1
SYNOPSYS PROFORMA FOR REGISTRATION OF SUBJECT
FOR
DISSERTATION
MS. UDAYA SANTHI
FIRST YEAR M.SC (NURSING)
COMMUNITY HEALTH NURSING
YEAR 2012
INDIAN ACADEMY COLLEGE OF NURSING
HENNUR CROSS, HENNUR MAIN ROAD
BANGALORE – 560 043
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
SYNOPSYS PROFORMA FOR REGISTRATION OF SUBJECT
FOR
DISSERTATION
1. / NAME OF THE CANDIDATE AND ADDRESS / MS. UDAYA SANTHI1ST YEAR M.Sc. (NURSING) INDIAN ACADEMY COLLEGE OF NURSING,
HENNURCROSS,HENNUR MAIN ROAD,
BANGALORE – 560 043
2. / NAME OF THE INSTITUTION / INDIAN ACADEMY COLLEGE OF NURSING,
HENNUR CROSS, HENNUR MAIN ROAD
BANGALORE – 560 043
3. / COURSE OF THE STUDY AND SUBJECT / I ST YEAR M.Sc. (NURSING),
COMMUNITYHEALTH
NURSING
4. / DATE OF ADMISSION TO THE COURSE / 11/06/2012
5. / TITLE OF THE STUDY / “EFFECTIVENESS OF VIDEO ASSISSTED TEACHING ON KNOWLEDGE AND PRACTICE REGARDING SELECTED FIRST AID MEASURES AMONG NATIONAL SOCIAL SERVICE STUDENTS IN SELECTED SCHOOL OF BANGALORE.”
5. BRIEF RESUME OF THE INTENDED WORK
INTRODUCTION
Safety isn't expensive, it’s priceless
-Jerry Smith
Students are the future citizens of the country and have different roles to play. Though they should devote a greater part of their time in attending to their studies they should spend a portion of their time in the service of the people. It is needless to say that they get much time for merry making, playing, amusements, touring etc. apart from their routine life of study. Students should cultivate the spirit of service from the very formative stage.1
The school is a place where the process of socialization occurs. School children being more active and adventuresome, they are prone to falls, sports injury, drowning, vehicle accidents etc. Accidents and injuries are major cause for disability and death among children.2
NSS is a voluntary association of young people in Schools, Colleges, and Universities and at +2 levels working for a campus-community linkage.Popularly known as NSS, the scheme was launched in Gandhiji's Centenary year, 1969. Aimed at developing student's personality through community service.5
The motto of NSS is "NOT ME BUT YOU". It underlines that the welfare of an individual is ultimately dependent on the welfare of the society as a whole. This expresses the essence of democratic living and upholds the need of self-less service and appreciation of the other man's point of view and also consideration for fellow human beings. Therefore NSS volunteers shall strive for the well being of the society.5
School health services are comprehensive care to the health and wellbeing of children throughout the school years. First aid and emergency care are important aspects of school health.4
First Aid is the temporary help given to an injured or a sick person before professional medical treatment can be provided. This timely assistance, comprising of simple medical techniques, is most critical to the victims and is, often, life saving. Any layperson can be trained to administer first aid, which can be carried out using minimal equipments.8
Basic training in first aid skills should be taught in school, in work places and, in general, be learnt by all, as it is mandatory to our modern and stressful life.
The main aims of first aid are to:
(1) Preserve life (this includes the life of the casualty, bystander and rescuer),
(2) Protect the casualty from further harm (ensure the scene is safe),
(3) Provide pain relief (this could include the use of ice packs or simply applying a sling),
(4) Prevent the injury or illness from becoming worse (ensure that the treatment you provide does not make the condition worse), and
(5) Provide reassurance. 7
First aid knowledge also increases the social responsibility of the society and strengthens humanitarian values. An injury is defined as unintentional or intentional damage to the body resulting from acute exposure to thermal, mechanical, electrical, or chemical energy or from the absence of such essentials as heat or oxygen.8
Injuries include unintentional injuries (such as those caused by motor vehicle crashes and fires) and Intentional injuries (violence and suicide).
