ARTICLE INFO

Article Type

Original Research

Authors

Maleki Bab Hoveyzi   M.R. (1 )
Babatabar Darzi   H. (* )
Rahmani   R. (2 )
Salari   M.M. (3 )






(* ) Anesthesiology Department, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
(1 ) Trauma Research Center, Baqiyatallah Univesity of Medical Sciences, Tehran, Iran
(2 ) Military Nursing Department, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
(3 ) Health Department, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran

Correspondence

Address: Nursing Faculty, Velayat Educational Complex, Araj Threeway, Aqdasieh, Tehran, Iran
Phone: +98 2122286057
Fax: +982126127237
babatabar1343@yahoo.com

Article History

Received:  July  13, 2014
Accepted:  November 25, 2014
ePublished:  February 4, 2015

BRIEF TEXT


… [1-6] Iran is one of the 10 most disaster-prone countries in the world and its people are at the risk of earthquakes and floods. Iran is sixth country in the world in terms of natural disasters [7]….[8, 9] During wars and other events, the period of rescue and correct transportation of the wounded to safe areas or clinics is important to minimize the adverse effects. If the rescue and transfer time is short, the mortality will be reduced significantly [10-12].The most important way to prevent or reduce the effects of events is training efficient human resources [14, 15].

In reviewing of the medical curriculum in terms of military medicine approach, 26 military special courses such as trauma, self and non-self-aid, etc. have been added to the medical curriculum [16]…[17] Comprehensive learning curriculum including all elements of military emergency medicine in both practical and theoretical courses has been designed for four years [18]. … [19].

The aim of this study was to develop the "Rescue and Transport" course for nursing undergraduates with military approach.

This is a descriptive and survey study.

Pundits, experts, commanders in health category in a military organ and faculty members of the medical university for armed forces, other universities, Iran Red Cross and emergence centers who had the experience of war or were in crisis or teaching in the field of rescue and transfer were studied in 2013.

48 members of university faculty and experts were chosen purposively using Delphi method and Snowball sampling until reaching saturation. In the first phase 35 and in the second phase 28 people cooperated. 7 experts participated in an expert group meeting (third phase). Inclusion criteria were as follows: having at least three months of working in martial health centers during the war or crisis for the nurses, having at least five years’ working experience in rescuing and transfer for the martial health managers and the rescue and transfer expert, and having the experience of teaching “Rescue and Transport” course for the members of faculty of medical universities. Each of the participants who did not wish to continue their cooperation as comment presentations or completing the questionnaire was excluded from the study.

First, need assessment was conducted using the opinions of managers, leaders and learners. Based on the conducted need assessment, the purpose of the program was prepared and approved by the advisors. Extracted issues were listed in the found frequency order through note taking from the texts, printed and electronic documents related to nursing curriculum and other related fields in the domain of rescue and transport in Iran and other countries in 26 course headings, and it was turned to a questionnaire. Validity of the questionnaire was assessed through formal and content validities. Reliability of the questionnaire was assessed using test-retest method through giving the questionnaire to 10 faculty members of a medical university in Tehran. Then, to complete the questionnaire, Delphi method was used in three phases. In the first phase a questionnaire was set by 26 headings and with the options of “necessary”, “useful but not necessary” and “not necessary” and it was replied by 48 experts. In this stage a semi-structured questionnaire was used in form of open questions in relation to the needs of the nurses to learn rescue and transport which was replied by the experts. Experts not only replied to the questions, but also they suggested their proposed headings. In this stage, 35 members of faculty completed the questionnaire. In the second stage, the comments of the first phase were summarized. Based on the frequency of comments and applying the experts’ opinions, the suggested headings were increased to 32 and the questionnaire was again given to the experts. The 28 faculty members completed the questionnaire. Scoring was done based on the content validity ratio (CVR). Headings which had the less than minimum rate of survival were excluded. 26 headings with high scores entered the next stage. At this stage, also, the amount of teaching hours (theoretical, practical and training) was determined. In the third stage, in a meeting with the expert group consisted of 7 senior experts and faculty members, the results of first and second stages of Delphi method were discussed. Finally, the course of Rescue and Transport reached the final approval with 8 main titles and 33 headings in 4 credits (two theoretical credits, one practical credit and one training credit). Data were analyzed using SPSS 19 software. The quantitative section was analyzed descriptively and the qualitative section was analyzed using a model range (description, interpretation, implementation and neighborhood). Then the educational content was prepared based on internet and library studies and it was approved by scientific advisors and prepared as a lesson manual.

25 participants (71.4%) had graduate degree and 9 participants (25.7%) had PhD. 22 participants (62.9%) were men, 13 were women (37.1%). 32 were martial (91.4%) and 3 were non-martial (8.6%). Mean age was 44.6± 11.2years. Mean professional work-experience was 19.3±6.2years. Mean experience in teaching aid and transport was 5.5± 3.8years. Mean war presence was 12.4± 3.8months. 31 participants (88.6%) considered the necessity of course in rescue and transport as very high, 3 stated it as high (8.6%) and one chose the choice of “ I have no opinion”. 34 participants (97.2%) emphasized the necessity of the course of rescue and transport for undergraduate nursing. 32 experts (91.4%) evaluated the knowledge, attitude and skills of current undergraduate nurses as average to low in terms of first aiding and transfer of wounded people and none of the experts chose the choice of very high. 9 experts (25.7%) considered the needs to the review of current nursing curriculum very high, 18 participants (51.4%) considered it as high and 5 participants (14.3%) expressed it as average and 3 experts (8.6%) did not have any opinion in this domain. According to the conducted survey, the course of Rescue and Transport was designed for undergraduate Nursing Course in terms of military approach including two theoretical credits, one practical credits and one training credit (Table 1).

Concerning rescue and transport, employment of teams of nurses in the fronts can leads to significant decrease of complications after the injury [20]. This result is consistent with the result of this study. “Terrestrial Rescue and Transport” title was approved with the CVR equal to 0.93 with 9 theoretical hours, 14 practical hours and 18 training hours. The rate of transportation of the wounded people and the safety of ambulances is very effective in the rate of mortality and its complications and it has been very effective in elderly people for the prevention of cardiac and respiratory disorders [21, 22]. “Aerial Rescue and Transfer” title was approved with the CVR equal to 0.93 in 7 theoretical hours, 8 practical hours and 12 training hours. Implementation of standards in the aerial rescue leads to mortality reduction, as well as reducing many complications, via reducing transport length [23]. In emergency transports in which the ambulances can be problematic due to their low speed, helicopters are useful [4]. Transportation with the helicopter has decreased the rate of mortality 39% comparing with the transportation with the ambulances [24]. ….[25-28].

This course should be evaluated after some administration in nursing universities with respect to the number of credits, content and efficiency and capabilities of the students.

Restricted access to the sources of “Rescue and Transport” courses in other countries was of the limitations for the present study.

Considering the geographical and geopolitical situation of Iran in the Middle East and considering the view of experts regarding the gap due to lack of "Rescue and Transport" course in undergraduate Nursing Course, the course must be included to increase knowledge, attitude and skills of military nurses.

Researchers appreciate the cooperation of the personnel of Trauma Research Center, School of Nursing, Tarbiat Modarres University and Tehran Red Crescent and Emergency Center.

Non-declared

All stages were confirmed by the research commission in Nursing School.

This research has been funded by Trauma Research Center and Nursing School.

TABLES and CHARTS

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