Level of Knowledge and Confidence on Emergency

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Response of Nursing Graduate Students

Sage M. Raguindin, BSN, RN, PhD NEd

Professor, Nursing Department Health Administration

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Al Ghad International Colleges for Applied Medical Sciences
Buraydah, Kingdom of Saudi Arabia
Email Address: drsagemesiasraguindin@yahoo.com

ABSTRACT

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This study is an assessment of the level of knowledge and confidence on emergency response of
nursing graduate students. Specifically, on answered the following problems: (1) What is the profile of
the nursing graduate students in terms of age, sex, employment, number of years as a professional

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nurse, and in-service training? (2) What is the level of knowledge on emergency response in first-aid,
basic life support, intravenous therapy, and triage? (3) What is their level of confidence in providing
emergency response in first-aid, basic life support, intravenous therapy, and triage? (4) Is there a

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significant difference between the level of knowledge and the level of confidence in rendering emergency
response? (5) What interventions may be proposed to enhance
response of the nurses?
the level of knowledge on emergency
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A total of forty Bicol University Graduate School Gubat Campus Master in Nursing students
serve as respondents. It considered survey design using descriptive method and resorted to
questionnaire-checklist and assessment test. The level of knowledge (39 items/situations scenario) and
level of confidence (24 items/ situations scenario) were described using the 3-point Likert scale of 1 for
low (≤1.50); 2 for moderate (1.51-2.50); and 3 for high (≥2.51). Other data and information were
generated and/or verified through document analysis and unstructured interview. Frequency count,
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weighted mean, percent-age, rank and t-test statistics were computed using MS Excel and SPSS.
Some of the significant findings and conclusions of the study on level of knowledge and
confidence on emergency response of nursing graduate students are: 1. There is predominant of female,
young, volunteer, less than five years of professional experience with good participation in first aid and
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basic life support emergency among the nurses enrolled in the Bicol University Graduate School Gubat
Campus. 2. The level of knowledge of the graduate nursing students remained average in first aid, basic
life support, intravenous therapy, and triage. 3. Graduate nursing students of the Bicol University in
Gubat displayed moderate confidence in first aid and basic life support. A similar level (moderate) of
confidence is noted except for “others” employment (low) in intravenous therapy and triage emergency.
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4. Knowledge and confidence level of the graduate nursing students differed significantly. 5. The
proposed intervention to enhance the knowledge and confidence in emergency response of the graduate
nursing students is a direct manifestation of their professional preparation and competence.
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Keywords: Level of knowledge and confidence, Emergency, Emergency Response, Profile

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This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=2658565
 1. Introduction

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Caring for patients and the opportunity to save lives is what professional nursing is all about
especially in times of emergencies and disasters. Disaster events provide nurses with the opportunity to
do both. Nursing as what it is today is the result of changes in the scientific, technological, political,
social, and economic climate.1 It is even observed that through the years, the concept of nursing has

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been expanded and subsequently, the roles of the nurse have become broader to meet the changing needs
of the society. Likewise, career opportunities in nursing have greatly expanded. 2 These insights
prompted the researcher as a practitioner to work on health emergency concern. In times of emergencies,
few minutes can spell the difference between life and death. Few seconds of hesitation in rendering
health care services can cause aggravation and suffering for a lifetime. There is the continuum of
emergency to disaster.

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The World Health Organization (WHO) defines emergency as the “sudden occurrence demanding
an immediate response” and that “all disasters are emergencies.”3 This could either be natural or man-
made. Bicol Region experiences diverse emergencies and disasters particularly those brought about by
natural causes. On the average, the region experienced an average of three to five typhoons yearly for the

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past ten years.4 One of the latest and most disastrous incidence was the typhoon Reming in November
2006 having the strength up to 230 kilometers per hour; the strongest recorded typhoon in Philippine
history. Available documents showed a total of 217 injuries, claimed 715 deaths and 764 persons

