SYNOPSIS FOR REGISTRATION

OF SUBJECT FOR DISSERTATION

SUBMITTED BY:

Mr. SHYAMRAJ V.

I M.Sc. NURSING

MEDICAL SURGICAL NURSING

(2011-2013 BATCH)

FORTIS INSTITUTE OF NURSING#20/5, YELACHENAHALLI, KANAKAPURA ROAD

BANGALORE-560078

SYNOPSIS FOR REGISTRATION OF SUBJECT FOR

DISSERTATION

1. NAME OF THE

CANDIDATE AND

ADDRESS

Mr. SHYAMRAJ V.

M.Sc. NURSING 1ST YEAR,

FORTIS INSTITUTE OF

NURSING,

#20/5, YELACHENAHALLI,

KANAKAPURA MAIN ROAD,

BANGALORE – 560 078.2. NAME OF THE

INSTITUTION

FORTIS INSTITUTE OF

NURSING

3. COURSE OF THE

STUDY AND THE

SUBJECT

MASTERS DEGREE IN

NURSING,

MEDICAL SURGICAL

NURSING4. DATE OF ADMISSION

TO COURSE

31ST MAY 2011.

5. TITLE OF THE TOPIC “A STUDY TO ASSESS

THE EFFECTIVENESS OF

STRUCTURED TEACHING

PROGRAMME ON

KNOWLEDGE REGARDING

SELECTED FIRST AID

MEASURES AMONG SCHOOL

TEACHERS OF SELECTED

URBAN SCHOOLS IN

BANGALORE”.

1

6.0 BRIEF RESUME OF THE INTENDED WORK

INTRODUCTION

“Not using a skill regularly increases the likelihood of forgetting

and of losing confidence with ability.”

- Unknown Author

Injuries are very common now a day and can occur at any point of

time in our day to day life. Among them, injuries in school children rank

a major part. The most frequent causes of school related injuries requiring

hospitalization are falls and sports activities. Play ground equipment

related injuries occur on school play ground during school hours and

these require adequate supervision.1

First aid is the immediate care given to a person who has been

injured or suddenly fallen ill. It includes self-help and home care if

medical assistance is not available or is delayed. It also includes well-

selected words of encouragement, evidence of willingness to help, and

promotion of confidence by demonstration of competence.2

First aid is the immediate care given to victims of accidents before

trained medical workers arrive. Its goal is to stop and, if possible, reverse

harm. It involves rapid and simple measures such as clearing the air

passageway, applying pressure to bleeding wounds or dousing chemical

burns to eyes or skin. First aid personnel are persons on the spot,

generally workers who are familiar with the specific conditions of work,

and who might not be medically qualified but must be trained and

prepared to perform very specific tasks. Not every worker is suitable to

be trained for providing first aid. First aid personnel should be selected

carefully, taking into account attributes such as reliability, motivation and

the ability to cope with people in a crisis situation.3

2

First aid training not only provides with knowledge and skill to

give life support and other emergency care but also helps you to develop

safety awareness and habits that promote safety at home, at work, during

recreation, and on the streets and highways. In the promotion of safety

awareness, it is important to closely relate three terms: cause, effect, and

prevention.2

The purpose of first aid is twofold: In cases where a person will

need help from a medical practitioner or nurse, to give treatment for the

purpose of preserving life and minimising the consequences of injury and

illness until such help is obtained and to treat minor injuries which would

otherwise receive no treatment or which do not need treatment by a

medical practitioner or nurse. It is on this basis that facilities and

arrangements for first aid should be provided in educational

establishments.4

Every school establishment shall have as a minimum one member

of staff who is a trained first aider and two emergency first aiders in the

work place. Head teachers and managers must ensure that a qualified first

aider is in attendance at all times, including foreseeable absences.

