Informatics Publishing Limited

K. R. Ramya ¹, Lisa Paul ²

Affiliations
1 Jubilee Mission College of Nursing, Jubilee Gardens, Kachery,Thrissur, Kerala, 68005, IN
2 Jubilee Mission College of Nursing, Thrissur, Kerala, IN

Abstract

Alcohol abuse is a major health problem in India and world at large. For the past thirty to forty years alcohol consumption has increased tremendously. The problem of alcoholism until a few decades was considered a moral problem and a sign of social irresponsibility. Alcoholism is not only a disease but also a serious problem that all the family has to deal with. Disruption in family caused by alcoholism is a serious, complex and pervasive societal problem. Disruption in family caused by alcoholism is a serious, complex and pervasive societal problem. Alcoholism statistics reveals that alcohol abuse of male is the major cause behind the broken family in Kerala. The impact of alcoholism reflects not only on the consumer, but also on his family especially his wife. The wives of alcoholics suffer a lot with their alcoholic husband resulting in various problems in wife. In this context we attempted to identify and measure the psychosocial problems of wives of alcoholics. It was conducted using a quantitative, descriptive survey method; data were collected from wives of alcoholics’ selected using convenient sampling admitted in selected hospital using a demographic data sheet, a four point rating scale containing 16 items to assess psychosocial problems of wives. Findings revealed that revealed that majority of subjects belonged to the age group of >40 years (60%), educated till 10th standard (83.3%), were unemployed, (63.3%) family income <1500/month (56.8%), belonged to Hindu religion (56.8%), duration of alcoholism for >16 years (60%). Majority of wives of alcoholics had severe psychological (33.3%) and social (46.4%) problems. Knowledge gained from this study can be utilized to provide awareness about managing their partner’s unhealthy habit and coping strategies.

Keywords

Alcoholism, Psychosocial Problems, Alcoholics.

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K. R. Ramya ¹, G. R. Andrews ²

Affiliations
1 Shri Guru Ram Dass College of Nursing, Canal Colony Road, Hoshiarpur, IN
2 College of Nursing All India Institute of Medical Sciences, New Delhi, IN

Abstract

Heart valve surgery is in no way unique in the respect that treatment aimed to improve patient status, may also lead to consequences which can result in the opposite. Whatever the method used, all surgical intervention in the heart valve disease will influence the patient's quality of life. This randomized control trial was undertaken to evaluate the effectiveness of discharge counseling on improving the compliance and decreasing the problems of patients who have undergone mechanical heart valve replacement. Total 60 patients were studied during June- December 2008. The two groups were homogenous with regard to all demographic and clinical variables. Findings revealed that one to one discharge counseling is effective in increasing the compliance and decreasing the problems after mechanical heart valve replacement as compared to routine care. Hence a protocol should be developed regarding discharge counseling and the nursing personnel working in the cardiothoracic surgery unit need to be trained to provide discharge counseling to patients undergoing heart valve replacement.

Keywords

Heart Valve Replacement, Problems, Compliance, Discharge Counseling.

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K. R. Ramya ¹, R. Kiran Batra ²

Affiliations
1 Jubilee Mission College of Nursing, Thrissur, Kerala, IN
2 Silver Oaks College of Nursing, Abhipur, Punjab, IN

Abstract

Emerging epidemiological evidence is compelling for the importance of childhood and adolescence in the development of risk for coronary artery disease (CAD).It is important in India as it has a huge adolescents and children population along with the existing economic, social, and health inequalities among the general population. The literature indicates that a lengthy time interval occurs between exposure to high risk factors and the development of disease, and that many such high risk exposures begin in young adolescence. well-documented trends on tobacco, physical activity, hypertension, diet, obesity present an immediate obstacle to achieving future reductions in CAD disease burden These findings underline the value of targeting children and adolescents for primary prevention efforts in health care and health education for the attainment of overall healthy population in our country.

Keywords

Coronary Artery Disease, Risk Factor, Adolescents, Primary Prevention

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K. R. Ramya ¹

Affiliations
1 Baby Memorial College of Nursing, Kozhikose, Kerala, IN

Abstract

Resumption of spontaneous circulation (ROSC) after prolonged, complete, whole-body ischemia creates a pathophysiological state following successful cardiopulmonary resuscitation. The components of post cardiac arrest syndrome comprise post cardiac arrest brain injury, myocardial dysfunction, systemic ischemia/reperfusion response and persistent precipitating pathology. So a comprehensive, structured, multidisciplinary system of care should be implemented in a consistent manner for the treatment among eligible post- cardiac arrest patients. Management of post cardiac arrest care include initial stabilization, general and specific intensive care and monitoring, hemodynamic optimization, circulatory and respiratory support, urgent angioplasty and percutaneous coronary intervention, optimizing neurological recovery include therapeutic hypothermia, sedation and neuromuscular support, seizure control, glycemic control, and neurological, physical and cardiac rehabilitation restore normal functioning for survivors.