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missing.5 Records of volcanic eruptions, earth-quakes and landslides are experienced by the Bicolanos at
any given time.6 These are some examples of natural emergencies that are extremely life threatening.
More so cause irreversible damage and lifetime suffering.
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More so, with the hospitals particularly in the provinces of Albay and Sorsogon with two active
volcanoes admit thousands of other emergency cases such as gunshot wounds, cardiac arrest, shellfish
poisoning, vehicular accidents, trauma and other injuries. Nurses have been important personnel of
emergency preparedness and response. History will tell that they have been a part of disaster
preparedness. Although the early nurses who responded to emergencies during historic events may have
been something other than the professional nurses; their described role is consistent with a modern under-
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standing of nursing.7 A nurse is expected to render care for the alleviation of sufferings and prevention of
life loss. In times of emergencies and disasters, they are often called upon to take the roles as first
responder, direct care provider, on-site coordinator of care, information provider or educator, mental
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health counselor and triage officer.8 The aforementioned insights on the importance of the nurses
capability to render emergency cases partly justify the conduct of this study.

There is a need for continuous professional growth to meet the challenges incorporating recent
developments such as climate change and adaptation. This means the enhancement of nursing knowledge,
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attitudes, and skills must take the front stage in terms of priority. Since nursing is a science, knowledge
competency is important to be assessed to address its strengths and weak-nesses as to adapt to the
changing needs brought about by time. Recent improvement in the nursing curriculum must pave the way
for the “integration of disaster nursing in the nursing curriculum” and show the importance of the
nurses’ emergency response.9 Among others, the nurses nowadays are expected to demonstrate abilities
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to perform basic therapeutic interventions, including first-aid, wound care, oxygen therapy, urinary and
gastric catheter insertion, and lavage (gastric, wounds, and eyes). It is even observed that:

Post-baccalaureate nursing courses offered by recognized and accredited nurses’

organizations such as certification in intravenous therapy (IVT), basic life support (BLS),
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advance cardiac life support (ACLS), and hemodialysis are some examples of
quantifying and qualifying the nurses’ skills needed in rendering emergency care.10

This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=2658565
 The nursing profession demands that nursing care be delivered with confidence.11 Confidence is

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generally regarded as a positive quality and is essential to being a safe and competent practitioner.
Although the relevance of professional confidence is acknowledged in literature, there is little written
about nurses’ confidence in delivering emergency response. Likewise, since most nurses do not respond
to emergencies every day, it is necessary to identify competency for nurses to be ready to respond in such
cases.

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Corollary is the importance of nursing education where the roles of nurses are prescribed as
regard emergencies is the issuance of Presidential Decree No. 1566. Said issuance serves as the legal
basis in “strengthening the Philippine disaster control, capability and establishing the national program
on community disaster preparedness.”12 The Department of Health is a member in ensuring the
implementation of this policy whereas its primary role is “to ensure health emergency preparedness and
response among the general public and to strengthen the health sector’s capability to respond to
emergencies and disasters.”13

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The Bicol University (BU) is a premiere and a comprehensive university in the Philippines
responded by offering Master in Nursing (MN) in 1976. The curriculum for Master in Nursing is compose
of: Foundation Courses (12 units), N 107 - Foundation of Nursing Education, N108 - Research Methods,

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and N109 - Statistics Methods, N110 - Curriculum Development in Nursing. Major Courses (18 units)
such as N 111 Clinical Teaching and Program Development, N 112 - Clinical Teaching Practicum, N 113
- Teaching of Medical and Surgical Nursing, N 114 - Seminar in Medical and Surgical Nursing, etc.

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Cognates (9 units), N 124 – Computer, N 125 – Seminar in Nursing Leadership, etc., and Thesis Writing,
N 128 - Seminar in Thesis Writing and N 129 - Thesis Writing. A total of 45 units to finish the degree
(MN). (See Appendix __Curriculum for Master in Nursing). For the period of 34 years, this program
MN has produce hundreds of graduates who are now leaders in the field of nursing in the Philippines and
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in foreign countries.

