IJCNE: JUL–DEC 2014, VOL 15, NO 2

IJCNE Journal

Goto Abstract
Editorial
Enhancing Nurses’ Communication Skills in Today’s Healthcare World (Punitha Ezhilarasu)

Concepts and Issues
Application of Simulation Technology in Advanced Practice Nurse Programs (Jewel Abraham)

Clinical Article
Percutaneous Insertion of Peritoneal Dialysis Catheter: Role of a Nurse (Reena George, Anbu S. Kumar, Usha Jacob)

Research Article
Relationship between Nurses’ Interpersonal Communication Satisfaction and Growth satisfaction in Job and Job Burnout (Johnsam I. Rajesh , Suganthi L)
Incidence of Catheter Associated Urinary Tract Infection in Intensive Care Unit and Associated Risk Factors (Pushpalatha K. Soundararajaperumal, Bharti Muninarayanappa)

Research Series No.12
Sample Size Calculation (Grace R. John)

Continuing Education Series No: 27
Hematopoietic Stem Cell Transplantation and a Case Report (Selva T. Chacko, Amalorpavamary Lucas, Lillian P. Kujur, Margaret Devathanam,Preethi Sathianathan, Anitha Loganathan, Jayakumari Jebaraj)

Student Section
Will He Speak Again? A Case Report (Anu George, Nirmala M. Emmanuel, Hepsi Raju, Esther G. Asirvatham)

Research in Brief
Measurement of Noise level in an Intensive Care Unit of Iran (Shirin Esmaili, Saleh Por,Soltan Absdi, Firouzeh Talischi, Saeid F. Tafti)
Use of Body Mass Index in Assessing Nutritional Status among School Children (Rupehali Sharma, Sangeetha Priyadarshini, Ansuya)
Hot Versus Cold Application in Improving the Mobility Status of Patients with Rheumatoid Arthritis (Sajitha S. R. Suraj, Lakshmi Ramasamy)
Depressive Symptoms among Primary Caregivers of Patients with Mental Disorders: A Pilot Study (Paul P. K. Gnanaprakasam, Manoranjitham Sathiyaseelan)

Abstracts

Application of Simulation Technology in Advanced Practice Nurse Programs
* Jewel Abraham, RN., MSN., CNE
* Director, Virtual Nursing Learning Center, College of Nursing and Health Professions,Valparaiso University, Indiana
ABSTRACT
Advancement in nursing calls for highly skilled nursing professionals often referred to as advanced practice nurses. Simulation provides a safe ground for educators to train advanced practice nurses in advanced skills. Simulation has been quoted as a superior clinical teaching strategy for undergraduate nursing education. This paper tries to develop an insight into the use of simulation in advanced practice nursing curriculum. It also tries to categorize common themes emerging from literature related to implementation of simulation.

Keywords: Simulation, nursing, advanced practice nurse, advanced practice nurse program
REFERENCES

