Urmila Bhardwaj

A Comparative Study to Assess the Effectiveness of Endotracheal Suctioning with and without Normal Saline Instillation in Terms of Physiological Parameters and Patient Outcome Measures among Mechanically Ventilated Patients in Selected Hospital of New Delhi

Intubated patients are unable to cough sufficiently to remove pulmonary secretion. Nurses occasionally encounter thick and tenacious secretions during endotracheal (ET) suctioning. To manage these secretions, normal saline instillation (NSI) is used throughout the world. The use of NSI before endotracheal suctioning is intended to lubricate the catheter, liquefy and soften secretions, and stimulate coughing. The objectives of the study were to assess the effectiveness of endotracheal suctioning with normal saline instillation in terms of physiological parameters and patient outcome among mechanically ventilated patients; to assess the effectiveness of endotracheal suctioning without normal saline instillation in terms of physiological parameters and patient outcome among mechanically ventilated patients; and to compare the effectiveness in terms of physiological parameters and patient outcome in mechanically ventilated patients with and without normal saline instillation. Methods: A quantitative research approach with comparative descriptive design was used for the study. The study was conducted in Max Super specialty Hospital, Saket and New Delhi. Purposive sampling was used for selecting 60 mechanically ventilated patients, from which 30 had undergone ET suctioning with normal saline instillation and 30 had undergone ET suctioning without normal saline instillation. Physiological parameters were assessed by using an observation checklist. Patient outcomes were assessed through observations made at 0–72 hours. Results: The significant findings of the study revealed that mechanically ventilated patients, who had undergone ET suctioning with NSI in comparison to patients who had undergone ET suctioning without NSI, were significant in terms of ventilator tidal volume at 18 hours, p value was 0.005 (p1), similarly systolic blood pressure at 6 hours and 12 hours were 0.001 and 0.049 respectively, significant at 0.05 level of significance. p value of temperature at 12 hours was 0.031, p values of ABG PaO2 at 0 hour, 6 hours,12 hours and 18 hours were 0.036, 0.005, 0.022 and 0.043 respectively, significant at 0.05 level of significance, p values of ABG Na+ at 6 hours and 12 hours were 0.003 and 0.001 respectively, significant at 0.05 level of significance, p values of ABG K+ at 6 hours were 0.046, p values of ABG Ca++ at 0 hour and 12 hours were 0.044 and 0.045 which were significant at 0.05 level respectively; however, the p2 value calculated by ANOVA test from 0–72 hours of patient outcome was not significant at 0.05 level of significance. Conclusion: The findings of the present study conclude that normal saline instillation while ET suctioning was effective in comparison to ET suctioning without normal saline instillation among mechanically ventilated patients in terms of respiratory parameters.

Visual Communication Board – Bridge for Communication between Patient and Nurse

Nurses as healthcare professionals focus on serving needs of humanity. Nurses face difficulty while communicating and giving care to patients with impaired communication abilities or compromised communication status. Nursing personnel should look forward to ways of improving patient care by developing communication skills and technical skills to help patients in fulfillment of their needs leading to satisfaction of both the patient and the nurse. Also, hospital administration can enhance patient satisfaction by introducing visual communication board in care of patients with compromised communication. Visual communication board can serve as a bridge for communication between the patient and the nurse, if it is readily available and nurses possess skills to use it.

Descriptive Study to Assess the Pattern of Usage of Nonprescribed Medication among Adults in Delhi

