IJGMP - Medicine - Evaluation of Nurse's Knowledge - Dr. Sajjad Salim - Iraq - OPaid

International Journal of General Medicine
and Pharmacy (IJGMP)

ISSN(P): 2319-3999; ISSN(E): 2319-4006
Vol. 3, Issue 5, Sep 2014, 139-156
© IASET
EVALUATION OF NURSE'S KNOWLEDGE ABOUT ASTHMA IN CHILDREN
SAJJAD SALIM ISSA

University of Basra, College of Nursing, Basrah, Iraq
ABSTRACT
Problem of project: 'Are the nurses in pediatric emergency room and pediatric wards have adequate knowledge
about asthma in children?
Goals of Project
• To evaluate nurses' knowledge about asthma in children.
• To identify relationship between level of knowledge and variables of study.
• Make comparision among hospitals regarding level of knowledge.
Review of Literatures: this chapter focuses on definition of asthma, causes, triggers of asthma, clinical
manifestation, and management of asthma.
Methodology
Setting of the Project: This study was carried out from nursing staff working in pediatric emergency room and
pediatric wards in different hospitals from 5-11-2013 to 1-2 2014 as following:
• Basra general hospital.
• Al-Mawany general hospital.
• Al-Basra hospital for maternity and children
• Al-Fayhaa general hospital.
Sample of the Study: Simple random sample was collected which involves nursing staff from different hospitals
from 17-11-2013 to 27-11-2013 as following;
• Al-Basra general hospital (13) sample.
• Al-Mawany general hospital (13) sample.
• Al-Basra hospital for maternity and children (12) sample.
• Al-Fayhaa general hospital (8) sample
Project Instrument: Instrument of this study was aquestionnaire composed of (30) question about asthma in
children to evaluate nurses 'knowledge about this subject.
Statistical Data Analysis: We used (Mean, Variance, Standard Deviation, Standard Error, Percentage,
Pearson correlation, one way anova F-test, and L.S.D test).
www.iaset.us editor@iaset.us
140 Sajjad Salim Issa
Results: this chapter focuses on;
• Descriptive statistics of level of nurse's knowledge about asthma in children.
• Pearson correlation between level of knowledge and variables of study.
• One way anova (F-test) and L.S.D test to compare hospitals regarding level of knowledge.
Conclusions
• Nursing staff in pediatric emergency room and pediatric wards have sufficient knowledge about asthma in
children.
• Level of education and years of experience play an important role in development of nurse's information.
• We can rank hospitals according to level of knowledge as following ;( Al-Fayhaa general hospital, Al-Basra
general hospital, Al –Mawany general hospital, Al-Basra hospital for maternity and children)
Recommendations
• Frequent sessions should be organized for nurses about Asthma and its management to improve their information.
• Frequent research studies are recommended to evaluate improvement of nurse's information about asthma and its
management within the hospital.
• Take into account the importance of level of education for nurse’s work in pediatric emergency room and
pediatric wards and limited to preparatory level or diploma.
KEYWORDS: Nurse’s Knowledge about Asthma in Children, Large Number of Emergency Room Visits and
Hospitalizations
INTRODUCTION
Acute asthma accounts for a large number of emergency room visits and hospitalizations, as well as leading to
school absenteeism, restriction of physical activity, and parents having to take time off from work.[1] Although acute
asthma management might seem simple at first glance, it requires that health professionals know the basics so that they can
act effectively, reducing the risk of hospitalization and minimizing side effects, as well as maximizing cost-effectiveness.
Two well-established principles to be considered in asthma management, for patients of all ages, are that inhalation is the
most effective way of delivering medication and that short-acting β2 agonists are the first-line drugs. Inhaled medications
are most often delivered via nebulizers or metered dose inhalers The most common way of delivering β2 agonists is by
nebulization. In children, metered dose inhalers should be used with a spacer.[2] Various studies have shown that the use of
metered dose inhalers attached to a spacer, be it conventional or homemade, is as effective as is that of conventional
nebulization.[3]In choosing between using metered dose inhalers and nebulization, another important aspect to be
considered is the cost. There are no guidelines specifying the preferred type of device for managing acute asthma in
children. However, how to choose the type of inhalation device in the long-term management of asthma, by age group, is
described in the National Institutes of Health/World Health Organization Global Initiative for Asthma guidelines on
asthma management in children up to five years of age.[4]
Impact Factor (JCC): 2.9545 Index Copernicus Value (ICV): 3.0