  • Alinier, G., Hunt, B., Gordon, R., & Harwood, C. (2006). Effectiveness of intermediate-fidelity simulation training technology in undergraduate nursing education. Journal of Advanced Nursing, 54(3), 359-369. Retrieved from http://ezproxy.valpo.edu/login?url=http://search.proquest.com/docview/232495960? accounted =14811
  • American Association of Colleges of Nursing (2006). Nursing research (position statement). Washington, DC: American Association of Colleges of Nursing. Retrieved from http://www.aacn.nche.edu/publications/ position/NsgResearch.pdf
  • Austin, E. N., Hannafin, N. M., & Nelson, H. (2013). Pediatric disaster simulation in graduate and undergraduate nursing education. Journal of Pediatric Nursing, 28(4), 393-399.doi:10.1016/j.pedn. 2012.12.004
  • Bearnson, C. S., & Wiker, K. M. (2005). Human patient simulators: A new face in baccalaureate nursing education at Brigham young university. Journal of Nursing Education, 44(9), 421-425.
  • Bennett, L., & Cohen, F. (2012). Human simulation for nurse anesthesia. In L. Wilson & L. Rockstraw (Eds.), Human simulation for nursing and health professions (1st ed. pp.206-218). New York: Springer.
  • Boulet, J. R., & Swanson, D. B. (2004). Psychometric challenges of using simulations of high-stakes assessment. In W. F. Dunn (Eds.), Simulators in critical care and beyond (pp. 119-130). Des Plaines, IL: Society of Critical Care Medicine.
  • Bradley, P. (2006). The history of simulation in medical education and possible future directions. Medical Education,40(3), 254-262.
  • Byrd, J. F., Pampaloni, F., & Wilson, L. (2012). Hybrid simulation. In L. Wilson & L. Rockstraw (Eds.), Human simulation for nursing and health professions (1st ed., pp. 267271). New York: Springer.
  • Chism, L. (2013). The doctor of nursing practice: A guidebook for role development and professional issues (2nd ed.). Sudbury, MA: Jones and Bartlett.
  • Corbridge, S., Robinson, F., Tiffen, J., & Corbridge, T. (2010). Online learning versus simulation for teaching principles of mechanical ventilation to nurse practitioner students. International Journal of Nursing Education Scholarship,7(1), 1-11. doi:10.2202/1548-923X.1976
  • Eid, A., Petty, M., Hutchins, L., & Thompson, R. (2009). Breaking bad news: Standardized patient intervention improves communication skills for hematology-oncology fellows and advanced practice nurses. Journal of Cancer Education, 24(2), 154-9. doi:http://dx.doi.org/10.1080/ 08858190902854848.
  • Gardner, R., & Raemer, D. B. (2008). Simulation in obstetrics and gynecology. Obstetrics and Gynecology Clinics of North America, 35(1), 97-127.
  • Garrett, B., (2005). Student nurses perception of clinical decision-making in the final year of adult nursing studies. Nursing Education in Practice, 5(1), 30-39.
  • Hamric, A. B., Spross, J. A., & Hanson, C. M. (2009). Advanced practice nursing: An integrative approach. Philadelphia, PA: Saunders.
  • Hovancsek, M. T. (2007). Using simulations in nursing education. In P. R. Jeffries (Ed.), Simulation in nursing education: From conceptualization to evaluation (1st ed., pp. 1-9). New York: National League for Nursing.
  • Jeffries, P. R., & Rogers, K. J. (2007). Theoretical framework for simulation design. In P. R. Jeffries (Ed.), Simulation in nursing education: From conceptualization to evaluation (1st ed., pp. 2133). New York: National League for Nursing.
  • Jeffries, P. R., Woolf, S., & Linde, B. (2003). Technologybased vs. traditional instruction. A comparison of two methods for teaching the skill of performing a 12-lead ECG.
  • Nursing Education Perspectives, 24(2), 70-74. Kaplan, B. G., Holmes, L., Mott, M., & Atallah, H. (2011). Design and implementation of an interdisciplinary pediatric mock code for undergraduate and graduate nursing students. Computer, Informatics, Nursing: CIN, 29(9), 531-8. doi:10.1097/NCN.0b013e31821a166e.
  • Kim, T., Reibling, E., & Denmark, K. (2012). Student perception of high fidelity medical simulation for an international trauma life support course. Prehospital and Disaster Medicine, 27(1), 27-30. doi: 10.1017/ s1049023X11006790
  • Laschinger, S., Medves, J., Pulling, C., McGraw, R., Waytuck, B., Margaret, B. H., & Gambeta, K. (2008). Effectiveness of simulation on health profession students’ knowledge, skills, confidence and satisfaction. Adelaide, Australia: Joanna Briggs Institute.
  • Madden, C. (2006). Undergraduate nursing students’ acquisition and retention of CPR knowledge and skills. Nurse Education Today, 26(3), 218-227.
  • McCallum, J., Ness, V., & Price, T. (2011). Exploring nursing students’ decision-making skills whilst in a Second Life clinical simulation laboratory. Nurse Education Today, 31(7), 699-704. doi:10.1016/j.nedt.2010.03.010
  • Perkins, G., Kimani, P., Bullock, I., Clutton-Brock, T., Davies, R., Gale, M., & Stallard, N. (2012). Improving the efficiency of advanced life support training: A randomized, controlled trial. Annals of Internal Medicine, 157(1), 19-28.
  • Piscotty, R., Grobbel, C., & Huey-Ming, T. (2011). Integrating quality and safety competencies into undergraduate nursing using student-designed simulation. Journal of Nursing Education, 50(8), 429-436. doi:10.3928/01484834-20110429-04
  • Pittman, O. A. (2012). The use of simulation with advanced practice nursing students. Journal of the American Academy of Nurse Practitioners, 24(9), 516-520. doi:10.1111/j.1745-7599.2012.00760.x
  • Plummer, J., & Owen, H. (2001). Learning endotracheal intubation in a clinical skills learning center: A qualitative study. Anesthesia Analog, 9, 656-62.
  • Reznek, M. A. (2004). Current status of simulation in education and research. In G. E. Loyd, C. L. Lake, & R. B. Greenberg, (Eds.), Practical healthcare simulation (1st ed., pp. 27-48). Philadelphia: Elsevier Mosby publication.
  • Shawler, C. (2008). Standardized patients: A creative teaching strategy for psychiatric-mental health nurse practitioner students. Journal of N
  • Alinier, G., Hunt, B., Gordon, R., & Harwood, C. (2006). Effectiveness of intermediate-fidelity simulation training technology in undergraduate nursing education. Journal of Advanced Nursing, 54(3), 359-369. Retrieved from http://ezproxy.valpo.edu/login?url=http://search.proquest.com/docview/232495960? accounted =14811
