JAN – JUN 2016    VOL-17, NO.1

CAPACITY BUILDING IN NURSING EDUCATORS

* Meena Putturaj, M. Sc (N)
** Research Officer, Institute of Public Health, Bangalore

ABSTRACT

Health manpower resources pose new challenges in today's health care scenario. Nurses constitute a major proportion of the human resources in the health care industry. Despite the increase in the number of professional nurses, the competency of the nurses graduating from the nursing educational institutions is questionable and is highly variable. In this context, nurse educators are girded with the responsibility of equipping themselves to contribute towards efficient nursing workforce who is capable to adapt to today's health care dynamics. The main objective of this concept paper is to analyse the need and strategies for capacity building of nurse educators in India.

Keywords: capacity building, nurse educators, nursing workforce

REFERENCES

Canadian International Development Agency. (2000). Capacity development: Why, what, and how. Retrieved from http://portals.wi.wur.nl/files/docs/SPICAD

Evans , C., Razia, R., & Cook, E. (2013). Building nurse education capacity in India: Insights from a faculty development programme in Andhra Pradesh. BMCNursing, 12, 8. doi: 10.1186/14726955128 International Center for AIDS Care and Treatment Program. (2013). Global nurse capacity building program/nursing education partnership initiative update. Retrieved from file:///C:/Documents%20and%20Settings/Administrator/My%20Documents/Downloads/2013_Plenary_8_Jen nifer_Dohrn_and_Yegomawork_NEPI_Update%20(1).pdf

International Institute of Educational Planning. (2006). Capacity building. Retrieved from http://www.iiep. unesco.org/fileadmin/user_upload/ research-highlightsemergrncies/cahpter3.pdf

Sharghi, N. R., Alami, A., Khosravan, S., Mansoorian, M. R., & Ekrami, A. (2015). Academic training and clinical placement problems to achieve nursing competency. Journal of Advances in Medical Education and Professionalism, 3(1), 15.

United Nations Development Programme. (2009). UNDP primer on capacity development. Retrieved from http://www.undp.org/content/dam/aplaws/publication/en/publications/capacity-development/ capacitydevelopment-a-undpprimer/CDG_PrimerReport_final_web.pdf

United Nations Education, Scientific, and Cultural Organization. (2005). UNESCO thesaurus. Retrieved from http://databases.unesco.org/thesaurus

World Health Organization. (2005). Academy for Nursing Studies: Situational analysis of public health nursing personnel in India. New Delhi: World Health Organization. Retrieved from ftp://203.90.70.117/ searoftp/WROIND/whoindia/linkfiles/HSD_Resources_Situation_Analysis_of_Public_Health_Nurs ing_Personnel.pdf, accessed 14-03-11

SPEAK OUT AND UNLOCK THE ISSUE: NURSE AS A WHISTLEBLOWER

* Rogina J. S. Savarimuthu, M. Sc (N)., M. Sc (Psychology).,M. S (Counseling and Psychotherapy)
*Former Associate Professor, Christian College of Nursing, Ambilikkai

ABSTRACT

Whistleblowing is a deliberate act that involves voluntary disclosure of individual or organizational malpractice by a person who has had privileged access to anticipated wrongdoing within an organization. Nurses are involved in protecting the health and wellbeing of the patients under their care. Nurses as well as the patients whom they care should not be exposed to abuse. Nurses, in addition to being an advocate for their patients, need to advocate for themselves as well as each other. Nurses should whistleblow in situations where illegal, unethical or illegitimate practices occur and where internal mechanisms fail to respond to complaints made regarding these practices. Blowing the whistle, however, can be a life-altering incident and should be utilized as the last avenue.

Keywords: whistleblowing, nurse, nursing, barriers, challenges, protective disclosure

REFERENCES

American Nurses Asociation. (2014). Things to know about whistle blowing. Retrieved from http://www. nursing world.org/MainMenuCategories/ThePracticeofProfessionalNursing/workforce/Workforce-Advocacy/Whistle-Blowing.html

American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Retrieved from http://www.nursingworld.org/codeofethics

Dawson, S. (2000). Whistleblowing: A broad definition and some issues for Australia. Retrieved from www.uow.edu.au/ arts/sts/bmartin/dissent/documents/Dawson.html.

Department of Health. (2000). No secrets: Guidance on developing and implementing multiagency policies and procedures to protect vulnerable adults from abuse. Retrieved from https://www.gov. uk/.../No_secrets_guidance_on_developing_and_implementing_multi-agency_policies_and_procedures_to_protect_ vulnerable_ adults_from_abuse.pdf

Firtko, A. & Jackson, D. (2005). Do the ends justify the means? Nursing and the dilemma of whistle-blowing. Australian Journal of Advanced Nursing, 23(1), 51-56. Retrieved from http://ajan.com.au/Vol23/Vol23.1-7.pdf Hill, T. (2009). Whistle-blowing: The patient or the paycheck? Retrieved from http://www.t.hill_whistleblowing_the_patient_or_ the_paycheck_ks_nurse

Leary, E., & Diers, D. (2013). The silence of the unblown whistle: The Nevada hepatitis C public health crisis. The Yale Journal of Biology and Medicine, 86(1), 79.

