Comparison between Junior and Senior Students at the College of Nursing/ University of Baghdad toward their Knowledge about First Aid

: Background: Injuries and accidents can threaten lives of people worldwide especially when they do not receive the appropriate first aid from healthcare providers including nurses. Nursing students’ knowledge plays a significant role in improving their proficiency to deliver high quality care including first aid. Aims of the study: To assess the knowledge of the second and fourth stage students at the College of Nursing, University of Baghdad about first aid


INTRODUCTION
People might expose to various life-threatening injuries and accidents, including however not limited to: Road Traffic Accident (RTA), burns, heart attack, and fall from high, stroke, poisoning, and other lethal problems (1) . Without receiving the appropriate interventions, the morbidity and mortality rates will be increased with the injured people ( 1, 2 ). First aid is an essential approach to manage people with life-threatening injuries, which assist in decreasing the mortality rates and save lives (3,4) . Healthcare providers, including emergency team, should have the required competencies to provide the optimal care for patients especially those who need first aids care. Nurses, as an essential part of the healthcare team, get their knowledge base during their educational journey in nursing educational institutions.
In addition, nursing students attain and enhance their knowledge base about first aid from the offered educational courses (4) . Based on the aforementioned evidence, it is important to determine nursing students' knowledge about first aid during their educational journey. This study aimed to assess nursing students' knowledge toward first aid, and to compare between knowledge of the second and fourth stage nursing students toward first aid. This research endeavor is an important step toward answering a critical question: are nursing students knowledgeable about the basic life-saving measure? A research-based answer to the aforementioned question would highlight if knowledge deficit is existed, which enable tailored educational intervention. Nurse-student should be armed with the required knowledge and expertise of first aid which enables them to effectively intervene when faced with an emergency situation during their clinical training course and in their routine life.

AIMS OF THE STUDY
To assess the knowledge of the second and fourth stage students at the College of Nursing, University of Baghdad about first aid, and to make a comparison between students of the two stages regarding first aid.

METHODOLOGY
-Design of the Study: A descriptive comparative study design was carried out in order to achieve the objectives of the study. The study was initiated from November 1st, 2019 through January 15th, 2021. -Setting of the Study: The study was carried-out at the College of Nursing, University of Baghdad. -The Sample of the Study: A non-probability (purposive) sample of (60) nursing students were selected (30 from the second stage and 30 from the fourth stage who have been studying in College of Nursing, University of Baghdad). -Data collection: Data were collected through the use of a questionnaire by means of Google form to collect nursing students' responses from the July5th, 2020 until the July 15th, 2020. -The Study Instrument: A questionnaire was designed and constructed by the researchers to measure the study variables and achieve study objectives. The construction of the study questionnaire was achieved through the review of literature and related studies. The questionnaire consisted of 2 parts: Demographic Data sheet, which consisted of (5) items, including age, gender, level of education, participation in first aid educational course, and sharing in training sessions related to first aid; nurses' knowledge sheet comprised of (35) items that concerned with nurses' knowledge toward first aid. -Rating and Scoring: The items have been rated and scored according to the following patterns: Three-point Likert scale is used for rating the items as correct, uncertain, and incorrect; the three points type Likert scale is scored as 3 for correct, 2 for uncertain, and 1 for incorrect, the higher-grade scoring of the questionnaire (MS) the greater knowledge toward first aid. -Statistical data analysis: Data were analyzed through the use of IBM-Statistical Package of Social Sciences (SPSS) which included descriptive statistics (Frequency (F) Percentage (%), Mean, and Standard Deviation; and Inferential statistics (t-test) (Polit and Hungler, 1999) (8) .  (1) presented that 83.3 percent of the second stage students and 96.6 of the fourth stage nursing students were within age group (19 -24) years old. Moreover, 76.6 percent of the second stage and 80 percent of the fourth stage were male. The same number of both the second stage (30 participants) and fourth stage (30 participants) were selected to participate in the study. Neither the second stage participants nor the fourth stage participants were participated in education courses or training sessions related to first aid, which were accounted for 100 percent. Table (2) presented that mean of the second stage nursing students was 1.7 within the lowest limit of the moderate level; while, the mean of the fourth stage nursing students was about 2.3 within the upper limit of the moderate level. The responses of both groups were within the moderate level of knowledge about the first aid.  Table (3) presented that there was no significant difference between the responses of the second and fourth stage nursing students toward first aid. Table ( 1) presented that most of the study sample were male nursing students in both the second and fourth stage within the age group of (19 -24) years old. In addition, nursing students of both groups had not participated in any educational program or training sessions related to first aid. Pei et al. (2019) conducted a study to determine knowledge and other competencies toward first aid of nursing students in Tianjin University in China (4) .

Results in
The authors of this research found that 26.9 percent of 475 nursing students were male and the others were female; in addition, approximately half of the study sample had the opportunity to join training sessions related to first aid (4) . Makhlef (2014) also conducted a study to determine knowledge of university students toward first aid at the University of Mosul and found that the majority of nursing students had not participated in any training sessions about first aid (5) . It was reported that joining training sessions about first aid is an essential approach to improve knowledge of students toward this concept (6) .
In addition, first aid training sessions should be included in the educational courses of college students to improve their knowledge base and competencies toward this essential lifesaving approach (7) .
Findings in Table (2) revealed that responses of both groups of nursing students were within the moderate level of knowledge about the first aid. Pei et al. (2019) reported that knowledge of nursing students toward first aid was poor and need to be improved. Also, Gore et al. (2017) reported that knowledge base of medical and non-medical students about first aid was poor and need to be improved through training sessions (4, 1) .
Results in Table (3) presented that there was no significant difference between the responses of the second and fourth stage nursing students toward first aid. Pei et al. (2019) reported that there was a significant difference in the knowledge of nursing students at different levels about first aid (P value = .004). This finding could reflect that there was no focus on the first aid concept in the educational program, which means it should be included in the educational courses and also training sessions for nursing students (4) .

CONCLUSION:
The study concluded that both the second and fourth stage nursing students' knowledge about first aid was insufficient.

RECOMMENDATIONS:
The study recommended doing future studies on a large population to measure nursing students' knowledge and practices toward first aid and to be able to generalize results. First aid concept should be included and highlighted in the educational courses of nursing educational curriculum. In addition, nursing students must be encouraged to participate in training sessions about first aid to improve their knowledge base and be competent in life saving approach.