Journal of nursing science practice (vol4, issue3) by STM Journals Publication

Journal of Nursing Science & Practice (JoNSP) ISSN : 2348-957X

conducted

Jan - April 2014

STM JOURNALS Scientific

Technical

Medical

www.stmjournals.com

STM Publication(s) STM Publication, a strong initiative by Consortium E-Learning Network Private ltd.(Estd. 2006) was launched in the year 2010 under the support and guidance by our esteemed Editorial and Advisory board members from renowned institutes. Objectives of STM Publication(s): ? Scientific, Technical and Medical research promotions. ? Publication of genuine Research/Review, Short Articles and Case Studies through proper review

process. ? Publishing Special Issues on Conferences. ? Preparing online platform for other print Journals. ? Empowering the libraries with online and print Journals in Scientific, Technical and Medical

domains. ? Publishing and distribution of books on various subjects which mainly falls in the category of

Nanotechnology, Scientific and technical writing & Environment, Health and Safety. Salient Features: ? A bouquet of 100+ Journals that fall under Science, Technical & Medical domains. ? Employs Open Journals System (OJS) A Journal Management & Publishing System. ? The first and one of the fastest growing publication website in India as well as in abroad for its quality

and coverage. ? Rapid online submission and publication of papers, soon after their formal acceptance/ finalization. ? Facilitates linking with the other authors or professionals. ? Worldwide circulation and visibility.

Journal of Nursing Science & Practice (ISSN: 2348-957X) Focus and Scope Covers ? Assessment and Diagnosis ? Care planning ? Community and Home Care ? Critical Care & Pediatric Nursing ? Emergency Gerontology ? Geriatric Nursing

? Anesthesia Journal of Nursing Science & Practice is published (frequency: three times a year) in India by STM Journals (division of Consortium e-Learning Network Private Ltd. Pvt.) The views expressed in the articles do not necessarily reflect of the Publisher. The publisher does not endorse the quality or value of the advertised/sponsored products described therein. Please consult full prescribing information before issuing a prescription for any products mentioned in this publication. No part of this publication may be reproduced, stored in retrieval system or transmitted in any from without written permission of the publisher. To cite any of the material contained in this Journal, in English or translation, please use the full English reference at the beginning of each article. To reuse any of the material, please contact STM Journals (info@stmjournals.com)

STM Journals (division of Consortium e-Learning Network Private Ltd. ) having its Marketing office located at Office No. 4, First Floor, CSC pocket E Market, Mayur Vihar Phase II, New Delhi-110091, India is the Publisher of Journal. Statements and opinions expressed in the Journal reflect the views of the author(s) and are not the opinion of STM Journals unless so stated. Subscription Information and Order: Cost of Journal: ? National Subscription: Rs. 3750/- per Journal (includes 3 print issues), Single Issue copy purchase Rs.1500/copy ? International Subscription: ? Online Only- $99, Print Only-$149 (includes 3 print issues) ? Online + Print-$199 (includes 3 print issues + online access of published back volumes )

To purchase print compilation of back issues please send your query at info@stmjournals.com Subscription must be prepaid. Rates outside the India includes speed delivery charges. Prices subject to change without notice. Mode of Payment: At par cheque, Demand draft, and RTGS (payment to be made in favor of Consortium E-Learning Network. Pvt. ltd., payable at Delhi/New Delhi. Online Access Policy A). For Authors: In order to provide maximum citation and wide publicity to the authors work, STM Journals also have Open Access Policy, authors who would like to get their work open access can opt for Optional Open Access publication at nominal cost as follows India, SARC and African Countries: INR 2500 or 100 USD including single hard copy of Author's Journal. Other Countries: USD 200 including single hard copy of Author's Journal. B). For Subscribers: ? Online access will be activated within 72 hours of receipt of the payment (working days), subject to receipt of

correct information on user details/Static IP address of the subscriber. ? The access will be blocked: ? If the user requests for the same and furnishes valid reasons for blocking. ? Due to technical issue. ? Misuse of the access rights as per the access policy.