NSW Nurses and Midwives' Association. (2012). Guidelines on whistleblowing and nursing re-endorsed by annual conference 2012. Retrieved from http://www.NSWNMA-Guidelines-on-Whistleblowing-Nursing Nursing and Midwifery Council. (n.d.). Raising concerns: Guidance for nurses and midwives. Retrieved from http://www.nmc-uk.org/documents/nmc-publications/nmc-raising-and-escalating-concerns.pdf

Philipsen, N. C., & Soeken, D. (2011). Preparing to blow the whistle a survival guide for nurses. Journal for Nurse Practitioners, 7(9), 740-746. Retrieved from http://www.medscape.com/viewarticle/751347 Policy Regulation and Research Division of the Canadian Nurses Association. (1999). I see and am silent/I see and speak out: The ethical dilemma of whistle-blowing. Retrieved from https://www.cna-aiic.ca/~/media/cna/page-content/pdf-en/ethics_pract_see_silent_november_1999_e.pdf

Royal College of Nursing. (2014). Raising concerns: A guide for RCN members. Retrieved from http://www.rcn.org.uk/support/raising_concerns/ a_guide_for_rcn_members

The Trained Nurses' Association of India. (2003). Constitution rules and regulations and bye-laws. New Delhi: Author.

CARING FOR A CHILD WITH BERNARD - SOULIER SYNDROME

* Ida S. Priyadarshini, M. Sc (N)., M.B.A.
*Junior Lecturer, College of Nursing, CMC, Vellore

ABSTRACT

Bernard-Soulier Syndrome (BSS) also known as hemorrhagiparous thrombocytic dystrophy is characterized by low platelet counts, abnormally large (giant) platelets, and impaired or absent platelet aggregation by the inducer antibiotic Ristocetin. This syndrome is extremely rare, and the occurrence is one case per million population. The syndrome is transmitted as an autosomal recessive trait. The underlying defect is a deficiency or dysfunction of the glycoprotein GP1b-VIX complex, a platelet restricted multi subunit receptor required for normal primary hemostasis. Clinical manifestations of BSS mainly include unexplained purpura, epistaxis, bleeding from gastrointestinal and urinary tract, menorrhagia, and prolonged bleeding during trauma or surgeries. Treatment usually requires blood or platelet transfusion. Tranexamic acid and factor VIIa administration have been shown to shorten the bleeding time in some patients. Caring for a child with hematological disorder such as BSS could be challenging for a pediatric nurse, and it is essential for the nurse to understand the underlying cause and the serious impact it has on the child for a life time. This paper is a case report of a four year old girl child with BSS who underwent cleft palate repair.

Keywords: Bernard-Soulier Syndrome, autosomal recessive, platelet transfusion

REFERENCES

Aubin, N. (2008). Canadian hemophilia society. Retrieved from http:// www.hemophilia.ca /files/ Bernard_Soulieren.pdf

Berber, I., Erkurt, M. A., Yetkin, F., Irfan, K. U. K. U., Emin, K. A. Y. A., Bodakci, E., ... & Nizam, I. (2014). BK virus in allogeneic and autologous bone marrow transplantation: Review article. American Journal of Medical Sciences and Medicine, 2(5), 85-88.

Carpenito-Moyet, L. J. (2009). Nursing care plans and documentation: Nursing diagnoses and collaborative problems. Delhi: Lippincott Williams & Wilkins.

Hockenberry, M. J., & Wilson, D. (2014). Wong's nursing care of infants and children. Philadelphia: Elsevier Health Sciences.

Kliegman, R. M., Stanton, B., Geme, J. S., Schor, N. F., & Behrman, R. E. (2015). Nelson textbook of pediatrics. Philadelphia: Elsevier Health Sciences.

Lanza, F. (2006). Bernard-Soulier syndrome. Orphanet Journal of Rare Disorders, 1, 46.

National Organisation for Rare Disorders. (2015). Bernard-Soulier Syndrome. Retrieved from https://rare diseases.org/rare-diseases/bernard-soulier-syndrome/

CARING FOR A FAMILY AS THEY JOURNEY THROUGH THE LOSS OF THEIR CHILD : A SPIRITUAL ASSESSMENT PERSPECTIVE

Vinitha Ravindran, M.Sc (N), Ph. D (N)
*Professor, College of Nursing, CMC, Vellore

ABSTRACT

Spiritual dimension is an assimilating aspect of the physical, psychological, and social dimensions of a person. Many hospitalized patients and their families place high value on having their emotional and spiritual needs met and therefore spiritual assessment and care becomes an integral part of nursing practice. In this paper I reflect on a clinical encounter with parents whose child was admitted with nephroblastoma and apply a spiritual assessment tool to elucidate their spiritual issues. I attempt to demonstrate the integration of spiritual dimension in the everyday nursing care of this child and family.

Keywords: spirituality, health, religion, faith, culture

REFERENCES

Allen, M. (1997). Primary care nursing: Research in action. In L. Gottlieb & H. Ezer (Ed.), A perspective on health, family, learning and collaborative nursing: A collection of writing on the McGill model of nursing. Montreal, Quebec: McGill University School of Nursing.

Burkhardt, M. (1989). Spirituality: An analysis of the concept. Holistic Nursing Practice, 3(3), 69-77.

