Topic Importance
Knowledge, attitude, and practice play an important role in the prevention and control of virus outbreaks. Nursing is an essential component of medical care, and nurses’ knowledge about the disease directly affects healthcare effectiveness and patient outcomes. During an outbreak, nurses play a positive role in improving the recovery rate, reducing the length of the hospital stay and mortality, and preventing in-hospital infection (Jin et al., 2020). Knowledge of the disease significantly influences nursing practice, with incorrect attitudes and insufficient knowledge directly increasing the risk of infection (Zhang et al., 2020). Understanding the level of nurses’ awareness and preparedness towards COVID-19 allows health authorities to implement relevant measures directed at the prevention and control of infection in healthcare facilities.
Question
In COVID-19 patients, how does the nurses’ good knowledge and positive attitude influence patient outcomes, compared to insufficient knowledge and negative attitude during the pandemic?
Background Information
The COVID-19 pandemic has affected all groups of the population all over the world, with health care providers being at the most risk of contracting and transmitting the infection. At the initial stages of the disease outbreak, health care professionals working at the front line were often infected due to negligence and lack of knowledge (Tamang et al., 2020). The infection rates in most countries were reduced by increasing the level of knowledge and implementing protective and prevention measures, which also resulted in a more positive attitude of nurses and doctors towards COVID-19 patients. In order to control and prevent infection, education and training programs for healthcare workers need to be developed that address the most important issues encountered in their practice during the pandemic.
Topic Significance to Nursing Practice
Working with COVID-19 patients is challenging for nurses due to the novelty of the disease, lack of information, fear of infection, and the psychological trauma resulting from patient deaths. Decreasing the level of stress and anxiety among nurses is important for improving both the quality of care and their own wellbeing. The findings show that good knowledge of the disease and proper implementation of infection control measures are significant predictors of the nurses fulfilling their professional care obligations (Nashwan et al., 2020). If the factors that affect nurses’ knowledge, attitude, and practice towards COVID-19 can be determined promptly and properly, relevant training and policies can be developed that prioritize their protection and reduce the level of stress.
Purpose of the Project
The purpose of the project is to identify the problems in nurses’ knowledge and attitude towards COVID-19 patients based on cross-sectional survey results.
Literature Summary
Literature Analysis
Problems and Purposes
The reviewed literature focuses on the importance of increasing nurses’ knowledge and attitude towards COVID-19. During the pandemic, health care professionals experience a high risk of infection and transmitting the infection to patients (Hyuhn et al., 2020), with the lack of knowledge being the primary causative factor (Tamang et al., 2020). Increasing nurses’ awareness helps to improve clinical management strategies (Al-Dossary et al., 2020), enhance the ability of health care providers to perform their role (Alrubaiee et al., 2020), and improve patient outcomes (Nashwan et al., 2020). All reviewed articles aim to assess the knowledge, attitude, and practice of nurses and other healthcare workers towards COVID-19 and determine the main issues of concern that need to be addressed.
Research Methods
All ten reviewed articles use self-administered online questionnaires as the data collection method. There is no unified framework for survey design, and each research uses slightly different questionnaires developed by the authors based on previously published studies and modified in accordance with local specifics and research objectives. Most surveys include a section on demographic characteristics of the participants and three to four sections on knowledge, practice, and attitude towards COVID-19.
In most studies, surveys were distributed over the internet to nurses and health care practitioners working in hospitals in a particular region. The number of respondents varies between 159 and 1,572, with nurses constituting no less than a half of the respondents. In each case, the data was examined using different software, with descriptive statistics being the most popular method of analysis. The reviewed studies were performed from January to September 2020 in nine countries: Yemen, Qatar, China, Nepal, Vietnam, Libya, Saudi Arabia, Ethiopia, and South Africa.