Advertising and Commercial Reprint Inquiries: STM Journals with wide circulation and visibility offer an excellent media for showcasing/promotion of your products/services and the events-namely, Conferences, Symposia/Seminars etc. These journals have very high potential to deliver the message across the targeted audience regularly with each published issue. The advertisements on bulk subscriptions, gift subscriptions or reprint purchases for distribution etc. are also very welcome. Lost Issue Claims: Please note the following when applying for lost or missing issues: ? Claims for print copies lost will be honored only after 45 days of the dispatch date and before publication of the

next issue as per the frequency. ? Tracking id for the speed post will be provided to all our subscribers and the claims for the missing Journals will

be entertained only with the proofs which will be verified at both the ends. ? Claims filed due to insufficient (or no notice) of change of address will not be honored. ? Change of Address of Dispatch should be intimated to STM Journals at least 2 months prior to the dispatch

schedule as per the frequency by mentioning subscriber id and the subscription id. ? Refund requests will not be entertained.

Legal Disputes All the legal disputes are subjected to Delhi Jurisdiction only. If you have any questions, please contact the Publication Management Team: info@stmjournals.com; Tel : +91 0120-4781211.

Publication Management Team Chairman Mr. Puneet Mehrotra Managing Director STM Journals, Consortium eLearning Network Pvt. Ltd.(CELNET) Noida ,India

Group Managing Editor Dr. Archana Mehrotra Director CELNET, Delhi, India

Internal Members Puneet Pandeya Manager Associate Editors Gargi Asha Jha Nupur Anand

Monika Malhotra Assistant Manager Assistant Editors Priyanka Aswal Aditya Sanyal Sona Chahal Himani Garg Himani Pandey

External Members

Dr. Bimlesh Lochab Industrial Tribology Machine Dynamics & Maintenance Engineering Centre (ITMMEC) Indian Institute of Technology Delhi, India.

Dr. Rajiv Prakash School of Materials Science and Technology, Institute of Technology, Banaras Hindu University, Varanasi, India.

Prof. S. Ramaprabhu Alternative Energy Technology Laboratory, Department of Physics, Indian Institute of Technology, Chennai, India.

Dr. Rakesh Kumar Assistant Professor, Department of Applied Chemistry, BIT Mesra, Patna, India.

STM Journal (s) Advisory Board & Editorial Board

Dr. Ashish Runthala Lecturer, Biological Sciences Group, Birla Institute of Technology & Science, Pilani Rajasthan, India.

Prof. Bankim Chandra Ray Professor and Head, Department of Metallurgical and Materials Engineering National Institute of Technology, Rourkela, India.

Dr. Baldev Raj Distinguished Scientist & Director, Indira Gandhi Centre for Atomic Research (ICGAR)Kalpakkam, India.

Prof. D. N. Rao Professor, Department of Biochemistry, AIIMS, New Delhi, India.

Dr. Baskar Kaliyamoorthy Associate Professor, Department of Civil Engineering National Institute of Technology Trichy, India.

Prof. Jugal Kishore Professor, Department of Community Medicine, Maulana Azad Medical College, New Delhi, India.

Dr. Hardev Singh Virk Professor Emeritus, Eternal University, Baru Sahib, India.

Dr. Pankaj Poddar Scientist, Physical & Materials Chemistry Division, National Chemical Laboratory, Pune, India.

Dr. Nandini Chatterjee Singh Associate Professor, National Brain Research Centre, Manesar, India.

STM Journal (s) Advisory Board & Editorial Board

Dr. Priyavrat Thareja

Dr. Rakesh Kumar

Head, Materials and Metallurgical Engineering department, PEC University of Technology, Chandigarh, India.

Assistant Professor, Department of Applied Chemistry, BIT Mesra, Patna, India.

Dr. Shankargouda Patil

Dr. Shrikant Balkisan Dhoot

Asst. Prof., Department of Oral Pathology, KLE Society's Institute of Dental Sciences, Bangalore, India.

Head Research & Development, Nurture Earth R&D Pvt Ltd MIT Campus, Beed bypass road, Aurangabad, India.

Prof. Subash Chandra Mishra

Prof. Sundara Ramaprabhu

Professor, Metallurgical & Materials Engineering Department, NIT, Rourkela, India.

Professor, Department of Physics Indian Institute of Technology Madras, India.

Prof. Yuwaraj Marotrao Ghugal

Mrs Baby Sathish Nayak

Professor and Head Department, Govt. College of Engineering Station Road, Osmanpura, Aurangabad, India.

