BURN CARE AND PREVENTION JOURNAL

OBJECTIVES: This study aimed to assess the level of knowledge and awareness of first aid for minor burns of health care workers in a university hospital.
MATERIALS AND METHODS: A total of 402 subjects including nurses (n = 163), medical technicians (n = 94), technicians/patient care support personnel (n = 145) participated. Data were collected by face-to-face interview technique using our 2 evaluation forms (characteristics of participants was form 1 and first aid knowledge on minor burns was form 2) (P < .005).
RESULTS: Mean age was 29.7 years. Female to male ratio was 1:0.7. Form 2 was correctly answered by 76.9% of participants. Participants who stated that they have received first aid training on burns was 41.5%, but only 38.3% of the subjects felt confident for providing first aid. Running water was preferred by 85.6%. High education level, receiving first aid training, and seniority in the profession and in the institution were the effective factors for providing proper first aid (P < .005). Female (58.5%), single (59.8%), child-free (61.7%) participants and those who had attended first aid education programs more recently were prone to providing proper first aid than the others (P < .005).
CONCLUSIONS: In the present study, many participants had basic knowledge about first aid for minor burns, but they felt unconfident. Health care staff need periodical educational programs specific to them in addition to the basic awareness programs for burn injuries.

KEY WORDS: Burn, Education, First-Aid, Health care staff, Medical technician, Nurse, Survey

Burn injuries are a universal public health problem, considered one of the most common traumas in the world, and can affect individuals of all age groups in different ways.¹ Burns cause serious tissue damage and various physical, psychological, sociological, and economic problems.^1-3 In 2016, the World Health Organization reported that burn injuries are among the fourth-ranking traumas resulting in 180 000 deaths each year, with most deaths occurring in developing countries.⁴

The first hour after the burn injury is called the "golden hour" because, if the appropriate and effective first-aid interventions are provided, the injury outcomes will improve, including hospitalization and surgical intervention, by reducing the severity and depth of the tissue damage that may occur.^5-7 For this reason, everyone should receive the right information and training about first aid for burns since improper practices of burn care can have detrimental consequences, and the cost of treating burns represents a major burden on governments and health care systems.

Several studies have revealed that the knowledge level of health care workers is generally very low with wrong information.^5,7 There is evidence to suggest that correct and adequate first-aid intervention is not usually provided before hospitalization, and many wrong methods are widely used to reduce and heal the pain in the burn wound.⁵ Undesirable conditions such as infection, allergic reactions, pain, hypothermia, and shock can result from inappropriate management of the burn area.

The pivotal role of health care workers in providing appropriate initial aid to burn patients warrants good knowledge. However, previous studies have shown that the knowledge of initial aid to minor burns among health care workers was poor, although the number of health care workers included was low.^5,7 Poor quality information may contribute to a lack of understanding of appropriate first aid for burns by patients and the first responders.^8,9 First aid guidelines provide an important reference to first aid providers and medical professionals to guide them in the effective provision of safe, effective, and timely care. Therefore, health care providers must receive the best training and education for the proper management of burn injuries. For this reason, we aimed to identify and assess the level of knowledge and awareness of first aid for minor burns among health care workers in a university hospital.

MATERIALS AND METHODS

A cross-sectional descriptive study was conducted to identify and assess the level of knowledge and awareness of first aid for minor burns among health care workers at Baskent University Ankara Hospital between March 14 and April 4, 2022.

The protocol was approved by the Baskent University Medicine and Health Sciences Research Board and the Ethics Committee (Project no: KA22/101). In addition, during the implementation process of the research, verbal and written informed consent was obtained from the participants.

Population and sample of the research
The included population consisted of nurses, technicians, and care support personnel working in our hospital. All participants were informed about the criteria of the study, and those who agreed to participate were enrolled. Individuals working in burn-related fields (adult and pediatric emergency services, burn intensive care, and burn outpatient service) and those who refused to participate or failed to complete the questionnaires were excluded. The target sample size was calculated as 387 to ensure the 95% confidence level of the study; a total of 402 subjects took part in the study.

Data collection tools
After a comprehensive review of the literature,^2,5-11 a data collection form divided into 2 sections was designed: (1) "participants" introductory characteristics and information about minor burns” and (2) "first aid knowledge levels of health care professionals regarding minor burns evaluation form"

Form 1: participants' introductory characteristics and information about minor burns
The form consisted of 18 questions, including age, sex, educational status, occupation, professional and institutional experience, number of children, previous first aid training related to burns, and the place where burn training was received.