Findings and Conclusions
Different studies show varying levels of knowledge, attitude, and practice towards COVID-19 among health care professionals in different countries. It can be concluded that the general level of nurses’ awareness and preparedness depends on each country’s level of development, quality of healthcare, and pandemic response. For example, China, where the pandemic started, displays significant knowledge of COVID-19 among nurses (Zhang et al., 2020), while in less developed countries, such as Libya, health professionals show low levels of awareness and preparedness (Elhadi et al., 2020). Based on research results, specific problems can be identified that each particular region needs to address at the given period.
Strengths and Weaknesses
A questionnaire is a data collection method that allows researchers to gather lots of information from many people. They can be conducted online, which reduces the risk of disease transmission during the pandemic. They are also cost-effective, allowing researchers to collect data from large samples for a relatively low cost, which is especially relevant for less developed countries that cannot afford large-scale research (DeCarlo, 2018).
The weaknesses of the method include its inflexibility and depth. Most surveys generally consist of true/false or Lykert-scale questions that are easy to analyze but provide no detail to comprehensively examine the topic (DeCarlo, 2018). Particular problems and reasons behind them are hard to determine using standardized questionnaires. Overall, the questionnaire is a reliable method for quantitative evaluation of the knowledge and attitudes towards the disease at a given period in a particular region that can serve as a basis for future research.
Similarities and Differences
All ten studies have the same purpose and use the same data collection method. For each study, the questionnaires were developed by the authors based on the local specifics and research objectives, which explains differences in the structure and topics covered in each survey. For example, the study of nurses’ knowledge and attitudes in Ethiopia focuses on their psychological response towards the infection (Tadesse et al., 2020). The study conducted in Ho Chi Minh City concluded that the level of some knowledge and attitude among nurses was lower than expected for their position (Hyuhn et al., 2020). Overall, while addressing the same problem, each study approaches it from a slightly different perspective, which helps to develop a comprehensive picture of issues encountered by nurses during the pandemic.
Practical and Clinical Significance
The analysis of the level of knowledge, attitude, and practice among nurses in different countries at different stages of the pandemic provides important information on each country’s level of preparedness at a given period. The results have significant implications for future actions, such as increasing COVID-19 prevention awareness and control guidelines, providing training and support for nurses, improving healthcare strategies, and addressing specific problems identified in studies. The countries that display a low level of nurses’ knowledge and awareness could invest in training and implement measures to boost their willingness and preparedness to work with COVID-19 patients.
Research Question, Ethics Approval, and Timeline
The research aims to determine how does the nurses’ good knowledge and positive attitude towards COVID-19 patients influence patient outcomes, compared to insufficient knowledge and negative attitude during the pandemic. In order to answer the question, a comprehensive analysis of research articles needs to be conducted that assess the level of knowledge and attitude of nurses towards COVID-19 in different countries. The research needs to be reviewed by the relevant Institutional Review Board. It can be performed on site and requires no additional costs. The estimated project completion time is three months.
For participation in the research, an informed written consent needs to be obtained from the respondents. Participants must be provided with all relevant information about the research that permits them to make an informed and voluntary decision about whether or not to participate. The consent should be obtained prior to the research using an online consent form sent together with a link to the survey. The consent form can be obtained from the relevant IRB’s website (for example, Templates and forms, n.d.) and adapted to fit the research objectives.
Study Design
Subjects and Setting
For the purpose of the project, the questionnaire will be distributed among the nursing staff working in isolation, intensive care units, and ER. The setting is designated COVID-19 hospitals and non-designated public hospitals in the Madinah region of Saudi Arabia.
Sample Size
The target sample size is 300 nurses working in isolation, intensive care units, and ER. The target sample size is determined based on the previous studies, which included between 150 and 1,500 health care professionals, with around 300 nurses being an average sample size.
Inclusion Criteria
Inclusion criteria are employment in isolation, intensive care units, and ER in the hospitals in the target region, and participation in working with COVID-19 patients. No special requirements are placed on work experience, age, or education. Prior to the survey, the respondents need to confirm their willingness to participate by completing an online informed consent form.