Evaluation of Nurse's Knowledge about Asthma in Children 141
Problem of Project
Asthma is a common cause of emergency room visits and hospitalization during childhood, for this reason we ask
the question:
'Are the nurses in pediatric emergency room and pediatric wards have adequate knowledge about asthma in
children?
Goals of Project
• To evaluate nurses' knowledge about asthma in children.
• To identify relationship between level of knowledge and level of education.
• To identify relationship between level of knowledge and years of experience.
• Make comparison among hospitals regarding level of knowledge.
Definition of Asthma: Asthma is a common chronic inflammatory disease of the airways characterized by variable and
recurring symptoms, reversible airflow obstruction and bronchospasm.[5]
Causes of Asthma
Environmental
• Exposure to indoor allergens such as, dust mites, cockroaches, animal dander, and mold. [5]
• Air pollution and other environmental chemicals.[6]
• Low air quality from factors such as traffic pollution or high ozone levels. [7]
• Viral respiratory infections, such as respiratory syncytial virus and rhinovirus. [7]
Genetic
When changes happen in a person's genes (called mutations), these changes are passed on to their children. One or
both parents may have these changes or mutations in their genes, and some or all of their children may be born with them,
which means they inherited them. These mutations, once they happen, run in families from one generation to the next and
are permanent mutations, they change the gene in the DNA.
These changes can make a person more likely to get certain diseases like asthma. In some diseases it may be only
one change in one gene that may make a person get that disease, in asthma it may be changes in many different genes that
may make a person more likely to get asthma.[8]
Medical Condition
• Asthma occurring at a much greater rate in those who have either eczema or hay fever. [9]
• Individuals with certain types of urticarial may also experience symptoms of asthma. [10]
• There is a correlation between obesity and the risk of asthma with both having increased in recent years. [11]
• Beta blocker medications such as propranolol can trigger asthma in those who are susceptible. [12]
• Other medications that can cause problems are NSAIDs, and angiotensin-converting enzyme inhibitors. [13]
• Also, delivery via caesarean section is associated with an increased risk of asthma this increased risk is attributed
to the lack of healthy bacterial colonization that the newborn would have acquired from passage through the birth
canal.[14]
Triggers of Asthma
Tobacco Smoke: second-hand smoke can trigger an asthma attack.
Pets: animals give off chemicals called proteins, which are allergens; people can be allergic to them.
These allergens can act as irritants, make someone’s asthma worse, and trigger an asthma attack.
Bugs: different types of bugs, which may be found inside homes, may trigger asthma attacks. Some of the more
common bugs which may trigger asthma are dust mites, cockroaches and also bedbugs and fleas.[15]
Fungus Spores (Mold): Fungus reproduce by releasing spores into the air, if the spores land in a good place for
them to grow then a new fungus starts. Breathing in these spores can trigger asthma.
Strong emotions such as anger, stress and even laughter may worsen asthma symptoms.
Outdoor air pollutions can come from many sources such as car and truck fumes in areas of heavy traffic and
chemicals in the air near factories and refineries.
Weather: changes in the weather can trigger an asthma attack. Changes in air temperature can trigger an attack
not just cold air. [16]
Clinical Manifestation
Asthma is characterized by recurrent episodes of wheezing, shortness of breath, chest tightness, and coughing.[6]
Sputum may be produced from the lung by coughing but is often hard to bring up.[17]During recovery from an attack it may
appear pus like due to high levels of white blood cells called eosinophils.[18]Symptoms are usually worse at night and in the
early morning or in response to exercise or cold air.[19]
Status Asthmaticus
Status asthmaticus is an acute exacerbation of asthma that does not respond to standard treatments.[20]
Symptoms of Status Asthmaticus
• Shortness of breath.
• Wheezing.
• Chest tightness.[7]
Signs of Status Asthmaticus
• Use of accessory muscles of respiration (sternocleidomastoid and scalene muscles of the neck).
• Paradoxical pulse (a pulse that is weaker during inhalation and stronger during exhalation), and over-inflation of
the chest.[21]