Cavendish, R., Edelman, M., Naradovy, L., McPartlan Bajo, M., Perosi, I., & Lanza, M. (2007). Do pastoral care providers recognize nurses as spiritual care providers? Holistic Nursing Practice, 21(2), 89-98.

Clark, M., & Olson, J. (2000). Nursing within a faith community: Promoting health in times of transition. Thousand Oaks: CA: Sage publishing.

Farran, C., Fitchett., G, Quiring-Emblen, J., & Burck, R. (1989). Development of a model for spiritual assessment and intervention. Journal of Religion and Health, 28(3), 185-193.

Hart, T., Waddell, A. (2005). Spiritual issues in counseling and psychotherapy: Toward assessment and treatment. Childspirit Institute- spiritual assessment. Retrieved July 7, 2008, from http://66.160.135.253/index.php/spiritual_assessment/

Saylor, C. (2004). The circle of health: A health definition model. Journal of Holistic Nursing, 22(2), 97-115.

SELF ESTEEM, STRESS AND DEPRESSION IN NURSING STUDENTS

* Rajesh K. Kataria, M. Sc (N)

*Assistant Professor, College of Nursing, AIIMS Rishikesh, Uttarakhand

ABSTRACT

Nursing education is a challenging and stressful process. This study explored self esteem, stress and depression in nursing students and the relationship between the three variables. A descriptive survey was conducted in April 2014 among 199 nursing students who were included in the study using simple random sampling for undergraduate students and total enumeration sampling technique for post graduate students. The Rosenberg Self Esteem Scale (RSES), Perceived Stress Scale (PSS-14), and Beck Depression Inventory (BDI) were used to collect data from nursing students. Data were analyzed using descriptive and inferential statistics. Findings revealed that 17.6% of nursing students had high self esteem and 81.4% had normal self esteem. The study found that 43.7% students had severe stress and equal number of students (28.1%) had mild and moderate stress. Among the subjects, 13.6 % had borderline depression, 10.6% had moderate depression, and 3.5% had severe depression. A significant but weak negative correlation was found between self esteem and depression (r= -.396, p < .01). The study highlights the importance of designing and implementing realistic programme that addresses academic stress and depression in students and enhances the nursing students' level of self esteem. Also, practical knowledge on how to manage academic stress is to be imparted to these students to live a healthier college life.

Keywords: self esteem, stress, depression, nursing students

REFERENCES

Altiok, O. H., & Ustun, B. (2013). The stress sources of nursing students. Educational Sciences: Theory and Practice, 13(2), 760-766.

Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An Inventory for measuring depression. Archives of General Psychiatry, 4, 561-57.

Cha, N. H., & Sok, S. R. (2014). Depression, self-esteem and anger expression patterns of Korean nursing students. International Nursing Review, 61(1), 109-115.

Chon, K. K., Choi, S. C., & Yang, B. C. (2001). Integrated adaptation of CES-D in Korea. Korean Journal of Health Psychology, 6(1), 59-76.

Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385-396.

Dahlin, M., Joneborg, N., & Runeson, B. (2005). Stress and depression among medical students: A cross-sectional study. Medical Education, 39(6), 594-604.

Davis, M. (2004). Stress management is key during nursing school. The Student Voice, 1(3).

Dhar, R., Walia, I., & Das, K. (2009). A descriptive study to assess the causes of stress and coping strategies used by the newly admitted basic B.Sc nursing students. Nursing and Midwifery Research Journal, 5(1), 31-37.
Fardi, M. F., & Akhter, M. (2013). Self esteem of secondary school students in Pakistan. Middle East Journal of Scientific Research, 14(10), 1325-1330.

Furegato, A. R. F., Santos, J. L. F., & Silva, E. C. D. (2008). Depression among nursing students associated to their self-esteem, health perception and interest in mental health. Revista Latino-Americana de Enfermagem, 16(2), 198-204.

Furegato, A. R. F., Silva E. C., Campos M. C., & Cassiano, R. P. T. ( 2006). Depressao e auto-estima entre academicos de enfermagem. Rev Psiq Clin, 33(5), 239-244.

Gong, S. J., & Lee, E. H. (2006). Meditation effect of coping between life stress and depression in female college students. Korean Journal of Women Psychology, 11, 21-40.

Han, K. S. (2005). Self efficacy, health promoting behaviors and symptoms of stress among university students. Journal of Korean Academy of Nursing, 35(3), 585-592.

Jones, M. C., & Johnston. (1997). Stress and coping in first year student nurses. Journal of Advanced Nursing, 26(3), 472-82.

Kang, J., Ko, Y. K., Lee, H. K., Kang, K. H., Hur, Y., & Lee, K.H. (2013). Effects of self-esteem and academic stress on depression in Korean students in health care professions. Journal of Korean Academy of Psychiatric and Mental Health Nursing, 22(1), 56-64.

Kim, C. H., & Lee, M. K. (2006). The effect of personality style and interpersonal problems solving ability on life stress, depression. Korean Journal of Health Psychology, 1, 163-175.

Kim, O. S., & Kim, K. H. (2001). Social Support, depression, drinking and smoking in college and working females. Journal of Korean Academy of Adult Nursing, 13, 363-372.

Kumar, R., & Nancy. (2011). Stress and coping among nursing students. Nursing and Midwifery Research Journal, 7(4), 141-51.