Recent offering is the Health Emergency and Disaster Management (HEDM) as field of
specialization under the Master in Public Administration (MAPA) starting first semester of academic year
2008-09.14 MAPA is a Level II awaiting the final re-visit for Level III Accreditation Status.15 BU is the
only state university in the Philippines and perhaps in Asia and the Pacific with this pioneering course.16
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The university is committed to produce not only graduates but leaders including the nurses for
local and the world market. Pursuing this study would provide insights and would further validate the
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nursing graduate program of the university as well as the graduate students of the University along health
emergency and disaster management. The graduate students respondents in the study are in Gubat
Campus (Figure 1). The town of Gubat is experiencing on-going development in terms of education,
commerce, and government infrastructure to mention. It is an old progressive town. The Bicol University
Gubat Campus (BUGC) form part of the Bicol University (RA 4410) as of January 2010. Budgetary
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appropriation by the national government was provided in the Appropriation Act of 2010 under Bicol
University. Thereby, BUGC shall have the authority to offer more identified courses it deemed necessary
and competent both in the undergraduate and graduate levels. Hence, is the need to assess the health
emergency response competency of the nursing graduate students enrolled in Master in Nursing at Bicol
University Graduate School-Gubat, the pioneer (MN) graduates of Gubat Campus.
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2. Literature Review

This segment of the manuscript provides the discussion of the literature (books, journals,
periodicals, magazines, on-line sources, reports, etc.) and recently concluded studies (theses and
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dissertations). Reviewed literatures and studies were arranged based on the variables of the
study.

This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=2658565
 Nurses are “persons trained to care for the sick, disabled or old.”1 The professional nurse is a

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“person who has completed a basic nursing education program and is licensed in his country or state to
practice nursing.” Nursing being a profession requires the primary characteristics, namely: education,
theory, service, autonomy, code of ethics, and caring’ according to Udan.2 For professional preparation, a
nurse must have a license to practice nursing in the country, Bachelor of Science in Nursing (BSN), and
be physically and mentally fit. She is also expected to possess: (a) personal qualities and professional

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proficiencies like interest and willingness to work and learn with individuals/groups in a variety of
settings; (b) a warm personality and concern for people; (c) resourcefulness and creativity as well as
well-balanced emotional condition; (d) capacity and ability to work cooperatively with others; (e) initiate
to improve self and service; (f) competence in performing work through the use of nursing process, skills
in decision-making, communicating, and relating with others and being research oriented; and (g)
active participation in issues confronting nurses and nursing.3

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The four-year BSN degree is anchored on the “competency-based community oriented
curriculum to educate future nurse practitioner to assume their roles and responsibilities in the Philippine
Health Care System. It aims to prepare nurses for entry level positions in any health care setting in the
country like hospitals, clinics, health care centers, homes and communities.4 In this regard, it is worth

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mentioning that one of the terminal competencies expected to a graduate of nursing is “implementing
appropriate nursing interventions (wholly compensatory, partially compensatory, supportive, educative).5
Overall, the Bachelor of Science in Nursing program is intended to produce professional nurses who

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demonstrates the following behaviors: (a) of caring behavior (compassionate, competent and committed);
ability to practice legal, ethico-moral, social responsibilities/accountabilities; (b) critical and creative
thinking, skills in practicing SKA and values for the promotion of health, the prevention of illness,
restoration of health, alleviation; and (c) assisting clients to face death with dignity and in peace.” 6
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The aim of nursing actions is to assist patients, families, and communities to improve correct or
adjust to physical, emotional, psychosocial, spiritual, cultural, and environmental conditions for which
they seek help. Definitions of nursing have evolved to acknowledge six caring features of professional
nursing. These are: (a) provisions of caring relationship that facilitates health and healing; (b) attention to
the range of human experiences and responses to health and illness within the physical and social
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environments; (c) integration of objective data with knowledge gained from an appreciation of the patient
or group’s subjective experience, application of professional nursing knowledge through scholarly
inquiry; and (d) influence on social and public policy to promote social justice.7
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Clearly, nursing is a caring profession. It is a unique profession and practiced with an earnest
concern for the art of care and the science of health. It involves the “humanistic blend of scientific
knowledge, and holistic nursing practice.”8 Technically, caring implies that persons, events, projects,
and things matter to people; being connected involving stressful situation and the available options for
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coping. Caring creates possibility. It is an inherent feature of nursing practice; caring enables nurses help
clients recover in the face of illness, to give meaning to that illness and to maintain or re-establish
connection.9