Injuries are not accidents. They can be prevented by changing the environment, individual behaviour, products, social norms, legislation, and governmental and institutional policy. 5
Injuries requiring medical attention, or resulting in restricted activity, affect more than 20 million children and adolescents (250 per 1,000 persons) and cost $17 billion annually for medical treatment.5
The American Red Cross is implementing self-paced Basic First Aid course which can meet the needs of the student-teacher-nurse in a health education profitable for all. 7
First aid remains a core area of the International Federation of Red Cross and Red Crescent Societies (IFRC). The IFRC is the major first aid educator and provider in the world. Almost all 186 Red Cross Red Crescent National Societies have first aid as their core activity.The IFRC believes that first aid is a vital initial step for providing effective and rapid intervention that helps reduce serious injuries and improve the chance of survival.33
World First Aid Day,2009 was held on 12 September, using the theme “First Aid
For Humanity”. More than 32 National Societies reached over 20 million people globally, and more than 760,000 volunteers and staff were mobilised33
A study was conducted to assess the layman knowledge regarding Basic Life Support. The result shown that only 9.9% know the mouth to mouth respiration.84.28% knew about the Chest Compression Technique and 79.9% of these know the purpose. Only 14.5% know how to position the victim to perform Chest Compression Technique.82.48% reported a frequency below 60/minute.14
A study suggested that video retraining in first aid at 1 week, 1 month and 13 months after initial training demonstrates better retention of skills compared with no re-training over this period.13
The process of providing first aid and emergency care knowledge to the students especially to the volunteer groups like National Social Service is essential as they are the building blocks of the country.
6.1 NEED OF THE STUDY
.
Accidents are regrettable events that occur when you are unprepared. Accidents can take place anywhere and at any time. They come without any prior notice. It is absolutely necessary that you brace yourself at all times and be ready just in case an accident occurs. The best way is to be prepared is if you know first aid, and the only way you can know first aid is to do a first aid course. First aid courses are very important and highly recommended.18
Injuries–resulting from traffic collisions, drowning, poisoning, falls or burns - and violence - from assault , self-inflicted violence or acts of war–kill more than five million people worldwide annually and cause harm to millions more. They account for 9% of global mortality, and are a threat to health in every country of the world. For every death, it is estimated that there are dozens of hospitalizations, hundreds of emergency department visits and thousands of doctors’ appointments. A large proportion of people surviving their injuries incur temporary or permanent disabilities.26
The unintentional injuries are major causes of emergency department visits hospitalization, permanent disability and death among children aged 1 to 14 years in South American countries. The majority of unintentional injuries happen in or near to the home. Industrial burn injuries result in significant morbidity, infrequent mortality and man-hour loss, leading to loss of productivity.
The World Health Organization estimates injuries accounted for more than 5 million deaths in 2005, significantly impacting the global burden of disease. Nearly 3.9 million of these deaths were due to unintentional injury, a cause also responsible for more than 138 million disability-adjusted life years (DALYs) lost in the same year. More than 90% of the DALYs lost occur in low- and middle-income countries (LMICs), highlighting the disproportionate burden that injuries place on developing countries.26
Globally about 16,000 people die of injuries every day and about 58 million people die every year. This corresponds to an annual mortality rate of 97.9 per 1, 00,000 population. Mortality due to injury is only the tip of ice berg as millions of people require hospital treatment for several days. According to WHO report 2006, injury accounts for 12.2% of total burden of diseases. In comparison to other diseases and health conditions, injury morbidity, mortality and disability account for disproportionate death among children and young adults. This leads to a major burden on health sector and social welfare services and its socio economic consequences for the cause as well as loss of productivity.16
India is a home to almost 19% of the world’s children. More than one third of the country’s population, around 480 million, is below the age of 25 years (54% of the population). Children are the future of any nation. The healthy existence of children is essential to build up a challenging nation. India is the home to nearly 500 million young people among children less than 15 years are 37 %( 37 million).