Introduction: Self-medication or nonprescribed drug use is common in developing countries. Self-medication can be defined as obtaining and consuming drugs without the advice of a physician, either for diagnosis, prescription or surveillance of treatment. Descriptive study was conducted to assess the pattern of usage of nonprescribed medication among adults in Delhi, India. Objectives: Objectives of the study were to assess the pattern of usage of nonprescribed medication and identify the side effects with usage of nonprescribed medication and establish the relationship of patterns of usage of nonprescribed medication with selected demographic variables, i.e., age, sex, educational status and monthly family income and to develop and disseminate the information booklet on the hazards of using nonprescribed medication. Methodology: A quantitative approach with descriptive survey design was used to achieve the objectives of the study. Purposive sampling technique was used to select 120 subjects. The study was conducted in Sangam Vihar, New Delhi. The tool used for data collection was a semi-structured interview schedule that was administered to assess the pattern of usage of nonprescribed medications in a selected community of New Delhi. An information booklet on ‘Hazards of Usage of Nonprescribed Medications’ was developed and disseminated. Data was analyzed using descriptive and inferential statistics. Result: 86.66% gave nonprescribed medication to their family members. 36.66% gave nonprescribed medication to their parents/grandparents. All subjects consumed nonprescribed medication to treat health conditions. There was a significant co-relation between the pattern of usage of non prescribed medication and age, frequency of consuming nonprescribed medication and source of information. There was no significant relationship between age and duration of consuming nonprescribed medication. There was a significant co-relation between educational status and source of information. Conclusion: An information booklet on hazards of using nonprescribed medication was prepared and disseminated to all subjects. Awareness sessions on the hazards of using nonprescribed medication by the community health nurse or volunteers can help in reduction in the usage of nonprescribed medication in the community.

The Unmet Family Planning Needs: Effectiveness of Planned Teaching Program

Introduction: Family planning is a method of thinking and a life style which is chosen voluntarily and according to the attitudes and responsible determination of the couples in order to promote hygiene and convenience of the family. A pre-experimental study was done on existing knowledge deficit regarding use of family planning methods among the women of eligible couples in selected Community Health Centre, Sunder Nagri under St. Stephen’s Hospital, Delhi, with objectives to assess the knowledge of women of eligible couples regarding the use of family planning methods, to plan and implement appropriate interventions to solve and reduce the problem, to assess the effectiveness of planned teaching program and amount of knowledge gained after the intervention and to motivate the women of eligible couples to adopt small family norms. A semi-structured questionnaire tool was developed with the help of experts. The data collection tool selected for study was a structured interview schedule. The study was done on 30 women of reproductive age group, and purposive sampling method was used. Pre-test post-test was done. The study findings revealed that women in areas of Sunder Nagri had incomplete knowledge about the concept of family planning. The results showed that the concept of family planning was not well understood by women as only 33.3% women were aware of how much time gap is required for abortion, 56.6% were aware of time period of starting of oral contraceptive after lactation, only 26.6% were familiar with emergency contraceptive pills, 36.6% had knowledge on maximum durability CuT availability, only 16.6% were having clear concept on male sterilization; others were having myths, 40% were aware of side effects of CuT, 40% were aware of method of protection against STDs, 30% were aware of starting of oral pills on which day of cycle, 16.6% were knowing about administration of emergency contraceptive within 72 hours, 33.3% were aware about CuT replacement duration, 53.3% had knowledge on how to check CuT in place or not, 56.6% were aware of tubectomy, only 6.6% were aware of LAC in contraception, 46.6% knew about ideal gap which should be kept between two children, only 16.6% were aware of time taken for effectiveness after vasectomy, very few had misconception about contraceptive pills. The analysis was done using SPSS version 21 and T-test showed that there was an increase in knowledge of women after conducting the health teaching program, as the p-value was less than 0.005 level of significance

Knowledge regarding Malnutrition and Its Prevention – A Study on Slum Dwelling Mothers