Nikitha, S., Jose, T. T., & Valsaraj, B. P. (2014). A correlational study on academic stress and self-esteem among higher secondary students in selected schools of Udupi district. Nitte University Journal of Health Science, 4(1).

Papazisis, G., Nicolaou, P., Tsiga, E., Christoforou, T., & Sapountzi-Krepia, D. (2014). Religious and spiritual beliefs, self-esteem, anxiety, and depression among nursing students. Nursing and Health Sciences, 16(2), 232-238.

Papazisis, G., & Ulasidis, I. (2008). Depression and anxiety among students in Greece. Retrieved from http://www.annals-general-psychiatry.com/content/7/s1/s209.

Park, H. S., Son, C. N., & Oh, S.W. (1993). The effects of stress, social support, dysfunctional attitude and coping style upon depression. Korean Journal of Clinical Psychology, 12, 179-196.

Pheukphan, A. P. (2009). Stress and coping strategies among AU (Australian) nursing students. Retrieved from http://www.nurse.eu.edu.

Rosenberg, M. (1965). Society and the adolescent self image. Princeton, N.J: Princeton University Press.

Seyedfatemi, N., Tafreshi, M., & Hagani, H. (2007). Experienced stressors and coping strategies among Iranian nursing students. BioMedCentral Nursing, 6(1),1.

Zoccolillo, M., Murphy, G. E., & Wetzel, R. D. (1986). Depression among medical students. Journal of affective disorders, 11(1), 91-96.

KNOWLEDGE AND ATTITUDE OF NURSING PERSONNEL REGARDING PATIENT SAFETY

*Samarpita Pramanik, M.Sc. (N)
**T. S. Ravikumar, M. Sc (N)
***Florence Segaran, M. Sc (N)
****Edwin Stephen, M.S (Vascular Surgery)

*Vice Principal, School of Nursing, Christian Hospital Bissmacuttack, Odisha
** Professor, College of Nursing, CMC, Vellore
***Professor, College of Nursing, CMC, Vellore
****Professor, Vascular Surgery, CMC, Vellore

ABSTRACT

The concept of patient safety has gained global importance in response to the high prevalence of avoidable adverse medical errors. It is essential that all levels of healthcare providers are aware of patient safety. A descriptive approach was used to assess the knowledge and attitude of nursing personnel regarding selected aspects of patient safety. A total of 600 nurses were selected for the study using stratified systematic sampling technique. The data were collected using a self administered knowledge and attitude questionnaire developed by the researcher. The findings revealed that 70.8% of nursing personnel had moderately adequate knowledge and 60.8% had a favorable attitude regarding patient safety. A statistically significant weak positive correlation was identified between the overall knowledge and attitude of the nursing personnel (r = .36, p < .001). There was a significant association between the professional qualification and the knowledge and attitude of nursing personnel regarding patient safety (p < .05).

Keywords: patient safety, knowledge, attitude, nursing personnel.

REFERENCES

Almaramhy, H., Al-Shobaili, H., El-Hadary, K., & Dandash,K. (2011). Knowledge and attitude towards patient safety among a group of undergraduate students in Saudi Arabia. International Journal of Health Sciences, 5(1), 59-67.

Bayraktar, N., & Erdil, F. (2000). Blood transfusion knowledge and practice among nurses in Turkey. Journal of Intravenous Nursing, 23(5), 310-317.

Clancy, C. M., Farquhar, M. B., & Sharp, B. A. C. (2005). Focus on patient safety: Patient safety in nursing practice. Journal of Nursing Care Quality, 20(3), 193-197.

Demarré, L., Vanderwee, K., Defloor, T., Verhaeghe, S., Schoonhoven, L., & Beeckman, D. (2012). Pressure ulcers: knowledge and attitude of nurses and nursing assistants in Belgian nursing homes. Journal of clinical Nursing, 21(9-10), 1425-1434.

Duerink, D. O., Djoko, R., Wahjono, H. Lestari, E. S., Hadi, U., Wille, J. C., . . . Van den Broek, P. J. (2006). Surveillance of healthcare-associated infections in Indonesian hospitals. Journal of Hospital Infection, 62(2), 219-22.

Graban, M. (2011). Statistics on healthcare quality and patient safety problems - Errors and harms. Retrieved from http://www.downloads.imune.net/medicalbooks/Statistics%20on%20Healthcare%20Quality%20and%2 0Patient%20Safety%20Problems.pdf

Hanafi, S., Torkamandi, H., Hayatshahi, A., Gholami, K., & Javadi, M. (2012). Knowledge, attitudes and practice of nurses regarding adverse drug reaction reporting. Iranian Journal of Nursing and Midwifery Research, 17(1), 21-25.

Haynes, A. B., Weiser, T. G., Berry, W. R., Lipsitz, S. R., Breizat, A. H., Dellinger, E. P., . . . & Gawande, A. A. (2011). Safe Surgery Saves Lives Study Group: Changes in safety attitude and relationship to decreased postoperative morbidity and mortality following implementation of a checklist-based surgical safety intervention. British Medical Journal of Quality and Safety, 20(1), 102-107.

Institute of Medicine. (1999). To err is human: building a safe health system. Washinton DC: National Academy Press. Retrieved from http://www.nap.edu/openbook_php?isb=0309068371

Kennedy, A. M., Elward, A. M., & Fraser, V. J. (2004). Survey of knowledge, beliefs, and practices of neonatal intensive care unit healthcare workers regarding nosocomial infections, central venous catheter care, and hand hygiene. Infection Control and Hospital Epidemiology, 25(9), 747-752.

