INTRODUCTION
Clinical pathways,  common in many health care 
organizations throughout the world, are best described as 
planned and systematic detailing of the usual patterns of care 
for a patient with a specic disease or diagnosis. Clinical 
pathways are paths that health professionals can follow that 
should enable them to provide the best possible outcome for 
patient, the health care team, and health care organization.

Need of the study
Harry et al suggested that the ideal clinical pathway should 
includes medical notes with care plan for nursing staff and 
allied health professionals for reducing redundant 
information and improves the understanding of the roles of 
other disciplines. (Harry et al, 1998)

Nurse's have a key role in all aspects of clinical pathway use. 
Nurse's participation is essential for successful impleme 
ntation of clinical pathways, and ultimately, the opportunity to 
improve patient care. (Brunner, 2004)

Asthma affects an estimated 25,000,000 Indians every year 
and this number is likely to increase by 50% by the year 2016. 
COPDs and asthma account for nearly 1.5 % of total disease 
burden in the country. Among adults, women have a 30 % 
greater prevalence of asthma than man. Yet there are over 
4000 deaths per year from asthma. (Lewis, 2011)

Hence it would be benecial if a study is conducted among the 
staff nurses, to assess effect of teaching on clinical pathway of 
respiratory diseases like Asthma, Chronic Obstructive 
Pulmonary Disease (COPD), and Pneumonia. This would help 
in bringing the need for clinical pathway awareness among 
nurses on the need & importance.

Statement of the problem
“A Study To Assess The Effect Of Teaching On  Knowledge 
Regarding The Clinical Pathway Of Selected Respiratory 
Diseases  Among Staff Nurses Working In Selected Hospitals 
Of Pcmc, Pune.”

Objectives of study 
1) To assess the level of knowledge of staff nurses regarding 

clinical pathway of selected respiratory diseases.
2) To assess the effect of teaching regarding knowledge of 

clinical pathway of selected respiratory diseases among 
staff nurses.

3) To correlate the knowledge score regarding clinical 
pathway with selected demographic variable of staff 
nurses.

Hypothesis
H : There will be no signicant difference between the pre & 0

post test knowledge score on clinical pathway among staff 
nurses.

RESEARCH METHODOLOGY
Research Design A pre- experimental pre and post test study 
design used for the present study. 

Sample, Sample Size and sampling technique
The 60 sample were selected for the present study by using 
non probability convenience sampling technique.

Development & Description of the Tool
After an extensive review of literature and discussion with 
experts the tool was developed. The tool was divided into two 
parts 

Section 1: consist of ve items for obtaining the base line 
information of the staff nurses regarding age, gender, 
educational qualication, years of experience, area of 
experience and sources of knowledge on clinical pathway of 
selected respiratory diseases. 

Section 2: consist of 20 items of structured knowledge 
questionnaire, which covers the following categories, clinical 
pathway, clinical pathway of asthma, chronic obstructive 
pulmonary disease (COPD) pneumonia. And role of nurse in 
clinical pathway based care. 

The areas covered in teaching were:
Clinical pathways of asthma, COPD, pneumonia and Role of 
nurse in clinical pathway based care

Scoring Procedure:
Each correct answer carried one score and the total score of 
the structured knowledge questionnaire was 20.

Validity and reliability 
To ensure the content validity of the tool, the structured 
knowledge questionnaire and lesson plan was submitted to 
18 experts. The opinion and suggestions were considered and 
tool was prepared. To check the  reliability of the tool, it was 

CLINICAL PATHWAY OF SELECTED RESPIRATORY DISEASES AMONG 
STAFF NURSES WORKING IN HOSPITALS OF PCMC, PUNE

Original Research Paper

Mrs. Banashankari 
P Hiremath

M.Sc Nursing Assistant Professor, Dr. Hedgewar College of Nursing 
Aurangabad. Maharashtra, India.

