had the opportunity to ask questions about it and any questions that I have asked have
been answered to my satisfaction. I consent voluntarily to participate as a participant in this research.
Code of Participant
Signature of Participant
Date
Day/month/year
Statement by the researcher /person taking consent
I have accurately read out the information sheet to the potential participant, and to the best of my ability made sure that the
participant understands the procedures to be done:
I confirm that the participant was given an opportunity to ask questions about the study, and all the questions asked by the
participant have been answered correctly and to the best of my ability. I confirm that the individual has not been coerced into
giving consent, and the consent has been given freely and voluntarily.
A copy of this ICF has been provided to the participant.
Name of Researcher/person taking the consent

Signature of Researcher /person taking the consent
Date
Day/month/year
Annexure 10
Blueprint
Blueprint of the questionnaire on knowledge on nursing initial assessment
S No Areas Knowledge Frequency %

1 baseline proforma 1-6 6 30
2 clinical parameters 7-13 7 35
3 Obstetric Gynecology 14-17 4 20
4 mini mental status examination 18-20 3 15
Total 20 100

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Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1338
ISSN: 2319-7064
Scoring
Good: 15-20
Average: 10-14
Poor: 0-9
Blue print of the rating scale on practice of nurses on nursing initial assessment
Percentage
S no Areas Items Frequency
(%)
1 Admission Procedure practices 1-5 5 25%
2 Basic procedures practices 6-15 15 75%
Total 1-20 20 100%
Scoring:
Maximum score: 45
Minimum score:15
Annexure 11
Baseline proforma
Socio Demographic Proforma
Instructions: This section seeks information about you and your family. Kindly read the following questions and give
appropriate information
1) Age in years.-------------
2) Gender
a. Male ( )
b. Female ( )
3) Educational Qualification.
a. GNM. ( )
b. BSc nursing ( )
c. P.B.BSc Nursing( )
d. MSc Nursing ( )
e. Additional qualification if any specify
4) Place of work
a) General ward( )
b) High density unit( )
c)Private ward ( )
5) Years of clinic experience
a) Less than 1year ( )
b) 2-5years ( )
c) 6-10 years ( )
d) Above 11 years ( )
Annexure 12
Structured knowledge questionnaire on nursing initial assessment Subject code :
Instructions: Please fill your response to all the items given below by placing a () mark against the appropriate answer.
1) How long is the nursing initial assessment done?

a) 5-15 minutes
b) 16-30 minutes
c) 31-45 minutes
d) 46-60 minutes
2) Which of the following is not typically a part of the initial nursing assessment?
a) Collection of the data
b) Sorting of data
c) Documentation of data
d) Formulating a medical diagnosis

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Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1339
ISSN: 2319-7064
3) What do you mean by the primary language in the nursing initial assessment form?
a) Language which patient knows
b) Language which patient speaks
c) Language which nurse speaks
d) Language which doctor speaks
4) What do you mean by medication reconciliation?

a) Medication which patient is taking before admission
b) Medication which patient is allergic
c) Medication which patient takes after admission
d) Medication which patient should continue after discharge
5) What can clubbing of nails indicate?

a) Hypoxia
b) Diabetes Mellitus
c) Hypovolemia
d) Syphilis
6) When is the anthropometric measurement checked?

a) Children Above 10 years
b) Below 5-10 years
c) Above 5 years
d) 0-5 years
7) How is BMI calculated?

a) Weight in kgs/height in m2
b) Height in m2/weight in kgs
c) Weight in gms/height in cm2
d) Weight in kgs/height in cm2
8) What is the normal pulse rate in adults?

a) 50-70 bpm
b) 80-100bpm
c) 100-130bpm
d) 60-100bpm
9) What is the normal respiratory rate in adults?

a) 10-30breaths/min
b) 40-60 breaths/min
c) 50-60 breaths/min
d) 16-24 breaths/min
10)What is the normal time for capillary refill in adults?

a) Less than or equal to 2 seconds
b) Less than or equal to 3 seconds
c) Greater than 3 seconds
d) Greater than 2 seconds
11) When do we consider a person severely malnourished?

a) BMI is below 22.5
b) BMI is below18.5
c) BMI is 19.5
d) BMI is 20.5
12) What is the normal GCS score?

a) 8-9
b) Less than 3
c) 9-12
d) Greater than 13
13) What is the normal random blood glucose level in an adult?

a) 70-130mg/dl
b) 60-160mg/dl
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Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1340
ISSN: 2319-7064
c) 60-100mg/dl
d) 75-100mg/dl
14) What do you mean by EDD?

a) Expected Delivery Date
b) Expired Date of Drug
c) Estimated Dosage of Drug
d) Emotional Deprivation Disorder
15) What is POG?

a) Period of Gestation
b) Paediatric Oncology Group
c) atient Oriented Goal
d) Patients of Gynaecology
16) What is FHS?