Kumar, S., & Chaudhary, S. (2009). Medical errors and consequent adverse events in critically ill surgical patients in a tertiary care teaching hospital in Delhi. Journal of Emergencies, Trauma, and Shock, 2(2), 80.

Kurien, S. T. (2012). Effect of structured teaching programme regarding physical and chemical restraints on the knowledge, attitude and practice of nursing personnel (Unpublished master's thesis). Tamil Nadu Dr. MGR Medical University, Chennai.

Lee, D. T., Tam, E. P., & Yeung, W. S. (1999). Use of physical restraints on elderly patients: an exploratory study of the perceptions of nurses in Hong Kong. Journal of Advanced Nursing, 29(1), 153-159.

Nightingale, F. (1860). Notes on nursing: What it is, and what it is not (1st ed.). America: Appleton. Parihar, M., & Passi, G. R. (2008). Medical errors in pediatric practice. Indian Pediatrics, 45(7), 586 589.

Saillour-Glenisson, F., Tricaud, S., Mathoulin-Pelissier, S., Bouchon, B., Galperine, I., Fialon, P., & Salmi, L. R. (2002). Factors associated with nurses' poor knowledge and practice of transfusion safety procedures in Aquitaine, France. International Journal for Quality in Health Care, 14(1), 25-32.

Sessa, A., Di Giuseppe, G., Albano, L., & Angelillo, I. F. (2011). An investigation of nurses' knowledge, attitudes, and practices regarding disinfection procedures in Italy. BioMedCentral Infectious Diseases, 11, 148.

Srivastava, R. K. (2010). National consultation workshop report on patient safety. Directorate General of Helath Services, Ministry of Health and Family Welfare. Government of India. Retrieved from fklip.limb.enet.in/---/12_Anon_Technical_Report_National

Van Gaal, B. G., Schoonhoven, L., Vloet, L. C., Mintjes, J. A., Borm, G. F., Koopmans, R. T., & van Achterberg, T. (2010). The effect of SAFE or SORRY. Program on patient safety, knowledge of nurse in hospitals and nursing homes. International Journal of Nursing Studies, 47(9), 1117-1125.doi.10.1016.inurstu.2010.02.001

Varghese, B. (2001). A study on the knowledge andpractices of nurses in the intensive care unit on the prevention of nosocomial infection (Unpublished master's thesis).Tamil nadu Dr. MGR Medical University, Chennai.

Warburton, R. N. (2009). Improving patient safety: An economic perspective on the role of nurses. Journal of Nursing Management, 17(2), 223-229.

Yan, Y., Zhang, G., Chen, Y., Zhang, A., Guan, Y., & Ao, H. (2006). Study on the injection practices of health facilities in Jingzhou district, Hubei, China. Indian Journal of Medical Sciences, 60(10), 407-416.

Zakari, N. M. A. (2011). Attitude of academic ambulatory nurses toward patient safety culture in Saudi Arabia. Life Science Journal, 8(3), 230-237.

EFFECTIVENESS OF VIRTUAL REALITY THERAPY ON COGNITION AMONG OLD AGE PEOPLE

* D. Chitra M.Sc (N), M.Sc (Psy)
** K. Vijayalakshmi M.Sc (N), M.A (Psy), MBA, Ph. D (N)
*** Latha Venkatesan M.Sc (N), MBA, M. Phil., Ph. D (N)

* M.Sc (N) Student at the time of submission, Apollo CON, Chennai
** Professor, Apollo CON, Chennai
*** Principal, Apollo College of Nursing, Chennai

ABSTRACT

Old age is a normal, inevitable, biological phenomenon. Old age is viewed both as a stage in the life span of individual and also a segment of the population of the society. Cognitive impairment is often seen in geriatric patients, which can be disabling. The aim of the study was to assess the effectiveness of virtual reality therapy upon cognition among old age people residing at selected old age homes in Chennai. Study was conducted using pre experimental, one group pretest posttest research design. The participants of the present study were selected using purposive sampling technique. Data were collected using demographic variable proforma, clinical variable proforma, and mini mental status examination scale. The collected data were statistically analyzed and the results revealed that cognition scores in old age people in posttest was higher (M=18.9, SD=2.032) than the pretest (M = 15.3, SD = 2.092). This difference was found to be statistically significant at p < .001. The study findings revealed that virtual reality therapy is effective in improving cognition among old age people. Nurses can be instrumental in administering virtual reality therapy to improve the cognition by which psychological wellbeing and coping of the old age persons can also be improved.

Keywords : old age, cognition, virtual reality therapy, mini mental status examination

REFERENCES

Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-mental state: A practical method for grading the cognitive state of patients for the clinician. Journal of psychiatric research, 12(3), 189-198.

Hurford, I. M., Kalkstein, S., & Hurford, M. O. (2011). Cognitive rehabilitation in schizophrenia: Strategies to improve cognition. Psychiatric Times, 28(3), 43-43.

Kramer, A. F., Erickson, K. I., & Colcombe, S. J. (2006). Exercise, cognition, and the aging brain. Journal of Applied Physiology, 101(4), 1237-1242.