Expectedly, all nurses should have an awareness of the basic life cycle of disasters, the health
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consequences associated with the major events, and a framework to support the necessary. To emphasize,
emergency refers to the “sudden occurrence demanding an immediate response” while disaster is a
“serious disruption of the functioning of society, causing widespread human, material or environmental
losses, which exceed the ability of the affected people to cope using their own resources.”10
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Recent observations show that the health emergencies and disasters are “increasingly deadly and
costly threats especially for poor and vulnerable countries like the Philippines. Regardless of type or
origin, whether caused by extreme weather events, earthquakes, volcanic eruptions, terrorist attacks or

This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=2658565
 major pandemics, damage caused by disasters is made worse by the lack of careful preparation and early

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anticipatory response.”12 Categorically, this suggests that competence in nursing is “approaching
problems intellectually rather than emotionally” and “displaying knowledge and ability to deal with
situations.”13 It is safe to claim that:

Development of key competencies and terminal objectives for training of all

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healthcare workers in disaster preparedness is crucial. A competency was defined as a
complex combination of knowledge, attitudes, and skills demonstrated by individuals
that are critical to the effective and efficient function of an organiza-tion.14

Moreover, is the need for independent or nurse-initiated interventions are autonomous actions
based on scientific rationale that is executed to benefit the client in a predicted way related to the nursing
diagnosis and client-centered goals. These can solve the client’s problems without consultation or

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collaboration with the physicians or other health care professionals. An example is a nurse giving first-aid
measures to a client.15 The aforecited explanations are the expected level of knowledge of the graduate
nursing students on emergency response.

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First aid is the provision of initial care for an illness or injury. It is usually performed by a lay
person to a sick or injured casualty until definitive medical treatment can be accessed. Certain self-
limiting illnesses or minor injuries may not require further medical care past the first aid intervention. It

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generally consists of a series of simple and, in some cases, potentially life-saving techniques that an
individual can be trained to perform with minimal equipment.

Basic life support (BLS) is a level of medical care which is used for patients with life-
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threatening illness or injury until the patient can be given full medical care. It can be provided by trained
medical personnel, including emergency medical technician, and by laypersons who have received BLS
training. BLS is generally used in the pre-hospital setting, and can be provided without medical
equipment. BLS generally does not include the use of drugs or invasive skills, and can be contrasted
with the provision of Advanced Life Support (ALS). Most laypersons can master BLS skills after
attending a short course. Firefighters and police officers are often required to be BLS certified. BLS is
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also immensely useful for many other professions, such as daycare providers, teachers and security
personnel.
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Intravenous therapy or IV therapy is the giving of liquid substances directly into a vein. It can
be intermittent or continuous; continuous administration is called an intravenous drip. The word
intravenous simply means "within a vein", but is most commonly used to refer to IV therapy. The
simplest form of intravenous access is a syringe with an attached hypodermic needle. The needle is
inserted through the skin into a vein, and the contents of the syringe are injected through the needle into
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the bloodstream. This is most easily done with an arm vein, especially one of the metacarpal veins. Often
it is necessary to use a tourniquet first to make the vein bulge; once the needle is in place, it is common to
draw back slightly on the syringe to aspirate blood, thus verifying that the needle is really in a vein; then
the tourniquet is removed before injecting.
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Triaging is another activity that would requires competence among the health workers as it is
resorted to in “identifying treatment priorities. This is a process by which a decision is made on which
victim receives treatment and which does not. Incidentally, this covers four basic priorities of patient
treatment and transport. The objective of triaging is “to quickly identify victims needing immediate
stabilization or transport and the level of care need by these victims by assessing airway, breathing, and
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circulation” according to the Health Emergency Management Staff. Triaging is done if there are more
victims than health responders. Reverse triaging is done during search and rescue stage where the priority
is to get as much people out of danger with the least effort.

