PROFORMA FOR REGISTRATION OF SUBJECT FOR

DISSERTATION

Mr.VEERESH

I YEAR M. Sc NURSING

MEDICAL SURGICAL NURSING

YEAR 2011-2012

TULZA BHAVANI COLLEGE OF NURSING

NO, 899/3, NEAR HAJRAT JUNEEDI DARGA, GYANG BAWADI,

BIJAPUR-586101

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECTS FOR

DISSERTATION

1. / NAME OF THE CANDIDATE AND ADDRESS / MR.VEERESH
I YEAR M.Sc. (NURSING),
TULZA BHAVANI COLLEGE OF NURSING
NEAR HAJRAT JUNEEDI DARGA ,
GYANG BAWADI, BIJAPUR -586101.
2. / NAME OF THE INSTITUTE / Tulza Bhavani College of Nursing, No, 899/3, Near Hajrat Juneedi Darga, Gyang Bawadi, Bijapur-586101.
3. / COURSE OF THE STUDY AND SUBJECT / I Year M.Sc. (Nursing),
Medical surgical Nursing
4. / DATE OF ADMISSION TO THE COURSE / 14thMay 2011
5. / TITLE OF THE STUDY / “A descriptive study to assess the knowledge, attitude and practice regarding blood donation among degree students in selected degree colleges of Bijapur, with a view to develop an informational booklet .”

6. BRIEF RESUME OF THE INTENDED WORK.

6.1INTRODUCTION

If you can’t feed a hundred people, then feed just one.

-Mother Teresa

Life is the most precious gift mankind has. Human life starts with a single cell and the future from that cell will be decided by the genetic material in it, which in turn reflects the health of ancestor. So the most important aspect to take ultimate use of life is to maintain adequate health. Health in turn is most delicate in sense that it has to be maintained at optimum balance level. Neither high nor low is acceptable. Healthis the level of functional and/or metabolic efficiency of a living being. Inhumans, it is the general condition of aperson's mind, body and spirit, usually meaning to be free fromillness,injuryorpain(as in “Good health” or “Healthy”).1

TheWorld Health Organization(WHO) defined health in its broader sense in 1946 as "A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”.2

Maintaining proper health is one of the crucial challenges man has to face since birth. The maintenance and promotion of health is achieved through different combination of physical,mental and social well-being, together sometimes referred to as the “health triangle”. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. One of the most important factors that play a vital role in maintenance of health is blood. It maintains optimum homeostasis so that there should not be any decrease or increase in body constituents and their physiological actions. So it gets the first preference to be maintained.One can almost say that blood is that magic portion which gives life to another person. Though tremendous discoveries and inventions have been made in science it has not yet been possible to make this magic potion blood. Human blood has no substitute. Requirement of blood is increasing and voluntary blood donation is the only measure to overcome the requirement.3

Bloodis a specializedbodily fluidinanimalsthatdelivers necessary substances such as nutrients andoxygento thecellsand transports metabolic wasteproducts away from those same cells. Invertebrates, it is composed ofblood cellssuspended in aliquidcalledblood plasma. Plasma, which constitutes 55% of blood fluid, is mostly water (92% by volume),and contains dissipated proteins,glucose, mineral ions,hormones,carbon dioxide(plasma being the main medium for excretory product transportation),plateletsand blood cells themselves.Albuminis the main protein in plasma, and it functions to regulate the colloidalosmotic pressureof blood. The blood cells are mainlyred blood cells(also called RBCs or erythrocytes) andwhite blood cells, including leukocytes andplatelets. The most abundant cells in vertebrate blood are red blood cells. These containhemoglobin, aniron-containing protein, which facilitates transportation ofoxygenby reversibly binding to thisrespiratorygas and greatly increasing its solubility in blood. In contrast, carbon dioxide is almost entirely transported extracellular dissolved in plasma asbicarbonateion.

Blood performs many important functions within the body including:

  • Supply ofoxygento tissues (bound tohemoglobin, which is carried in red cells)
  • Supply of nutrients such asglucose,amino acids, andfatty acids(dissolved in the blood or bound toplasma proteins(e.g.,blood lipids))
  • Removal of waste such ascarbon dioxide,urea andlactic acid
  • Immunological functions, including circulation ofwhite blood cells, and detection of foreign material byantibodies
  • Coagulation, which is one part of the body's self-repair mechanism (blood clotting after an open wound in order to stop bleeding)
  • Messenger functions, including the transport ofhormonesand the signaling oftissuedamage
  • Regulation of bodypH
  • Regulation of corebody temperature and hydraulicfunctions.4

Ablood donationoccurs when a personvoluntarilyhasblooddrawn and used fortransfusionsor made into medications by a process calledfractionation.In the developed world, most blood donors are unpaid volunteers who give blood for a community supply. In poorer countries, established supplies are limited and donors usually give blood when family or friends need a transfusion. Many donors donate as an act of charity, but some are paid and in some cases there are incentives other than money such aspaid time offfrom work. A donor can also have blood drawn for their own future use. Donating is relatively safe, but some donors have bruising where the needle is inserted or may feel faint.The amount of blood drawn and the methods vary. The collection can be done manually or with automated equipment that only takes specific portions of the blood. Most of the components of blood used for transfusions have a shortshelf life, and maintaining a constant supply is a persistent problem.