Nursing

Clinical pathways are care plans developed collaboratively by physicians, nurses, physical therapists, 
technicians, pharmacists, speech therapists, case managers, and other staff members involved in 

patient care. Nurses are instrumental in ensuring the successful use of clinical pathways and can best contribute by gaining a 
thorough understanding of why and how pathways are used. Hence, a study was conducted to assess the effect of teaching on 
knowledge regarding the clinical pathway of selected respiratory diseases among staff nurses working in selected hospitals of 
PCMC, Pune. 
A pre experimental one group pre test-post test was adopted for the study. A non probability convenient sampling technique was 
used to draw 60 samples. The data was collected by using structured knowledge questionnaire with 20 items. Major Findings of 
the Study depict that mean difference between the post-test (18.2) & pre-test (9) was signicant (t(59)=44.2;p<0.05). The study 
concluded that teaching was effective in increasing the knowledge of staff nurses on clinical pathway of selected respiratory 
diseases.

ABSTRACT

KEYWORDS : Clinical pathway, teaching, respiratory diseases, staff nurses. 

VOLUME-8, ISSUE-11, NOVEMBER-2019 • PRINT ISSN No. 2277 - 8160 • DOI : 10.36106/gjra

28 X GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS



administered to 10 samples as per the criteria. Reliability was 
assessed using test-retest method. Pearson's correlation 
coefcient was found to be 0.99.

Data Collection
Formal written permission was obtained from the medical 
superintendent selected hospitals of PCMC area Pune. A 
pretest was conducted by using structured knowledge 
questionnaire; on same day teaching was administered to the 

thsubjects. Post-test was conducted on 7 day.

Data Analysis and interpretation 
The study reveals that, most of the nurses 71.7% were from the 
age group 21-30 years and 16.7 % were from 41-50 years. 
Majority 75% were female and 25% were male. 61.7% were 
from medicine ward and 28.3% were from ICU. 

Table no 1 Distribution of knowledge score among staff 
nurses

Table 1shaows  paired t test value to compare difference 
between average scoring of before and after teaching. Since P 
value is less than 0.05 (P value = 0.000) difference in average 
scores is statistically signicant. There is  5% level of 
signicance and 59 degrees of freedom that the above data 
gives sufcient evidence that staff nurses after receiving  
teaching regarding clinical pathway of selected respiratory 
diseases had higher mean knowledge scores in post-test than 
in  pre-test. Hence the null hypothesis is rejected and research 
hypothesis is accepted. It can be concluded that, the teaching 
on clinical pathway of selected respiratory diseases among 
staff nurses was effective.

Bar diagram showing area-wise mean pretest and posttest 
knowledge score on clinical pathway

None of the demographic variable was found to have 
signicant association with pretest knowledge score.
 
RECOMMENDATIONS: 
Based on the ndings of the present study the following 
recommendation is made:
1. Similar study can be conducted to assess the practice of 

staff nurses on clinical pathway.
2. A similar study may be conducted to teach clinical 

pathway other respiratory diseases.
3. Similar study can be conducted to assess the practice of 

staff nurses on clinical pathway.

REFERENCES
1. Brunner and Suddarth (2004), Text book of medical surgical nursing, 

Lippincott Williams and Wilkins publication, 10th edition, pp 492-595. 
2. Gail P.Poirrier & Melinda G.Oberleitner, 1999‘Clinical pathway in nursing’ 

springhouse publication, st,edition,pp:1-5.
3. Harry et al (1998), “Integrated care pathways” British medical journal, Vol, 

316, D.o.p,10 Jan,1998.Pp:133-137.
4. Lewis’s (2011) ‘Medical-surgical nursing’ Elsevier publication, 7th edition, 

pp608-632.
5. Nicasio am,2010 et al (2010), ‘pharmacodynamic-based clinical pathway for 

empiric antibiotic choice in patients with ventilator-associated pneumonia’, 
journal 2010 mar;25(1):69-77. Epub 2009 may 7.

6. Nishimura et al, (2011), ‘A prospective study clinical pathway for acute 
exacerbations of chronic obstructive pulmonary disease: method 
development and ve years of experience’, international journal of copd, 
2011; 6: 365–372, Published online 2011 June 29. Doi:10.2147/COPD.s20423

7. Sciartelli C (1995), ‘a study using a clinical pathway approach to document 
patient teaching for breast cancer surgical procedures’, oncology nursing 
forum, 1995 jan-feb;22(1):131-7.

VOLUME-8, ISSUE-11, NOVEMBER-2019 • PRINT ISSN No. 2277 - 8160 • DOI : 10.36106/gjra

Test Mean SD T df p-value

Pretest 9.0 2.3 44.2 59 0.000

Posttest 18.2 1.0

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