This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=2658565
 Ideally, the following information should be contained in the patient’s color tag: (a) patient’s

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sequence number; (b) name of patient; (c) injuries identified; and (d) previous interventions given at the
scene. Red tag is first priority suggestive of life-threatening, needs to be treated within 1 to 3 hours. This
is to be determined using the following parameters: (a) obstruction/damage airway; (b) breathing
disturbance [RR = 30/min or RR<10/min]; (c) circulation disturbance [HR = 100/min or weak pulses]; (d)
altered level of consciousness; and (e) external bleeding with CVS collapse. Yellow tag is second priority

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where the person needs to be treated within 4 to 6 hours. Indicators or parameters are: (a) major burns --
involving hands, feet or face excluding respiratory tract; complicated by major soft tissue trauma; (b)
spinal injuries -- long bone or pelvic fractures; and (c) environmental injuries [heat/cold exposure]. Green
tag is third priority which requires no treatment or can be delayed. These includes minor injuries not
threatened by ABC instability, minor fractures/ soft tissue injuries/ burns, and injuries so severe that
survival cannot be expected even under the most ideal conditions; obviously mortal wounds where death
is certain such as head injuries or massive burns. Lastly, black tag is tantamount to death or moribund

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state. In emergency situations, the most practical means of tagging may only be by color ribbons or
even pentel pens.16

These are some parameters and measures that would describe best the competencies of the nurses

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enrolled in the Master in Nursing course of Bicol University. Substantial insights, knowledge and
information previous learned may be verified, validated and/or enhanced the presentation of this
manuscript..

3. Methodology
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The descriptive-correlational type of research was considered in this study in describing the
level of knowledge and confidence of the nursing graduate students in Bicol University Graduate School
Gubat Campus in the second legislative district of the Province of Sorsogon. Survey techniques requires
the natural setting where it is capable of providing information of the part and present even projecting
future occurrence of the event.1
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Parel et al., stressed the idea that descriptive studies provide the necessary back-ground for the
formulation of a more precise problem for subsequent more specific study for the development of
hypothesis.2 Consistent with the purpose of making assessment of the knowledge and confidence in
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providing or responding to various emergency situations/ statements, it considered the questionnaire-

checklist as the main source of data and information. Likewise, this study resorted to document analysis
and the conduct of unstructured interview to validate and/or improve the presentation of the findings.

The main source of data were the responses of the forty nursing graduate students of Bicol
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University Graduate School-Gubat enrolled in Master in Nursing for academic year 2009-2010. Other
sources of data and information came from the records of admission under the custody of the Registrar of
the University.

The respondents of this study consisted of all the graduate students enrolled in the Master in
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Nursing at Bicol University Graduate School Gubat Campus for the second semester of academic year
2009-10. There were ten (10) males and thirty (30) females, a total of forty (40) nurse respondents
whose ages ranges from 20 to 55. Most of them were nurse volunteer (16) and hospital nurse (15).
Majority (19) were less than one year as professional nurse.
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A letter-request to conduct the study addressed to the Dean of Bicol University Graduate Schools
(Appendix A) was prepared as soon as the outline was accepted by Bicol University Graduate School.

This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=2658565
 Said letter solicits the endorsement of the Dean to encourage the respondents to participate in the study.