  • American Association of Colleges of Nursing (2006). Nursing research (position statement). Washington, DC: American Association of Colleges of Nursing. Retrieved from http://www.aacn.nche.edu/publications/ position/NsgResearch.pdf
  • Austin, E. N., Hannafin, N. M., & Nelson, H. (2013). Pediatric disaster simulation in graduate and undergraduate nursing education. Journal of Pediatric Nursing, 28(4), 393-399.doi:10.1016/j.pedn. 2012.12.004
  • Bearnson, C. S., & Wiker, K. M. (2005). Human patient simulators: A new face in baccalaureate nursing education at Brigham young university. Journal of Nursing Education, 44(9), 421-425.
  • Bennett, L., & Cohen, F. (2012). Human simulation for nurse anesthesia. In L. Wilson & L. Rockstraw (Eds.), Human simulation for nursing and health professions (1st ed. pp.206-218). New York: Springer.
  • Boulet, J. R., & Swanson, D. B. (2004). Psychometric challenges of using simulations of high-stakes assessment. In W. F. Dunn (Eds.), Simulators in critical care and beyond (pp. 119-130). Des Plaines, IL: Society of Critical Care Medicine.
  • Bradley, P. (2006). The history of simulation in medical education and possible future directions. Medical Education,40(3), 254-262.
  • Byrd, J. F., Pampaloni, F., & Wilson, L. (2012). Hybrid simulation. In L. Wilson & L. Rockstraw (Eds.), Human simulation for nursing and health professions (1st ed., pp. 267271). New York: Springer.
  • Chism, L. (2013). The doctor of nursing practice: A guidebook for role development and professional issues (2nd ed.). Sudbury, MA: Jones and Bartlett.
  • Corbridge, S., Robinson, F., Tiffen, J., & Corbridge, T. (2010). Online learning versus simulation for teaching principles of mechanical ventilation to nurse practitioner students. International Journal of Nursing Education Scholarship,7(1), 1-11. doi:10.2202/1548-923X.1976
  • Eid, A., Petty, M., Hutchins, L., & Thompson, R. (2009). Breaking bad news: Standardized patient intervention improves communication skills for hematology-oncology fellows and advanced practice nurses. Journal of Cancer Education, 24(2), 154-9. doi:http://dx.doi.org/10.1080/ 08858190902854848.
  • Gardner, R., & Raemer, D. B. (2008). Simulation in obstetrics and gynecology. Obstetrics and Gynecology Clinics of North America, 35(1), 97-127.
  • Garrett, B., (2005). Student nurses perception of clinical decision-making in the final year of adult nursing studies. Nursing Education in Practice, 5(1), 30-39.
  • Hamric, A. B., Spross, J. A., & Hanson, C. M. (2009). Advanced practice nursing: An integrative approach. Philadelphia, PA: Saunders.
  • Hovancsek, M. T. (2007). Using simulations in nursing education. In P. R. Jeffries (Ed.), Simulation in nursing education: From conceptualization to evaluation (1st ed., pp. 1-9). New York: National League for Nursing.
  • Jeffries, P. R., & Rogers, K. J. (2007). Theoretical framework for simulation design. In P. R. Jeffries (Ed.), Simulation in nursing education: From conceptualization to evaluation (1st ed., pp. 2133). New York: National League for Nursing.
  • Jeffries, P. R., Woolf, S., & Linde, B. (2003). Technologybased vs. traditional instruction. A comparison of two methods for teaching the skill of performing a 12-lead ECG.
  • Nursing Education Perspectives, 24(2), 70-74. Kaplan, B. G., Holmes, L., Mott, M., & Atallah, H. (2011). Design and implementation of an interdisciplinary pediatric mock code for undergraduate and graduate nursing students. Computer, Informatics, Nursing: CIN, 29(9), 531-8. doi:10.1097/NCN.0b013e31821a166e.
  • Kim, T., Reibling, E., & Denmark, K. (2012). Student perception of high fidelity medical simulation for an international trauma life support course. Prehospital and Disaster Medicine, 27(1), 27-30. doi: 10.1017/ s1049023X11006790
  • Laschinger, S., Medves, J., Pulling, C., McGraw, R., Waytuck, B., Margaret, B. H., & Gambeta, K. (2008). Effectiveness of simulation on health profession students’ knowledge, skills, confidence and satisfaction. Adelaide, Australia: Joanna Briggs Institute.
  • Madden, C. (2006). Undergraduate nursing students’ acquisition and retention of CPR knowledge and skills. Nurse Education Today, 26(3), 218-227.
  • McCallum, J., Ness, V., & Price, T. (2011). Exploring nursing students’ decision-making skills whilst in a Second Life clinical simulation laboratory. Nurse Education Today, 31(7), 699-704. doi:10.1016/j.nedt.2010.03.010
  • Perkins, G., Kimani, P., Bullock, I., Clutton-Brock, T., Davies, R., Gale, M., & Stallard, N. (2012). Improving the efficiency of advanced life support training: A randomized, controlled trial. Annals of Internal Medicine, 157(1), 19-28.
  • Piscotty, R., Grobbel, C., & Huey-Ming, T. (2011). Integrating quality and safety competencies into undergraduate nursing using student-designed simulation. Journal of Nursing Education, 50(8), 429-436. doi:10.3928/01484834-20110429-04
  • Pittman, O. A. (2012). The use of simulation with advanced practice nursing students. Journal of the American Academy of Nurse Practitioners, 24(9), 516-520. doi:10.1111/j.1745-7599.2012.00760.x
  • Plummer, J., & Owen, H. (2001). Learning endotracheal intubation in a clinical skills learning center: A qualitative study. Anesthesia Analog, 9, 656-62.
  • Reznek, M. A. (2004). Current status of simulation in education and research. In G. E. Loyd, C. L. Lake, & R. B. Greenberg, (Eds.), Practical healthcare simulation (1st ed., pp. 27-48). Philadelphia: Elsevier Mosby publication.
  • Shawler, C. (2008). Standardized patients: A creative teaching strategy for psychiatric-mental health nurse practitioner students. Journal of Nursing Education, 47(11), 528-531.
  • Walton-Moss, B., O’Neill, S., Holland, W., Hull, R., & Marineau, L. (2012). Advanced practice nursing students: Pilot test of a simulation scenario. Collegian, 19(3), 171-176.
  • Wilson, L., & Rockstraw, L. (2012). Human simulation for nursing and health professions (1st ed.). New York: Springer.ursing Education, 47(11), 528-531.
  • Walton-Moss, B., O’Neill, S., Holland, W., Hull, R., & Marineau, L. (2012). Advanced practice nursing students: Pilot test of a simulation scenario. Collegian, 19(3), 171-176.
  • Wilson, L., & Rockstraw, L. (2012). Human simulation for nursing and health professions (1st ed.). New York: Springer.

