STM JOURNALSScientific Technical Medical

Journal of Nursing Science & Practice

(JoNSP)ISSN : 2348-957X

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Jan - April 2014

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Journal of Nursing Science & Practice

Journal of Nursing Science & Practice

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Industrial Tribology Machine Dynamics & Maintenance

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Mrs Baby Sathish NayakProfessor and HOD Department of

Child Health Nursing Manipal College of Nursing Manipal, India.

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 write-

ups/ 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

Director's Desk

STM JOURNALS

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 1

2. Importance of Clinical Decision Making by Nurses in Care of Patients in Acute Care Settings Muthuvenkatachalam S., James Geethu 9

3. Nurses' Perceived Barriers to Research Utilization in a Selected Hospital at Bangalore Mala Thayumanavan, Blessy Paul. 14

4. Opinionnaire of Staff Nurses on Situation, Background, Assessment, Recommendation (SBAR) Handoff ProtocolShalini, Castelino Flavia, Latha T. 19

5. Prevention of Varicose VeinsAkoijam Sangita Devi, Malar Kodi Aathi 23

6. Concept Maps as an Educational Strategy to Enhance Critical Thinking among Student NursesJeena Pradeep, Smriti Arora, Brajmohan Singh. 30

7. Digital Tympanic Membrane Temperature versus Digital Axillary Temperature: Comparative Study among NeonatesCijo Koshy, Smriti Arora 38

8. Effectiveness of Brushing Technique on Oral Health Status of Secondary School Children in a Selected School, Kolkata, West BengalNargis Ahamed 47

ContentsJournal of Nursing Science & Practice

JoNSP (2014)© STM Journals 2014. All Rights Reserved

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

JoNSP (2014)© STM Journals 2014. All Rights Reserved

Journal of Nursing Science & Practice ISSN: 2348 – 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 Geethu

2

1Himalayan College of Nursing, Swami Rama Himalayan University, Dehradun, India

2All 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. Evidence-based 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 client’s life.

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

JoNSP (2014) © STM Journals 2014. All Rights Reserved

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

JoNSP (2014)© STM Journals 2014. All Rights Reserved

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

JoNSP (2014)© STM Journals 2014. All Rights Reserved

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 doctor’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

JoNSP (2014)© STM Journals 2014. All Rights Reserved

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 Arora

1*, Brajmohan Singh

2

1Jamia Hamdard, New Delhi, India

2VMMC & 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 non-equivalent 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

JoNSP (2014)© STM Journals 2014. All Rights Reserved

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 (−0.273 to 0.264) between digital tympanic thermometry and skin probe thermometry in comparison to digital axillary and skin

probe thermometry (−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

JoNSP (2014) © STM Journals 2014. All Rights Reserved

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