Additional trained staff may therefore be required to ensure that suitable

arrangements are in place to ensure that first aid of a sufficient standard

can be administered.4

The provision of first aid should always have a direct relationship

to general health and safety organization, because first aid itself will not

handle more than a small part of workers’ total care. First aid is a part of

the total health care for workers. In practice, its application will depend to

a large extent on persons present at the time of an accident, whether co-

workers or formally trained medical personnel. This immediate

3

intervention must be followed by specialized medical care whenever

needed.3

First aid cannot be planned in isolation. It requires an organized

approach and co-operative effort. The training of first aid personnel is the

single most important factor determining the effectiveness of organized

first aid. Training programme will depend on the circumstances within

the enterprise, especially the type of work and the risks involved. First aid

boxes should always be easily accessible near areas where accidents

could occur. They should be able to be reached within one to two

minutes.3

6.1 NEED FOR THE STUDY

Our environment is full of accidents, emergency illnesses and other

health problems that have different level of severity and magnitude. The

problems can be generally classified into two. These are accidents

(deliberate and incidental) and emergency illnesses. The consequences of

these health problems could end up in physical disability and death.

However, the physical disability or death can be significantly reduced

and/or prevented by first-aid treatment using locally available materials.5

According to the National safety council’s report (1952), on the

location at which injuries occur, it was reported that 57% was school

related injuries occurred in the school building, school play ground or

while going or coming back from the school and only 43% were non-

school injuries and occurred either at home or in public places. Immediate

medical attention and early medical help is essential to reduce morbidity

and mortality associated with such trauma.6

Teachers in five primary schools were surveyed for their

knowledge and attitudes about epilepsy. An analysis of 113 teacher

4

responses revealed knowledge deficits. Misconceptions regarding first aid

were also common. Few teachers had not attended any educational

programme on epilepsy. Only about one-fifth of the teachers were

confident in dealing with an epileptic child.7

Most of the accidents requiring first aid in a school situation are

minor and subsequently are not brought to the attention of a medical

professional. Even the most incidental injury should command the

teachers attention and first aid care. The procedures involved in the first

aid cannot be acquired completely from a text book alone and it must be

practised over a period of time until the first aider can perform the

procedure correctly. First aid courses provide opportunities to practice,

acquire proper skills in procedures and to complete first aid for

emergencies. Hence each teacher should be trained to render first aid

care, so that when any emergencies arrive he or she will be competent in

their ability to deal with the situation.6

WHO technical report series (1999) showed that schools had the

potential to provide an excellent base for large scale programming and

there is a need to strengthen the school as a setting for health intervention.

