RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA

SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

SUSHIL CHOUDHARY M.Sc NURSING, 1st YEAR MEDICAL SURGICAL NURSING YEAR 2011-12

DHANWANTARI COLLEGE OF NURSING No.41/3, VINAYAK NAGAR, HESSARGHATTA ROAD, CHIKBANAVAR, BANGALORE 560 090.

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1.

NAME ADDRESS

OF

THE AND

SUSHIL CHOUDHARY I YEAR M.Sc , NURSING, DHANWANTARI COLLEGE OF OF NURSING, NURSING,

CANDIDATE

2. 3. 4. 5.

NAME

OF

BANGALORE - 560 090. THE DHANWANTARI COLLEGE

INSTITUTION BANGALORE 560 090 COURSE OF STUDY M.SC. (NURSING) AND SUBJECT MEDICAL SURGICAL NURSING DATE OF ADMISSION COURSE TITLE OF THE TOPIC 15/06/2011 KNOWLEDGE PRACTICE AND KNOWLEDEGE TRANSFUSION ON OF

REGARDING

WHOLE BLOOD AND COMPONENT OF BLOOD AMONG NURSES 5..1 STATEMENT OF THE PROBLEM A STUDY TO ASSESS THE EFFECTIVENESS OF SELF INSTRUCTIONAL OF WHOLE AT MODULE BLOOD ON AND TRANSFUSION KCG

COMPONENT OF BLOOD AMONG NURSES IN HOSPITAL BANGALORE, KARNATAKA.

6.

BRIEF RESUME OF INTENDED WORK

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6.1.

INTRODUCTION :

Blood is a fresh life link between a mother and a child. the life force in all human begins, regardless of colour, race or belief, flows through their arteries and veins. it is a red liquid which depending on whether they are well or ill bears good and bad tidings. Its various components form a highly developed defense and transport system, which gives and saves life. the persons health is determined by the state of his or her blood, which reveals the innermost workings of the body.(WHO 2000) Blood transfusion saves 4 million lives each year and saves ten thousand lives every day among trauma and burn victims, surgical patients, people with anemia, mothers with postnatal bleeding and patients with bleeding disorders.(Aswin patel 2000). Blood transfusion is a liquid transplant. Nurse are having more responsibility in many aspects of the transfusion process such as taking and labeling blood samples, collection of blood from the blood bank ,short term storage in ward areas, checking , administering ,documenting transfusion process and monitoring of the patient, it is vital that they are through and methodical in all task related to transfusion to ensure patients safety and must be aware of the steps necessary at each stage to safe guard the patient. (baallerd 2003) Blood transfusion is an important life saving intervention and improves quality of life in a range of clinical conditions. the risk associated with blood transfusion and errors can lead to serious and even fatal consequences. many of these reactions are associated with human error an related to inadequate nursing intervention.

6.2

NEED FOR STUDY:

Blood transfusion is a complex process dependent on a variety of professionals interacting effectively and efficiently across time and distance. To perform safety, professionals depend on their knowledge and skills. Nursing is a essentially link in the process. To be effective, nurses need to practice in environments that recognize the importance of reducing error and improving safety through use of eduction . knowledgeable staff is an essential element of safe blood transfusion. Mechanisms to monitor knowledge of nurses along with on going feed back are necessary to maximize the performance.

6.3 REVIEW OF LITERATURE:

SECTION :A studies related to incidence of blood transfusion Nicholis MD 1994 HOSPITAL transfusion practice is directed towards the optimization of transfusion. Therapy.the fresh frozen plasma audit was performed on 316 consecutive fresh plasma units. the FFP transfusion in 119 epixodes to 75 patients. The result was prophylactic to therapeutic and surgical to medical use was 48%:52% and 56%;44% respectively. In this audit 4 groups of patients received fresh frozen plasma appropriately for the following indicators, coagulation factor deficiency 40%,acute reversal of anti coagulation therapy 19% and massive blood transfusion 27% and complex medical problems including intensive plasmapheresis 12% and only 2% of patients received FFP INAPPROPRIATELY.A total of 98.7% of FFP units were considered appropriately transfused.. Mggrath,k.m 1995 A RETROSPECTIVE STUDY WAS CONDUCTED ON APPROPRIATENESS of transfusion of red blood cell, platelets and fresh frozen plasma in tertiary care teaching hospital. the objective of the study was to determine the current hospital practice for transfusion of RBC, platelets and fresh frozen plasma with confirmed published criteria. The study result showed that number of individual units administered were 16%,10% for red cells ,13% for platelets, and 24%,16% were fresh frozen plasma. The RBC and FFP were used in appropriately but most frequently in association with a surgical procedure for platelets 26 transfusion were deemed in appropriateness ,education

of the health professional and a monitoring system to ensure proper blood transfusion practice.

