PERFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
MR.GIBIN G THOMAS
MSC (N) 1ST YEAR
PAEDIATRIC NURSING
ORIENTAL COLEGE OF NURSING BANGALORE
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCE, BANGALORE, KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1 / NAME OF THE CANDIDATE AND ADDRESS / MR.GIBIN G THOMASISTYear M.Sc.Nursing
Oriental college of Nursing
43/52,2nd main,industrial town,west of chord road,Rajaji nagar,bangalore – 44
2 / NAME OF THE INSTITUTION / Oriental college of nursing
3 / COURSE OF THE STUDY AND SUBJECT / IST Year M.Sc.Nursing
Paediatric nursing
4 / DATE OF ADMISSION OF COURSE / 12-05-2010
5 / TITLE OF THE STUDY / ‘‘A Study To Assess The Effectiveness Of Video Assisted Teaching On Knowledge Regarding Basic Life Support In Paediatric Emergencies Among Third Year Gnm Students In Selected Nursing Schools Bangalore’’
6 / BRIEF RESUME OF THE INTENDED WORK
6.0 Introduction
6.1 Need for the study
6.1.1 Statement of the problem
6.2 Review of Literature
6.3 Objectives of the study
6.3.1 Operational definitions
6.3.2 Assumption
6.3.3 Sampling criteria
(Inclusion and Exclusion criteria) / Enclosed
Enclosed
Enclosed
Enclosed
Enclosed
Enclosed
Enclosed
Enclosed
7 / MATERIALS AND METHODS
7.1 Source of data :-. Information provided by Students regarding Planned Parenthood
7.2 Method of data collection : The data will be collected from clients by using Self Knowledge Questionnaire for knowledge assessment
7.3 Does the study require and investigation or interventions to be conducted on the patients or other human being or animals - NO
7.4 Has ethical clearance been obtained from your institutions?
YES,ethical committee's report is here with enclosed.
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCE, BANGALORE, KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1 / NAME OF THE CANIDATE AND ADDRESS / MR.GIBIN G THOMASIST Year M.Sc.Nursing
Oriental college of Nursing
43/52,2nd main,industrial town,west of chord road,Rajaji nagar,bangalore – 44
2 / NAME OF THE INSTITUTION / Oriental College of Nursing
Banaglore – 560 079.
3 / COURSE OF THE STUDY AND SUBJECT / I st year M.Sc. Nursing Paediatric nursing
4 / DATE OF ADMISSION / 12-05-2010
5 / TITLE OF THE STUDY / ‘‘A Study To Assess The Effectiveness Of Video Assisted Teaching On Knowledge Regarding Basic Life Support In Paediatric Emergencies Among Third Year Gnm Students In Selected Nursing Schools Bangalore.’’
6. BRIEF RESUME OF THE INTENDED WORK
6.0 INTRODUCTION
Children are living jewels dropped unsustained from heaven.
Robert Pollok
Children are the future promise of the world .It is important that to raise a good future community for a good world. Children are high risk group to get accident and injuries.A proper first aid management in the right time will save the valuable life of our future generation. Every year a huge number of deathsare happening around the globe. Good knowledge of basic life support (BLS) and emergency management skills help to save the causalities.
Basic life support refers to maintain the airway and support respiration and circulation without the use of equipment. Each year, a number of babies and children will suffer with an accident or illness severe enough to stop their breathing and leads to respiratory arrest. In a small number of these cases, it will even stop their heart beating and leads to cardiac arrest. The best chance of ensuring their survival is to give them emergency treatment known as cardiopulmonary resuscitation (CPR). CPR can consist of many different things, but the initial, vital part is Basic Life Support (BLS).