• Ablue color of the skin and nails may occur from lack of oxygen.[22]
Table 1: Show Severity of an Acute Exacerbation.[23]

Severity Clinical Signs
-No features of acute severe asthma
Moderate
-Worsenning symptoms
-Unable to complete sentences in one breath
Acute severe -Heart rate ≥ 110 beats per minute
-Respiratory rate ≥ 25 breaths per minute
-Altered level of consciousness
-Arrhythmia
Life threatening
-Cyanosis
-Low blood pressure
Management
Short Term Control
• Short-acting beta2-adrenoceptor agonists (SABA), such as salbutamol (albuterol USAN) are the first line
treatment for asthma symptoms.
• Anticholinergic medications, such as ipratropium bromide, provide additional benefit when used in combination
with SABA in those with moderate or severe symptoms.[24]
Long Term Control
• Fluticasone propionate metered dose inhaler commonly used for long-term control.
• Corticosteroids are generally considered the most effective treatment available for long-term control. Inhaled
forms such as beclomethasone are usually used except in the case of severe persistent disease, in which oral
corticosteroids may be needed.
• Leukotriene antagonists (such as montelukast and zafirlukast) may be used in addition to inhaled corticosteroids,
typically also in conjunction with LABA.
• Mast cell stabilizers (such as cromolyn sodium) are another non-preferred alternative to corticosteroids.[25]
• Long-acting beta-adrenoceptor agonists (LABA) such as salmeterol and formoterol can improve asthma. [26]
Others Medication
When asthma is unresponsive to usual medications, other options are available for both emergency management
and prevention of flareups. For emergency management other options include:
• Oxygen to alleviate hypoxia if saturations fall below 92%.
• Methylxanthines (such as theophylline) were once widely used, but do not add significantly to the effects of
inhaled beta-agonists.
• Intravenous salbutamol is not supported by available evidence and is thus used only in extreme cases.[27]
• Magnesium sulfate intravenous treatment has been shown to provide a bronchodilating effect when used in
addition to other treatment in severe acute asthma attacks.
• Heliox, a mixture of helium and oxygen, may also be considered in severe unresponsive cases.[28]
• The dissociative anesthetic ketamine is theoretically useful if intubation and mechanical ventilation is needed in
people who are approaching respiratory arrest; however, there is no evidence from clinical trials to support this.[29]
METHODOLOGY
In this cross-sectional study, aquestionnaire (Appendix B) composed of (30) question about asthma in children
was distributed to (7) of college's teachers (Appendix A) to add their notes. After that, aquestionnaire was distributed to
(46) nurses, all with at least one year of experience and level of education either preparatory or diploma. They are working
in pediatric emergency room and pediatric wards in different hospitals as following:
• Al-Basra general hospital.
• Al-Basra hospital for maternity and children.
All participient answer 30 question through direct interview , and we collect the score of each sample by give (3)
score to correct answer ,(2) score to false answer ,and (1) score to I don't know answer , to evaluate knowledge of nurses
about asthma in children.
Setting of the Project
This study was carried out from nursing staff working in pediatric emergency room and pediatric wards in
different hospitals from 5-11-2013 to 1-2-2014 as following:
• Al-Basra general hospital.
• Al-Basra hospital for maternity and children.
Sample of the Study
Simple random sample was collected from 17-11-2013 to 27-11-2013,it involves (46) sample (Appendix C ) of
nursing staff work in pediatric emergency room and pediatric wards ,all with at least one year of experience and level of
education either preparatory or diploma in different hospitals as following:
• Al-Basra general hospital (13) sample.
• Al-Mawany general hospital (13) sample.
• Al-Basra hospital for maternity and children (12) sample.
• Al-Fayhaa general hospital (8) sample.