Percutaneous Insertion of Peritoneal Dialysis Catheter: Role of a Nurse
* Reena George, M. Sc (N), **Anbu S. Kumar, M. Sc (N), ***Usha Jacob, RN., RM
*Associate Professor, College of Nursing, CMC, Vellore, **Professor, College of Nursing, CMC, Vellore, ***Peritoneal Dialysis Nurse Educator, CMC, Vellore
ABSTRACT
Peritoneal dialysis as a renal replacement therapy modality is gaining more popularity among patients with chronic kidney disease stage five with the advantage of being a home-based therapy. Open surgical peritoneal dialysis catheter placement has been the conventional mainstay of access placement necessitating the availability of an operating room, experienced surgeon and anesthetist. Over the past five years at the Christian Medical College, Vellore, bedside percutaneous peritoneal dialysis catheter insertion by the nephrologists has become the procedure of choice and is done in the clean procedure suite of the dialysis unit with good success rates. This has considerably decreased the hospital stay and surgical costs and has also facilitated early initiation of peritoneal dialysis. In this article the procedure, the care rendered to these patients, and the advantages of the procedure are discussed.

Keywords: peritoneal dialysis, chronic kidney disease, renal nurse, peritoneal catheter
REFERENCES

  • Renal Care India. (2013). Know everything about your kidney: Statistics. Retrieved from http://renalcareindia.org/Statistics.aspx
  • Schieppati, A., & Remuzzi, G. (2005). Chronic renal diseases as a public health problem: Epidemiology, social, and economic implications. Kidney International, 68(98), S7-S10.
  • Singh, P., & Bhandari, M. (2004). Renal replacement therapy options from an Indian perspective: dialysis versus transplantation. Transplantation Proceedings, 36(7), 2013-4.
  • Varughese, S., Sundaram, M., Basu, G., Tamilarasi, V., & John, G. T . (2010). Percutaneous continuous ambulatory peritoneal dialysis (CAPD) catheter insertion – A preferred option for developing countries. Tropical Doctor, 40(2), 104-5.

Relationship between Nurses’ Interpersonal Communication Satisfaction and Growth Satisfaction in Job and Job Burnout
* Johnsam I. Rajesh, M.Sc (Comm. & Journ.)., M. Sc (Psychol.), **Suganthi L, Ph. D (Management Science)., M.B.A
*Organizational Development Training Consultant, Ratna Sagar P. Ltd.Chennai, **Professor, Dept of Management Studies, Anna University, Chennai
ABSTRACT
Job satisfaction and job burnout have been previously linked to social support of supervisors and colleagues. More specifically, supportive supervisory communication (social support) has been linked in the earlier researches to job satisfaction and job stress/burnout. Against this backdrop, a unique attempt has been made in this research to find out the relationship between nurses’ interpersonal communication satisfaction with the supervisors and growth satisfaction in job and job burnout. A descriptive correlational design was utilized in this study. A convenience sampling was used to select the nurses. The data were collected from 103 nurses working in six different hospitals located in southern India. Three validated self reported instruments were used to measure the study variables. The results from correlation and hierarchical regression analysis revealed that nurses’ interpersonal communication satisfaction with supervisors was significantly related to growth satisfaction in job, while there was an inverse relationship found with respect to job burnout among nurses. A partial mediation of nurses’ interpersonal communication satisfaction between growth satisfaction and job burnout was also reported in this study indicating that there could be many other related mediating factors. Hence, the importance of supportive interpersonal communication of supervisors has been ascertained in the nursing management.
Keywords : communication satisfaction, job satisfaction, job burnout, nurse, supervisor, supervisory communication
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Incidence of Catheter Associated Urinary Tract Infection in Intensive Care Unit and Associated Risk Factors
*Pushpalatha K. Soundararajaperumal, M. Sc (N), Ph. D (N)., M.A., MBA., M.Phil., ** Bharti Muninarayanappa, M. Sc (N), Ph. D (N)
*Associate Professor, Shanmuga College of Nursing, Salem, ** Principal cum Professor, ESIC College of Nursing, Bengaluru
ABSTRACT
Catheter-associated urinary tract infection is one of the most common infections a person can contract in the hospital. This study was aimed to assess the incidence of catheter-associated urinary tract infection among catheterized patients in Intensive Care Unit. It was conducted among 50 patients who underwent catheterization and admitted in the Intensive Care Unit of SKS Hospital at Salem during the month of January to April 2010. Catheter-associated urinary tract infection was assessed in the urine sample collected 72 hours after removal of catheter. These findings revealed that the rate of catheter-associated urinary tract infection was 34% and 89 for 1000 catheter days. Hence it is recommended that nurses should adopt specific protocols or guidelines during insertion, monitoring and removal of urinary catheter.

Keywords:catheter associated urinary tract infection, incidence, intensive care unit
REFERENCES

  • Apisarnthanarak, A., Rutjanawech, S., Wichansawakun., Ratanabunjerdkul, H., Patthranitima, P., Thongphubeth, K., . . . Fraser, V. J. (2007). Initial inappropriate urinary catheters use in a tertiary-care center: Incidence, risk factors, and outcomes. American Journal of Infection Control, 35(9), 594-9.
  • Dantas, S. R., Kuboyama, R. H., Mazzali, M., & Moretti, M. L. (2006). Nosocomial infections in renal transplant patients: Risk factors and treatment implications associated with urinary tract and surgical site infections. The Journal of Hospital Infection, 63(2), 117-23.
  • Foxman, B. (2002). Epidemiology of urinary tract infections: Incidence, morbidity and economic costs. The American Journal of Medicine, 113(1), 5-13.
  • Jain, M., Dogra, V., Mishra, B., Thakur, A., Loomba, P. S., & Bhargava, A. (2011). Candiduria in catheterized intensive care unit patients. Indian Journal of Pathology and Microbiology, 54(3), 552-555.
  • Lee, J. H., Kim, S. W., Yoon, B. I., Ha, U. S., Sohn, D. W., & Cho, Y. H. (2013). Factors that affect nosocomial catheterassociated urinary tract infection in intensive care units: 2 year experience at a single center. Korean Journal of Urology, 54(1), 59-65.
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  • Tissot, E., Limat, S., Cornette, C., & Capellier, G. (2001). Risk factors for catheter- associated bacteriuria in a medical intensive care unit. European Journal of Clinical Microbiology and Infectious Diseases, 20(4), 260-262.
  • Zacharias, S., Dwarakanath, S., Agarwal M., & Sharma, B. S. (2009). A comparative study to assess the effect of amikacin sulfate bladder wash on catheter-associated urinary tract infection in neurosurgical patients. Indian Journal of Critical Care Medicine, 13(1), 17-20.

