Protocol on: Evaluate the Effectiveness of Nursing Protocol on Knowledge and Practices Regarding Hemodialysis Care among Professional Staff

Background: The prevalence rate of chronic kidney disease (CKD) ranges from 1 < percent to 13% and recently international society of nephrology reported In India, the prevalence rate of chronic kidney disease was 17 % in 2015. Objective: 1. To assess the existing level of knowledge regarding hemodialysis care among professional staffs. 2. To assess the existing Practice regarding hemodialysis care among professional staffs. 3.To assess the effectiveness of nursing protocol on knowledge and practice regarding hemodialysis care among professional staffs. 4.To find out the correlation between knowledge and practice regarding hemodialysis care among professional staffs. 6.To associate the level of knowledge and practice regarding hemodialysis with selected demographic variable. Methodology: It is Quasi experimental one group pre-posttest research design will be used in this research study conducted on the professional staff in the selected hospital of Wardha. Nonprobability purposive sampling technique will be used to select samples for analysis. This research study included 60 professional staff of selected hospital of Wardha district. Expected Results: Outcome includes To evaluate the nursing care for hemodialysis patients. Study Protocol Morey and Sharma; JPRI, 33(52A): 82-87, 2021; Article no.JPRI.75130 83 Through, improve and evaluate the knowledge and performance of hemodialysis care among professional staff before and after the education and training interventions. To assess the existing practice of hemodialysis care and the generation of new evidence. Conclusion: Conclusion will be drawn from the statistical analysis.

Through, improve and evaluate the knowledge and performance of hemodialysis care among

INTRODUCTION
Dialysis nurses should have good knowledge and have skillful practices in hemodialysis (HD) treatment. In the dialysis unit have an important role in monitoring, promoting the treatment, and educating of patients. In the developing and developed countries, with changes in lifestyle and advances in life expectancy, chronic diseases such as end-stage renal diseases, cardiac diseases, and diabetes mellitus are increasing steadily [1][2][3].
A major health problem in the world is chronic renal disease. End-stage renal disease (ESRD) is the number of patients that are irreversible and progressive kidney failure disease in developed and developing countries to increase Chronic Renal Failure (CRF). Chronic renal failure (CRF) results from total loss of kidney function. Total loss of kidney function results in chronic renal failure (CRF) [3,4].
The prevalence rate of chronic kidney disease (CKD) ranges from 1 < percent to 13 percent and recently international society of nephrology reported In India, the prevalence rate of chronic kidney disease was 17 percent in 2015. The risk factors and etiological factors are different in overall India [5][6][7].
End-stage renal disease or chronic kidney disease are common health problems in India. It includes diabetes mellitus, elderly, obese people. Many people around the world suffer from Endstage renal disease (ESRD) and require longterm dialysis [8][9][10].
Chronic renal failure is medically managed with fluid adjustments, correction of electrolyte imbalances, proper low protein diet, and drug. dialysis and renal replacement are the ultimate renal replacement therapy [11,12].
Standards of nursing care that the nurse shows and learns through nursing activities include assessment, diagnosis, recognition of outcomes, planning, implementation and evaluation. The nursing method considers clinical decision-making concepts and fundamentals, clinical guidance and includes all essential nurses' practices in delivering treatment to all patients [13,14].
Professional nursing practice standards are authoritative descriptions of the duties that are required to be performed competently by all registered nurses, regardless of their position, level of care or efficiency, beliefs and preferences, population or specialization, by which the quality of nursing practice can be measured [15][16][17].

Aim of the Study
To evaluate the nursing care for hemodialysis patients. Through, improve and evaluate the knowledge and performance of hemodialysis care among professional staff before and after the education and training interventions. To assess the existing practice of hemodialysis care and the generation of new evidence.