Lee, C. S., & Burdea, G. C. (2003). Virtual reality technology. John Wiley &Sons, USA.

Lezak, M. (2013). Nebraska symposium on motivation. Retrieved from www.Psychology.unl.edu on 11.12.2014

Panigrahi, A. K., & Syamala, T. S. (2012). Living arrangement preferences and health of the institutionalised elderly in Odisha. The Institute for Social and Economic Change: Working paper 291

Park, K. (2009). Text book of preventive and social medicine. New Delhi: Banarsidas Bhanot publishers. Vanitha, S. (2013). Effectiveness of virtual reality therapy upon cognition among schizophrenic patients (Unpublished master's thesis). Tamil Nadu Dr. MGR Medical University, Chennai.

Yang, S., Chun, M. H., & Son, Y. R. (2014). Effect of virtual reality on cognitive dysfunction in patients with brain tumor. Annals of Rehabilitation Medicine, 38(6), 726-733.

EARLY MANAGEMENT OF SEVERE TRAUMA

* Jeyalindha Christopher, M. Sc (N)
** T. S. Ravikumar, M. Sc (N)

* Professor, College of Nursing, CMC, Vellore
** Professor, College of Nursing, CMC, Vellore

ABSTRACT

Trauma is a global public health problem and the burden of ill health due to injuries is increasing. A systematic approach and team work are necessary for effective management of patients with trauma. Transportation of trauma patients to a trauma care centre within the Golden Hour improves survival rates. Primary survey and resuscitation helps to identify and address life threatening injuries. A simple mnemonic 'ABCDEFGHI' is used as a memory aid for the sequence in which problems should be addressed.

Keywords: trauma, early management, primary survey, secondary survey, airway, breathing, circulation, disability, exposure

REFERENCES

American College of Surgeons Committee on Trauma. (2012). Advanced trauma life support student course manual (9th ed.). Chicago, IL: American College of Surgeons.

Black J. M., Hawks, J. H., & Keene, A. M. (2001). Medical surgical nursing: Clinical management for positive outcomes. Philadelphia: W. B. Saunders.

David, D. J. (2014). Initial evaluation of the trauma patient. Retrieved from http://emedicine.medscape.com/ article/434707-overview#a7

David, S. S. (2012). Handbook of Emergency Medicine. India: Elsevier.

Griggs, W. C. W. M. (2001). Early management of the acute severe trauma patient. ADF Health, 2, 4-11

Lemon Punch. (2016). Basic life support. Retrieved from https://www.lemonpunch.net/threads/wake-raresglobalist-medical-corps-guide.13538/

Lerner, E. B., & Moscati, R. M. (2001). The golden hour: Scientific fact or medical urban legend? Academic Emergency Medicine, 8(7), 758-760.

Mayglothling, Julie et. al. (2012). Emergency tracheal intubation immediately following traumatic injury. Journal of trauma, 73(5), S333-S340.

Newberry, L., & Sheehy, S. B. (2003). Sheehy's emergency nursing: Principles and practice. Mosby Incorporated.

Ollerton, J. E. (2007). Adult trauma clinical practice guidelines, emergency airway management in the trauma patient. NSW Institute of Trauma and Injury Management. Retrieved from https://www.seslhd. health.nsw.gov.au/ Trauma/policies/ITIM1.PDF

Pinterest. (2016). Bone, orthopedics, muscles. Retrieved from https://www.pinterest.com/hdperley/ rnbonesorth opedicsmuscles/

Quizlet. (2016). Airway management, artificial ventilation, and oxygenation. Retrieved from https://quizlet.com/92803324/emt-chapter-10-airway-managementartificial-ventilation-and-oxygenation-flash-cards/

Roberts, I., Alderson, P., Bunn, F., Chinnock, P., Ker, K., & Schierhout, G. (2004). Colloids versus crystalloids for fluid resuscitation in critically ill patients. Cochrane Database Systematic Review, (4): CD000567. PM:154950013.

Sobrino, J., & Shafi, S. (2013). Timing and causes of death after injuries. Proceedings (Baylor University. Medical Center), 26(2), 120-123.

Zunder, I. (n.d.). Initial trauma assessment: The anaesthetist's role. Retrieved from http://www.trauma. org/archive/ anaesthesia/initialassess.html

PERIPHERAL ARTERIAL OCCLUSIVE DISEASE : A CASE REPORT

* Nancy Jenefa N, B.Sc (N)
**Anu B. B. Rao, B. Sc (N) ***Nirmala M. Emmanuel, M. Sc (N)

*II year B.Sc (N) Student, College of Nursing, CMC, Vellore
**Tutor, College of Nursing, CMC, Vellore
*** Associate Professor, College of Nursing, CMC, Vellore

ABSTRACT

Peripheral Arterial Occlusive Disease (PAOD) affects the extremities. It is a chronic disorder affecting the arterial blood flow. There are modifiable and non-modifiable factors which are associated with PAOD. It is characterized by intermittent claudication pain on exercise or activity. Narrowing of the artery leads to decreased blood flow to the extremities which causes pain due to ischemia. The disorder is diagnosed by studying the arteries to detect narrowing or stenosis. Life style modifications such as quitting smoking, taking low fat low cholesterol diet, and relaxation therapy such as yoga, arrest the progression of the disease and reduce the symptoms. Compression therapy is useful to improve the blood flow to the extremity. Surgery becomes the option if the other modes of treatment fail to give significant relief from the pain.