Sample Size Calculation
*Grace R. John, M. Sc (Biostatistics)
*Lecturer, Dept of Biostatistics, Christian Medical College, Vellore
ABSTRACT
Every research study requires systematic planning that involves series of steps. Selection of study design, subjects, and statistical methods are highly important of which sample size calculation is one of the vital steps. The power of the study and significant results always depends on the sample size as too little or too many can give us ambiguous results. How small is small? is still a debatable issue. Yet meticulously planned study with adequate sample size can yield a significant result with a reasonable power. This paper focuses on the very basic sample size calculation which are most commonly used in medical research namely sample size estimation for means and proportions specifically to test for equality in clinical trial.

Keywords: type I error, type II error, precision, power, sample size
REFERENCES

  • Antonisamy, B., Christopher, S., & Samuel, P. (2010). Biostatistics: Principles and practice. India: McGraw Hill Education Private Limited.
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  • Sahai, H., & Khurshid, A. (1996). Formulae and tables for the determination of sample sizes and power in clinical trials for testing differences in proportions for the two-sample design: A review. Statistics in Medicine, 15(1), 121.
  • Chow, S. C., Wang, H., & Shao, J. (2003). Sample size calculations in clinical research (pp 376). USA: CRC Press.
  • Devane, D., Begley, C. M., & Clarke, M. (2004). How many do I need? Basic principles of sample size estimation. Journal of Advanced Nursing, 47(3), 297302.
  • Lemeshow, S., Hosmer, D. W., Klar, J., & Lwanga, S. K. (1990). Adequacy of sample size in health studies. Chichester: Wiley.
  • Machin, D., Campbell, M. J., Fayers, P. M., & Pinol, A. P. Y. (1987). Sample size tables for clinical studies (2nd ed.). Oxford, London, Berlin: Blackwell Science Ltd.
  • Munro, B. H. (2005). Statistical methods for health care research (5th ed.). Philadelphia: Lippincott Williams & Wilkins.
  • Sahai, H., & Khurshid, A. (1996). Formulae and tables for the determination of sample sizes and power in clinical trials for testing differences in proportions for the two-sample design: A review. Statistics in Medicine, 15(1), 121.

Hematopoietic Stem Cell Transplantation and a Case Report
* Selva T. Chacko, M.Sc (N)., Ph.D, ** Amalorpavamary Lucas, M.Sc (N), *** Lillian P. Kujur, M.Sc (N), **** Margaret Devathanam, P.B.B.Sc (N), ***** Preethi Sathianathan, B.Sc (N), ****** Anitha Loganathan, B.Sc (N), ******* Jayakumari Jebaraj, P.B.B.Sc (N)
* Dean, College of Nursing, CMC, Vellore, ** Professor, College of Nursing, CMC, Vellore, *** Reader, College of Nursing, CMC, Vellore, **** Charge Nurse, Hematology OPD, CMC, Vellore, ***** BMT Co-ordinator, CMC, Vellore, ****** Hemostasis Nurse, CMC, Vellore, ******* Charge Nurse, BMTU, CMC, Vellore
ABSTRACT
Hematopoietic stem cell transplantation is increasingly being used in the treatment of several hematologic and non hematologic disorders. The procedure involves administration of high dose chemotherapy with or without radiation followed by infusion of hematopoietic stem cells. The treatment has been proven effective but is not without risks. Complications due to myeloablation and a plethora of systemic complications including graft versus host disease, poses immense challenge to the nurse caring for these patients. This article is an overview of the process of allogenic hematopoietic stem cell transplantation, its complications and management including nursing management and the follow up care. A case report is also presented.

Keywords: hematopoietic stem cell transplantation, allogenic stem cell transplantation, bone marrow transplant unit, nursing care, case report
REFERENCES

