Nurses' Knowledge Regarding Evidence-Based Guidelines for Preventing Ventilator-Associated Pneumonia

Abstract Introduction: Problem solving is an essential skill for living at present century. Problem solving skills and knowledge-based decision making are expected behaviors from nursing students and learning these skills should be initiated during student period. Objective: The purpose of present study was to determine the problem solving skills and their related factors in undergraduate nursing students of Guilan University of Medical Sciences. Methods: This is a descriptive-analytical study conducted on all undergraduate nursing students (N=456) enrolled in faculties of Shahid Beheshti Nursing and Midwifery (N=317) and East Guilan (N=139) and according to the inclusion criteria, they were not guest or transitional students. Finally from all eligible students, 404 entered the study after completing the written consent forms. Referring to classes and clinical training environments, the subjects were asked to complete the questionnaires in twenty minutes. Data collection tool was a two-part questionnaire. First part included Heppner & Petersen Problem Solving Inventory (PSI) with 32 items. The answers were designed with Likert scale ranging from 1 (completely agree), to 6 (completely disagree). The most and least scores of problem solving were 192 and 32, respectively. Scores lower than the mean indicated a higher ability in problem solving. This tool consisted of three components of self confidence in problem solving, proximity-avoidance and personal control. The tool was used with permission of the original author. The second part consisted of factors related to problem solving skills covering a two-part questionnaire of individual and educational factors. In order to determine the validity of this tool, 13 faculty members were asked to review it. Content validity ratio for all items of this questionnaire was 1. Furthermore, content validity index obtained was between 7.0 to 1.&nbsp; Cronbach's alpha coefficient and test-retest were used to define the internal consistency with a ten-day interval. In a pilot study, 20 questionnaires were given to 20 undergraduate nursing students. For re-test, after ten days the same tool was given to them. Cronbach's alpha coefficient showed a good internal consistency (problem-solving skills &alpha;=0.80, proximity-avoidance &alpha;=.81, self-confidence &alpha;=0.71, personal control &alpha; =0.78). Internal correlation coefficient for this tool and all its dimensions were between 0.82-0.97 which indicated the reliability of the tool. Data were analyzed by descriptive statistics (mean and standard deviation) and inferential statistics (Chi-square, Kruskal-wallis, Mann-Whitney, Spearman&rsquo;s correlation coefficients and multiple regressions). P<0.05 was considered as the significance level. In order to determine the most important factors related to problem-solving skills, all significant or nearly significant variables in univariate analysis were entered into the regression model by backward step wise (LR) method (Entry 0.05, Removal 0.1). In this model, the response variable, the problem solving skill was analyzed considering zero for scores > mean and 1 for scores &le; mean. Results: The mean age of students was 21.35 &plusmn; 2.75 years old. Most of them were female (60.6%), single (91.9%) and local (81.1%). 48.1% of them were living with their family. 41% of students' fathers and 41.8% of mothers had high school diploma. 51.4% of their income was equal to between 175 -350 $. Results showed 94.3% had no smoking and 98% no alcohol or drug use experience. 44.6% of the students saw themselves successful in solving problems. Majority of them (63.6%) requested their family support when dealing with a problem. Most of these students believed their parents were democratic (73.8% of fathers' behavior and 70.4% of mothers' behavior). 82.5% had acceptable grades in their university courses and 97.7% with no failure. 81.3% of all samples had never participated in life skills classes. 52.2% declared their academic success was average. Results suggested that the total mean score of problem-solving skills equaled to 91.45 &plusmn; 20.90 (ranging from 32 to 192). The problem solving score was less than mean among these students. The mean of all scores of self-confidence in problem solving was 30.27 &plusmn;6.92 (ranging from 11-66), avoidance-proximity 44.12&plusmn;12.28 (ranging from 16-96) and personal control 17.06 &plusmn;5.53 (ranging from 5-30). In addition, the students had a lower score than mean in self-confidence and avoidance-proximity dimensions and lower and near to mean in personal control. Conclusion: Surveying the socio-demographic and educational factors revealed that based on multivariate logistic regression model, a positive relationship existed between the number of siblings (P=0.019, OR=0.85), mothers&rsquo; educational status (p=0.026, OR=0.74), success in problem solving (p=0.0001, OR=1.95), perceptions about their mothers&rsquo; attitude (p=0.011, OR=2.01), school and department of education (p=0.024, OR=1.76), satisfaction with field of study (p=0.006, OR=1.44) and success in professional and clinical skills (p=0.03, OR=1.48).