Blood donations are divided into groups based on who will receive the collected blood.Anallergenic(also calledhomologous) donation is when a donor gives blood for storage at ablood bankfortransfusionto an unknown recipient. Adirecteddonation is when a person, often a family member, donates blood fortransfusionto a specific individual.Directed donations are relatively rare when an established supply exists.Areplacement donordonation is a hybrid of the two and is common in developing countries such asGhana.In this case, a friend or family member of the recipient donates blood to replace the stored blood used in a transfusion, ensuring a consistent supply. When a person has blood stored that will be transfused back to the donor at a later date, usually after surgery, that is called anautologousdonation.Blood that is used to make medications can be made from allogeneic donations or from donations exclusively used for manufacturing. The actual process varies according to the laws of the country and recommendations to donors vary according to the collecting organization.The World Health Organizationgives recommendations for blood donation policies,but in developing countries many of these are not followed. For example, the recommended testing requires laboratory facilities, trained staff, and specialized reagents, all of which may not be available or too expensive in developing countries.5

6.2 NEED FOR THE STUDY

“Not everyone gets the opportunity to save life, if you get feel privileged and help”.

Need for the study means scientific method which refers to a body of technique for investigation phenomena, acquiring new knowledge or collecting and integrating previous knowledge to be termed scientific method of enquiry must be based on gathering empirical and measurable evidence subject to specific principles of reasoning.

Blood donation is a noble missionto help people in need of something that could make such a great difference as life and death. Youngsters would have helped a person in need and will get a great feeling of satisfaction and well being. It wouldcontribute to a boost of your self-esteemwhen one thinks he or she has something valuable to give others; a feeling of possession.6

Donation of blood can help heal tens of thousands of people afflicted with terrible diseases and with time the need for most of these donations is growing, not shrinking but the need stays still high. The total requirement in India is 8.5 million units of blood while the total collection is hardly six million units. So in India there is a gap between demand and supply. It's not just private hospitals that are facing the crunch, big government hospitals are looking for outside help.7

Internationally, worldwide June 14 is celebrated as blood donors’ day. The theme for World Blood Donor Day 2011 was, "More blood, More life."This theme reinforced the urgent need for more people all over the world to become life-savers by volunteering to donate blood regularly. The world scenario of blood requirement. According to the statistics of BBC 2010, one person dies every six minutes and 10 are injured in the same time frame. Non availability of blood is the major cause to death. The availability blood is still short becauseof Unawareness among people and Non availability of blood in the blood bank.65% of all blood donations are made in developed countries, home to just 25% of the world's population. In 73 countries, donation rates are still less than 1% of the population (the minimum needed to meet basic needs in a country). Of these, 71 are either developing or transitional countries.42 countries collected less than 25% of their blood supplies from voluntary unpaid blood donors, which is the safest source.31 countries still reported collecting paid donations in 2007, more than 1 million donations in total.41 countries were not able to screen all blood donations for one or more of the following transfusion-transmissible infections (TTIs)–HIV, hepatitis B, hepatitis C and syphilis. Global data suggests that blood transfusion saves lives and improves health, but millions of patients needing transfusion do not have timely access to safe blood. The WHO programme on blood transfusion Safety monitors key quantitative blood safety indicators to assess theglobal situation on blood safety, monitor trends and progress and identify priority countries for support. This fact sheet is based on data collected for 2007.2

In 2007, 162 countries provided data to WHO on 85.4 millionblood donations. The data comes from countries that account fora total of 5.9 billion people, representing 92% of the global population. The report covers 7,997 blood centers which collected on average 9 000 donations per centre (range from 20–499 212). In developed countries, the average annual collection per blood centre was 13 600 (range 49–289 075), in transitional countries 6000 (range 20–499 212) and in developing countries 2,800 (range 114–23 251).While the need for blood is universal; there is a major imbalance between developing and developed countries in the level of access to safe blood. It is estimated that donation by 1% of the population (10 per 1000 population) is generally the minimum needed to meet a nation's most basic requirements for blood; the requirements are higher in countries with more advanced health-care systems. Of the 85.4.million donations in 2007, about 65 % were collected in developed countries, home to just about 25% of the represented population. Blood donations per 1000 population, which also reflect the general availability of blood in a country, vary widely and the lowest levels of availability are found in developing and transitional countries. The average donation rate in developed countries is 38.1 donations/1000 population (range 4.92–68.01); in transitional countries, this rate is 7.5 (range 1.07–35.18) and in developing countries an average 2.3 (range 0.40–7.46) donations per 1000 population were collected.73 countries reported collecting fewer than 10 donations per 1000 population. Among them, 71 are either developing or transitional countries. Throughout the world there is still high need of blood donation. The only measure to provoke is to develope awareness regarding that. According to a national survey by the American Red Cross, about one in five (19 percent) respondents plan on giving blood this holiday season. These donations are desperately needed as the Red Cross heads into the busy month of December.8