  • Adarsh, D. (2014). Bone marrow transplant: Cost in India, Singapore and USA. Retrieved from http://www.patienthelp. com/28657/cost-bone-marrow-transplant-indiasingapore-usa
  • Ball, E. D., Lister, J. W., & Law, P. (2000). Hematopoietic stem cell therapy. Philadelphia: Churchill Livingstone.
  • Berz, D., McCormack, E. M., Winer, E. S., Colvin, G. A., & Quesenberry, P. J. (2007). Cryopreservation of hematopoietic stem cells. American Journal of Hematology, 82(6), 463-472. doi:10.1002/ajh.20707
  • BissKey Parabola. (2014). Allogenic stem cell transplantation the leukemia. Retrieved from http:// bisskey.net/allogeneic/allogeneic-stem-celltransplantation- the-leukemia-.html
  • Doctors Only. (2014). Bone marrow harvest. Retrieved from http://doctorsonly.co.il/?attachment_id=3965
  • Geer, J. P., Arber, D. A., Glader, B., List, A. F., Means, R. T., Paraskevas, F., … Foerester, J. (2009). Wintrobe’s clinical hematology (13th ed.). Philadelphia: Lippincott Williams & Wilkins.
  • Gonzalez-Espada, W. (2014). Therapeutic aphaeresis: Experience in Puerto Rico. Retrieved from http://www.cienciapr.org/en/podcasts/radiocapsulascienciapr/ therapeutic-aphaeresis-experience-puertorico
  • Groenwald, S. L., Frogge, M. H., Goodman, M., & Yarbro, C. H. (1993). Cancer nursing principles and practice (3rd ed.). Sudbury, M.A: Jones and Bartlett.
  • Jinca, C., Ordodi, V., Arghirescu, S., John, J., Isac, A., Dehelean, L., & Serban, M. (2009). Chimerism analysiscritical diagnostic tools for the outcome assessment of allogenic hematopoietic stem cell transplantation. Revista Romana De Medicina De Laborator, 15(2), 17- 25.
  • Kumar, L. (2007). Haematopoietic stem cell transplantation: Current status. The National Medical Journal of India, 20(3), 128137.
  • Miaskowski, C., & Buchsel, P. C. (1999). Oncology nursing: Assessment and clinical care. St. Louis: Mosby.
  • Nair, V., Sharma, A., Das, S., Sharma, S., Grover, N., & Kaur, J. (2013). Allogeneic haematopoietic stem cell transplantation: The army hospital experience. The National Medical Journal of India, 26(1), 611.
  • Yarbro, C. H., Wujcik, D., & Gobel, B. H. (2011). Cancer nursing: Principles and practice. Sudbury, Mass: Jones and Bartlett Publishers.
  • Young, N. S., Gerson, S. L., & High, K. (2006). Clinical Hematology. Philadelphia: Elsevier.

Will He Speak Again?: A Case Report on Carcinoma Tongue
* Anu George, B. Sc (N), ** Nirmala M. Emmanuel, M. Sc (N), *** Hepsi Raju, M. Sc (N), **** Esther G Asirvatham, RN., RM
*Nursing Student, College of Nursing, CMC, Vellore, **Associate Professor, College of Nursing, CMC, Vellore, ***Junior Lecturer, College of Nursing, CMC, Vellore, ****Staff Nurse, CMC, Vellore
ABSTRACT
Oral carcinoma is one of the leading causes of cancer death among males. Squamous cell carcinoma of the tongue is a common presentation of oral cancers. Smoking and alcohol consumption are habits which are at high risk for such cancers. If detected early the prognosis is better. Surgical management along with radiation and chemotherapy is effective to prolong the lives of patients. Postoperative patients present with nutritional problems, disturbed body image, distorted verbal communication, and flap rejection. Nursing management of these patients is a major challenge and nurses require good counseling skills. This article focuses on the disease process of carcinoma tongue and the nursing care of a patient with the same, using nursing process approach.

Keywords: oral cancer, carcinoma tongue, nursing care, communication, case report
REFERENCES

  • Bhat, S. M. (2009). SRB’s manual of surgery. New Delhi:Jaypee brothers.
  • Black, J. M., & Hawks, J. H. (2008). Medical surgical nursing: Clinical management for positive outcomes (8th ed.). Philadelphia: Elsevier.
  • Cancer Research UK. (2014). Oral cancer incidence statistics. Retrieved from http://www.cancerresearchuk.org/cancer-info/cancerstats/types/oral/incidence/ukoral-cancer-incidence-statistics
  • Coelho, K. R. (2012). Challenges of the oral cancer burden in India. Journal of Cancer Epidemiology,17.Retrieved from http://www.hindawi.com/journals/jce/2012/701932/Will He Speak Again?
  • Gosselin, B. J. (2013). Malignant tumours of the mobile tongue. Retrieved from http://emedicine.medscape.com/article/847-428-overview
  • Ipe, E. M., Pandey, M., Mathew, A., Thomas, G., Sebastian, P., & Nair, M. K. (2001). Squamous cell carcinoma of the tongue among young Indian adults. Neoplasia, 3(4), 273-277. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1505859
  • Krishnamurthy, A., & Ramshankar, V. (2013). Early stage oral tongue cancer among non-tobacco users: An increasing trend observed in a South Indian patient population presenting at a single center. Asian Pacific Journal of Cancer Prevention, 14(9), 5061 65.
  • Mehrotra, R., Pandya, S., Chaudhary, A. K., Kumar, M., & Singh, M. (2008). Prevalence of oral pre-malignant and malignant lesion at a tertiary level hospital in Allahabad, India. Asian Pacific Journal of Cancer Prevention, 9,263- 266.
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  • Thiagarajan, S., Nair, S., Nair, D., Chaturvedi, P., Kane, S. V., Agarwal, J. P., & D’Cruz, A. K. (2014). Predictors of prognosis for squamous cell carcinoma of oral tongue. Journal of Surgical Oncology, 109(7), 639-644.doi:10.1002/jso.23583
  • Werning, J. W. (2007). Oral cancer diagnosis, management and rehabilitation. New York: Thieme Medical Publishers. Will He Speak Again?

Measurement of Noise level in an Intensive Care Unit of Iran
* Shirin Esmaili, RN, ** Saleh Por, MD, *** Soltan Abadi, RN, **** Firouzeh Talischi, MD, ***** Saeid F. Tafti, MD
ABSTRACT
Noise pollution can delay patient recovery, prolong hospitalization and increase costs of stay. The noise level was measured in an intensive care unit (ICU) at Masih Daneshvari Hospital, Iran. The 2 intensive care unit had 12 beds with the size of 150 m. The noise level was measured using a noise dosimeter casella CEL-320 by a specialist from the health department. The ICU was divided into 48 measurement points and the measurements were taken in a circulating fashion during the specified hours of the day. The mean of two measurements was recorded in decibels. Human factors appear to be important contributors to noise levels in the ICU. The results showed that the decibel of sounds measured at some locations closer to the nursing station was higher than the accepted standard.

