ASSESSMENT OF NURSES' KNOWLEDGE AND SELF-REPORTED PRACTICE REGARDING HYDROCEPHALUS CARE AT GULAB DEVI HOSPITAL, LAHORE

Abstract

Background: Hydrocephalus is a critical neurological condition marked by abnormal cerebrospinal fluid (CSF) dynamics and ventricular enlargement. Safe clinical management relies heavily on bedside nursing vigilance, including accurate neurological monitoring, sterile external ventricular drain (EVD) maintenance, and rapid recognition of ventriculoperitoneal (VP) shunt failure.

Objective: This study aimed to evaluate the baseline level of knowledge and self-reported clinical practice regarding hydrocephalus care among registered nurses at Gulab Devi Hospital, Lahore, and analyze the associations between nurses' professional characteristics and their competence scores.

Methodology: A descriptive cross-sectional quantitative research design was conducted among 103 registered nurses working in pediatric, neurosurgical, intensive care, and emergency departments at Gulab Devi Hospital, Lahore. Participants were recruited through convenience sampling based on a calculated finite population (N=140, n=103 via Slovin's formula). Data were gathered via a structured questionnaire encompassing demographic profiles, 20 factual knowledge items, and 18 self-reported clinical practice items. Data were analyzed using SPSS version 26, employing descriptive statistics, chi-square tests, one-way ANOVA, independent-samples t-tests, and Pearson correlation coefficients at p < 0.05.

Results: Out of 103 nurses, 78.6% were female, 31.1% were aged 26–30 years, 44.7% held a Nursing Diploma, and 32.0% had 1–3 years of clinical experience. The overall mean knowledge score was 10.57 ± 4.84 out of 20 (52.9%), reflecting predominantly Moderate knowledge (45.6%, n=47), followed by Good (31.1%, n=32) and Poor knowledge (23.3%, n=24). Distinct knowledge deficits were identified regarding Cushing's triad (28.2%), EVD transducer reference leveling (28.2%), and normal adult ICP ranges (31.1%). In contrast, overall self-reported practice was considerably higher, with a mean score of 39.09 ± 11.13 out of 54 (72.4%), categorized as Good (60.2%, n=62) and Moderate practice (37.9%, n=39). Pearson correlation demonstrated a positive relationship between total knowledge and practice scores (r = 0.359, P = 0.0002). Formal neuro-nursing training was the most significant predictor of superior performance, with trained nurses achieving significantly higher knowledge (59.05% vs. 43.12%, p < 0.001) and practice scores (79.12% vs. 61.76%, p < 0.001).

Conclusion: While nurses at Gulab Devi Hospital exhibit good adherence to routine care practices, substantial gaps remain in advanced physiological and device-specific knowledge. Institutional implementation of standardized EVD care bundles, practical simulation training, and structured continuous nursing education is strongly recommended.