Professor and HOD Department of Child Health Nursing Manipal College of Nursing Manipal, India.

Director's Desk

STM JOURNALS

I take the privilege to present the hard copy compilation for the [Volume 4 Issue (3)] of Journal of Nursing Science & Practice. The intension of JoNSP is to create an atmosphere that stimulates creativeness, research and growth in the area of Nursing Science & Practice. The development and growth of the mankind is the consequence of brilliant Research done by eminent Scientists and Engineers in every field. JoNSP provides an outlet for Research findings and reviews in areas of Nursing Science & Practice found to be relevant for National and International recent developments & research initiative. The aim and scope of the Journal is to provide an academic medium and an important reference for the advancement and dissemination of Research results that support high level learning, teaching and research in the domain of Nursing Science & Practice. Finally, I express my sincere gratitude and thanks to our Editorial/ Reviewer board and Authors for their continued support and invaluable contributions and suggestions in the form of authoring writeups/ reviewing and providing constructive comments for the advancement of the journals. With regards to their due continuous support and co-operation, we have been able to publish quality Research/Reviews findings for our customers base. I hope you will enjoy reading this issue and we welcome your feedback on any aspect of the Journal.

Dr. Archana Mehrotra Director STM Journals

Journal of Nursing Science & Practice

Contents

1. Effectiveness of Video-based Teaching Program on Breastfeeding in Terms of Knowledge and Practice among Postnatal Mothers in a Selected Rural Community of West Bengal, India Barkha Devi

2. Importance of Clinical Decision Making by Nurses in Care of Patients in Acute Care Settings Muthuvenkatachalam S., James Geethu

3. Nurses' Perceived Barriers to Research Utilization in a Selected Hospital at Bangalore Mala Thayumanavan, Blessy Paul.

4. Opinionnaire of Staff Nurses on Situation, Background, Assessment, Recommendation (SBAR) Handoff Protocol Shalini, Castelino Flavia, Latha T.

5. Prevention of Varicose Veins Akoijam Sangita Devi, Malar Kodi Aathi

6. Concept Maps as an Educational Strategy to Enhance Critical Thinking among Student Nurses Jeena Pradeep, Smriti Arora, Brajmohan Singh.

7. Digital Tympanic Membrane Temperature versus Digital Axillary Temperature: Comparative Study among Neonates Cijo Koshy, Smriti Arora

8. Effectiveness of Brushing Technique on Oral Health Status of Secondary School Children in a Selected School, Kolkata, West Bengal Nargis Ahamed

Journal of Nursing Science & Practice ISSN: 2348 – 957X Volume 4, Issue 1 www.stmjournals.com

Effectiveness of Video-based Teaching Program on Breastfeeding in Terms of Knowledge and Practice among Postnatal Mothers in a Selected Rural Community of West Bengal, India Barkha Devi* Sikkim Manipal College of Nursing, Sikkim Manipal Institute of Health and Medical Sciences Gangtok, Sikkim, India

Abstract The study assessed knowledge and practice of breastfeeding in a rural community of West Bengal. The investigator adopted the pre-experimental approach with single group pretest-posttest design, took 30 postnatal mothers by convenient sampling technique, and used a structured interview schedule and observational checklist for data collection to see the effectiveness of video-based teaching program on breastfeeding and found out the relationship knowledge and practice. Study findings reveal that 56.6% mothers are doing exclusive breastfeeding and video-based teaching program is effective in enhancing knowledge and practice among postnatal mothers as seen by ‘t’ value (t29 = 2.04, P < 0.05) and there is relationship between posttest knowledge score and posttest practice score as seen by correlation coefficient (P < 0.05).The posttest knowledge score is not significantly associated with parity and educational status of mothers as seen by chi square value (χ2(1) = 3.841, P > 0.05) respectively. This study shows a noteworthy result of breastfeeding duration and cost-effective method of breastfeeding education.