Schools can provide many services to young people, in addition to formal

education, such as health education, skill development in the areas such

as life saving skills. A school is an appropriate setting for the introduction

of teaching and training on life saving first aid skills and is often

economically efficient and there are possibilities for short term and long

term evaluation.8

In response to the Health and Safety (First Aid) Regulations 1981,

guidance from the Health and Safety Executive in the Approved Code of

Practice 'First Aid at Work', amended 1997 and advice from the

5

Department for Education and Skills, the Department has issued a

detailed policy and guidance to all establishments. It is recognised that

there is a need in educational establishments to provide facilities and

arrangements for first aid when an accident occurs. First aid is a vital

part of every establishment’s provision for health and safety. The aim is

to clarify the Department’s policy on the standard and level of first aid

provision in schools and to provide guidance for managers to assist them

when assessing their needs. It is not possible in most cases to determine

precise requirements for first aid provision due to the wide nature of

establishment types and activity. Head teachers and managers should

assess their own requirements for first aid provision based on local needs

and the minimum guidelines.4

In America, to ensure the safety and well being of students while

they are in school, the students and school personnel are trained to

provide first aid and this is the first critical link in the management of

trauma (American School Health Association, 2000), each school should

have a well equipped first aid room, a trained first aider available in the

first aid room or on call, at least one student from each class trained in

first aid. They have also pointed out that their pupils will be an asset to

children/school at the time of emergency and there is no substitute for

proper training.6

WHO (1999) through its expert committee as comprehensive

school health education and promotion pointed out that some of the

components of school health programmes, have proved to be effective but

there is no practical guidance on their implementation and they have

recommended that every school should enable children and adolescent at

all levels to learn critical health and life saving skills.8

6

The Health and Safety Executive has issued the following

guidance: “Research has shown that following training, the practical

skills of first aiders can deteriorate. The Health and Safety Executive

strongly recommends that it is good practice for first aiders to undergo

annual ‘refresher’ courses. It is important that employers make sure

qualified first aiders attend these courses to help maintain their basic

skills and keep up to date with any changes to first aid procedures.” Head

teachers must ensure that all first aiders holding the First Aid at Work

certificate, the Schools First Aid certificate completes annual basic skills

update. First Aiders in designated services and settings who hold either

the First Aid at Work or Emergency First Aider in the Workplace

certificates may also need to complete the annual skills updated if this has

been identified via the Children’s Services first aid risk assessment.4

Providing first aid in the emergency situations can be

overwhelming and traumatic. Encouraging more people to learn basic

first aid and to intervene will rely to some extent on the development of

improved strategies to provide support to those who have given first aid

care in an emergency.9 so the investigator feel that it is necessary to

impart knowledge to the school teachers regarding selected first aid

measures with the help of structured teaching programme which help

them to take appropriate first aid measures in emergencies.

6.2 REVIEW OF LITERATURE

A review of literature on the research topic makes the researcher

familiar with the existing studies and provides information which helps to

focus on a particular problem, lays a foundation upon which to base new

knowledge. It creates accurate picture of the information found on the

subjects.10

7

Reviews include,

6.2.1 Reviews related to first aid measures in school children.

6.2.2 Reviews related to knowledge of teachers regarding first aid

measures.

6.2.3 Reviews related to effectiveness of structured teaching programme.

6.2.1 Reviews related to first aid measures in school children.

A retrospective study of the hospital files of patients younger than

12 years admitted to the institute of ophthalmology of Verona University

for eye injuries suggests that eighty-eight cases of eye injuries [69 (78%)

boys, 19(22%) girls] were identified; mean age of children admitted was

7.2 years. The most frequent causes of eye injuries were domestic

accidents in patients younger than 6 years (25%) and accidents at play in

those older than 6 years (35%). Scissors were the most frequent causative

agents in children under 6 and toys, stones, and ball injuries in those over

6. It was concluded that the major cause of eye injuries in childhood are

preventable; thus more adequate adult supervision and educational and

legislative measures are necessary and useful in order to reduce

prevalence and morbidity of these accidents.11

A descriptive study was conducted to estimate the incidence of

minor injuries and to study the wound care practices of school children. A

fortnightly follow up of urban and rural high school children was done in

Chandigarh and rural Haryana. Initial point prevalence survey was

followed by fortnightly follow up survey involving interview for

assessing incidence and wound care practices among students. The setting

was government high schools of Chandigarh and rural Ambala. It was

found that in average episodes of minor injuries per year, point

prevalence was higher in urban area. First aid training of teachers or the

8

students were lacking in both the areas. Many of the injuries occurred

during the school time. Rural students were more tolerant to minor

injuries. It was concluded that incidence of minor injuries was higher in

rural area as compared to urban area. Training on wound care is

recommended.12

A descriptive study was conducted in New Zealand to determine

the incidence, nature and circumstances of unintentional injuries to

students at school which resulted in death or hospitalization. Fatalities

were identified from national mortality data for inclusive. Hospitalization

cases were identified from the national hospital discharge summary. The

circumstances of deaths were diverse with the most frequent event being

a fall. Injury rates declined with increasing age, and males had higher

rates than females for all ages. Fractures of the upper and lower limbs and

intracranial injury represented more than three-quarters of all injury. The

results suggest that prevention policy should place emphasis on those in

their first two years of schooling, provision of protective equipment for

sporting activities, establishment of standardized injury referral

procedures, first-aid training, and a standardized injury reporting

system.13

6.2.2 Reviews related to knowledge of teachers regarding first aid

measures.

