Rajiv Gandhi university of health sciences, Karnataka
SYNOPSIS
FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1 / Name of the Candidate / MS. AMANPREET KAUR2. / Name of the Institution / Diana College of Nursing,
No. 68, Chokkanahalli, Jakkur Post,
Bangalore – 64
3. / Course of Study and Subject / Master of Science in Nursing
Pediatric nursing.
4. /
Date of Admission to Course
/ 10.06.2009.5. /
Title of the Topic / A STUDY TO ASSESS THE EFFECTIVENESS OF SELF-INSTRUCTIONAL MODULE ON FIRST AID AMONG TEACHERS OF SELECTED SCHOOLS, BANGALORE
6. Brief resume of the intended work
Introduction
The future pillars of the nation and future of the nation rests on the hands of the children health today. Healthy children make healthy nation. For children the world is limitless, life is an adventure and inquisitiveness is the driving force. Many people across the world still maintain a strong sense of fatalism that assumes life, and especially a child’s life, is “in the hands of God” or otherwise predetermined. Successful injury prevention empowers families and communities to gain control over their child’s safety 1
Children are the future of every country and all societies strive to ensure their health and safety. India is home to nearly 500 million young people among, whom children less than 15 years are 370 million. Since India's independence, continuous efforts have been made to improve the status of children. It became apparent that children are saved from diseases of yesterday due to massive efforts of Indian govt. but still they become victims of injury on road, at home and in public and recreational places. 2
Children spend most of their time in the schools. A majority of children have much close contact with teachers in the schools than health team members. Therefore the school teachers are the best channel to activate and empower children for dynamic health education and action for health. 3
School age children are active and adventurous. They becoming increasingly independent and learn to take greater responsibility for their day to day care. During this time, children are testing their physical abilities and also their thinking (intellectual) abilities. At this age, children may think they are invincible and that accidents and injuries happen to other people and not to them. They may act impulsively or take risk without thinking of the consequences of their actions. Taking risk is particularly common among this group, especially during the growth period to adolescence. 3
“Whatever can happen to one man can happen to every man”
(Lucius Annaeus Seneca)
In Asia, 900,000 deaths from injury take place every year in children. An estimated 400,000 young children are injured each year at school. First aid can save lives in a number of situations. For example, immediate CPR treatment is thought to double or triple the chances of survival for heart attack casualties according to the first aid charity. 4
First aid is a temporary and immediate care given to the person who is injured or suddenly become ill. First aid can save a victim’s life especially if the victim is bleeding heavily and has stopped breathing. It also prevents medical emergencies that can arise from an injury or illness. 5
An organized world wide effort of giving first aid came only in 1877, though that aid was being practiced from ancient times. The famous German Surgeon, General Esmatch who was first concerned with the idea of first aid led to the formation of St.John Ambulance Association of England. In 1922, Red Cross Society of India was established with more than 400 branches all over the India. 6
6.1. Need for the study
American health academy stated that teachers spend most of their time with children. Teacher’s knowledge of what action taken in times of minor or major injuries is crucial to student’s safety. Injuries can happen at any time and it may require the teachers to act alone. First aid and CPR training is mandatory requirement for teachers in schools. Teachers who are around children can know how to react when a child gets an injury. Proper reaction to such injuries could mean saving a child’s life. 7
WHO estimates, nearly 950,000 children die in the world due to an injury each year. 8
A study found that annul incidence rate of 5.4 injury event/100 children, which appears to be underestimate of actual rates of all the injury events 28.7% resulted in serious injuries were significant by more frequent in elementary as opposed to the secondary schools.9
One of Maryland institute of emergency medical services describes, the time immediately, after an accident as the “Golden hour” when life that hangs in the balance can be saved through administration of proper first aid and emergency care. 10
Canada safety council stated that teachers can benefit at least introductory CPR training. It put them in a position to help in life threatening situations, which require swift effective responses. 7
Injuries sustained in schools account for 20–30% of all accident and emergency attendances in school age children. Two years of routine school incident reports were analyzed. From 135 schools only 1,660 report forms were returned in the two year period. It showed that 1,440 reports referred to injuries to school children. The peak incidence of injuries was in the 10–12 years age group. The male: female ratio was 37:1. Laceration and fractures were the commonest diagnoses reported for both Primary and Secondary Schools. 11
Epidemiological survey of child's burns was conducted among 2161 children. About 40,000 people are burned annually; 12% of these are children less than 14 years of age.1531 (72.82%) burns were due to a hot liquid. 147 (7.07%) burns were Electric burns. Flame was the cause of burning in 267 children (12.71%).Contact burns were observed in 129 children (6.14%). 12
An article by safe kids USA reported that more than 53 million children in the United States spend almost one-fourth of their total waking hours in school or on school property. An estimated 10 to 25 percent of the more than 14 million unintentional injuries sustained by children ages 14 and under each year occur in and around schools. Annually, one in 14 students suffers a medically attended or temporarily disabling injury at school. An estimated 2.2 million children aged 14 and under sustain school-related injuries each year. 80% of elementary school students were seen by a school nurse for an injury-related complaint. 13
Playground injuries are the leading cause of injury among children ages 5 to 14 in the school environment. Nearly 40 percent of playground-related injuries occur during the months of May, June and September. Of all playground equipment-related injuries, nearly 70 percent involve falls to the surface, and 10 percent involve falls onto equipment. Lack of supervision is associated with 40 percent of playground injuries. A recent study found that children play without adult supervision more often on school playgrounds (32 percent of the time) than playgrounds in parks (22 percent) or childcare centres (5 percent). 13