Project Instrument
Instrument of this study was aquestionnaire (Appendix B) composed of 30 question about asthma in children to
evaluate nurses 'knowledge about this subject, also include variables (level of education, and years of experience) to
identify relationship between level of knowledge and these variables.
Statistical Data Analysis
Mean, Variance, Standard Deviation, Standard Error, Percentage, Pearson correlation, One way anova (F-test),
L.S.D test.
Descriptive Statistics of Level of Nurses' Knowledge Regarding Asthma in Children
Table 2: Show Descriptive Statistics of Nurse's Knowledge about Asthma in Children

Descriptive Statistics
No. Minim. Maxim. Mean Standard Deviation Variance Standard Error
46 61 81 74.48 5.608 31.455 0.827
This table represent descriptive statistics of nurse's knowledge about asthma in children.
According to this table, we have (46) score, the minimum score is (61), and maximum score is (81).
Mean of score is (74.48), Standard deviation is (5.608), Variance is (31.455), and Standard Error is (0.827).
Table 3: Show Percentage of Successful and Failed

Statistics of the Percentage
Number of Successful Present Number of Failed Present
46 100 % 0 0%
This table represent percentage of successful and failed.
According to this table, number of successful is (46) which present (100%),and number of failed is (0) which
present (0%).
Relationship between Level of Knowledge and Level of Education, Level of Knowledge and Years of Experience
Table 4: Show Descriptive Statistics of Level of Nurse's Knowledge and Level of Education
Variables Mean Standard Deviation No. Standard Error
Level of knowledge 74.48 5.608 46 0.827
Level of education 1.54 0.504 46 0.074
This table represent descriptive statistics of level of nurse's knowledge and level of education.
According to this table, Mean of score is (74.48), Standard deviation is (5.608), number of score is (46), and
Standard Error is (0.827).
Mean of level of education is (1. 54), Standard deviation is (0. 504), number is (46), and Standard Error is (0.0
Table 5: Show Pearson Correlation between Level of Knowledge and Level of Education
Correlations
Pearson Degree of Significant
Variables Result
Correlation Freedom (n-2) (2-Tailed)
Level of knowledge Signifi
0.307 44 0.038
level of education cant
This table represent pearson correlation between level of knowledge and level of education.
According to this table, pearson correlation between level of knowledge and level of education is (0.307),
Significant (2-tailed) is (0.038) at degree of freedom (44) and result is significant correlation between level of knowledge
and level of education at 0.05 level.
Table 6: Show Descriptive Statistics of Level of Nurse's Knowledge and Years of Experience
Variables Standard Standard
Mean No.
Deviation Error
Level of knowledge 74.48 5.608 46 0.827
Years of experience 13.87 13.124 46 1.935
This table represent descriptive statistics of level of nurse's knowledge and years of experience.
According to this table, Mean of score is (74.48), Standard deviation is (5.608), number of score is (46) ,and
Standard Error is (0.827).
Mean of years of experience is(13.87), Standard Deviation is (13.124), number is (46), and Standard Error is
(1.935).
Table 7: Show Pearson Correlation between Level of Knowledge and Years of Experience
Correlations
Pearson Degree of Significant
Variables Result
Correlation Freedom (n-2) (2-Tailed)
Level of knowledge Significan
0.425 44 0.003
years of experience t
This table represent pearson correlation between level of knowledge and years of experience.
According to this table, pearson correlation between level of knowledge and years of experience is (0.425),
Significant (2-tailed) is (0.003) at degree of freedom (44) and result is significant correlation between level of knowledge
and years of experience at 0.01 level.
Comparison among Hospitals Regarding Level of Knowledge
Table 8: Show Descriptive Statistics of Nurse's Knowledge about Asthma in Children for Each Hospital
Standard Standard
Hospitals No. Mean Minim. Maxim.
Deviation Error
Al-Basra G. H 13 76.69 2.428 0.674 71 79
Al-Mawany G. H 13 72.77 7.452 2.067 61 81
Al-Basra H. for
12 71.92 5.728 1.654 61 79
maternity and children
Al-Fayhaa G. H 8 77.50 3.024 1.069 72 81