Keywords: Effectiveness, knowledge, practice, breastfeeding, video based teaching program, postnatal mothers

Journal of Nursing Science & Practice ISSN: 2348 â&#x20AC;&#x201C; 957X Volume 4, Issue 1 www.stmjournals.com

Importance of Clinical Decision Making by Nurses in Care of Patients in Acute Care Settings Muthuvenkatachalam S.1*, James Geethu2 1

Himalayan College of Nursing, Swami Rama Himalayan University, Dehradun, India 2 All India Institute of Medical Sciences, New Delhi, India

Abstract Clinical decision making is a complex process. Healthcare workers need to consider various aspects of healthcare using a vast body of knowledge while formulating a clinical decision. More recently, clinical decision making has become a collaborative process and patients are also involved as much as possible. The ultimate goal of every clinical decision making is to achieve the best health outcomes for the clients. Through review of relevant literatures, seven core skills were identified as a guide to decision making in nursing practice, i.e., pattern recognition, critical thinking, communication skills, evidence-based approaches, team work, sharing, and reflection. The graduate nurses use mainly three models of clinical decision making: hypothetic-deductive reasoning, pattern recognition, and intuition. The registered nurses and midwives are expected to practice within the relevant competency standards and decision making. Skill rehearsal through simulated environments and appropriate feedback or reflection help nurses to demonstrate cognitive pitfalls in decision making and rectify the mistakes. More guidance to novice nurses through appropriate graduate training and continuous professional development programs will be helpful to enhance clinical decision making. Evidencebased practice needs to be incorporated in clinical practice by nurses to enhance clinical decision making. In order to promote effective clinical decision making, education needs to be provided to consider and manage multiple factors influencing it, rather than focusing only on immediate decision making tasks like nursing diagnosis and interventions. Thus effective clinical decision making by nurses can improve the quality of nursing care and clientâ&#x20AC;&#x2122;s life.

Keywords: Decision making, clinical decision making, acute care nursing

Journal of Nursing Science & Practice ISSN: 2348 – 957X Volume 4, Issue 1 www.stmjournals.com

Nurses’ Perceived Barriers to Research Utilization in a Selected Hospital at Bangalore Mala Thayumanavan*, Blessy Paul Manipal College of Nursing, H. V. Halli, Rajarajeshwari Nagar, Bangalore, India Abstract Evidence-based nursing (EBN) involves identifying research findings and implementing them in nursing practice to increase the quality of patient care. In recent years, there has been an increasing demand for quality health care. Thus a greater emphasis has been placed on EBN. However, there has been little documentation on the implementation of evidence-based practice (EBP) in Indian scenario. The perceptions of nurses play a significant role in the adoption of new guidelines and practices based on EBP. Therefore, the purpose of this study was to explore the perceived barriers that prevent the translation of research into practice. A descriptive design was adopted for research. The setting is a private hospital at Bangalore. The sample included 150 registered nurses with qualification of GNM and B.Sc. Nursing recruited using purposive sampling technique. A Structured questionnaire was used. Socio demographic variables and Barriers to Research Utilization Scale-five point Likert scale were used. The data was collected among nurses working at acute care setting. The highest mean scores of barrier scale were: insufficient time on the job to implement new ideas (2.97); nurses does not have enough authority to change nursing procedures (2.87); nurses do not have time to read research (2.80), etc. The moderate to great barrier perceived by nurses were: the nurses do not see the value of research for practice (69.3%); research reports are not readily available (68%); etc. The results are consistent with previous studies and suggest that nursing leaders should address the deficit areas and establish systems to meet the needs of nurses.

Keywords: Evidence based nursing, perceived barriers, research utilization

Journal of Nursing Science & Practice ISSN: 2348 – 957X Volume 4, Issue 1 www.stmjournals.com

Opinionnaire of Staff Nurses on Situation, Background, Assessment, Recommendation (SBAR) Handoff Protocol Shalini*, Castelino Flavia, Latha T. Department of Medical Surgical Nursing, Manipal College of Nursing, India Abstract This study aimed at obtaining the opinion about situation, background, assessment, recommendation (SBAR) technique of handoff using an opinionnaire among nurses. A survey approach was used. The study was conducted in a tertiary care hospital and consisted of 44 staff nurses. The data were collected through an opinionnaire on SBAR technique during patients’ handoff. The data was analyzed by using descriptive statistics. Out of 44 subjects, 25 strongly agree that SBAR is relevant to their work area and 26 of them agree that it is applicable to nursing practice. Two of them disagree that the information in SBAR is easy to comprehend. Twenty-seven samples strongly agree that SBAR helps in ensuring patient safety, 26 of them strongly agree that it brings uniformity in handing over and 28 of them strongly agree that it helps in providing quality care. Majority (30) of the samples strongly agreed that SBAR provides a framework to briefly present the patient situation and 26 of them strongly agreed that it enables quick glance to patient. Findings of the study revealed that majority of staff nurses either agree or strongly agree for most of the items on SBAR technique of communication during patients’ handoff.