A descriptive study was conducted to determine the extent of

training and emergency care knowledge of public school teachers in

Midwestern states. A secondary purpose was to assess the frequency of

injury and illness in the school setting requiring the teacher to first

respond. A questionnaire was developed and pretested. A discrimination

index was used for validation of the instrument and a reliability

coefficient was computed using the Kuder-Richardson Formula. A

9

randomly recruited group of public school nurses from Arkansas, Kansas

and Missouri administered the instrument to 334 teachers who had no

prior knowledge of the test. One third of the teachers had no specific

training in first aid. Most of the respondents strongly agreed that

emergency care training should be required in teacher preparation

programs. The average score for all respondents on the emergency care

test was 58%. Significant deficiencies were noted for recognition and

appropriate treatment of student emergencies. It was concluded that most

of the public school teachers in this study were deficient in both training

and knowledge of emergency care and basic life support modalities.14

A descriptive study was conducted to determine the knowledge and

attitudes of a sample of Turkish teachers regarding the administration of

first aid. Three hundred and twelve teachers took part in this study and

data were obtained using a questionnaire. It included 30 questions that

help identify the teachers and determine their knowledge and attitudes

about first aid. Data were analyzed by chi-square test. In this study it was

determined that most of the teachers do not have correct knowledge and

attitudes about first aid. It was found that as the age of the teachers

increases, appropriate first aid practice becomes more and more unlikely.

The results of this study showed that teachers did not have enough

knowledge about first aid.15

A descriptive study was conducted to assess the level of knowledge

of primary school teachers in Ajman with regards to the immediate

emergency management of dental trauma. It was done by means of self-

administered structured questionnaire which was sent to teachers in

randomly selected primary schools in Ajman. A total of 161 teachers

responded. Among 138 respondents gave the appropriate management for

fractured tooth. Most teachers were unsatisfied with their level of

10

knowledge for dental trauma and the majority were interested in having

further education on the topic. The findings revealed that the level of

knowledge of management of dental trauma among school teachers in

Ajman is inadequate, and education campaigns are necessary to improve

their emergency management of dental injuries.16

6.2.3 Reviews related to effectiveness of structured teaching

programme.

An experimental study was conducted to find out the effectiveness

of a structured teaching programme on knowledge about cancer

prevention and early detection among 99 teacher trainees in a selected

college of education in Udupi taluk. The findings of the study revealed a

significant increase in mean post-test knowledge scores on cancer

prevention. This indicates that the structured teaching programme was an

effective method to improve knowledge of the people.17

6.3 STATEMENT OF THE PROBLEM

A STUDY TO ASSESS THE EFFECTIVENESS OF

STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE

REGARDING SELECTED FIRST AID MEASURES AMONG

SCHOOL TEACHERS OF SELECTED URBAN SCHOOLS IN

BANGALORE.

6.4 OBJECTIVES

1. To assess the demographic profile of the school teachers.

2. To assess the knowledge of the school teachers regarding selected

first aid measures.

3. To find out the effectiveness of structured teaching programme on

knowledge of school teachers regarding selected first aid measures

by conducting post-test.

11

4. To find out the association between the post-test knowledge scores

of school teachers regarding selected first aid measures and

selected demographic variables.

6.5 OPERATIONAL DEFINITIONS

6.5.1 ASSESS: In the present study assess refers to, ‘statistical

measurement of the knowledge scores of the school teachers regarding

selected first aid measures as observed by using structured questionnaire’.

6.5.2 EFFECTIVENESS: In the present study effectiveness refers to,

‘the gain in knowledge among school teachers as evidenced by

improvement in post-test knowledge scores when compared with pre-

test’.

6.5.3 STRUCTURED TEACHING PROGRAMME: In the present

study structured teaching programme refers to, ‘systematically developed

structured teaching programme designed for a group of school teachers

to provide information regarding selected first aid measures such as

injuries, fracture, heat stroke, heat exhaustion, nose bleeding, foreign

bodies, poisoning, snake bite, electric shock, and drowning’.

6.5.4 KNOWLEDGE: In the present study Knowledge refers to, ‘the

correct responses of the school teachers related to the selected first aid

measures’.