Recruitment Plan
The link to the online questionnaire, together with a consent form. will be distributed through the nursing services of the region, and social platforms used by nurses employed in target hospitals. Participation is voluntary, and the survey will be conducted among nurses who fit all requirements, agree to take part in the research, and sign the consent form.
Data Collection
An online self-administered questionnaire will be used to collect the knowledge, attitude, and practice towards COVID-19. This method was selected as the most reliable, fast, and cost-effective way of evaluating knowledge and attitude based on the previous research on the subject.
Dependent Variables
Dependent variables are the nurses’ knowledge, attitude, and practice towards COVID-19 patients.
Independent Variables
Independent variables are sociodemographic and personal characteristics of nurses working with COVID-19 patients.
References
Al-Dossary, R., Alamri, M., Albaqawi, H., Al Hosis, K., Aljeldah, M., Aljohan, M., Aljohani, K., Almadani, N., Alrasheadi, B., Falatah, R., & Almazan, J. (2020). Awareness, attitudes, prevention, and perceptions of COVID-19 outbreak among nurses in Saudi Arabia. International Journal of Environmental Research and Public Health, 17, 8269. Web.
Alrubaiee, G. G., Al-Qalah, T. A. H., & Al-Aawar, M. S. A. (2020). Knowledge, attitudes, anxiety, and preventive behaviors towards COVID-19 among health care providers in Yemen: An online cross-sectional survey. BMC Public Health, 20, 1541. Web.
DeCarlo, M. (2018). Scientific inquiry in social work. Radford University.
Elhadi, M., Msherghi, A., Alkeelani, M., Zorgani, A., Zaid, A., Alsuyihili, A., Buzreg, A., Ahmed, H., Elhadi, A., Khaled, A., Boughididah, T., Khel., S., Abdelkabir, M., Gaffaz, R., Bahroun, S., Alhashimi, A., Biala, M., Abulmida, S., Elharb, A.,… Amshai, A. (2020). Assessment of healthсare workers’ level of preparedness and awareness regarding COVID-19 infection in low-resource setting. The American Journal of Tropical Medicine and Hygiene, 103(2), 828–833. Web.
Hoque, A. M., Buckus, S., Hoque, M., & Hogues, M. E. (2020). Knowledge, attitude & practices of primary healthcare workers on COVID-19 from a rural setting of Kwa-Zulu-Natal, South Africa. Clinical and Experimental Investigations. Web.
Huyhn, G., Nguyen, T. N. H., Tran, V. K., Vo, K. N., Vo, V. T., & Pham, L. A. (2020). Knowledge and attitude towards COVID-19 among healthcare workers at District 2 Hospital, Ho Chi Minh City. Asian Pacific Journal of Tropical Medicine, 13(6), 260–265. Web.
Jin, Z., Luo, L., Lei, X., Zhou, W., Wang, Z., Yi, L., & Liu, N. (2020). Knowledge, attitude, and practice of nurses towards the prevention and control of COVID-19. Research Square. Web.
Nashwan, A., Abujaber, A., Mohamed, A., Villar, R., & Al-Jabry, M. (2020). Nurses’ willingness to work with COVID-19 patients: The role of knowledge and attitude. Nursing Open, 0, 1–7. Web.
Tadesse. D. B., Gebrewahd, G. T., & Demoz, G. T. (2020). Knowledge, attitude, practice and psychological response toward COVID-19 among nurses during the COVID-19 outbreak in northern Ethiopia, 2020. New Microbes and New Infections, 38. Web.
Tamang, N., Rai, P., Dhungana, S., Sherchan, B., Shah, B., Pyakurel, P., & Rai, S. (2020). COVID-19: A national survey on perceived knowledge, attitude and practice among healthcare workers in Nepal. Research Square. Web.
Templates and forms. (n.d.). Northwestern. Web.
Zhang, M., Zhou, M., Tang, F., Wang, Y., Nie, H., Zhang, L., & You, G. (2020). Knowledge, attitude, and practice regarding COVID-19 among healthcare workers in Henan, China. Journal of Hospital Infection, 105 (2), 183–187. Web.