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Once approved with the endorsement, the distribution of the survey-questionnaires and tests was
conducted. The researcher distributed the questionnaire-checklist, administer the tests and allot the
specified time for all of them to be accomplished and answered. The accomplished questionnaires and
tests once received by the researcher was processed using appropriate statistics as basis of analysis.

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The administration of the questionnaire checklist and test was done during a seminar-workshop
conducted by the Master in Nursing students in Mariners School in Peot, Sorsogon. The research
instrument was accomplished right after the cited activity.

4. Data Analysis and Discussions

The summary of findings, conclusions and recommendations of the level of knowledge and

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confidence on emergency response of nursing graduate students are presented in this chapter.
Specifically, it answered the following problems: (1) What is the profile of the nursing graduate students
in terms of age, sex, employment, number of years as a professional nurse, and in-service training?
(2) What is the level of knowledge on emergency response in first-aid, basic life support, intravenous

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therapy, and triage? (3) What is their level of confidence in providing emergency response in first-aid,
basic life support, intravenous therapy, and triage? (4) Is there a significant difference between the level
of knowledge and the level of confidence in rendering emergency response? (5) What interventions may

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be proposed to enhance the level of knowledge on emergency response of the respondents? A total of
forty Bicol University Graduate School Gubat Campus Master in Nursing students serve as respondents.

This study considered the survey design using descriptive method and resorted to questionnaire-
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checklist and assessment test. The level of knowl-edge (39 items/situations scenario) and level of
confidence (40 items/situations scenario) were described using the 3-point Likert scale of 1 for low
(≤1.50); 2 for moderate (1.51-2.50); and 3 for high (≥2.51) and subsequently determined using weighted
mean. Other data and information were generated and/or verified through document analysis and
unstructured interview. Computation of the other statistics such as frequency count, percentage, rank and
t-test statistics was done using MS Excel and SPSS. .
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Profile of the Master in Nursing Graduate Students As earlier mentioned, the profile of the
forty Master in Nursing (MN) graduate students consisted of age, sex, employment, number of years as a
professional nurse, and in-service training. Said profile served as basis in describing their level of
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knowledge and confidence in providing emergency response to various situations as well. To begin with,
the findings are presented in the succeeding discussions.

Sex. As shown in Table, there were 10 (25.00%) male and 30 (75.00%) female nurses or a total
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of forty (40) respondents. Apparently, this leads to a male : female ratio of 1:4. This means that for every
four nurse respondents, one is a male and three are females. Hence, the male is out-numbered by female
nurses. This can be attributed to historical records where it is dominated by females like the teaching
profession. It is only the recent years; for the past two decades where the profession continued to attract
the male population.
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Age. Presented from the same table is age profile of the respondents, The finding reveals that 29
or 72.50 belongs to 20-24 years old or seven for every ten nurses. The remaining number of respondents
constituted the 25-35 (8 or 20.00%), 46-55 (2 or 5.00%) and 36-45 (1 or 2.50%) in that sequence.
Corollary to the previous pronouncement, the 25 to 55 years old nurses accounted for the 30.00 percent
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share of the age profile distribution. With the information, there is bright prospective for health care and
service to be provided by future generation of nurses. There likewise the likelihood of and for sharing
their experiences with their colleagues.

This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=2658565
 ed
Employment. By specific employment, the nurses enrolled in the Master in Nursing degree is
dominated by nurse volunteers with 16 or 40.00 percent share as shown in Table 1. Employment as
hospital nurse constituted 15 (37.50%) while the public health nurse is represented by 4 (10.00%) or a
total of 19 or 47.50 percent, respectively. Others reported employment with one respondent each include
nurse educator, nurse trainee, nurse attendant, midwife and unemployed.