This table represent descriptive statistics of nurse's knowledge about asthma in children for each hospital.
According to this table,
AL-Basra general hospital, number of score is (13), minimum score is (71), maximum score is (79), Mean of
score is (76.69), Standard deviation is (2.428), Standard Error is (0.674).
Al-Mawany general hospital, number of score is (13), minimum score is (61), maximum score is (81), Mean of
score is (72.77), Standard deviation is (7.452), Standard Error is (2.067).
Al-Basra hospital for maternity and children, number of score is (12), minimum score is (61), maximum score is
(79), Mean of score is (71.92), Standard deviation is (5.728), Standard Error is (1.654).
Al-Fayhaa general hospital, number of score is (8), minimum score is (72), maximum score is (81), Mean of score
is (77.50), Standard deviation is (3.024), Standard Error is (1.069).
Table 9: Show Differences among Hospitals Regarding Level of Knowledge

One Way Anova (F-Test)
Variance Sum of Mean Significant
df F Result
Source Sequares Square (P-Value)
Between
253.485 3 84.495
Groups
3.054 0.039 Sign.
Within Groups 1161.994 42
27.667
Total 1415.478 45
This table represent differences among hospitals regarding level of knowledge.A ccording to this table;
Sum of sequares between groups is (253.485), degree of freedom is (3), Mean sequare is (84.495).
Sum of sequare within groups is (1161.994),degree of freedom is (42),Mean sequare is (27.667) .
F-test value is (3.054), Significant( P-value) is (0.039) and result is significant difference among hospitals
regarding level of knowledge.
Table 10: Show L. S .D Test among Hospitals in Means

Mean Significant
Hospitals Means Results
Difference (P- Value)
Al-Basra G.H- Al-Mawany G.H 76.69-72.77 3.923 0.064 Insign.
Al-Basra G.H- Al-Basra H. for
76.69-71.92 4.776 0.029 Sign.
Al-Basra G.H- Al-Fayhaa G.H 76.69-77.50 -0.808 0.734 Insign.
Al-Mawany G.H- Al-Basra H. for
72.77-71.92 0.853 0.688 Insign.
Al-Mawany G.H- Al-Fayhaa G.H 72.77-77.50 -4.731 0.052 Insign.
Al-Basra H. for maternity and children
71.92-77.50 -5.583 0.025 Sign.
–Al-Fayhaa G.H
This table represent L.S.D test among hospitals in mean.According to this table;
Al-Basra general hospital-Al-Mawany general hospital,Mean difference is (3.923), Significant(P-value) is