Keywords: peripheral arterial occlusive disease, intermittent claudication, pain, ischemia, compression therapy

REFERENCES

Al Mahameed, A. (2009). Peripheral arterial disease. Retrieved from http://www.clevelandclinicmeded.com/ medicalpubs/diseasemanagement/cardiology/peripheral-arterial-disease/

Bhatt, S. (2007). Manual of surgery (3rd ed.). New Delhi: Jaypee Brothers.

Black, J. M., & Hawks, J. H. (2009). Medical surgical nursing (8th ed.). Philadelphia: Saunders.

Blazer, J. O., Thalhammer, A., Khan, V., Zangos, S., Bogl, T. J. & Lehnert, T. (2010). Angioplasty of the pelvic and femoral arteries in PAOD: Results and review of the literature. European Journal of Radiology, 75(1), 48-56.

Gulanick, M., & Myer, J. (2013). Nursing care plan (8th ed.). Chicago: Elsiever.

Healthwise. (2016). Peripheral arterial diseases of the leg. Retrieved from https://myhealth.alberta.ca/Health/_ layouts/15/healthwise/media/medical/hw/h9991299_001.jpg

Ignataviciuis, D. D., & Workman, L. (2013). Medical surgical nursing (8th ed.). St.louis: Elsevier.

Klabunde, R. E. (2012). Cardiovascular physiology concepts (2nd ed.). Philadelphia: Lippincott Williams &Wilkins.

Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., & Bucher, L. (2014). Medical surgical nursing (9th ed.). Philadelphia: Elsevier.

Mannava, K., & Money, S. R. (2007). Current management of peripheral arterial occlusive disease. American Journal of Cardiovascular Drugs, 7(1), 59-66.

Mayoclinic. (2016). Peripheral artery disease. Retrieved from http://www.mayoclinic.org/diseases-conditions/ peripheral-artery-disease/symptoms-causes/dxc-20167421

Meiner, S. E. (2012). Gerontological nursing (5th ed.). Missouri: Mosby's Elsevier Health Sciences.

Monteiro, D. P., Britto, R. R., Lages, A. C. R., Basilio, M. L., Pires, M. C. O., Carvalho, M. L. V., . . . Pereira, A. G. (2013). Heel-rise test in the assessment of individuals with peripheral arterial occlusive disease. Vascular Health Risk Management, 9, 29-35.

Nemes, R., Surlin M. V., Chiutu, L., Georgescu, E., Georgescu, M., & Georgescu, I. (2011). Retroperitoneoscopic lumbar sympathectomy Results from a series of 50 consecutive patients. Surgical Endoscopy, 25(9).

Pudner, R. (2010). Nursing the surgical patients (3rd ed.). China: Elsevier Health Sciences.

Smeltzer, S., & Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2012). Brunner and Suddharth's text book of medical surgical nursing (12th ed.). China: Lippincott Williams and Wilkins.

Sudheendra, D. (2014). Peripheral artery disease leg. Retrieved from https://www.nlm.nih.gov/medlineplus/ ency/article/000170.htm

Tsetis, D., & Uberoi, R. (2008). Quality improvement guidelines for endovascular treatment of iliac artery occlusive disease. Cardiovascular and Interventional Radiology, 31, 238.

PREVALENCE AND RISK FACTORS OF POSTPARTUM DEPRESSION

* Pooja S. Baby, M.Sc (N)
** Diana David, M.Sc (N)
*** Ruby Jose, M.D., DGO

*Quality Assurance Nurse, Medical Trust Hospital, Ernakulum
** Professor, College of Nursing, CMC, Vellore
*** Professor, Obstetrics & Gynaecology, C.M.C., Vellore

ABSTRACT

Undetected post partum depression affects the mother, her infant, her family and further affects the society through illness, social dysfunction, death, and the cost of medical services. It is estimated that only 20 % of mothers with post partum depression are diagnosed and treated, leaving thousands of new mothers to suffer in silence. A descriptive study was done to identify hospital based prevalence and risk factors related to postpartum depression among postnatal mothers in Well Baby Clinic and Obstetrics and Gynaecological Out Patient Departments of a tertiary level hospital. 250 postnatal mothers who were willing to participate in the study were recruited for the study. The Edinburgh Postnatal Depression Scale was used to identify mothers who were at risk for depression. The scale to assess the risk factors associated to the risk levels of postpartum depression was developed by the investigator. The content validity of the tool was 0.87. The prevalence of higher likelihood of having postpartum depression among mothers from six to ten weeks postnatally was found to be 52.4%. Need for migration during pregnancy, heavy house hold work, financial difficulties, thoughts of abortion in the antenatal period, expectation on specific gender of the child, perception of high stress during delivery, low birth weight babies, and presence of constant worry about the child were some of the factors that were significantly associated with a higher risk for depression. Mothers whose family were dependent on relatives for daily needs, who had an unhappy married life, and unplanned pregnancy were also found be at a high risk of developing postpartum depression. The study identifies the importance of early screening by nurses for postpartum depression and educating the family on the importance of early identification of symptoms and treatment of postpartum depression.

