NURSING STUDENT SATISFACTION IN USING APPLICATION NAMED IS

“GUIDE FOR ASSESSMENT AND INTRAVENOUS FLUID INFUSION FOR

PEDIATRIC BURN PATIENTS”

Thanathbhorn Koolsantao1
Duangrat Kathalae
Sakdithus Thippawat

Boromarajonnani Nakhonratchasima Nursing College, Nakhonratchasima, Thailand

ABSTRACT

“Guide for Assessment, and Intravenous Fluid Infusion for Pediatric Burn Patients” is
very important for nurses in Burn Unit when giving care the patients with intravenous fluid
Infusion. This quasi-experimental study aimed to evaluate knowledge and satisfaction of nursing
students on using an application named “Assessment and Intravenous Fluid Infusion for
Pediatric Burns Patients.” Population in this study second-year nursing students who were taking
in the Pediatric nursing course. Simple random sampling technique was used to select 90
samples. The samples were randomly assigned to experimental and control groups with equal
size. The experimental group was randomly assigned to use the application for practicing and
assessing the percentage of body surface burn area of pediatric burn patient while the control
group was received an intervention of application named “Guide for Assessment and
Intravenous Fluid Infusion for Pediatric Burns Patients.” Content validity of the application, the
control group, used manual guide for pediatric burn patient assessment and three experts
approved intravenous fluid transfusion for pediatric burns patients, teaching plan, satisfaction
with using application questionnaire, and pretest-posttest questionnaire. KR20 for the reliability
of the pretest-posttest questionnaire was 1.00 Cronbach’s alpha coefficient for the reliability of
satisfaction on using application questionnaire was .96.
The results showed that there was statistically significantly different in mean scores of
knowledge between experimental and control groups at posttest ( =6.00 S.D.=.08; = 3.98
S.D.=.88) (p< .05). The post-test mean score of knowledge for the experimental group ( = 1.63
S.D.=1.24 ) was statistically higher than the pre-test mean score ( =5.37, S.D.=1.16) (p < .05).
The satisfaction of using application was at a good level ( =4.65 S.D.=.12). The results of this
study revealed how the importance of the percentage burn area accuracy for Assessment and
Intravenous Fluid Infusion for Pediatric Burns Patients. As a result, the patients will receive the
right dose for intravenous fluid therapy. However, the technique in percentage calculation form
of this application needed to be improved for more precisely

Keyword: satisfaction, pediatric burn, application, intravenous fluid.

1
Correspondence concerning this article should be addressed to Thanathbhorn Koolsantao
at E-mail: thanathbhorn@knc.ac.th and Tel: +669 5349 9578
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Introduction

