1.1 Introduction
Burns are injuries to the skin or other body tissues caused by heat, chemicals, electricity, radiation, friction, or contact with hot substances. According to the World Health Organization, burns represent a major public health problem worldwide and are among the leading causes of morbidity and mortality, particularly in developing countries where access to specialized burn care is limited. Burn injuries vary in severity from minor superficial burns to extensive tissue destruction that may result in permanent disability or death if not properly managed (World Health Organization, 2023). The management of burns involves a series of coordinated medical and nursing interventions aimed at preserving life, preventing complications, promoting wound healing, relieving pain, and restoring physical and psychological well-being. Burn care is usually categorized into emergency care, acute care, rehabilitative care, and long-term follow-up. Nurses are actively involved in all these stages through continuous patient monitoring, wound dressing, fluid replacement therapy, infection prevention, nutritional support, pain management, and emotional counseling (Smeltzer et al., 2018).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are significance of the study, scope of work, research hypothesis and questions, limitation of the study and definition of terms.
1.2 Background of Study
Historically, burn care has evolved from traditional methods of treatment to more scientific and specialized approaches involving modern wound management techniques and critical care practices. In earlier times, burn injuries were associated with high mortality rates because of poor infection control and inadequate medical knowledge. However, advances in medical science and nursing practice have improved the prognosis of burn patients considerably. Atiyeh, Gunn, and Hayek (2009) reported that developments in fluid resuscitation, infection prevention, nutritional therapy, and wound care have transformed burn treatment and increased survival rates globally.
In Nigeria and many other African countries, burn injuries are frequently linked to domestic accidents, kerosene explosions, electrical faults, industrial accidents, and road traffic crashes. The use of open flames for cooking and heating, combined with unstable electricity supply, increases the risk of burn incidents in homes and workplaces. Ahuja and Bhattacharya (2004) asserted that burns in developing countries are often associated with inadequate preventive measures and poor healthcare infrastructure, which contribute to high morbidity and mortality rates. In many hospitals, shortages of equipment, dressing materials, and trained personnel create additional challenges in the effective management of burn patients.
Globally, the burden of burn injuries continues to increase due to domestic accidents, industrial hazards, road traffic accidents, and unsafe handling of flammable substances. In many developing countries, including Nigeria, burns are common among children and adults because of overcrowding, poor safety practices, unstable electricity supply, and the widespread use of kerosene stoves and open flames for cooking and heating (Ahuja & Bhattacharya, 2004). The consequences of burns often extend beyond physical injuries to include emotional trauma, social isolation, loss of productivity, and financial hardship for affected individuals and their families.
Burn injuries have remained a major public health concern across the world because of their devastating physical, emotional, social, and economic consequences. Burns affect individuals of all ages and are commonly caused by fire outbreaks, hot liquids, chemicals, electricity, and radiation. According to the World Health Organization, burns account for a significant number of injuries and deaths annually, particularly in low and middle income countries where healthcare facilities and preventive measures are often inadequate. The management of burns requires a multidisciplinary approach involving physicians, nurses, physiotherapists, nutritionists, and psychologists in order to ensure comprehensive patient care and recovery.
Nurses occupy a strategic position in the management of burns because they provide continuous care to patients from the point of admission until discharge and rehabilitation. Their responsibilities include assessing the severity of burns, monitoring vital signs, administering medications, performing wound dressing, preventing infection, managing pain, and offering psychological support to patients and their families. These nursing interventions are essential in promoting healing and reducing complications associated with burn injuries. Lewis et al. (2020) stated that effective nursing care in burn management contributes significantly to improved survival rates and enhances the overall quality of patient recovery.
The role of nurses in burn management becomes more important because burn patients require intensive and continuous monitoring throughout the treatment process. Nurses are usually the first healthcare professionals to interact with burn victims during emergency situations. They assist in airway management, fluid replacement therapy, wound assessment, and the stabilization of patients during the critical phase of care. Smeltzer et al. (2018) affirmed that nurses play an important role in detecting early signs of complications such as shock, dehydration, and infection, thereby ensuring timely medical intervention and improved patient outcomes.
This study is set against the backdrop of the increasing incidence of burn injuries and the critical role nurses play in ensuring effective management, recovery, and rehabilitation of burn patients.
1.3 Statement of Problems
Investigation revealed that burn care outcomes are influenced by the availability of skilled healthcare personnel and the quality of nursing interventions provided during the acute and rehabilitative phases of treatment. Nurses play a central role in the management of burns through wound assessment, pain control, infection prevention, fluid management, psychological support, and patient education. However, challenges in burn care delivery continue to persist due to limited specialized training, inadequate staffing, and insufficient resources in many healthcare facilities (World Health Organization, 2023).