6.5.5 SCHOOL TEACHER: In the present study, school teacher refers

to ‘a person who is qualified and provides education for the students’.

6.5.6 FIRST AID: In the present study First aid refers to, ‘First aid is the

immediate care given to a person who has been injured or suddenly fallen

ill, before taking him to hospital’.

12

6.5.7 SELECTED FIRST AID MEASURES: In the present study

selected first aid measures refers to, ‘providing first aid in school for

injuries, fracture, heat stroke, heat exhaustion, nose bleeding, foreign

bodies, poisoning, snake bite, electric shock, and drowning ’.

6.6 HYPOTHESIS

H0: There is no significant difference between the pre and post-test

knowledge scores of the school teachers regarding selected first

aid measures.

H0.1: There is no significant association between the post-test knowledge

scores of school teachers regarding selected first aid measures

with their demographic variables.

H1.1: There is a significant difference between pre and post-test

knowledge scores of school teachers regarding selected first aid

measures.

H1.2: There is a significant association between post test knowledge

scores of school teachers with selected demographic variables

6.7 VARIABLES

INDEPENDENT VARIABLE:

Structured teaching programme regarding selected first aid measures

among school teachers of selected urban schools, Bangalore.

DEPENDENT VARIABLE:

Knowledge of school teachers regarding selected first aid measures.

DEMOGRAPHIC VARIABLES:

It includes age, sex, religion, educational status, income, years of

teaching experience, place of residence, and previous exposure to the

information.

13

7.0 MATERIALS AND METHODS

7.1.1 Source of data : School teachers of selected urban

schools, Bangalore.7.1.2 Research approach : Experimental approach.7.1.3 Research design : Quasi-experimental design with one

group pre-test Post-test.7.1.4 Population : School teachers of selected urban

schools in Bangalore.

7.1.5 Sample : School teachers working in selected

urban schools, Bangalore.

7.1.6 Research setting : Selected urban schools of Bangalore.

7.1.7 Sampling technique : Non probability purposive sampling

technique7.1.8 Sample size : 607.1.9 SAMPLE CRITERIA

INCLUSION CRITERIA: School teachers who are,1. willing to participate in the study.

2. present during the period of data

collection.EXCLUSION CRITERIA: School teachers who had,

1. already undergone first aid

training.

14

7.2.1 TOOL FOR DATA COLLECTION

SECTION 1: Includes age, sex, religion, educational status, income,

years of teaching experience, place of residence, and previous exposure to

the information.

SECTION 2: Structured questionnaire to assess the knowledge of school

teachers regarding selected first aid measures.

7.2.2 METHOD OF DATA COLLECTION

Pre-test knowledge will be assessed by using structured

questionnaire, followed by administration of a structured teaching

programme, and post-test knowledge will be assessed by administering

the same structured questionnaire.

DESCRIPTIVE STATISTICS

Mean, mean %, median and standard deviation will be used for assessing

the demographic characteristics.

INFERENTIAL STATISTICS

Student’s paired t-test will be used to find out the significant mean

difference between mean pre and post-test knowledge scores of the

School teachers. Chi-square (χ2) test for measuring association between

the knowledge levels of school teachers with selected demographic

variables.

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR

INTERVENTIONS TO BE CONDUCTED ON OTHER

HUMANS OR ANIMALS? IF SO, PLEASE DESCRIBE

BRIEFLY.

YES.

15

7.4 HAS THE ETHICAL CLEARANCE BEEN OBTAINED FROM

INSTITUTION?

1. The ethical clearance is obtained from the research committee of

Fortis Institute of Nursing.

2. Written permission will be obtained from the concerned authorities

of selected urban schools in Bangalore.

3. Written consent will be obtained from each of the participants.

16

8.0 LIST OF REFERENCES

1. Facts about injuries to children at school. Available at: URL:

http://ukhealthcare.uky.edu/uploadedFiles/school.facts.pdf .