The current progress in technology plays essential roles in the educational facilitation
more than before. This is consistent with 2007 contribution of the kingdom of Thailand,
Section 80, Item 3 which stipulate that the state must develop quality and standards of the
educational facilitation of all levels to consist with economic and social changes. It also
confirmed to the four-year official practice plan (2012-2018) of office of the Permanent
Secretary of Ministry of Education. The plan realized the importance of technology using in the
teaching/learning facilitation. It was stipulated in the educational facilitation policy to have
information network for the development of “Cyber home” system sending knowledge to
learners through the high-speed internet. This aimed to elevate Thai quality education to meet
the international standards and increase the educational opportunity and diverse learning forms.
In the 21st century, education focuses on a high level of learning skills, not textbooks like
in the past. The curriculum in this century puts the importance on integrated projects and
learner-centered. According to the literature review, classroom research should be conducted
which smartphone assists teaching/learning as a learning media for the development of learning
achievement of the learner (Vipathumiprathed, T., 2016).
The integration was focused on learning skills and innovation, life skills and information
skill occupations, media technology, and information literacy including skills in rapid learning
access, reliability assessment, and media which can communicate in many ways, e.g., VDO,
Website, application, etc. In fact, the application plays essential roles to access various data
quickly and conveniently for education, teaching/learning media, and knowledge exchange
(Surpare, K. & Watthananaiya, C., 2015). At present, there is a tendency to use smartphone and
tablet more than before due to an effect of technology and application development (Appling,
G. & Pappalardo, G., 2010). Learning caused by external stimuli. This learning comes from the
fact that individuals experience through both senses and feelings. This learning curve will expand
over time when nursing students get new experiences or knowledge (Khaemanee T.,2012).
According to a comparative study on learning achievement of the application using
before and after learning based on the learning achievement scores, it was found that the score
after learning through application media was higher than the score before with a statistical
significance level at .05. This was similar to a study of Surpare, K. & Watthananaiya, C. (2015).
Many Nursing Colleges had developed and applied application to promote learning since it was
convenient to use and flexible based on needs of learners direct access to the website and
through QR Code (Wattananarong, 2013). The term of researchers applied strong points of
progress in technology together with modernize of internet network system to promote and
support roles in activity holding for learning through an application on smartphone or tablet.
This conformed to a problem found in Burn’s ward in an assessment and intravenous fluid
therapy to burn child patients. In fact, the body touching heat, cold, chemical substance,
electrical current, and radiation will make the skin layers be destroyed, and it will change
depending on temperature and time span of heat touching (Amita, R.S.& Lillian, F.L., 2017).
The burn child patients of 20 percent and above will have swollen tissues a decreased
amount of fluid in the circulatory system which has no relation with a member of blood cells,
results in increased concentration of the red blood cell (Hematocrit) (Tanprayoon T. et al.,
2007). Not only this, blood circulation to Various parts of the body of the body is decreased.
Usually, the body loses water through the skin for about 30-50 ml per hour and it will increase to
4-15 times when there is a burning wound (1.5-3.5 ml./hr./TBSA on average) (Jitmittapap, S., &
Nawicharoen, P., 2016; Chen, Z., & Yuan, K., 2011; Muangman, P. et al., 2014). Importantly, the
Hypovolemic shock will occur in the care of patients does not receive replacing water in time
(Gautam, K., Ellie. W., & Stephen, R., 2014; Siobhan, C., 2014; Joachim, B. & Michael, P.,
2017). Such the change may happen within 24-48 hours after the occurrence of a burning
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wound. (Hallerc, M. L., Tropd, H., Seligae, P., Nagelef, D., & Lumentaa, B., 2013; Siobhan S,
2014; Jitmittapap S.& Nawicharoen P, 2016 Tanprayoon, T. et al.,2007). According to the
statistics during 2015-2016 found in Child Surgical ward of Nakhonratchasima Maharaj hospital,
there were 89 burn child patients, and most of them (77.53%) were 0-15 years old. Therefore,
the team of researchers was inspired to conduct a study related to application development for
the smartphone on the operational system (ios and android) on assessment and appropriate
intravenous fluid infusion to burn child patients by using application as a tool for second year of
nursing students, 62nd batch, Boromarajonani college of nursing , Nakhonratchasima.

Objectives of the study

Specifically, this study aimed to assess:

1. Knowledge about the application using on “Guide for Assessment and intravenous
fluid infusion for pediatric burn patients.
2. Sample group satisfaction with the application using.

Hypothesis of the study

1. An average mean score of the posttest was higher than that of the pretest.
2. An average mean score of sample group satisfaction with the application using was at
a high level.

Conceptual Framework
This study employed theoretical concepts as follows: Apperception or Herbartionism of
John Locke, Wilhelm, W., Titchener, and Herbart (Grinder, R. E.,1989).
The principles of the experiment were as follows:
1, Assisting learners to create relationships between existing knowledge and a new one to
enhance their understanding.
2. Teaching based on the five steps of Herbart which with help the learners learn well and
rapidly :
1) Preparation - Creation of interest to learners and review of existing knowledge.
2) Presentation of new knowledge.
3) Relationships between existing knowledge and the new ones (comparison and
abstraction) such as comparison and combination.
4) Generalization - conclusion of learning to be various principles or rules which can
be applied to other problems or situations.
5) Application – the teacher has learners solve problems of new situations.