Keywords: SBAR, handoff, nurses, patients, opinionnaire

Journal of Nursing Science & Practice ISSN: 2348-957X Volume 4, Issue 1 www.stmjournals.com

Prevention of Varicose Veins Akoijam Sangita Devi1*, Malar Kodi Aathi2 Department of Medical Surgical Nursing, M. M. Institute of Nursing, M. M. University, Mullana, Ambala, Haryana-133207, India Department of Child Health Nursing, M. M. Institute of Nursing, M. M. University, Mullana, Ambala, Haryana-133207, India

Abstract Varicose veins are abnormal, dilated blood vessels caused by weakening in the vessel wall. Such conditions that increase pressure on the leg veins such as overweight, lack of exercises, hormonal fluctuations during pregnancy and menopause, smoking; constipation or people who have prolonged standing or sedentary position or repeated heavy lifting make veins of legs very weak and develop into varicose veins. Researchers report that a mild care of varicose veins does not usually require a doctorâ&#x20AC;&#x2122;s care, discomfort can be relieved with at-home treatment and various alternative remedies, such as acupuncture and acupressure, aromatherapy, color therapy, diet and supplements, herbal therapy, exercise, Yoga, homoeopathy, hydrotherapy, etc. Other preventive measures are maintaining ideal weight and avoiding prolonged standing and tight clothing that constricts waist, groin or legs; avoiding crossing legs while sitting, avoiding wearing high heels and eating low-salt diet that is rich in high fiber food to reduce retention of water or swell. Superficial varicose veins normally do not require medical attention but to relieve the discomfort; the doctor may recommend elastic support stockings.

Keywords: Varicose veins, hormonal fluctuations, acupuncture, acupressure, aromatherapy, color therapy, herbal therapy, homoeopathy, hydrotherapy, elastic support stockings

Journal of Nursing Science and Practice ISSN: 2348–957X Volume 4, Issue 1 www.stmjournals.com

Concept Maps as an Educational Strategy to Enhance Critical Thinking among Student Nurses Jeena Pradeep1, Smriti Arora1*, Brajmohan Singh2 1

Jamia Hamdard, New Delhi, India VMMC & Safdurjung Hospital, New Delhi, India

Abstract A quasi experimental study to assess the effectiveness of concept maps as a teaching strategy to facilitate critical thinking among student nurses with regard to congenital heart defects was conducted with primary objective to assess effectiveness of concept maps as a teaching strategy on critical thinking of student nurses with regard to congenital heart defects. Ethical clearance from the Institutional Review Board was obtained. The conceptual framework adopted was Stufflebeam’s CIIP model. A quantitative experimental research approach was adopted for the study with nonequivalent control group design using total enumerative sampling technique. The study involved 86 B.Sc. 3rd year student nurses of Nightingale Institute of Nursing (45) and Rufaida College of Nursing (41) as control and experimental group respectively. The control group was exposed to lecture method, one of the conventional teaching methodologies, and experimental group was taught with concept maps. The primary outcome variable, critical thinking ability was measured using a structured critical thinking questionnaire. The pretest and posttest scores were assessed on day 1 and day 10 respectively. Data collected were analyzed using SPSS 16. Maximum number of sample subjects 43(77%) in control group were in the age group of 19–21 years as compared to 35 (76%) in the experimental group. Majority of the students 31 (68%) belonged to Christian religion in the control group whereas most of the students 19 (46%) belonged to Muslim religion in the experimental group. The findings also show that the mean posttest critical thinking scores of the control group (15.42 + 3.48) and experimental group (18.80 + 5.55) were higher than their mean pretest critical thinking scores. However, comparison revealed a statistically significant difference between the posttest scores of both the groups indicating a higher score in experimental group. The study showed a significant improvement in the critical thinking ability of student nurses who were exposed to concept maps. It is needed to develop a critical thinking assessment tool which will suit the Indian nursing community and study can be conducted on a large sample for different topics.