In 2002, 26 children ages 14 and under were killed, and in 2001 an estimated 4,500 were injured, in school bus-related incidents. More than 40 percent of these deaths were child pedestrians. 13
A study reported that the total incidence rate of injuries in the previous year was 21.1%. The incidence rate among boys was 24.2%, while that among girls was 17.4%, which was significant. The incidence rate among junior high school students was 23.1%, while that among senior high school students was 15.5%, which was also significant. 2
According to a study reported in India very third child brought to the casualty department was due to a road traffic injury (40 %), while every fifth injured child was due to a fall. Animal bites (dog bites in particular) and poisoning were responsible for nearly 10% of hospitalizations, each. Burns (9%) and assault (6%) due to interpersonal violence were other leading causes of child injury hospitalization. 2
A study stated that First aid responders were virtually absent, and doctors and nurses were the first to provide any first aid; 3% of fatal cases received care within an hour. The commonest and the first place of first aid was the nearby hospital in 92% of road traffic injury patients, and this was mainly in the public (47%) and private hospital (45%). 2
The annual overall injury rate on nonfatal injuries among middle and high school students was 32.3 per 100 students. Boys had a significantly higher injury rate than the girls (34.8 vs. 30.3 per 100 students), and a significantly higher proportion of injuries in boys was caused by other students (28.1% vs. 19.4%). A higher proportion of injuries in girls (40.7%) occurred at home. 14
The study on Unintentional injuries showed that a total of 1013 first admissions to hospital were identified, giving an overall incidence rate of 152/100000 students/year. Injury rates declined with increasing age, and males had higher rates than females for all ages. Fractures of the upper and lower limbs and intracranial injury represented more than three-quarters of all injury. The two leading causes of injury mainly falls, and incidents involving striking against or being struck by a person or object, represented 89% of all incidents. 15
A study showed that 75 cases of injury were reported giving an overall one-year incidence rate of 22.2 per 1000 person-years-at-risk. The maximum incidence was reported among year three pupils in both genders (33 per 1000 boys and 19.8 per 1000 girls). Fall was the most common cause of injuries. Legs and hands were the main injured body area (56%). Only five pupils were admitted in hospital. 16
A study on incidence of minor injuries and wound care practices of school children showed that many of the injuries (41-46%) occurred during the school time. Fingers/hand or feet were the commonly affected most. Rural students were more tolerant to minor injuries. Lesser number of rural students had taken tetanus toxoid. Wound washing with water as the first action was reported by 20-22% students in both the areas. 17
First aid can save lives and prevent minor injuries becoming major ones, and under health and safety legislation employers have to ensure that there are adequate and appropriate equipment and facilities for providing first aid in the workplace. 18
Hence keeping all these above points in the mind and personal interest made the researcher to educate the school teachers regarding first aid.
6.2. REVIEW OF LITERATURE
Review of literature is the key step in research process. Review of literature refers to an extensive, exhaustive and systematic examination of publications relevant to the research topic. A thorough literature review focuses on prior research that provides a foundation on which knowledge is based. Review is an essential component of the research process. It helps in planning and conducting the study in a systematic and scientific manner.
Review of literature is a critical summary of research on a topic of interest generally prepared to put a research problem in context or to identify gaps and weakness in prior studies so as to justify a new investigation.
Literature review for this study has been collected and presented under the following headings.
1) Literature related to knowledge on first aid among school teachers.
2) Literature related to first aid on various health problems among children.
3) Literature related to education of teachers regarding first aid
1. Literature related knowledge on first aid among teachers.
A study was conducted on Emergencies in the school setting to determine the extent of training and emergency care knowledge of 334 teachers who had no prior knowledge of the test were selected randomly. The study concluded that one third 112 teachers had no specific training in the first aid and 40% of respondents strongly agreed that emergency care training should be required in teacher preparation programs. Eighteen percent of teachers responded to more than 20 injured or ill students annually, and 17% reported that they had encountered at least one life-threatening emergency in a student during their career. The study concluded that most of public school teachers were deficient in both training and knowledge of emergency care. 19
A study was conducted on the knowledge of teachers and high school students on the principles of first aid. The study was based on a sample of 227 secondary school students (34 males and 193 females) and 79 secondary school teachers (28 males and 51 females). The study concluded that the knowledge of secondary school students and teachers appears to be insufficient to perform basic life support. 20
A study was conducted to evaluate first-aid knowledge and attitude of Turkish primary school teachers. 312 teachers took part in the study. Data were obtained by using a questionnaire. It included 30 questions. 65.1% of teachers gave incorrect answers regarding epistaxis, 63.5% for bee stings, and 88.5% for abrasion. The study concluded that most of the teachers do not have correct knowledge and attitudes about first aid. 21
A study was conducted on assessment of knowledge about first aid among teachers of chosen high schools. The survey was carried out among 100 teachers from two high schools. A standardized questionnaire was used. The study findings showed that the level of knowledge about giving the first aid is insufficient in teachers. The half of respondents knows rules of giving first aid, and one third declares that can put these rules into the practice. A large part of respondents demonstrates rather passive attitude towards giving the first aid in case of emergency. There are no major differences in the level of knowledge about first aid between teachers from a large city and a small town. The study concluded that systemic solutions for improvement of the knowledge of rules of giving the first aid among teachers and pupils are mandatory. 22