(0.064),and result is insignificant difference between Al-Basra general hospital and Al-Mawany general hospital at 0.05
level regarding level of knowledge.
Al-Basra general hospital-Al-Basra hospital for maternity and children,Mean difference is (4.776), Significant
(P-value) is (0.029), and result is significant correlation between ,Al-Basra general hospital and Al-Basra hospital for
maternity and children at 0.05 level regarding level of knowledge.
Al-Basra general hospital-Al-Fayhaa general hospital,Mean difference is (-0.808), Significant (P-value) is (0.734),
and result is insignificant difference between Al-Basra general hospital and Al-Fayhaa general hospital at 0.05 level
regarding level of knowledge.
Al-Mawany general hospital- Al-Basra hospital for maternity and children,Mean difference is (0.853), Significant
(P-value) is (0.688), and result is insignificant difference between Al-Mawany general hospital and Al-Basra hospital for
maternity and children at 0.05 level regarding level of knowledge.
Al-Mawany general hospital- Al-Fayhaa general hospital,Mean difference is (-4.731), Significant (P-value) is
(0.052), ), and result is insignificant difference between Al-Mawany general hospital and Al-Fayhaa general hospital at
0.05 level regarding level of knowledge.
Al-Basra hospital for maternity and children- Al-Fayhaa general hospital, Mean difference is (-5.583),
Significant (P-value) is (0.025),and result is significant correlation between Al-Basra hospital for maternity and children
and Al-Fayhaa general hospital at 0.05 level regarding level of knowledge.
Discussion of Results
According to table 3 and 4, the arithmetic mean of score is (74.48) and percentage of number of successful is
(100%),
These result explain that nurses in pediatric emergency room and pediatric wards in (Al-Basra general hospital,
Al- Mawany general hospital, Al-Basra hospital for maternity and children, and Al-Fayhaa general hospital) have
sufficient knowledge about asthma in children. These result may be because we limited our study to nurses with at least
one year of experience and level of education either preparatory or diploma.
According to table 6, Pearson correlation between level of knowledge and level of education is (0.307),
these result explain that there is significant correlation between level of knowledge and level of education, these result may
be because nurses with diploma level study different medical science which play an important role in development of
nurse's information, but nurses with preparatory level study medical science in less extent.
According to table 8, Pearson correlation between level of knowledge and years of experience is (0.425),
these result explain that there is significant correlation between level of knowledge and years of experience, these result
may be because frequent admission of cases of asthma and contact between nursing staff and medical staff during case
management play an important role in improvement of nurse's information.
According to table 10, F-test is (3.054) which explain that there is significant differences among hospitals
regarding level of knowledge, but L. S. D test table 11 explain that there is significant differences only between
(Al-Basra general hospital -Al-Basra hospital for maternity and children), and (Al-Basra hospital for maternity and
children- Al-Fayhaa general hospital ) .
Significant difference between (Al-Basra general hospital -Al-Basra hospital for maternity and children) may be
because nurses in Al-Basra general hospital with at least three years of experience, but nurses in Al-Basra hospital for

maternity and children with at least one year of experience.
Also, significant difference between (Al-Basra hospital for maternity and children- Al-Fayhaa general hospital)
may be because sample size of Al-Fayhaa general hospital smaller than sample size of Al-Basra hospital for maternity and
children.
Our data supported by '' A study done in Pakistan[30],
The pre-test data shows 40-50% of RNs lacked the knowledge of causes, sign and symptoms and the management
of asthma. More than 30% were not able to demonstrate the correct inhaler technique of MDIs. Evaluation after several
teaching sessions shows 80-90% improvement in the knowledge and competence of nurses to use inhalers.
CONCLUSIONS
Nursing staff in pediatric emergency room and pediatric wards have sufficient knowledge about asthma in
children.
• Level of education and years of experience play an important role in improvement of nurse's information.
• We can rank hospitals according to level of knowledge as following;
o Al-Fayhaa general hospital
o Al-Basra general hospital
o Al –Mawany general hospital
o Al-Basra hospital for maternity and children
RECOMMENDATIONS
• Frequent sessions should be organized for nurses about asthma, and its management to improve their information.
• Frequent research studies are recommended to evaluate improvement of nurse's information about asthma and its
management within the hospital.
• Take into account the importance of level of education for nurse’s work in pediatric emergency room and
pediatric wards and limited to preparatory level or diploma.
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APPENDICES
Appendix A
Appendix B
Appendix C
Sample of Study
Table 11
Level of Years of Experience Mark
Seq
Education (Year) (90)
1 2 11 71
2 1 3 74
3 2 44 79
4 1 6 79
5 2 11 76
6 2 6 75
7 2 34 77
8 1 30 77
9 2 35 78
10 2 25 79
11 2 37 79
12 2 35 78
13 1 4 75
14 2 8 73
15 1 5 61
16 2 1 74
17 2 7 78
18 1 5 62
19 1 18 75
20 1 29 75
21 1 1 62
22 2 26 79
23 1 1 80
24 1 7 66
25 2 34 81
26 2 6 80
27 2 1 65
28 2 1 68
29 1 1 61
30 1 30 79
31 2 1 75
32 1 5 66
33 1 36 73
34 1 9 71
35 2 12 77
36 2 9 78
37 1 8 75
38 2 28 75
39 2 2 72
40 2 29 78
41 1 7 81
42 1 1 81
43 2 14 77
44 1 1 75
45 1 5 77
46 2 9 79
Level of education
Diploma=1
Preparatory =2