SECTION B; Studies related to knowledge and practice of nurses in blood transfusion Soumerais 1993 A Study was conducted on a controlled trail of educational outreach to improve the blood transfusion practice in teaching hospital. A study design was randomized control design the objective of the study was to determine whether brief educational programme to the nurses improve the appropriateness of blood transfusion Practice. the sample size was 100 staff nurses were selected by random method. The result showed that after the educational programme to the nurses there was a significant improvement in blood transfusion. Wenz 1997 A descriptive study was conducted on practical method to improve transfusion safety and patient identification system. The study revealed that the human error is a leading cause of transfusion associated death. Many of these events were associated with failure to identify the patient. BUITING 1998 A descriptive study was conducted on blood transfusion practice with in the Dutch hospital. A questionnaire was provided to 50 nurses. The results showed that 91% variations were found in transfusion medicine. Study concluded that continuous education should be encouraged for the nurses to prevent variations in the blood transfusion practice. Hodgkin 1998 A study was conducted towards safe blood transfusion. The objective was to determine the current state of transfusion practice with a view to making recommendation to improve safety. Transfusion practice was monitored using a questionnnarie and concurrent audit design. Questions included blood bag identification, documentations of transfusion process, patient observation. The result reveled that nurses

are having inadequate knowledge in identifying deficiencies in transfusion practice in order to improve the patient care.

Rafi 2000 A study was conducted on blood transfusion error in United Kingdom hospital. The study showed that 15 patients were and more become seriously ill. These incidents showed that 15 deaths, in this 5 are definitely due to blood transfusion,2 are probably and 8 are possibly to the blood transfusion. The concluded the most common death was occurred due to error by failure to identify the patient and blood bag. Brayon.S 2002 Most hemolytic reactions result from administration of ABO incompatible blood. Even a small amount of incompatible blood may initiate a reaction and cause devastating consequences leading to death. Careful monitoring of the patiens is important in recognizing symptoms of transfusion reaction so that reaction may be promptly detected and treatment will be started quickly. Nurse have avoid transfusion error. opportunity to establish polices and procedures, design nursing practice and educate nurses to help to

6.4

STATEMENT OF THE STUDY:

A study to assess the effectiveness of self instructional module on transfusion of

whole blood and component of blood among nurses in KCG Hospital at Bangalore.

6.5
1) 2) 3) 4)

OBJECTIVES:
To assess the knowledge and knowledge on practice regarding transfusion of whole To assess the effectiveness of self instructional module on transfusion of whole To compare & correlate the knowledge and knowledge on practice regarding To associate to demographic variables with knowledge & knowledge. 6

blood & component of blood among nurses. blood & component of blood among nurses. transfusion of whole blood and component of blood among nurses.

6.6

HYPOTHESIS:
NULL HYPOTHESIS There is no significant between pre-test and post-test scores on knowledge of nurse

regarding transfusion of whole blood and component of blood.

6.7

OPERATIONAL DEFINITION
EFFECTIVENESS It refers to the extent to which the self instructional module on transfusion of whole

blood & component of blood has achieved the desired effect in improving the knowledge. TRANSFUSION The process of transferring the whole blood and component of blood from one person to another person. WHOLE BLOOD It is a living tissue circulates through the heart, arteries, veins and capillaries and carrying nourishment, electrolytes, hormones, vitamins, antibodies and oxygen to the bodys tissue.

6.8
1.

ASSUMPTION
Nurses have inadequate knowledge and knowledge on practice regarding

transfusion of whole blood and component of blood. 2. Nurse need education regarding of whole blood and component of blood.

6.9
1)

DELIMITATIONS
The nurses in KCG Hospital, Bangalore

The study is delimited to :-

2) 3)

The nurses who are working in critical care unit, casualty, dialysis units. The nurses who are willing to participate in the study.

7. 7.1.

MATERIALS & METHODS OF THE STUDY RESEARCH APPROCH

Research methodology is a method to solve the research problem systematically. It

may be understood as a science of studying how research is done scientifically. 7.1.1. RESEARCH OF DATA

7.1.2. RESEARCH DESIGN

One group pre-test , post test , pre experimental design is adopted in this study.

7.1.3. RESEARCH DESIGN

The study is conducted in KCG Hospital, Bangalore. The hospital has bed strength of 300 and has all the major departments. The supporting departments include radiology, bio-chemistry, microbiology, pathology and research laboratory. The Hospital also has a physical medicine and blood bank department. VARIABLES:Influencing variable Dependent variable : Age, sex, area of work : Knowledge and knowledge and practice of nurses regarding transfusion . Independent variable : Self instructional module on transfusion of whole blood & component of blood

Extraneous variable

: Increased number of working hours Job stress Job satisfaction

7.1.4 POPULATION
Total population of the present study was 75

7.2 7.3

METHOS OF DATA COLLECTION SAMPLING CRITERIA

Sample is the subset of population selected to participate in a research. study

Sample size is determined by using Mahajans formula Sampling technique Stratified random sampling technique is adopted for this study.