2. Parker G Thomas. Introduction to first aid. Available at: URL:

http://www.healthguidance.org/entry/8941/1/introduction_to_First_

Aid.html.

3. Dajer J Antonio. First aid. Available at: URL:

www.ilo.org/safework_bookshelf/english?content&nd=857170142

4. Health and safety team. Guidance for Head teachers and managers on

first aid. East Sussex county council, Flinder University. 2011.

Available at: URL:

https://czone.eastsussex.gov.uk/schoolmanagement/healthsaftey/

main/Documents/First%20Aid%20guidance .

5. Ababa Addis. First Aid extension package. Federal Democratic

Republic of Ethopia, Ministry of health. 2003 Sep. Available at:

URL: http://cnhde.ei.columbia.edu/training/documents/First_Aid.pdf

6. Baby Elizabeth. Effectiveness of planned teaching programme on

First Aid for students in a selected high school in Mangalore.

Published Dissertation. 2002 May.

7. Pala I, Vankar GK. Epilepsy and teachers: a survey. Indian J Pediatr.

1997 Mar-Apr;64(2):211-4.

8. WHO Technical Report Series. World Health Organization, Geneva.

1999.

9. Arbon Paul, Hayes Jo. First Aid and harm minimisation for victims of

road trauma. A population study. 2007 Jun. Available at URL:

http://www.ambulance.net.av/clicktosave/www/docs/Australian_po

pulation_study_on_victims_of_Road_Trauma.pdf

17

10. Polit Denise F, Beck Cheryl Tatano. Nursing research generating and

assessing evidence for nursing practice. 8th ed. New Delhi: Wolters

Kluwar (India) Pvt Ltd; 2008. P.105.

11. Tomazzoli L, Renzi G, Mansoldo C. Eye injuries in childhood. Eur J

opthalmol. 2003 Oct;13(8):710-3.

12. Singh AJ, Kaur A. Minor injuries in ninth class school children of

Chandigarh and rural Haryana. Indian Pediatr. 1996 Jan;33(1):25-

30.

13. Boyce SH, Quigley MA. An audit of sports injuries in children

attending an accident and emergency department. Scott Med J. 2003

Aug;48(3):88-90.

14. Gagliardi M, Neighbors M, Spears C, Byrd S, Snarr J. Emergencies

in the school setting: are public school teachers adequately trained

to respond. Prehospital Disaster Med. 1994 Oct-Dec;9(4):222-5.

15. Baser M, Coban S, Tasci S, Sungur G, Bayat M. Evaluating first aid

knowledge and attitudes of a sample of Turkish primary school

teachers. J Emerg Nurs. 2007 Oct;33(5):428-32.

16. Hashim R. Dental trauma management awareness among primary

school teachers in the Emirate of Ajman. Eur J Pediatr Dent. 2011

Jun;12(2):99-102.

17. Prathibha S. The effectiveness of structured teaching programme on

knowledge about cancer prevention and early detection among

teacher trainees in a selected college of education Udupi taluk.

Unpublished Master in Nsg Dissertation, University of MAHE

Manipal. 1997.

18

9 SIGNATURE OF THE

CANDIDATE SHYAMRAJ V

10 REMARKS OF THE GUIDE Study is feasible. Adds to the knowledge base of nursing. Tests the effectiveness of structured teaching programme on knowledge of school teachers regarding first aid measures.

11 NAME AND DESIGNATION OF 11.1 THE GUIDE

MR. PRABHUSWAMY A.CASSOCIATE PROFESSOR

11.2 SIGNATUREPRABHUSWAMY A.C

11.3 CO-GUIDE PROF. SHRIDHAR K.V

11.4 SIGNATURESHRIDHAR K.V

11.5 HEAD OF THE DEPARTMENT

PROF. SHRIDHAR K.V

11.6 SIGNATURESHRIDHAR K.V

12 REMARKS OF THE PRINCIPAL

Study is feasible. The designed structured teaching programme helps to improve the knowledge of school teachers regarding first aid measures.

12.1 SIGNATURE SHRIDHAR K.V

19