Keywords

Spontaneous Circulation, Cardiac Arrest, Post Cardiac Arrest Syndrome, Survivor.

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K. R. Ramya ¹, Kiran Batra ²

Affiliations
1 Jubilee Mission College of Nursing, Jubilee Gardens, Kachery, Thrissur, Kerala, 68005, IN
2 Silver Oaks College of Nursing, Abhipur, Punjab, IN

Abstract

Non communicable disease burden is increasing in alarming rate globally. Cardiovascular disease (CVD) has assumed epidemic proportion in India. Atherosclerosis in Indians has been shown to occur prematurely, that is, at least a decade or two earlier than their counterparts in developed countries. The present cross-sectional survey was undertaken among 42 school going students of Thrissur district of Kerala to understand their Perception, Knowledge of Coronary Heart Disease using a pretested structured questionnaire. Findings revealed that most adolescents were not aware of the seriousness of the heart disease. Only 14.3% students thought that CHD is a public health concern, 28.6% were aware of their own body weight, and none of them had heard of the term Body Mass Index (BMI). 26.2% adolescents had moderately adequate and 73.8% had inadequate knowledge regarding CHD. Heavy alcohol consumption and smoking were perceived as important top three risk factors for CHD. However, a very small percentage could identify obesity, physical inactivity, and consumption of fatty foods as important risk factors. Study reveals that a large proportion of adolescents are not aware of the lifestyle associated risk factors of CHD and its prevention. This suggests the need for population based programmers in Kerala to increase adolescent knowledge, and skills to halt the progression of this deadly disease.

Keywords

Knowledge, Perception, Coronary Heart Disease, Risk Factors, Adolescents.

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K. R. Ramya ¹, R. Vineetha ²

Affiliations
1 Baby Memorial College of Nursing, Green View Villa Colony, Kuthiravattam P O, Calicut-16, Kerala, IN
2 NIMHANS, Bangalore, IN

Abstract

Medication use in hospitals is a complex process and depends on successful interaction among health care professionals functioning at different areas. Errors may occur at any stage of prescribing, documenting, dispensing, preparation, or administration. This descriptive survey was conducted in the cardiac wing at a private tertiary care teaching hospital in Kerala, South India during January- February 2013 among 50 registered nurses with an aim to investigate what constitutes a medication error (ME), types of commonly observed errors, drugs involved, causes of error, reasons and existing barriers to reporting medication errors and characteristics of good and effecting ME reporting system among nurses working in a cardiac care center. Analysis revealed that the overall mean of medication errors they could remember making was 3.52, over the course of their career. Antibiotics, digoxin, warfarin / acitrom, dopamine/dobutamine were mostly involved in medication errors. The most common types of errors observed were drug administering without a physician order, omission error, followed by drug calculation error, Incorrect IV therapy timing/dosage/administered technique, and wrong time. Culture of blame within team members (15), Degree of harm occurred to the patient (15),patient aware of error(14), Sense of shame(13), Lack of familiarity/skills with how best to handle a situation (12), Error tolerance of institution(10), Rapport between patient and provider(6) influenced the decision to disclose a medication error. The most common barriers to reporting medication errors were , not getting any positive feedback for passing medications error (22) possible adverse consequences like loss of job/ disciplinary action (21), not agreeing with hospital's definition of a medication error (16), feeling of incompetency from team members (15) and not recognizing occurred error (15). According to nurses the top 5 characteristics of a good and effective ME reporting system were the systems in which Medication orders are rewritten at transfer, Reasons for medication changes made at transfer are documented, non-punitive approach to reporting , Feedback of the results of the error analysis given those healthcare professionals involved, Home medications are brought in by patients. Despite a desire to deliver high quality care, errors occur on both a systems and personal level. Nurses have to take a front seat role in initiatives that have sought to address issues related to medication error, develop significant expertise in medication administration and associated systems to tackle issues of medication error.

Keywords

Medication Errors, Nursing, Perception, Reporting, Medication Administration.

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K. R. Ramya ¹

Affiliations
1 Baby Memorial College of Nursing, Green View Villa Colony, Kuthiravattam P O, Calicut -16, Kerala, IN

Abstract

Familial aggregation of coronary heart disease (CHD) is thought to account for 50% to 60% of total documented CHD before the age of 60 years. First-degree relatives of people with premature CHD (proband) exhibit a risk that is 2 to 12 times greater than that of the general population. This descriptive study was undertaken during November- December 2012 among 100 first degree relatives to assess the perception and behaviors of relatives of people with premature coronary heart disease. Analysis revealed that only 40% of the relatives noted cancer as their greatest health concern and only 23%percieved heart disease as their greatest health concerns; 50% identified road traffic accident as the leading cause of death in India. Only 17% were concerned of getting future heart attacks and 15% perceived their risk of getting heart attack is more than other people in the general population.