BLS is a sequence of events that need to be undertaken to initially try to revive a collapsed person. It can be performed by anyone who has been trained to do so, and in almost any setting. If started as soon as the person requires it, BLS provides the best possible chance of a good outcome for the collapsed infant or child. The key points in BLS are. Airway,Breathing,Circulation or ABC for short
BLS for babies and children differ in some important ways from that for adults and therefore require specific training for it to be effectively delivered. The most important difference is that BLS for babies and children is mainly required for a respiratory or breathing emergency. This means in the majority of babies and children, starting adequate BLS as soon as necessary may require only the breathing part to be given, as their heart will not be particularly affected. However, as damage to the brain and other vital organs (such as the kidneys and heart muscle) starts to occur after just a few minutes of being short of oxygen, it is essential that when needed BLS should be started immediately. Therefore, any person who suspects a baby or child is not breathing adequately, must be able to assess the need for, and start BLS without delay.1
In children sudden causescardiac arrest are include trauma, poisoning, and various respiratory disorders (e.g., airway obstruction, smoke inhalation, drowning, infection, sudden infant death syndrome).Cardiac arrest is the terminal event in any fatal disorder. It also may occur suddenly and as such occurs outside the hospital in about 400,000 /yr in the US, with a 90% mortality in children2
Choking in children is also a major emergency .It is alters a child's normal breathing by obstructing or compressing the trachea .Putting things in their mouths is one of the ways that babies and small children explore the world. Anything that fits in their mouths can be a danger. Choking is usually caused by food, toys, and other small objects that can easily lodge in a child's small airway. A study was done on nonfatal choking episodes treated in emergency departments in 2001 by the CDC (Centres for Disease Control & Prevention). The CDC found 60% of the choking episodes were associated with food items; 31% with non-food objects including coins; and in 9% the substance was unknown or unrecorded.3
As a part of the health care team the nurses have to complete the necessary steps in the basic life support in paediatric emergencies .It is tools to assess and act promptly in life-threatening emergencies the need of basic life support for nursing students help them to assess life threatening emergencies in paediatrics like airway obstruction,drowning ,cardiac arrest etc.The appropriate management in paediatric emergencies helps to reduce the incidence of casualities4
6.1 NEED FOR THE STUDY
Cardiac arrest is one among the world’s largest killer claiming 17.5 million lives every year. Out of this 2 million arechildren dying due to airway obstruction,chocking,cardiac problems,and electric shock. About every 29 seconds a new case is reporting in the globe. Around 20,000 new heart patients develop everyday in India, six crore Indians suffer from heart disease and 30 percent more are at high risk. By 2020, India will have the largest coronary heart disease (CAD) burden in the world and will account for one third of all deaths; many of them will be adolescents. About 75 percent to 80 percent of all out-of-hospital paediatrics emergencies happen at home. Hence, being trained to perform basic life support (BLS) can make the difference between life and death for a victim5
Every food poses a choking risk in young kids. Because food choking causes nearly one childhood death in the United States every five days. Infants and young children under 3 years of age are particularly prone to food-choking because they don't have a full set of teeth to chew and grind the food before swallowing. Children between 3 and 4 years of age have molars but are still learning how to chew. Children's high level of activity also puts them at risk for inhaling food while playing or running around. A study was done inDallas, United states of America 2001 analysis by the Centres for Disease Control showed that 60 percent of the 17,537 non-fatal choking incidents seen in U.Sand 77 percent of these choking episodes occurred in children under the age of 3 years Most airway foreign body aspirations occur in children younger than 15 years; children aged 1-3 years are the most susceptible. Vegetable matter tends to be the most common airway foreign body, pop corn and peanut is aspirated in more of the cases peanuts and hotdog are the most common food items aspirated by young children. The incidence of metallic foreign body aspirations, particularly of safety pins and paper clips6
Based on a study conducted by American Heart Association that many children receive no resuscitation at all because rescuers fear doing harm as they have not been taught paediatric resuscitation. Bystander resuscitation significantly improves outcome in children and there is evidence from experimental models that doing either chest compression or expired air ventilation alone may result in a better outcome than doing nothing. It follows that outcomes could be improved if bystanders, who would otherwise do nothing, were encouraged to begin resuscitation, even if they do not follow an algorithm targeted specifically at children. Therefore, a separate paediatric algorithm is justified for healthcare professionals who have a duty to respond to paediatric emergencies and who are in a position to receive enhanced training about paediatric basic life support 7
A study was conducted in out-of-hospital cardiac patients under the age of 16 who received emergency care in suburban King County, Washington. The etiology, cardiac rhythm, and outcome were identified for each case. During the study period of 6½-years 40% of paediatric victims less than 16. Sudden infant death was the most common etiology about (32%), and drowning was the second most common. Only 6% of patients treated with basic life support care were discharged. In contrast to resuscitation from cardiac arrest in adults, the successful resuscitation in children is very poor. This is due to different etiologies and the higher proportion of a systole seen in paediatric cardiac arrest as compared with adults. The lack of knowledge about the first aid management in paediatric emergency is also a contributing factor .The result shows that all the members of the health care team should have a proper knowledge about the skills and practice of basic lif support measures to act well in emergency8
The upcoming health care providers like nursing students needs to grow into healthy behaviour should acquire knowledge and skills to perform the basic life support in paediatric emergencies. Hence the investigator felt that video assisted teaching programme is the best method of imparting knowledge on Basic Life Support. For the nursing students and they can perform the skills and knowledge regarding the immediate management in paediatric emergencies.