Introduction: A large proportion of under-five-year kids are suffering from malnutrition. A study was conducted to assess the knowledge of mothers regarding malnutrition and its prevention and evaluate effectiveness of structured teaching program regarding malnutrition and its prevention in terms of knowledge gain in mothers of under-five children attending a creche run by an NGO in a slum area of New Delhi. Methodology: Quantitative research approach with one group pre-test, post-test design was used. Tool used for generating necessary data was a structured knowledge questionnaire, after establishing its validity and reliability. Purposive sampling technique was used to select 45 mothers having children under five years of age. The study was conducted at a creche run by an NGO in a slum area of Delhi. Results : Before administration of the structured teaching program, 18 (40%) mothers had poor knowledge, 15 (33.3%) had average knowledge and 12 (26.7%) had good knowledge about malnutrition and its prevention, while after administration of structured teaching program, 12 (26.7%) had poor knowledge, 21 (46.7%) had average knowledge and 12 (26.7%) had good knowledge about malnutrition and its prevention indicating that the intervention was effective. There was significant relationship between knowledge gain and age, education and monthly family income of mothers. Conclusion: Finding of the study revealed that mothers having children under five years of age had poor knowledge about malnutrition and its prevention. The structured teaching program was an effective tool to enhance the knowledge of mothers.

Muscle Cramp Management: Intra-Dialytic Stretching Exercise

A study to assess the effect of intra-dialytic stretching exercise on muscle cramps in patients undergoing hemodialysis (HD), of a selected Hospital in New Delhi was conducted with the aim to assess the severity of muscle cramps among experimental and control groups and to compare the effect of intra-dialytic stretching exercise on muscle cramps in patients undergoing hemodialysis in experimental and control groups. A total of 60 samples were selected for the study. Data was collected using structured interview schedule and pain was assessed using numerical pain rating scale. Intra-dialytic stretching exercise was administered to the experimental group for three alternate days during dialysis whereas the control group resumed with routine nursing care. Ethical clearance was obtained from the Institutional Ethics Committee Board of Jamia Hamdard and formal permission obtained from the private hospital prior to conducting the study. Data was analyzed using descriptive and inferential statistics. The findings revealed that there was a significant reduction in the pain score after performing intra-dialytic stretching exercise among experimental group on day 1, 3 and 5 and the mean difference of pain score obtained was 1.57 on day 5. In the control group, there was a significant increase in the pain score on day 1, 3 and 5 and the mean difference of pain score obtained was 0.7 on day 5. While comparing the experimental and control groups on day 1, 3 and 5, there was a significant reduction in pain score among experimental group and the mean difference of pain score obtained was 2.07 on day 5, thus indicating that intra-dialytic stretching exercise is an effective measure in reducing muscle cramps among hemodialysis patients. The study concluded that intra-dialytic stretching exercise was effective in reducing muscle cramps among patients undergoing hemodialysis.

Visual Communication Board for Communication Compromised Patients

Background Human speech is the wonderful gift given to human being by God for communicating their ideas, needs and feelings. But an inability to speak, no matter temporary can be catastrophic for the patients in tertiary care. Some patients in tertiary care units may be communication compromised due to various reasons. A quasi experimental study was conducted to evaluate the effectiveness of visual communication board on satisfaction regarding communication needs of communication compromised patients in selected hospitals of Delhi. Objectives Objectives of the study were 1) To assess and compare the level of satisfaction regarding communication needs of communication compromised patients in both experimental and control group after administration of visual communication board in experimental group and traditional methods in control group 2) To establish association between the level of satisfaction regarding communication needs of communication compromised patients in both experimental and control group with selected variables after administration of visual communication board in experimental group and traditional methods in control group. Methodology The quasi experimental research with posttest only control group design was used. Sample comprised of total 60 communication compromised patients (30 experimental and 30 control group) selected by purposive sampling. Patient data record sheet and Satisfaction scale were tools used for data collection. Results In experimental group maximum of study subjects i.e. 13(43.33%) were satisfied followed by 9(30%) study subjects completely satisfied and only 2(6.67%) were unsatisfied. In control group maximum of study subjects i.e. 11 (36.67%) were completely unsatisfied followed by 10(33.33%) study subjects unsatisfied and only 2(6.67%) were satisfied. The level of satisfaction perceived by study subjects in experimental group was significantly higher than the control group. Conclusion The visual communication board improved the level of satisfaction of communication compromised patients & thus can be used to cater the communication needs of communication compromised patients.