Keywords: noise, noise level, noise pollution, measurement, intensive care unit environment
REFERENCES

  • Bharathan, T., Glodan, D., Ramesh, A., Vardhini, B., Kiselev, P., & Goldenberg, G. (2007). What do patterns of noise in a teaching hospital and nursing home suggest? Noise Health, 9(35), 31-34.
  • Christensen, M. (2005). What knowledge do ICU nurses have with regard to the effects of noise exposure in the intensive care unit? Intensive and Critical Care Nursing, 21(4), 199-207.
  • Christensen, M. (2007). Noise levels in a general intensive care unit. Critical Care Nurses, 12(4), 188-197.
  • Macedo, I. S., Mateus, D. C., Ede, M. C., Asprino, A. C., & Lourenco, E. A. (2009). Noise assessment in intensive care units. Brazilian Journal of Otorhinolaryngol, 75(6), 844-6.
  • Saeed, A., Reyhanak, T., Farhad, S., & Yousefi, H. (2011). Evaluating the noise level and sources in Isfahan University hospitals’ intensive care units. Journal of Isfahan Medical School, 28(118), 1267-1274.
  • Stanchina, M. L., Abu-Hijleh, M., Chaudhry, B. K., Carlisle, C. C., & Millman, R. P. (2005). The influence of white noise on sleep in subjects exposed to ICU noise. Pulmonary/Critical Care and Sleep Medicine Division,6(5), 423-428.
  • Tsara, V., Nena, E., Serasli, E., Vasileiadis, V., Matamis, D., & Christaki, P. (2008). Noise levels in Greek ospitals. Noise and Health, 10(41), 110-112.
  • Xie, H., Kang, J., & Mills, G. H. (2009). Clinical review: The impact of noise on patients’ sleep and the effectiveness of noise reduction strategies in intensive care units. Critical Care, 13, 208. doi:10.1186/cc7154

Use of Body Mass Index in Assessing Nutritional Status among School Children
* Rupehali Sharma, M.Sc (N), ** Sangeetha Priyadarshini, M.Sc (N), *** Ansuya, M.Sc (N)
* M.Sc Nursing Student at the time of submission, Manipal College of Nurisng, Manipal, ** Assistant Professor, Manipal College of Nurisng, Manipal, *** Assistant Professor, Manipal College of Nurisng, Manipal
ABSTRACT
Malnutrition among children is a major public health problem in developing countries but it can be prevented. A descriptive study was conducted to assess the nutritional status of school children (6-12 years) in terms of body mass index (BMI) according to World Health Organization growth norms. Descriptive survey design was used. Data were collected from 450 school children studying in private and government schools of Kundapura, Udupi district. Stratified random sampling was used to select the schools, sections, and standards from first to sixth. Total enumeration technique was done to select children from every standard. Sociodemographic and anthrometric data were collected (weight and height). The study results showed that 53.11% of children were in wasted category, 0.67% were overweight, and 46.22% had normal BMI. There 2 was a significant association found between BMI and age of the children ( value = 34.26, p

Keywords: nutrition assessment, nutritional status, school children, obese, overweight, malnutrition, anthropometry, body mass index
REFERENCES

  • Hasan, I., Zulkifle, M., & Ansari, A. H. (2009). An assessment of nutritional status of the children of government Urdu higher primary schools. Archives of Applied Science Research, 3(3), 167-176.
  • Hegde, P. (2012). National shame, but who cares. Retrieved from http://easytoact.org/index.php?option=com_content& view=frontpage
  • Medhi, G. K., Mahanta, J., & Barua, A. (2006). A study to assess growth and nutrition of school age children of tea garden workers. Indian Journal of Pediatrics, 19(2), 83-85.
  • Smile Foundation (2013). Our children. Retrieved from http://smilefoundationindia.org/ ourchildren.htm
  • Saluja, N., Garg, S., Chopra, H., Bajpai, S. K., & Pandey, S. M. (2011). Socio-demographic factors affecting morbidity in primary school children in urban area of Meerut. The Internet Journal of Epidemiology, 9(2).
  • Warraich, H. J., Javed F, Faraz-ul-Haq, M., Khawaja, F. B., & Saleem, S. (2009). Prevalence of obesity in school-going children of Karachi. Public Library of Science, 4(3). doi:10.1371/journal.pone.0004816
  • World Health Organization (2014). Bulletin of the world health organization.Retrieved from http://www.who.int/ bulletin/en/

Hot Versus Cold Application in improving the Mobility Status of Patients with Rheumatoid Arthritis
* Sajitha S.R. Suraj, M.Sc (N), ** Lakshmi Ramasamy, M.Sc (N)., Ph.D
* Assistant in Public Health and Prevent Medicine, Directorate Medical Service, Chennai, ** Principal, College of Nursing, Madras Medical College, Chennai
ABSTRACT
Rheumatoid arthritis, an autoimmune reaction is a chronic condition that leads to progressive joint damage, disability, deterioration in quality of life, and shortened life expectancy. It is a major cause of disability and occurs in around 1% of the world’s population. Both pharmacological and non-pharmacological therapies are used in treatment. Among non-pharmacological therapy heat and cold modalities are the most commonly used physical agents. A comparative study was conducted to compare the effectiveness of hot versus cold application for assessing the mobility status of 60 patients with rheumatoid arthritis at Rajiv Gandhi Government General Hospital, Chennai. Randomly 30 were allocated to each group. Hot application was given for one group and cold application to another group for 4 days. Their mobility status was assessed using modified Western Ontario and McMaster Universities arthritis index before and after the treatment. The post test mean level of mobility status, in hot application group was 47.53 with a standard deviation of 11.21 and in cold application group it was 56.17 with a standard deviation of 13.21(t=2.72, p=.01). This shows that hot application is more effective than cold application in improving the mobility of patients with rheumatoid arthritis.