Form 2: first aid knowledge levels of health care professionals regarding minor burns evaluation form
The form consisted of 17 items containing correct and incorrect statements that can be performed in case the participant encounters minor burns. The level of knowledge was stated as true, wrong, and I don't know according to the 3-level Likert-type rating.

Application of research
The implementation of the study started after we obtained the permission of the local ethics committee and the institutional medical directors. Questionnaires were distributed to the participants, and they were asked to fill it in at a convenient time. The forms were collected after 1 week.

Statistical analyses
The paper questionnaire was converted to its electronic replica, and the results were calculated using the answer key. Data were analyzed using SPSS (Statistical Package for Social Sciences, SPSS Inc) version 25.0 package program. The statistical significance level was accepted at P < .05. As descriptive statistics in the study, frequency (number) and percentage (%) values were used to evaluate categorical variables. In examining the relationship between categorical variables, the Pearson chi-square test was used when the test assumptions were met and the Fisher exact test was used when it was not.

Female-to-male ratio was 1:0.7, with 59% of the participants being female, 63.4% in the 20- to 29-year age group, 56% having a bachelor's degree or higher, 40.5% nurses, and 47% having 6 years or more experience in practice. In addition, most participants were single (60.9%) and had no children (63.2%) (Table 1).

Among participants, 40% stated that they had previous burn injuries, with almost all (97.5%) stating that their injuries healed completely. Among participants, 85.6% stated that only water should be applied to the burned areas. Of all participants, 41.5% had already received training on first aid for burns (68.9% were trained at school); 38.3% felt confident about their knowledge; however, only 5.2% were very confident in providing first aid for minor burns. Most (94%) stated that they would prefer to receive future first aid training on burns (Table 2).

Among those who had previous first aid training, 53.9% were nurses and 70% graduated from university of or a higher academic degree (Table 3 and Table 4). Among participants, 76.9% correctly answered form 2 (Table 5). Participants who were women (58.5%), single (59.8%), and without children (61.7%) and those who had attended more recent first aid education programs answered the form better than the others (P < .005). Seniority in the profession and in the institution increased the self-confidence in providing first aid. Participants who had received first-aid training were more confident (Table 6). These factors had positive effects in providing accurate first aid (P < .005).

First aid is defined as emergency care or treatment given before regular medical attention. Therefore, first aid treatment in burns plays an important role as it stops tissue damage, stabilizes the vascular system, and reduces edema. Although there are some varieties in details, it is well known that the application of running tap water is the main component of first aid for minor burns.^5,12 Hence, health care workers should be aware of this principle.

Our data revealed that 85.6% of the health care staff in our study stated that they would only apply water when faced with a burn injury. This finding suggested that most of our participants had basic awareness of first aid for minor burns. However, insufficient knowledge on first aid for burns among health care workers and other occupational groups has been previously shown. Riaz and associates reported that medical and nonmedical students had insufficient knowledge about first aid for burns.¹¹ In a similar different study, only 66.8% of health workers in a university hospital in Saudi Arabia gave the correct answer of applying water after burns.¹⁰

In our study, 76.9% of the participants answered form 2 correctly. Factors such as a high level of education, receiving previous training on first aid, and long experience in the profession and in the institution seemed to affect this finding. A study conducted in the United Kingdom found that health care professionals had below average knowledge of first aid for burns.¹³ In another study from Australia, 30% to 50% of health care staff incorrectly answered questions on various burn-related scenarios, with 14.5% to 17.2% improvement in participants who had taken a first aid course within the past 5 years.⁶ In our study, 41.5% of the participants stated that they received first-aid training on burns and 81.8% received this training in the recent 0 to 5 years. Among our participants, 52.7% of those who received first aid training in burns stated that they could intervene in a "self-confident" way, and they were more confident than the ones who had not taken a course.

Results from different studies suggest that first aid training for burns during the pregraduate education of health care staff is essential, but updating the awareness, eliminating common misapplications, and improving emergency skills by periodical training programs during employment is as crucial as the one provided at school. Our suggestion is supported by the study conducted by Wallace and associates, who reported that those who participated in a first aid course gave 15% more correct answers than those who did not.⁶ Similarly, a significant improvement in emergency management of burn injuries was reported in Vietnam among health care workers after workers received burn-related first aid training courses.¹⁴

One of the limitations of our study is that the data were obtained from a single institution; thus, the results cannot be generalized, but the opinion is inspiring. In addition, a limitation of surveys in general is that they measure knowledge rather than practice.

Most of the participants had basic knowledge about first aid for minor burns, but they need specific and repeated trainings and basic awareness programs for burn injuries. Larger-scale studies are needed to reduce the occurrence of common and highly preventable minor burn injuries and to raise awareness among health care professionals.

Volume: 2 Issue: 3 September 2022

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