IJGMP - Medicine - Evaluation of Nurse's Knowledge - Dr. Sajjad Salim - Iraq - OPaid

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IJGMP - Medicine - Evaluation of Nurse's Knowledge - Dr. Sajjad Salim - Iraq - OPaid

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International Journal of General Medicine

and Pharmacy (IJGMP)

EVALUATION OF NURSE'S KNOWLEDGE ABOUT ASTHMA IN CHILDREN

SAJJAD SALIM ISSA

• To evaluate nurses' knowledge about asthma in children.

• To identify relationship between level of knowledge and variables of study.

• Make comparision among hospitals regarding level of knowledge.

• Basra general hospital.

• Al-Mawany general hospital.

• Al-Basra hospital for maternity and children

• Al-Fayhaa general hospital.

• Al-Basra general hospital (13) sample.

• Al-Mawany general hospital (13) sample.

• Al-Basra hospital for maternity and children (12) sample.

• Al-Fayhaa general hospital (8) sample

Results: this chapter focuses on;

• Descriptive statistics of level of nurse's knowledge about asthma in children.

• Pearson correlation between level of knowledge and variables of study.

Impact Factor (JCC): 2.9545 Index Copernicus Value (ICV): 3.0

• To evaluate nurses' knowledge about asthma in children.

• To identify relationship between level of knowledge and level of education.

• To identify relationship between level of knowledge and years of experience.

• Make comparison among hospitals regarding level of knowledge.

• Air pollution and other environmental chemicals.[6]

Tobacco Smoke: second-hand smoke can trigger an asthma attack.

Symptoms of Status Asthmaticus

Signs of Status Asthmaticus

Impact Factor (JCC): 2.9545 Index Copernicus Value (ICV): 3.0

Table 1: Show Severity of an Acute Exacerbation.[23]

Long Term Control

• Oxygen to alleviate hypoxia if saturations fall below 92%.

• Al-Basra general hospital.

• Al-Mawany general hospital.

• Al-Basra hospital for maternity and children.

• Al-Fayhaa general hospital.

Setting of the Project

• Al-Basra general hospital.

• Al-Mawany general hospital.

• Al-Basra hospital for maternity and children.

• Al-Fayhaa general hospital.

Sample of the Study

• Al-Basra general hospital (13) sample.

• Al-Mawany general hospital (13) sample.

• Al-Basra hospital for maternity and children (12) sample.

• Al-Fayhaa general hospital (8) sample.

Impact Factor (JCC): 2.9545 Index Copernicus Value (ICV): 3.0

Statistical Data Analysis

Descriptive Statistics of Level of Nurses' Knowledge Regarding Asthma in Children

Table 2: Show Descriptive Statistics of Nurse's Knowledge about Asthma in Children

Table 3: Show Percentage of Successful and Failed

This table represent percentage of successful and failed.

Comparison among Hospitals Regarding Level of Knowledge

Impact Factor (JCC): 2.9545 Index Copernicus Value (ICV): 3.0

According to this table,

Table 9: Show Differences among Hospitals Regarding Level of Knowledge

Sum of sequare within groups is (1161.994),degree of freedom is (42),Mean sequare is (27.667) .

Table 10: Show L. S .D Test among Hospitals in Means

Al-Basra general hospital-Al-Mawany general hospital,Mean difference is (3.923), Significant(P-value) is

Impact Factor (JCC): 2.9545 Index Copernicus Value (ICV): 3.0

maternity and children with at least one year of experience.

Our data supported by '' A study done in Pakistan[30],

• We can rank hospitals according to level of knowledge as following;

o Al-Fayhaa general hospital