Independent variable Dependent variables

1. Knowledge about an assessment and

intravenous fluid infusion to pediatric
Application on an assessment and burn patients.
intravenous fluid infusion for 2. Satisfaction with the application
using for an assessment and
pediatric burn patients.
intravenous fluid infusion for pediatric
burn patients.

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Operational Definition of terms

Knowledge refers to an understanding about an assessment and intravenous fluid

therapy and intravenous fluid infusion to pediatric burn patients.
Satisfaction refers to the preference of the application users.
The application refers to a tool used for checking the correctness of answer finding on
guide for an assessment and intravenous fluid therapy and transfusion to pediatric burn patients.

Research Methodology

This study employed the quasi-experimental research (Pretest and Posttest), and it was
conducted at Boromarajonani College of Nursing, Nakhonratchasima during July – August 2017.

Population and Sample group.

1. The population in this study were 187 second-year nursing students (62nd batch)
studying at Boromarajonani College of Nursing, Nakhonratchasima, the academic year 2016.
2. The Sample Group Right Protection and Data Collection.
The term of researchers informed the sample group about objectives of the study and
asked them a favor to coordinate in the study and data collection as well as from the college
direct. Importantly, the sample group members could give up their coordination anytime.
Obtained data were kept confidentially.

Research Instrument.
1. The application on guide for assessment and intravenous fluid infusion for pediatric
burn patients.
2. A manual on an assessment and intravenous fluid infusion for pediatric burn patients.
3. A lesson plan on an assessment and intravenous fluid infusion for pediatric burn
patients.
4. Test paper before and after learning (Pretest-posttest)
5. A questionnaire on satisfaction will the application using (Cronbach’s alpha coefficient
for the Likert's scale) questionnaire was at 1.00 of reliability which implied that the questionnaire
was appropriate. The questionnaire consisted of 2 parts:
Part 1: General data of the respondents-sex, age, and experience in an assessment
and computation of intravenous fluid therapy and infusion to pediatric burn patients.
Part 2: Satisfaction of the application on users by three aspects: 1) meeting needs
of the application users; 2) operation by the function of the application, and 3) convenience in an
application using.

Quality of the Instrument

Their specialists checked the content validity of the questionnaire, and then it was tried at
with second-year nursing students (IOC=0.50) Based on method, the reliability of the
pretest/posttest was found at 1.00, and the Cronbach's alpha coefficient value was at 0.96 Data
Collection Method.
The team of researchers collected data by themselves with the following steps.
1. Coordination with the second year nursing students to ask for permission to conduct
the study and inform them the objectives.

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 2. The team of researchers had the nursing students do pre-test on guide for assessment
and intravenous fluid infusion for pediatric burn patients.
3. Classroom session by using the application. The sample group (45 persons) learned
through the application whereas the experimental group (45 persons) learned
through a manual. After that, the team of researchers had them do posttest.
4. The experimental group answered questions in the questionnaire.

Data Analyses

- Descriptive statistics – the size of the population and the sample group, frequency,
mean, and standard deviation.
- Inferential statistics – Independent t-test and paired t-test.

Results of the Study

Results of the Study revealed that most of the respondents (92.7%) were female 19 years
old, and none of them (100%) experience in care-taking of pediatric burn patients.

Table 1. Meeting needs of the system users (Functional Requirement test).

Item Level of satisfaction

Mean S.D. Description
Data processing 4.20 .65 High
Data connection 4.17 .51 High
Mean 4.19 .58 High

According to Tables, meeting needs of the system users (Functional Requirement Test)
was found at a high level (Data processing and connection)

Table 2. Ability to work based on work function of the system (Function Test)

Item Level of satisfaction

S.D. Description
1. Correctness of data retrieval 4.39 .71 High
2.Correctness of outcome processing in the application 4.24 .52 High
3. Correctness of outcome of answer finding 4.37 .68 High
4.Rapidness of outcome processing in the application 4.20 .49 High
5.Reliability of the application 4.22 .63 High
6. Content coverage in the application 4.17 .72 High
Mean 4.27 .63 High

According to Table 2. (Function test) as a whole, there was a high level of satisfaction of
all items.