Keywords: Concept maps, critical thinking, education

Journal of Nursing Science and Practice ISSN: 2348-957X Volume 4, Issue 1 www.stmjournals.com

Digital Tympanic Membrane Temperature versus Digital Axillary Temperature: Comparative Study among Neonates Cijo Koshy, Smriti Arora* Rufaida College of Nursing, Jamia Hamdard, New Delhi, India Abstract Neonatal hypothermia continues to be a significant issue in the developing countries and there remains considerable controversy regarding the most appropriate thermometer and the best anatomical site for temperature measurement. In this diagnostic study, the prime objective was to find which thermometry practice could be proved effective for assessment of temperature in neonates. For this, the authors evaluated the agreement between tympanic thermometry measurements, digital axillary thermometry measurements and skin probe thermometry in neonates and evaluated the diagnostic utility of digital axillary and digital tympanic thermometers in making decisions for the assessment of hypothermia. They also measured the nursing time associated with both thermometry methods. The study was conducted from December 2012 to February 2013. The setting was a rural tertiary care institution. Neonates of gestational age 32 weeks and above, admitted in the nursery under constant skin temperature monitoring (gold standard) were recorded with their axillary temperature using a digital axillary thermometer and tympanic temperature using an infrared tympanic membrane thermometer. The temperatures were recorded three times a day and consecutively for three days of a particular neonate and all observations were recorded in the temperature recording sheet. Significant agreement between the tympanic thermometry measurements and digital axillary thermometry in comparison to skin probe thermometry was found. Diagnostic utility of digital tympanic thermometer and significantly less nursing time associated with tympanic thermometry was found. Statistical analysis showed positive correlation and good agreement (â&#x2C6;&#x2019;0.273 to 0.264) between digital tympanic thermometry and skin probe thermometry in comparison to digital axillary and skin probe thermometry (â&#x2C6;&#x2019;0.654 to 0.349) which showed a poor agreement. Digital tympanic thermometer was found to have high sensitivity (90.5%), specificity (92.9%), and positive predictive value (84.1%) than digital axillary thermometry with a sensitivity (88.6%) and specificity (82.4%) which was comparatively low. In addition to this, mean nursing time associated with digital tympanic thermometry was significantly less than the digital axillary thermometry. The agreement between digital tympanic thermometer and skin probe thermometry was good, with digital tympanic thermometry having high sensitivity, specificity and positive predictive values which makes a good diagnostic utility of the tool, especially in detecting cases of hypothermia. Nursing time associated with digital tympanic thermometry was found significantly less. Tympanic thermometer seems to be quick and fast in giving temperature results in comparison to digital axillary temperature.

Keywords: Digital axillary thermometry, digital tympanic thermometry, diagnostic utility, agreement

Journal of Nursing Science and Practice ISSN: 2348–957X Volume 4, Issue 1 www.stmjournals.com

Effectiveness of Brushing Technique on Oral Health Status of Secondary School Children in a Selected School, Kolkata, West Bengal Nargis Ahamed* Sikkim Manipal College of Nursing, Sikkim Manipal University, 5th Mile, Tadong, Gangtok, Sikkim–737102, India

Abstract A study was conducted to assess the effectiveness of brushing technique on oral health status of 5th and 6th standard secondary school children in a selected school, Kolkata, West Bengal. Objectives of the study were to assess the oral health status of the school children before and after demonstration of roll brushing technique, to determine the knowledge of oral health before and after demonstration of roll brushing technique and to find out the brushing technique practiced by school children before and after demonstration of roll brushing technique with structured teaching program to find out the effectiveness of such intervention on improving the knowledge and practice of school children. Pre-experimental research approach was used with one group pretest and posttest design. A valid and reliable structured knowledge questionnaire and observation checklists were used for data collection. The pilot study was conducted to find out the feasibility of the study. The final study was conducted in a selected school in Kolkata with 65 samples. Personal background data were analyzed in terms of frequency and percentage distribution. Relationship between oral health status, knowledge and practice was revealed by ‘t’ test. The demonstration of brushing technique was found to be effective. But significant relationship was not found between oral health status, knowledge and practice. The investigator recommends this type of further study in future to enhance the awareness among children regarding oral health.

Keywords: Technique, roll brushing technique, teaching program, structured teaching program with lecture and power point presentation