In 2006 the death increased to 3,14,704 and there was a gradual increase in the rate to 28.7%.The data show 43% increase in total death and 19% increase in rate of death over 10 years. In Karnataka 20,593 accidental deaths were reported in 2006 and the state’s percentage share to the country’s total accidental death and the rate were 6.5% and 36.5% respectively. In accidental deaths Karnataka has 13th position in the country. In Karnataka about 1133 children up to the age of 14 is dying every year and it comprises of 5.5%of the total accidental death. 16
In Bangalore about 99 reported accidental child death occurring every year and it is 3.9% of the total accidental deaths in the city. In 2007 All India accidental death rate was 30% whereas in Karnataka it is 39%.Unnatural accident rate in India was 36.3% whereas in Karnataka it is 43.2%.The unnatural accidents include road and rail accidents, poisoning, drowning, fire, falls, electrocution etc.25
One year data from Bangalore shown that 209 children below the age of 18 years died and 5,505 children brought to the hospital with injury. Majority of the children belonged to average socio economic house hold and were studying in schools. Nearly one fourth of the total death in children was due to road traffic accidents. These were followed by burns with 17% and falls with 13%.Drowning and poisoning accounts for 6% and 5% respectively. It is estimated that Bangalore witnesses an average of nearly 10,000 hospitalizations every year. Road traffic accidents were the leading cause of injury (40%).Falls are the second cause with 19% of injuries. Animal bites, Poisoning, Burns and Assault accounts for 11%, 10%, 9%, and 6% respectively.25
The investigator had personally witnessed, loss of human life in the public and hospital setting due to lack of appropriate and safe first aid management. From this study, the investigator will be able to assess the knowledge and attitude regarding first aid measures and provide teaching programme regarding first aid among the National Service schemes volunteers (NSS), as they stand in the front line of social service to save the life of the public.
Based on so much literatures and investigator’s experience, it is felt that it is essential to give adequate knowledge about first aid and emergency care to school children especially to groups like National social services. At the time of accidents, disasters, mass casualty’setc. National social service has significant role in rescue services. The knowledge regarding first aid and emergency care in addition to the physical and adventurous training to National social service help them to play a major role in emergency management in adverse conditions where the medical professionals find difficulty to reach.For this reason, investigator selected this topic to assess the knowledge and attitude regarding first aid measures among National service scheme volunteers and thereby to provide adequate information about first aid measures in selected situations.
6.2 REVIEW OF LITERATURE
Review of literature is a key step in the research process. It refers to an extensive, exhaustive and systematic examination of publications relevant to the research. A literature review helps to lay the foundation for a study and can also inspire new ideas. It can help with orientation to what is known about an area of enquiry to ascertain what research can best make a contribution to the existing base of evidence.28
Literature review was done for the following heading:
Section A: General information about First Aid measures
Section B: Knowledge and practice regardingselected first aid measures
Section C: Interventions on First Aid measures.