Keywords: postpartum depression, risk factors, prevalence, postnatal

REFERENCES

Centers for Disease Control and Prevention (2008). Prevalence of self-reported postpartum depressive symptoms--17 states, 2004-2005. MMWR. Morbidity and Mortality Weekly Report, 57(14), 361.

Hashemi, Z., Azar, I. A. S., & Forghani, F. (2006). Postpartum depression and its correlates among women living in Zabol (Iran). Iranian Journal of Psychiatry, 1(4), 140-147.

Chandran, M., Tharyan, P., Muliyil, J., & Abraham, S. (2002). Post-partum depression in a cohort of women from a rural area of Tamil Nadu, India. The British Journal of Psychiatry, 181(6), 499-504.

Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. The British Journal of Psychiatry, 150(6), 782-786.

Danaci, A. E., Dinç, G., Deveci, A., ªen, F. S., & Içelli, I. (2002). Postnatal depression in Turkey: epidemiological and cultural aspects. Social Psychiatry and Psychiatric Epidemiology, 37(3), 125-129.

Ludermir, A. B., Araya, R., de Araújo, T. V. B., Valongueiro, S. A., & Lewis, G. (2011). Postnatal depression in women after unsuccessful attempted abortion. The British Journal of Psychiatry, 198(3), 237-238.

Savarimuthu, R. J. S., Ezhilarasu, P., Charles, H., Antonisamy, B., Kurian, S., & Jacob, K. S. (2010). Postpartum depression in the community: A qualitative study from rural South India. International Journal of Social Psychiatry, 56I(1), 94-102.

Vigod, S. N., Villegas, L., Dennis, C. L., & Ross, L. E. (2010). Prevalence and risk factors for postpartum depression among women with preterm and low-birth-weight infants: A systematic review. BJOG: An International Journal of Obstetrics and Gynaecology, 117(5), 540-550.

Woolhouse, H., Gartland, D., Hegarty, K., Donath, S., & Brown, S. J. (2012). Depressive symptoms and intimate partner violence in the 12 months after childbirth: A prospective pregnancy cohort study. BJOG: An International Journal of Obstetrics and Gynaecology, 119(3), 315-323.

Yelland, J., Sutherland, G., & Brown, S. J. (2010). Postpartum anxiety, depression and social health: findings from a population-based survey of Australian women. BioMed Central Public Health, 10(1), 1.

KNOWLEDGE AND ATTITUDE OF STAFF NURSES REGARDING HANDLING SHARPS : A DESCRIPTIVE STUDY

* Sheeba Rani P, M.Sc (N)
**Anbu S. Kumar, M. Sc (N)
*** Henry Kirubakaran,
****Paul Hema
*****Ananda Ruby Jacob, M. Sc (N)
******Thenmozhi N, M. Sc (N)

* Reader, College of Nursing, CMC, Vellore
** Professor, College of Nursing, CMC, Vellore
***Professor, Staff & Student Health Services, CMC, Vellore
****Professor, Hospital Infection Control Committee, CMC, Vellore
***** Professor, College of Nursing, CMC, Vellore
****** Lecturer, College of Nursing, CMC, Vellore

ABSTRACT

A needle stick or cut from a contaminated sharp can result in a health care worker being infected with Human Immunodeficiency Virus, Hepatitis B Virus, Hepatitis C Virus, and other blood borne pathogens. Nurses are more at risk to sustain sharps related injuries. The present study assessed the knowledge and attitude of nurses regarding handling sharps and the association of these variables with their years of experience. A descriptive study was conducted for a period of 6 weeks among 100 nurses working in multispecialty inpatient areas. Assessment of overall knowledge revealed that 39% had adequate knowledge, 57% had moderately adequate knowledge and 4% had inadequate knowledge. Assessment of overall attitude revealed that 70% had most favorable, 28% favorable, and 2% unfavorable attitude. There was a significant association between years of experience and knowledge of nurses but no significant association was found with attitude of nurses. Ongoing in-service education on handling sharps, post exposure evaluation, and follow up will enhance safe work practices.
Keywords : nurses, handling sharps, needle stick injuries, knowledge, attitude

REFERENCES

Centers for Disease Control and Prevention. (2011). Stop sticks campaign. Retrieved from http://www.cdc.gov/niosh/stopsticks/sharpsinjuries.html

Ebrahimi, H., & Khosravi, A. (2007). Needlestick injuries among nurses. Journal of Research in Health Sciences, 7(2), 56-62.

Haris, J. (2014). Needlestick safety and prevention law. Retrieved from https://www.bd.com/us/safety/ pdfs/Needlestick_Safety_and_Prevention_Law.pdf

Muralidhar, S., Kumar Singh, P., Jain, R. K., Malhotra, M., & Bala, M. (2010). Needle stick injuries among health care workers in a tertiary care hospital of India. Indian Journal of Medical Research, 131(3), 405.

Sharma, S., Gupta, A., & Arora, A. (2010). Knowledge, attitude and practices on needle-stick and sharps injuries in tertiary care cardiac hospital: A survey. Indian Journal of Medical Sciences, 64(9). Occupational Safety and Health Administration. (n.d.). Healthcare wide hazards. Needle stick/sharps injuries. Retrieved from https://www.osha.gov/SLTC/etools/hospital /housekeeping/house keeping.html#contam.equ