Prevalence of unhealthy behaviors were found to be high; as 18% were currently using tobacco in any form,18% using alcohol on regular basis, physical inactivity at work (65%)and leisure (85%)poor dietary habits. Prevalence of high mental stress was also observed. Findings warrants risks factor education and reduction programs among relatives of people with CHD They form an ideal target population for primary prevention of CHD in high-risk patients.

Keywords

Perception, Health Related Behaviors, Relatives, Premature Coronary Heart Disease, Proband.

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Lissa Paul ¹, K. R. Ramya ²

Affiliations
1 Jubilee Mission College of Nursing, Thrissur, Kerala, IN
2 Jubilee Mission College of Nursing, Jubilee Gardens, Kachery, Thrissur, Kerala, 68005, IN

Abstract

In 2000, approximately 30% of India's population was aged 10 to 24 yr, that increased to 53 % when children younger than 10 were included. Alcoholism and alcohol related problems are on an increase in India. This may be due to various factors like adolescent's crisis, modernization, peer pressure, increased socio economic status, easy availability. The major concern is that alcohol consumption is associated with certain other behaviors and long range consequences. Most of the problems can be minimized, if not completely prevented by making the public aware of the complications related to alcoholism. In this context, we attempted to assess the knowledge and attitude of adolescents towards alcoholism so that knowledge gained from this study can be utilized to make effective public health programmes. It was conducted using a quantitative, descriptive survey method; data were collected using a structured knowledge assessment questionnaire and attitude inventory in 100 high school students selected by convenient sampling. Findings revealed that adolescents had inadequate knowledge as only 3% of adolescents had excellent knowledge regarding alcoholism while 21% had good,58% had average and 18% had poor knowledge and with respect to attitude 26% of adolescents had unfavorable attitude, 30% had favorable and only 44% had very favorable attitudes. 26% had unfavorable attitude towards alcoholism. The knowledge gained from this study can be utilized to develop and implement effective primary prevention strategies to tackle alcoholism and its associated morbidities. These findings underline the value of targeting adolescents for primary prevention efforts in health care and health education for the attainment of overall healthy population in a state like Kerala.

Keywords

Alcoholism, Knowledge, Attitude, Adolescents.

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K. R. Ramya ¹

Affiliations
1 Jubilee Mission College of Nursing and Lead, Quality Cell, Jubilee Mission Medical College & Research Institute, Thrissur, Kerala, IN

Abstract

Operating room (OR) is a specialized area of hospital with inherent multiple risks and hazards to both patients and staff. There are an estimated 200 million surgeries performed worldwide each year. Recent reports reveal that the adverse event rates for surgical conditions remain unacceptably high, despite wide spread patient safety initiatives over the past decade. Each year 7 million surgical patients are estimated to suffer from serious complications from adverse events and up to 1 million die. Evidences in the field of health care quality shows that nurturing a culture of safety can reduce adverse events and improve patient safety. The aim of the present study was to explore the perception of patient safety culture among nurses working in operating rooms. The study utilized a quantitative cross sectional survey deign using safety attitude questionnaire (SAQ). SPSS version 20 was used to analyze the data. The total number of participants in the study was 131. Results revealed that the mean experience of study participants in the present institution was 2.56±1.19 years, while the mean total professional experience was 4.19±4.96 years. The mean overall rating of the OR was 3.43±.785. The total score of the SAQ ranged from 40.90 to 80.56, with a mean 61.44±9.06.The mean score was found to be highest in safety climate while least in stress recognition. Only 4.7% of the study participants perceived a favorable climate for patient safety culture. Years of experience in the current institution was significantly associated with perception towards team work climate and patient safety culture at .05 and at .01 level resp. Years of total professional experience was significantly associated with perceptions of management and stress recognition at .05 level. Years of total professional experience was also significantly associated with safety climate at .01 level. Study recommends interventions to promote working conditions, job satisfaction, team work, communication, and conflict resolution to provide a safe environment for nurses and thereby for patients.

Keywords

Perception, Operating Rooms, Patient Safety, Culture.

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K. R. Ramya ¹

Affiliations
1 Jubilee Mission College of Nursing, Kachery, Thrissur, Kerala, IN

Abstract

Patient safety is a serious global public health issue. Estimates show that in developed countries as many as one in 10 patients is harmed while receiving hospital care. Increasingly complex healthcare, involvement of multiple disciplines and varied sources of information all contribute to the increasing likelihood and impact of medical errors. Different approaches and methods have been utilized and applied to optimize patient safety issues worldwide. Human factors and ergonomics provides a ‘tried and true’ framework for building and strengthening that elusive safety culture by correcting the mismatch between individuals, the equipments, systems, and process in which they work in, we can improve patient safety.

Keywords

Patient Safety, Human Factor, Ergonomics, Safety Culture.

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