Keywords: Rheumatoid arthritis, hot application, cold application, mobility status
REFERENCES

  • Bernstein, S. (2014). Gender differences in rheumatoid arthritis. Retrieved from http://www.arthritistoday.org/ about-arthritis/types-of-arthritis/rheumatoidarthritis/who-gets-ra-and-why/who-gets-ra/ra-andgender.php
  • French, S. D., Cameron, M., Walker, B. F., Reggars, J. W., & Esterman, A. J. (2009). Superficial heat or cold for low back pain. Cochrane Database Systematic Review, 2 5 ( 1 ) . Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/ 16437945.
  • Harrison, T. R., Fauci, A. S., & Langford, C. A. (2006). Harrison’s Rheumatology (Volume 323). New York: McGraw Hill Professional.
  • Hayes, K. W. (20005). Heat and cold in the management of rheumatoid arthritis. Arthritis and Rheumatism, 6(3), 156-166.
  • Hermann, J. (2009). Therapeutic heat and cold. Rheumatol, 99, 207-45.
  • Preisinger, E., & Quittan, M. (1994). Thermo and hydrotherapy. Wiener medizinische Wochenschrift, 144 ( 20 – 21 ), 520-26 . Retrieved from http://www.ncbi.nlm.nih.gov/ pubmed/7879403
  • The Hindu. (2009). Indian women above 40 are more prone to arthritis. Retrieved from http://www.thehindu.com/todays-paper/tp-national/tp-tamilnadu/indian-womenabove-40-are-more-prone-to-arthritis/article160918.ece
  • Welch, V. (2001). Heat therapy of rheumatoid arthritis. Cochrane Database Systemic Review, 108(7), 117-20. Retrieved from http:// www.ncbi.nlm.nih.gov/pubmed/2182487
  • Whales, K., & Koshukov, M. V. (2006). Non specific low back pain: Evaluation and treatment tips. American Journal of Physiology Cell Physiology, 59(8), 445-8.
  • Wilke, W. S. (2014). Rheumatoid arthritis. Retrieved from http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/rheumatology/rheumatoid-arthritis/
  • Woolf, A. D. & Pfleger, B. (2003). Burden of major musculoskeletal conditions. Bulletin of the World Health Organization, 81(9), 646-656.
  • Yildirim, N., Ulusoy, M., & Bodur, H. (2010). The effect of heat application on pain, stiffness, physical function and quality of life in patients with knee osteoarthritis. Journal of Clinical Nursing, 19(7-8), 1113-20. Retrieved from www.ncbi.nlm.nih.gov/pubmed/20492056

Depressive Symptoms among Primary Caregivers of Patients with Mental Disorders: A Pilot Study
* Paul P. K. Gnanaprakasam, M.Sc (N), ** Manoranjitham Sathiyaseelan, M.Sc (N)., Ph.D
* Junior Lecturer, College of Nursing, CMCH, Vellore, ** Professor, College of Nursing, CMC, Vellore
ABSTRACT
Family caregivers of mentally ill patients experience high care demand and burden that can lead to depressive symptoms. A descriptive study was conducted to assess the depressive symptoms among primary caregivers of patients with mental disorders admitted in the Department of Psychiatry at Christian Medical College, Vellore. In this pilot study, a sample of 30 consecutive primary caregivers were recruited after consent. The investigator used demographic variable proforma and Hamilton Depression Rating Scale (HDRS) to assess the depressive symptoms. It was found that 95% of the primary care givers had depressive symptoms. There was no significant relationship between depressive symptoms and socio-demographic variables.

Keywords: depressive symptoms, depression, caregivers, family caregivers, mental disorders, primary caregivers
REFERENCES

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  • Hamilton., M. (2000). Hamilton rating scale for Depression (Ham-D). In J. A. Rush, Handbook of psychiatric measures. Washington DC: American Psychological Association.
  • Magliano, L., McDaid, D., Kirkwood, S., & Berzins, K. (2007). Carers and families of people with mental health problems. In M. Knapp, D. McDaid, E. Mossialos, & G. Thornicroft (Eds.), Mental health policy and practice across Europe, 374-396, McGraw-Hill: Berkshire. Retrieved from http://aje.oxfordjournals.org/ content/106/3/203 on 23/12/10
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  • Osman, C. B., Alipah, B., & Tutiiryani, M. D. (2010). Depression among caregivers of patients with bipolar disorder. East Asian Arch Psychiatry, 20(3), 1433-1447.
  • Provencher H.L (2001). Positive and negative symptom behaviors and caregiver burden in the relatives of persons with Schizophrenia. Schizophrenia Research. 26, 71-80.
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  • Song L.Y, Biegel D.E, Milligan S.E (2004). Predictors of depressive symptomatology among lower social class caregivers of persons with chronic mental illness. Community Mental Health Journal, 33, 269-86.
  • Vikas, A., Avasthi, A., & Sharan, P (2011).Psychosocial impact of obsessive-compulsive disorder on patients and their caregivers: a comparative study with depressive disorder. International Journal of Social Psychiatry, 57(1), 45-46.