7.3.1 CRITERIA FOR SAMPLE SELECTION 7.3.2 INCLUSION CRITERIA

1) 2) 3) The nurses who are working in critical care unit, dialysis unit Nurses with GNM or B.Sc degree The nurse who are directly involved in patient care

7.3.3 EXCLUSION CRITERIA

1) 2) The nurses who is working in other wards The nurses who are not willing to participate. 9

7.3.4 DESCRIPTION OF THE TOOL

The tool is prepared on the basis of the objectives of the study. The following steps were adopted prior to the development of the tool. Review of literature provided adequate content for the tool preparation. Section A Section B Scoring Key scored as zero. Section C : The section consists of 20 multiple choice questions to assess the knowledge on practice of transfusion of whole blood. : This section consists of 8 items about demographic variables. : This section consists of 40 multiple choice questions to assess the : Each multiple choice questions has one correct and the three

knowledge on transfusion of whole blood and component of blood among nurses, answers. A score of 1 mark is given for every correct answer and the wrong answers are

7.3.5 PLAN FOR DATE ANALYSIS

Data is planned to analyze on the basis of objectives and hypothesis by using descriptive and inferential statistics. Descriptive statistics is used to analyze the frequency, percentage, mean and standard deviation of the following variables. Demographic data will be analyzed in terms of frequency and percentage. Inferential statistics is used to determine the comparison, relationship and association to identify the differences. Paired `t test is planned to find out the comparison. Co-efficient of variation is planned to find out the consistency. Chi square is planned to find out the association between knowledge and knowledge on practice of subjects with demographic variables.

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8.

LIST OF REFERENCE:BIBLIOGRAPHY BOOKS 1. Adlawrence plumer PRINCIPLES AND PRACTICE OF INTERVENOUS THERAPY,4th edition ,little and brown company, Boston 1987,page no 204 208 2. American association of blood bank, TECHNICAL MANUUAL,9th edition, alrington company,1985,page no 265 291. 3. Baswanthappa.B.TNURSING RESEARCH publications,Calcutta,1988,page no 93 129 Ist edition, j Aypee

4. James .H.Jandi,BLOOD TEXTBOOK OF HAEMOTOLOIGY,2nd edition,little brown and company,boston,1996,page no 305 315 5. John,B.Miale,LABORATORY MEDICINE IN edition,C.V.Mosby company, Toronto, 1982, page no 539 550 HAEMOTOLOGY,6th

6. Shiraz Kareem.MANUAL OF BLOOD TRANSFUSION IN CLINICAL MEDICINE,All India traveler book sellers,new delhi ,1st editon 1992,page no 8-132 7. Vickivine Earnest,CLINICAL SKILLS IN NURSING PRACTICEJ.B.Lippincott company,2nd edition ,Philadelphia,1993,page no 558 560. JOURNALS 1. Abdulgabar Salama,:A new strategy for the prevention of iga anaphylactic transfusion reactions,JOURNAL OF TRANSFUSION ,volume 44,april 2004,page no 509- 510. 2 Azita Hekmatdoost,transfusion transmitted JOURNAL,volume 25, no 11 ,2004 page no 1760 1761 virus,SAUDI MEDICAL

3. Helen Doodsworth,making sense of the use blood and blood products,JOURNAL OF NURSING TIMES,volume 91,no 1,1995,page no 25 -27 4. Dureja G.P Fluid Therapy; current practice JOURNAL OF HOSPITAL TODAY,VOLUME 7,NO;1 JAN 2004 ,PAGE NO 55 56 5. Baswanthappa.B.T,tips for blood transfusion,THE NURSING JOURNAL OF INDIA,VOLUME 4XXIV,no 3,1983,page no 65 -66. 6. Clark ,Renni,quality improvement report,effect of formal education programme on safety of transfusion,MEDLINE

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INTERNET http;//.mdhsonline.unime.edu.aul blood matters http;//.Bloodlink.bc.cal links http;//.www.transfusion guidelines.Org/uk http;//.www.blood transfusion

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SIGNATURE OF THE CANDIDATE

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REMARKS OF THE GUIDE

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NAME AND DESIGNATION

VISVANATH, M.SC NURSING, COLLEGE ASST. PROFESSOR, NURSING DHANWANTARI

12. 13.

HEAD OF THE DEPARTMENT VISVANATH SIGNATURE

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REMARKS OF THE PRINCIPAL

14.1

SIGNATURE

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