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Number of years as a professional nurse. Based on the information given in Table 1, 19 or
47.50 percent of the respondents have less than a year of experience as professional nurses whereas 14
or 35.00 percent indicated 1-3 years. Two respondents (5.00%) each have 10-15 and more than fifteen
years as professional practitioners. Three respondents or 7.50 percent opted for “others” which may be
interpreted as “no response.” It can also be viewed as 33 (82.50%) of the respondents have a maximum
number of three years as professional nurses. This implies that two out of ten respondents have four years

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or more professional experience. Most of them need a lot of exposure to nursing situations such as
responding to emergency situations such as first aid, basic life support, intravenous therapy and triage to
mention some.

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In-service training. In this study, in-service training covers four areas of interest of concern. As
indicated in the Table 1, in-service on basic life support (BLS) was attended by 27 respondents or 67.50
percent. Roughly, seven out of ten nurses have this type of training. Of the forty graduate nurses, 24

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(60.00%) or six out ten nurses have the opportunity to learn and give first aid. A small number of the
respondents have in-service trainings on intravenous therapy (9 or 22.50%) and/or triage (7 or 17.50%).
The information provided manifested the need for more training or continuing education in almost all
the identified emergency situations. However, immediate concern may be undertaken and/or instituted
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by the appropriate institution for intravenous therapy and triage emergency situations.

Some of the significant findings of the study on level of knowledge and confidence on
emergency response of nursing graduate students are as follows:

1a. Sex. There were 10 (25.00%) male and 30 (75.00%) female nurses giving a male:female
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ratio of 1:4.

1b. Age. A total of 29 (72.50%) belongs to 20-24 years old cohort or seven for every ten nurses.
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The 25 to 55 years old accounted for the 27.50 percent (8 or 20.00%) for 25-35; 2 (5.00%) for 46-55;
and 1(2.50%) for 36-45.

1c. Employment. Current employment consisted of 16 (40.00%) for nurse volunteers. Fifteen
(37.50%) are hospital and 4 (10.00%) public health nurses or 19 (47.50%), respectively. A respondent
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each claimed as nurse educator, nurse trainee, nurse attendant, midwife and unemployed.

1d. Experience. Nineteen (47.50%) have less than a year experience as professional nurse
whereas 14 (35.00%) with 1-3 years. Two (5.00%) nurses (5.00%) each have at least ten years as
professional practitioners. Three (7.50%) opted for “others” which may be interpreted as “no response.”
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Or, 33 (82.50%) of the respondents have a maximum number of three years as professional nurses.

1e. In-service training. On in-service on basic life support was attended by 27 (67.50%)
nurses. Roughly, seven out of ten nurses have this type of training. Twenty-four 24 (60.00%) or six out
of ten nurses have the opportunity to learn and give first aid. A small number of the respondents have
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in-service trainings on intravenous therapy (9 or 22.50%) and/or triage (7 or 17.50%).

This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=2658565
 2a. First aid. The highest score among the male is 6 (2) while 8 (1) for the female nurse scored

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8 out ten items while their mean scores are 4.40 and 4.37. In terms of age, the 25 years remains low
(3.91) compared with the 24 years old group (4.55) or average knowledge. The average is also upheld
by the public health nurses while the “others” category of employment is low (3.95). Moreover, the
respondents with four or more number of years as registered nurses yielded higher mean score than the
group with less than four years of experience (4.36). Both groups maintain average first aid knowledge

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where the mean scores of nurses with and without in-service training are 4.19 and 4.33.

2b. Basic life support. Mean score on basic life support for male is 6.00 while the female
nurses remained at 2.57 nurses. According to age, the mean score of 5.86 for the 25 years and 5.18 for
other group were obtained. Marginal difference of 0.01 in favor of the public health nurses (5.86) as
against the “others” group is noted as regard of employment profile. Nurses with 3 years and below
experience as professional nurses yielded a mean score of 5.75 while the group with 4 years or more,

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4.52. The nurses with in-service mean score stands at 5.77 while the ones without in-service training,
5.33.
2c. Intravenous therapy. The mean scores in intravenous therapy are 5.80 for the male and 5.87
for the female nurse or average. There is also a similar trend with slight numerical variation between the