Section A: General information about FirstAid measures
Martins CB,Andrade SM. (2008) conducted a study onaccidents with foreign bodies in children less than 15 years of age: epidemiological analysis offirst aidservices, hospitalizations, and deaths. This study aims to analyze accidents involving foreign bodies among children less than 15 years of age residing in Londrina, Paraná State, Brazil, in terms offirst aid, hospitalization, and death (2001). Data were obtained from general hospital records and the Municipal Mortality Database. A total of 434 accidents were analyzed, with a 3.7% hospitalization rate and 0.7% mortality. Boys predominated (53.7%), and the incidence rate was highest among children one to three years of age (7.2 per 1,000 children). Foreign body penetration in natural orifices (eyes, nostrils, and ears) accounted for 94%, inhalation/ingestion of food 2.8%, inhalation/ingestion of objects 2.5%, and aspiration of gastric contents 0.7%, and these causes accounted for all the deaths. The results contribute to epidemiological knowledge on such accidents and indicate the need to restructure health services in order to decentralize care for less complex injuries, besides emphasizing the need for preventivemeasures.21
Bollig G,Wahl HA ., (2009) conducted a study to determine if afirst aidteaching program including 5 lessons (45 min each) of theoretical and practical training for 6-7-year-old children can influence their performance in afirst aidscenario.228 primary school children at the age of 6-7 years were included in the study, 102 girls and 126 boys. One child was 5 years old. 117 children were taught basicfirst aidmeasuresand 111 without training served as control group. In the test scenario the children had to providefirst aid to an unconscious victim after a cycle accident. The course participants were retested after 6 months.Statistically significant differences between course participants compared to those without training could be shown for all tested subjects, including correct assessment of consciousness (p<0.001), correct assessment of breathing (p<0.001),knowledgeof the correct emergency telephone number (p<0.001), giving correct emergency call information (p<0.001),knowledgeof correct recovery position (p<0.001), correct airway management (p<0.001). Retesting after 6 months showed statistically significant differences for 5 of 6 tested items.6-7-Year-old children can give basicfirst aidto an unconscious patient. A course with 5 lessons leads to a significant increase infirst aidknowledgeand ills.Knowledgeretention is good after 6 months. All primary school children should receivefirst aidtraining starting infirstgrade.19
Myklebust AG,Østringen K ., (2011). Conducted a study on mixed methods approach using both quantitative and qualitative methods was used to investigate the effects of teachingfirst aidin the kindergarten in the present study. 10 kindergarten children at the age of 4-5 years were included in a pilot-study, 5 girls and 5 boys. Three of them were four years and seven were five years old. Two months after completion of thefirst aidcourse children were tested in a scenario where the children had to providefirst aidto an unconscious victim after a cycle accident. The next seven months the children were followed by participant observation.The findings suggest that 4-5-year-old children are able to learn and apply basicfirst aid. Tested two months after course completion 70% of the children assessed consciousness correctly and knew the correct emergency telephone number; 60% showed correct assessment of breathing and 40% of the participants accomplished the other tasks (giving correct emergency call information,knowledgeof correct recovery position, correct airway management) correctly. Many of the children showed their capabilities to do so in afirst aidscenario although some participants showed fear of failure in the test scenario. In an informal group testing most of these children could performfirst aidmeasures, too. Teachingfirst aidalso lead to more active helping behaviour and increased empathy in the children.20
Section B: Knowledge and practice regarding selected first aid measures
Abbas A,Bukhari SI,Ahmad F., (2011) conducted a study on Knowledgeoffirst aidand basic life support amongst medicalstudents: a comparison between trained and un-trainedstudents. This study was conducted on a convenience sample of 250 (125 trained and 125 untrained) medicalstudents. A pre-tested self administered questionnaire was used for data collection. The questionnaire covered all the major topics of FA-BLS.Amongst the trainedstudents99 (79.2%) had been trained at their respective medical colleges. The correct responses by the trainedstudentswere significantly better than untrainedstudentsregarding CPR, Recovery position, Asthma and Bleeding. The mean number of correct answers for trainedstudentswas 6.13 +/- 2.1 while 4.94 +/- 2.06 out of the total 13 questions for untrainedstudents.Although theknowledgeof trainedstudentswas found to be better than those of untrainedstudentsyet the mean of trainedstudentswas less than 50% which is not satisfactory. In order to improve theknowledgeof medicalstudentsonfirst aid, theirknowledgeshould be reinforced every year.22
Miller and Spicer (2007), A study was conducted with an objective to assess the knowledge and practices of urban and rural high school children regarding minor injuries.112 urban and 110 rural high school students were selected. A variety of local application for wound was described. Burnoil, Vaseline, talcum powder, mercurome were told only by urban students, irritating on wound was told by rural students. Washing of wound with water, use of turmeric, ointment, Dettol, spirit, sucking were told by urban students, while more of rural students told about use of mustard oil and other oils. Need of tetanus toxoid and immediate washing of wound was told more by urban students. Need for relevant health education was emphasized.15