RESEARCH METHODOLOGY
It is an academic based study. In this study will be used interventional research approach. Quasi experimental one group pre-posttest research design will be used. The study will be conducted in selected hospital of Wardha district. Sampling technique will be used non probability purposive sampling technique. In this research study the accessible population will be the professional staff in selected hospital of Wardha district.

Sample Size
To calculated to according working staffs.
In consideration of 10% dropout,120 participants will be assigned .
The sample consists of the unite which comprise the population. Sixty (60) professional staffs were selected using calculated formula to suit the study. Formula for calculating sample size [16].

Interventions
On the first day of the study, first the pre-test knowledge regarding hemodialysis care among professional staff will be assessed through a structured knowledge questionnaire. Observe the per practice regarding hemodialysis care among professional staff will be assessed through the observational checklist.
After the education and training interventions will be given on the same day to the professional staff.
On the 7 th day post-test the effectiveness of nursing protocol on knowledge and practice regarding hemodialysis care among professional staff.

Outcome Measures
Primary outcomes assessment of existing knowledge and practice regarding hemodialysis care among professional staff.
Secondary outcomes assessment of post-test knowledge and practice regarding hemodialysis care among professional staff.
The effectiveness of nursing protocol on knowledge and practice regarding hemodialysis care among professional staff.
Correlation between knowledge and practice regarding hemodialysis care among professional staff.
Association of knowledge and practice regarding hemodialysis with selected demographic variable.

Data Management and Monitoring
The demographic data (like age, education, place of work, total year experience.), in this pretest to assess the exiting level of awareness. Than given the intervention of nursing protocol on knowledge and practice regarding hemodialysis care after 7 the day to taken the post test.

Structured Questionnaire
It consists of three sections.
Section A. Consist of demographic data such as age, qualification, place of work, total year of experience

Scoring
The scoring system for each tool should putted under it.
• The correct answer was given 1 score.
• The wrong answer was given a 0 score • Knowledge was categorized from poor knowledge to excellent knowledge based on the scores • Practice was categorized from poor practice to excellent practice based on the scores

Statistical Analysis
Statistical analyses will be performed using SPSS software version 23.

EXPECTED OUTCOMES/RESULTS
This study is planned to improve effectiveness of nursing protocol on knowledge and practice regarding hemodialysis care among professional staff.

DISCUSSION
A quasi-experimental study was conducted in Egypt. The convenience samples of forty one nurses were all woman and had prior experience caring for patients on hemodialysis. 68.3 percent of nurses were unaware of hemodialysis nursing care quality, according to the report. More than half of nurses (61.0 percent -56.1 percent) had not attended a workshop in the previous five years and had not attended educational lectures. In comparison to the pre-test time, an equal proportion of nurses achieved very good or excellent overall total knowledge and efficiency in the post-test and follow-up times, as well as an improvement in total mean scores for findings related to overall infection control results [17].
A quasi-experimental study was conducted in Egypt. 90.6 percent of the nurses had adequate levels of expertise. In addition to the overall pre score, the nurses' practice scores improved significantly in the areas of general precautions, hand washing procedure, procedure of wearing gloves, wearing masks, procedure of catheter insertion, skin preparation procedure, taking care of patients' instruments, dealing with sharp items, dealing with blood, body secretions, and fluids, and ensuring a clean environment and healthy injection practices. Several aspects of the nurses' work, such as laboratory-style covering coats, complete isolation, and catheter treatment, saw major changes. The practice score level was satisfactory in 68.7 percent of the nurses, while it was insufficient in 31.3 percent. Older nurses and those with a bachelor's degree in nursing had slightly higher awareness scores and levels of progress after completing the education program [18].

CONCLUSION
Conclusion will be drawn from the statistical analysis.

CONSENT AND ETHICAL APPROVAL
This study is approved by the Institutional Ethics Committee of DMIMS (DMIMS(DU)/IEC/DEC-2019/8689). All participants will asked to read and sign the informed consent. The study results will be disseminated to study participants and published in peer-reviewed publications