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25-year (6.64) and the 24-year (5.55) old groups of nurses. Public health nurses mean score of 6.10
while the other group remains at 5.62. Notably, those with 4 years of experience as professional nurses
have higher mean score (7.00) than the “others” group (5.72). Contrary to the common expectation, the

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nurses without in-service training mean score of 6.00 is numerical higher the ones with in-service (5.81)

2d. Triage. The mean scores in triage of male and female nurses are 4.40 and 4.37. Likewise:
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4.41 and 4.27 among the 24-year and 25-year old groups; 4.47 and 4.23 representing the public health
nurse and “others” group. Moreover, 4.50 and 4.36 with 4 years or more and 3 years and below as
professional nurses; and 4.48 and 4.00 for nurses with and without in-service training.

3a. As far as responding to first aid emergency, the nurses indicated high confidence as
they can “easily manage nosebleeds” (2.72), “identify the signs an symptoms of asthma” (2.70)
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or have the “know how to manage patient who has mild hypothermia” (2.52).

3b. Not a single situation upheld high but two situations received low level of
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confidence as regard basic life support incidence. These are in “identify-ing what is most likely
revealed in a client who has cardiac arrest” (1.97) and “managing pregnant clients who
experience airway obstruction” (1.97).

3c. Low confidence in “managing pregnant clients who experience complications of

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intravenous therapy (1.95) is noted.

3d. Low confidence is dominantly reported singly even as a whole in responding to

triage emergency incidences.
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4. The t-test results describing the level of knowledge and confidence are 27.820 in first aid,
22.281 on basic life support, 20.046 for intravenous therapy and 29.683 in triage, (ρ = 0).

5. The proposed intervention would provide opportunities to learn and develop confidence in
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responding to a wide range health emergency scenario.

This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=2658565
 Significant Difference. The t-test results describing the level of knowledge and confidence are 27.820

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in first aid, 22.281 on basic life support, 20.046 for intravenous therapy and 29.683 in triage, (ρ = 0). The
proposed intervention would provide opportunities to learn and develop confidence in responding to a
wide range health emergency scenario.

5. Conclusions:

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5.1. From the findings of the study, the following conclusions are deduced to serve as basis for
the recommendations:

5.1.1 There is predominant of female, young, volunteer, less than five years of professional
experience with good participation in first aid and basic life support emergency among the nurses enrolled

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in the Bicol University Graduate School Gubat Campus.

5.1.2 The level of knowledge of the graduate nursing students remained average in first aid, basic
life support, intravenous therapy, and triage.

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5.3.1 Graduate nursing students of the Bicol University in Gubat displayed moderate confidence
in first aid and basic life support. A similar level (moderate) of confidence is also noted except for
“others” employment (low) in intravenous therapy and triage emergency.

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5.1.4 Knowledge and confidence level of the graduate nursing students differed significantly.

5.1.5 The proposed intervention to enhance the knowledge and confidence in emergency response
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of the graduate nursing students is a direct manifestation of their professional preparation and
competence.

Recommendations

In the light of the significant findings and conclusions of the study, the following
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recommendations are presented for consideration of the academic and health institutions:

1. The nursing students of the Bicol University Graduate School Gubat Campus be encourage to
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pursue their professional development in the field of emergency management being young
with more years to go in the service of health care.

2. There is the need to review and put more emphasis on the topics first aid, basic life support,
intravenous therapy, and triage the pre-service/nursing curriculum.
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3. Academic and health service institutions must aggressively provide the nursing graduate
students with teaching-learning opportunities in the areas of health emergency.

4. The theory-practice approach should be employed as a management strategy to ascertain the

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link between knowledge and confidence of the graduate nursing students responding the
health emergency scenario/situations at all times.

5. The proposed intervention should be piloted by health-based institutions for a period of three
years.
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6. A replication study should be conducted in the other colleges/campus of Bicol University and
institutions offering graduate programs in the field of nursing.

This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=2658565
 ed
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This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=2658565
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This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=2658565