6.1.1 STATMENT OF THE PROBLEM
“A Study To Assess The Effectiveness Of Video Assisted Teaching On Knowledge Regarding Basic Life Support In Paediatric Emergencies Among Third Year Gnm Students In Selected Nursing Schools Bangalore”
6.2REVIEW OF LITERATURE
A cross-sectional study was conducted by assessing the responses to 20 selected basic questions regarding Basic Life Support, among students of nursing colleges in Tamilnadu, India to study the awareness of Basic Life Support (BLS), innursing colleges After excluding the incomplete response forms the data was analysed on 1,054 responders. The results were analysed using an answer key prepared with the use of the Advanced Cardiac Life Support manual. Out of 1,054 responders no one among them had complete knowledge on BLS. Only 2 out of (0.19%) had secured 80 - 89% marks, 10 out of (0.95%) had secured 70 - 79% marks, 40 of (4.08%) had secured 60 - 69% marks and 105 (9.96%) had secured 50 - 59% marks. A majority of them that is 894 (84.82%) had secured less than 50% marks. Awareness of BLS among students in nursing colleges is very poor.9
A study was conducted to investigate the extent Indian nursing students acquire and retain CPR cognitive knowledge and psychomotor skills following CPR training. A quasi-experimental time series design was used. A pre-test, CPR training programme, post-test, and re-test were conducted. CPR knowledge was assessed by a multiple-choice assessment and psychomotor skills were assessed by observing CPR performance on a Resusci-Anne skill-meter manikin. The findings showed an acquisition in nurses’ CPR knowledge and psychomotor performance following a 4h CPR training programme. Despite this, at no point in this study, did any nurse pass the CPR skills assessment. Deterioration in both CPR knowledge and skills was found 10 weeks following CPR training. However, students’ knowledge and skills were improved over their pre-training scores, which clearly indicated a positive retention in CPR cognitive knowledge and psychomotor skills. The study findings present strong evidence to support the critical role of CPR training in ensuring that nursing students progress to competent and confident responders in the event of a cardiac related emergency.10
A cross-sectional study was carried out at six colleges of Karachi, three of which were medical colleges and three non-medical colleges. To assess knowledge, attitude and practices of first aid measures in undergraduate students of Karachi. Knowledge was assessed regarding various emergency situations with the help of a questionnaire. Students from medical colleges who scored at least 50% on the questionnaire are taken as 'exposed' and those who scored less were taken as 'unexposed'. Similarly, those from non-medical colleges who scored at least 50% on the questionnaire were taken as 'exposed' and those who scored less were taken as 'unexposed ‘The overall mean score of the students was very low (40.3%). This lack of knowledge of first aid amongst the university students is indicative of the fact that only a few people have formal first aid management in paediatric emergencies. In conclusion, the students across the six colleges had inadequate first aid knowledge, and many recognized the need for introduction of formal first aid training programme at school/ college level11
A descriptive study was conducted among staff nurses in public hospitals Bahrain.To investigate nurses' knowledge regarding CPR and to identify barriers to appropriate CPR evaluation. One hundred questionnaires were distributed to nurses. The results indicated that cognitive knowledge was not adequately retained. 58% of respondents perceived recalling CPR information as easy or extremely easy. Only 7% of respondents passed the knowledge test. In general, those who had less education and experience did not recall essential CPR knowledge. This study identified a significant problem with the knowledge surrounding CPR. More concerning was the lack of professional responsibility in dealing with this inadequacy12
A comparative study was conducted among nurses in a tertiary paediatric hospital in china the vast majority of those audited were not familiar with the difference of basic life support in adult and paediatric patients. The research tool was a written test with open questions assessing the knowledge of basic life support (BLS) and a questionnaire concerning the knowledge of latest guidelines and participation in courses. The test questions checked the knowledge of issues regarding adults, children and infants, in particular, the principles of chest compressions (method, place and frequency), artificial lung ventilation (number of rescue breath) in victims with the circulation preserved, manoeuvres to provide patent airways, compression: ventilation ratio in the presence of one or two rescuers and the respiratory volumes recommended in the guidelines. The result shows that the medical staff of a paediatric hospital was not adequately trained in cardiopulmonary resuscitation and their knowledge about current recommendations was minimal. Knowledge of cardio-pulmonary resuscitation among the medical personnel of a paediatric hospital was selective and their knowledge of guidelines inadequate13
A study was conducted in North America to determine the incidence of paediatric cardiac arrest .The result shows that the overall survival rate was 6.4% lower in infants compared with children and adolescent that is 8.9% from cardiac arrest. A greater survival rate is seen in paediatric patient who got the assistance of health care team witnessed cardiac arrest and un witnessed cardiac arrest. The proper assistance of the nurses brings the life of the patients. Apart from that it is mandatory to get adequate knowledge about basic life support in paediatric emergencies in nurse those who are working in NICU PAEDIATRIC CCU and so on14
A descriptive study was conducted in Kolkata toassess the effectiveness of basic life support training (basic life support) among nursing students. Students from 10 schools of nursing were randomly assigned to two types of CPR training. The result shows that the students undergone basic life support in paediatric emergencies have high score compared with those who are not participated in the study. Students who completed the BLS program and practiced CPR were significantly more accurate in their ventilations, compressions, and single-rescuer CPR than students who are not participated in the study.15
A study was conducted in university of Madrid to assess the effectiveness of paediatric basic life support in 5th and 6th year medical students. For the past eight years, the Faculty of Medicine of the Complutense University in Madrid has been offering formal training in paediatric cardiopulmonary resuscitation to the students. The course was evaluated by the students by means of an anonymous written questionnaire. The result shows that majority of these students acquired theoretical knowledge (97.2%) and adequate practical skills (93%) in paediatric basic cardiopulmonary resuscitation. They were generally satisfied with the lectures, practical training and ability of the teaching staff. The paediatric basic life support course is a useful method for theoretical and practical training. Paediatric cardiopulmonary resuscitation should be included in the medical training curriculum16.