During the holiday season, blood donations often decrease as weather woes increase and family schedules turn tumultuous. Every two seconds, someone in this country needs blood. On average, 44,000 blood donations are needed each day to help trauma victims, surgical patients, burn victims, patients with blood disorders and many others.9

The blood has always been the basic requirement of human life. Throught the world many programmes are in action to develop the awareness regarding blood donation but one of the important aspect is how well people know about even to maintain their health to a level optimum for blood donation. A study was conducted on Community blood donors' knowledge of anemia and design of a literacy-appropriate educational intervention. The purpose of project was to improve the health of blood donors by educating and motivating them to seek medical attention for anemia. The National Anemia Action Council, Blood Centre of Wisconsin, and the Medical College of Wisconsin formed a partnership to engage volunteer blood donors and develop an educational intervention to motivate donors with anemia to seek appropriate medical care. The conclusion of project was, volunteer donors are extremely dedicated and interested in increasing their understanding of anemia and the ability to continue donation. Community members' feedback on educational material is a valuable resource to improve the literacy level of information.10

National data fromIndiashows that there are 1,585 licensed blood banks with more than half of the blood banks collecting less than 1,000 units of blood annually. These blood banks, of which 45% are in the public sector and about 23% in the private sector, have different management structures and no effective coordination. Nationally, 40% of total blood collection is from voluntary non-remunerated blood donors and the rest from family/replacement donors. It is estimated that only 20% of the total blood collected is separated into blood components. Data shows that 74% of transfusions in adults are inappropriate. Interventions for improving clinical use of blood have been evaluated; from which it is clear that single interventions do not work and that a package of interventions with active clinician involvement is necessary. There is a lack of awareness of existing national policies and guidelines for the clinical use of blood. Of the 13 hospitals represented, none of the transfusion committees are active and none have provisions for preoperative or perioperative autologous transfusions. They do however; have access to plasma substitutes and nine blood banks prepare different blood components. Graduate training programme exist in all the hospitals from where the participants came to attend this workshop.11

While shortage of blood is not a new phenomenon in India, but reasons like the ongoing summer or festival seasons can make matter worse due to shortage of volunteers.12

Study of blood-transfusion services in Maharashtra and Gujarat States, India conclude that Blood-transfusion services are vital to maternal health because hemorrhage and anemia are major causes of maternal death in South Asia. Unfortunately, due to continued governmental negligence, blood-transfusion services in India are a highly-fragmented mix of competing independent and hospital-based blood-banks, serving the needs of urban populations. This paper aims to understand the existing systems of blood-transfusion services in India focusing on Maharashtra and Gujarat states. A mix of methodologies, including literature review (including government documents), analysis of management information system data, and interviews with key officials was used. Results of analysis showed that there are many managerial challenges in blood-transfusion services, which calls for strengthening the planning and monitoring of these services. Maharashtra provides a good model for improvement. Unless this is done, access to blood in rural areas may remain poor.13

In India, Indian Red Cross society is functioning consistently to enhance the blood provision for needles. The Indian Red Cross is a voluntary humanitarian organization having a network of over 700 branches throught the country, providing relief in times of disaster/emergencies and promotes health & care of the vulunarable people and communities. It is a leading member of the largest independent humanitarian organization in the world, the International Red Cross & Red Crescent Movement.14

Karnataka, a diverse state in the southwest of India, has a population of around 53 million. This is the news paper report in a Kannada daily (KannadaPrabha) on 18th march.Shortage of blood in blood banks: students busy with their exams; reduction in blood donation every year there is blood shortage by 4 lack units in the state -the city alone needs 2500 units everyday for the last 5 years the shortage of blood in blood banks is highlighted. The 90% of the donors who come forward to donatedon’t knowwhere to donate blood. Healthy people itself being hesitant to donate blood are a matter of concern.Special reportBangalore’s the fever of exams rising in the silicon city Bangalore the fear of blood shortage has come up. This shortage may increase in May, June. All over the states there is a fever of exams. Students have their major share in blood donation. Since their cannot be blood donation camps, there is high demand or blood. Every year there is a shortage of 4 lack blood units. Bangalore city alone faces the shortage of 1.5 lack units. Every day in Bangalore there is a requirement of2 to 2500 units of blood. According to Karnataka Aids Control Society Blood bank blood donor’s number is coming down day by day. If blood is donated it leads to weakness. This fear is the main reason for blood shortage. In the past one week itself rural people coming to Rastrothana blood bank itself is noticeable. Comparing to urban people arranging blood for rural people is difficult.Accidents count is in increasing order while blood is decreasing: Along with fast growing Bangalore accidents count is also increasing every day. 15

As per 2011 Indiacensus, Bijapur has a population of 326,360. Males constitute 51% of the population and females 49%. Bijapur has an average literacy rate of 84%, higher than the national average of 69%; with male literacy of 89% and female literacy of 78%. 12% of the population is under 6 years of age.Kannadais the major language spoken here.Marathi,UrduandHindiare also spoken widely in Bijapur city. There are six blood banks in Bijapur.16