On the other hand, Nurses are often required to manage complex wound dressings, administer analgesics, and monitor fluid balance in critically injured patients, yet their effectiveness is sometimes limited by lack of continuous professional development and access to modern burn care protocols (American Burn Association, 2022).
Furthermore, inadequate patient education on post-discharge care, scar management, and rehabilitation practices continues to affect long-term outcomes for burn survivors. Nurses are expected to bridge this gap, yet limited time, workload pressure, and lack of structured educational tools often hinder effective patient counseling. It is against this backdrop that this study seeks to examine the role of nurses in the management of burns.
1.4 Aim and Objectives of Study
The aim of this research is to assess the role of nurses in the management of burns in healthcare facilities in Nigeria. In achieving this aim, the following specific objectives were laid out as follows:
- To examine the role of nurses in the assessment and emergency management of burn patients.
- To determine the contribution of nurses to wound care and infection prevention in burn management.
- To evaluate the role of nurses in pain management among burn patients.
- To assess the involvement of nurses in psychological and emotional support of burn patients.
- To identify the challenges faced by nurses in the management of burn patients.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What is the role of nurses in the assessment and emergency management of burn patients?
- How do nurses contribute to wound care and infection prevention in burn management?
- What role do nurses play in pain management among burn patients?
- How do nurses provide psychological and emotional support to burn patients?
- What challenges do nurses face in the management of burn patients?
1.6 Research Hypotheses
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis 1
- H0: Nurses do not play a significant role in the assessment and emergency management of burn patients.
- H1: Nurses play a significant role in the assessment and emergency management of burn patients.
Hypothesis 2
- H0: Nurses do not significantly contribute to wound care and infection prevention in burn management.
- H1: Nurses significantly contribute to wound care and infection prevention in burn management.
Hypothesis 3
- H0: Nurses do not significantly influence pain management in burn patients.
- H1: Nurses significantly influence pain management in burn patients.
Hypothesis 4
- H0: Nurses do not play a significant role in psychological support for burn patients.
- H1: Nurses play a significant role in psychological support for burn patients.
Hypothesis 5
- H0: There is no significant relationship between nursing challenges and quality of burn care delivery.
- H1: There is a significant relationship between nursing challenges and quality of burn care delivery.
1.7 Significance of Study
It is believed that at the completion of the study, the findings will provide healthcare institutions with evidence on how nurses contribute to burn care outcomes, thereby improving clinical decision-making and patient management strategies. Also, the findings will assist nursing educators in strengthening training programs focused on burn care competencies and emergency response skills.
Furthermore, the findings will support hospital administrators in improving staffing levels and resource allocation in burn units. In addition, the research will enhance patient care outcomes by improving nursing practices in burn management.
Lastly, the findings will assist nursing educators in strengthening training programs focused on burn care competencies and emergency response skills.
1.8 Scope of Study
The scope of this study covers only nurses involved in burn care at Federal Medical Centre, Onitsha, and does not include other healthcare professionals or facilities outside this institution.
1.9 Limitations of the study
The study was limited by restricted access to some hospital records and respondents' reluctance to provide complete information in certain cases. It was also constrained by inadequate funding, which limited the scope of data collection, and time constraints, which reduced the depth of data gathering and analysis.
1.10 Definition of Terms
Burn:
A burn is a type of injury to the skin or other tissues caused by heat, chemicals, electricity, radiation, or friction, leading to tissue damage of varying severity. According to the World Health Organization, burns are a major global health problem associated with high morbidity and mortality (WHO, 2023).
Nurse:
A nurse is a trained healthcare professional responsible for providing patient care, health education, and support services in clinical settings. According to the International Council of Nurses, nursing involves autonomous and collaborative care of individuals of all ages to promote health and recovery (ICN, 2021).
Burn Management:
Burn management refers to the medical and nursing interventions aimed at treating burn injuries, preventing complications, and promoting healing and rehabilitation (Smeltzer et al., 2018).
Wound Care:
Wound care is the process of cleaning, dressing, and monitoring injuries to promote healing and prevent infection, especially critical in burn treatment (Lewis et al., 2020).
Infection Control:
Infection control refers to the policies and practices used in healthcare settings to prevent the spread of infections among patients and healthcare workers, particularly important in burn units due to open wounds (Church et al., 2006).
Rehabilitation:
Rehabilitation is the process of helping burn patients regain physical function, independence, and social reintegration after injury (Potter et al., 2021).
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