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Table 3 Convenience in the system using (Usability Test)

Item Level of satisfaction

S.D. Description
1. Convenience in the system using 4.56 .72 Highest
2. Appropriateness of the selecting of alphabet types on the screen 4.37 .48 High
3. Appropriateness of the selecting of alphabet sizes on the screen 4.27 .74 High
4. Appropriateness of the selecting of alphabet and picture color 4.34 .43 High
5. Appropriateness of message explaining for meaning conveyance 4.51 .71 Highest
6. Unification of the screen design 4.34 .59 High
7. Appropriateness positioning of components on the screen 4.44 .68 High
8. The system users understand vocabulary used in the application 4.56 .71 High
and be able to follow easily
Mean 4.42 .63 High

According to Table 3, (Usability test), convenience in the system using (Usability test)
was found at a high level. The following were found at the highest level: convenience in the
system using; appropriateness of message explaining for meaning conveyance; and the system
users understand the vocabulary used in the application and be able to follow easily. The rest
were found at a high level.

Discussions

According to results of the study, as a whole, the nursing students were satisfied with
data processing and connection. This was because the application on guide for assessment and
intravenous fluid infusion for pediatric burn patients, child patients having a burning wound on
the body was able to do data processing correctly. Besides, the connection of data was easy to
understand and presented pictures were clear. The result is consistent with the results of the
study to an estimation variance is to perform more accurate assessments and also to incorporate
new aiding technologies to improve the quality of body surface estimations and related decisions
which is related to the results of the study of Hallerc, M. L., Tropd, H., Seligae, P. , Nagelef, D.,
& Lumentaa, B. (2013). The potential impact of wrong TBSA estimations on fluid resuscitation
in patients suffering from burns; total body surface area among participants, also resulting in
significant variations of initial fluid resuscitation volumes. One option to address estimation
variances is to perform more accurate assessments; also incorporating new technologies aiding to
improve the quality of body surface estimations and related decisions
The application on guide for assessment and intravenous fluid infusion for pediatric burn
patients is essential for nurses in Burn Unit. Consistent with the results of the study of
Intravenous fluid therapy the basis for deciding which intravenous fluids to give, when to give it
and how much to give, more than ever before, can be based on sound scientific evidence.
(Gautam, K., Ellie, W., & Stephen, R. 2014); Relative to the results of the study of Chen, Z.,
Yuan, K. (2011) Full-thickness burn wounds received more volume of intravenous fluid than
superficial burn wounds, especially in the second 24 hr. Afterburn. The formula meets the fluid
predictions of different depth of wound by using the modified fluid coefficients.
This learning comes from the fact that individuals experience through both senses and
feelings (Khaemanee, 2012). This learning from application curve will expand over time. Thus,

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nursing students gain new experiences or knowledge for assessment and intravenous fluid
infusion over time for pediatric burn patients.

Expected Outcomes

1. The application on guide for assessment and intravenous fluid infusion for pediatric
burn patients, patients having a burning wound on the body is rapid and convenient to be used.
Hence, this media is beneficial to the assessment so that burn patients will be assisted rapidly and
safety.
2. There are application media for people in general because vocabulary used in the
application is easy to understand. Besides, the application is easy to understand. Besides, the application is
used easily for finding the efficiency of the application.

Suggestion for future study

1. It should have studied on guide for assessment and intravenous fluid infusion for
pediatric burn patients, to patients of various ages having a burning wound on the body.
2. It should have application development regarding other contents to be convenient in
learning nursing care of other diseases.
3. Global languages such as English and Mandarin should also be used in the application
so that foreigners can use it.
4. The application should be developed to be able to access people in general and
medical multidisciplinary.

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