a) Family History of Schizophrenia
b) Fetal heart sound
c) Family History of Seizure
d) Floppy Head Syndrome
17) What does P stands for in obstetrical score

a) Para
b) Peri
c) post
d) Pregnancy
18) When do we check MMSE?

a) When patient is oriented
b) When patient is unconscious
c) When patient is psychiatric
d) When patient is old
19) Which of the following is the main consideration in the psychosocial nursing assessment?
a) Health and emotional needs
b) Religious belief
c) Assisting in the formulation of a medical diagnosis
d) Financial background of the patient
20) What is euthymia associated with?

a) Slurred speech
b) Depression
c) Bipolar disorder
d) Mercy killing
Annexure 13
Self-rated rating scale on practice of staff nurses on nursing initial assessment Subject code
Instructions: Please read every question carefully and place √ mark against the practice that your following in the
ward.
S No Content Always Sometimes Never

1 I will take consent from the patient during the admission.
2 I will do the initial assessment system wise.
3 I can do the initial assessment at nurse‟s counter.
4 I will compulsorily check all the vitals during initial assessment.
5 I will identify whether the patients present diagnosis is affected by patient‟s past history.
6 I can give more importance to the treatment of patient than initial assessment.
7 I can skip explaining the ward routines during busy schedule.
8 I can do the nursing initial assessment even when the patient is not accompanied by the
bystander.
9 I will ask the patient about the medication‟s reconciliation during initial assessment.
10 I will give psychological support to the patient
during the initial assessment.
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Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1341
ISSN: 2319-7064
11 I will explain patient rights to the patient during initial assessment.
12 I will explain the hospital policies to the patient.
13 I will implement planned nursing interventions every time.
14 I will do psychological assessment of an unconscious patient.
15 I may allow the patient to keep their valuable with them during the admission.
Annexure 14
Statistical formula used for the study

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Paper ID: SR20518111615 DOI: 10.21275/SR20518111615 1342

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International Journal of Science and Research (IJSR)

A Descriptive Study on Knowledge and Practice of

Keywords: Nursing initial assessment, Practice, Knowledge

1. Introduction of the nursing process, involves the systematic and

2. Need for the Study Objectives

Hypothesis A cross sectional descriptive survey was conducted in 2007

Variables under the study Medical College Hospital at Mangalore. It is a

Setting of the study Sample and sample size

Volume 9 Issue 5, May 2020

Year of clinical experience

Figure 6: Pie Diagram That Shows Subjects According to

Table 2: Grading the knowledge of the staff nurses, n=170

Data in table 2 reveals that 118(69.47%) staff nurses had

Table 3: Mean, Standard Deviation and Mean Percentage of

Section 3: Practice towards nursing initial assessment

Volume 9 Issue 5, May 2020

Volume 9 Issue 5, May 2020

Volume 9 Issue 5, May 2020

Place: Mangalore Yours sincerely,

Volume 9 Issue 5, May 2020

Volume 9 Issue 5, May 2020

Letter requesting opinion of experts to validate the tool

Ms. Loycee Lolita Mascarenhas IIIrd year B.Sc (N)

TOPIC: A DESCRIPTIVE STUDY ON KNOWLEDGE AND PRACTICE OF STAFF NURSES TOWARDS

Objective of the study

Place: Mangalore Yours faithfully,

Date: Loycee Mascarenhas and Group

Statement of acceptance/non acceptance

I give my acceptance/ non acceptance to validate the tool.

TOPIC: “A DESCRIPTIVE STUDY ON KNOWLEDGE AND PRACTICE OF STAFF NURSES TOWARDS

Signature of the expert Designation and Address

Volume 9 Issue 5, May 2020

Tooli: Socio Demograhic Proforma

Question no : Agree Disagree Remarks

Tool III: Checklist

1) Ms. Darryl Aranha

2) Mrs. Victoria D‟Almeida

4) Mrs. Preethi Fernandes

5) Mrs. Sandra Saldanha Lecturer , dept of CHN

6) Mrs. Precilla D‟silva Lecturer , dept of OBG

Name of Sponsor (Grant agency):

Name of Project and Version:

This Informed Consent Form has two parts:

Type of Research Intervention:

Minimum of 45minutes of time is given to each participant.

Risks and Discomforts:

Sharing of Research Findings:

Right to refuse or withdraw:

Ms. Loycee Lolita Mascarenhas 9980688891/8310695639

The contact details of ethics committee are as follows:

Dr. Shivashankara A.R, Member Secretary,

Dr. Shalini Shenoy,

Statement by the researcher /person taking consent

A copy of this ICF has been provided to the participant.

Name of Researcher/person taking the consent

Blueprint of the questionnaire on knowledge on nursing initial assessment

S No Areas Knowledge Frequency %

Volume 9 Issue 5, May 2020

Socio Demographic Proforma