Assessment of nurse’s knowledge about care of children treated with Ventricular Peritoneal Shunt

Background: Hydrocephalus in children can treated medically or surgically, mostly surgical treatment managed preferred, usually by an opening of the obstructive lesion carried out by ventriculostomy or a shunt (ventriculoatrial, ventriculoperitoneal) insertion. The most common procedure is the insertion of a ventricular peritoneal VP shunt in neurosurgical intervention preferred treatment for hydrocephalus, which is an effective procedure for drainage the CSF from the brain ventricles in to peritoneal cavity. Aim: assessment nurse’s knowledge toward care of children treated with ventricular peritoneal shunt. Construct and Apply an interventional program for nurse’s according to their need assessment . Methods: A pre experimental design that perform to the interventional program at Mosul Teaching Hospitals. from 3 ed of December / 2021 till 30 th of March / 2022. The sample of the study was chosen purposively (non-probability). The participant was (30) nurses from morning and evening shift. The format of questionnaire consists of two parts (demographic data, knowledge questionnaire). Results: the total nurses' knowledge about care for children treatment with ventricular peritoneal shunt, that 53.3% (16) of the sample at Poor Knowledge level with mean (1.53) and standard deviation (0.629) of knowledge in assessment result. Conclusions: Most nurses in age between (20-29 years) and bachelor level of education. The years of work in hospital was between (1-5 years). The nurses have less than five years of experience in neurosurgery unit. And two thirds of nurses did not receive training courses about VP shunt. The result of total nurse’s knowledge during assessment was poor.


INTRODUCTION
Hydrocephalus in children can treated medically or surgically, mostly surgical treatment managed preferred, usually by an opening of the obstructive lesion carried out by ventriculostomy or a shunt (ventriculoatrial, ventriculoperitoneal) insertion (Marcdante and Kliegman, 2019;shahi et al., 2018).
The most common procedure is the insertion of a ventricular peritoneal VP shunt in neurosurgical intervention preferred treatment for hydrocephalus, which is an effective procedure for drainage the CSF from the brain ventricles in to peritoneal cavity (Hasanain et al., 2019;Dakurah et al., 2016;Jernigan et al., 2014;Ali et al., 2013).
According to the National Institute of Neurological Disorders and Stroke, stated that 1 -2 small children out of 1,000 were born with hydrocephalus annually.It estimated that 750,000 children in the world diagnosed with hydrocephalus, and 160,000 have VP shunts procedure each year.(Jea et al., 2017;Kahle et al. 2016).Many complications after operation can be result from different causes; insufficient nursing care can be one of them that could be effect on the child physical and neurological function or required to surgical revision.
Nursing management of children with a ventricular shunt required adequate knowledge to provide care and maintain hand hygiene, observe for any deviations from typical behavioural and physical state while lying just on unaffected side or on back with the head raised at 15° to 30°.In addition to check the VP shunt's appropriate functioning by clamping down on the valve in a specified reservoir section, Checking the skin for redness at the shunt placement on bony prominences, as well as taking note of hydration and fluid intake (Smith et al., 2016;Martin, 2017;Joseph, et al., 2017;Abd El Aziz, 2017;Vacca, 2018).
Objectives of the study Assessment nurse's knowledge toward care of children treated with ventricular peritoneal shunt.

METHOD
A quantitative design "descriptive" study that performed at Mosul Teaching Hospitals.from 3 ed of December / 2021 till 30 th of March / 2022.The sample of the study was chosen purposively (nonprobability).The participant was (30) nurses from morning and evening shift.
The format of questionnaire consists of two parts (demographic data, knowledge questionnaire), knowledge questionnaire consists of three domains: First domain (general knowledge which belongs to hydrocephalus) this section consists of (5 items), Second domain (general knowledge which belongs to VP shunt) this section consists of (5 items), Third domain (knowledge that belongs to complication of VP shunt) this section consists of (3 items).The gathered information was from the period of 17/ January/2022 up to the 17up to 25 / January / 2022.
The questionnaire was reviewed by ( 15) proficient in various medical and nursing domains, and the reliability confirmed by using the Cronbach's Alpha was (0.802) for knowledge questionnaire.

Statistical analysis
The collected data were compiled and analyzed using percentages, means and standard deviation, Alpha Cronbach.this investigation's data was dissected using the Social Science Statistical Package (SPSS) version 25.

RESULTS
The

CONCLUSIONS
Most nurses in age between (20-29 years) and bachelor level of education.The years of work in hospital was between (1-5 years).The nurses have less than five years of experience in neurosurgery unit.And two thirds of nurses did not receive training courses about VP shunt.The result of total nurse's knowledge in the result was poor during assessment.

ETHICAL CONSIDERATIONS COMPLIANCE WITH ETHICAL GUIDELINES
This study was completed following obtaining consent from the University of Baghdadand Ninavah Health Department.

Table 2 . Statistical Differences Result for Nurses' Knowledge about care for children treatment with ventricular peritoneal shunt
that the highest percent of nurses have attended training sessions and courses for caring for babies with hydrocephalus.The result of table (2) are supported by researcher Elbilgahy and Mohammed (2019) in her research in Egypt which explains that nurses' information was low during assessment of nurse's knowledge.