A study to Assess the Effectiveness of Video Assisted Preoperative Teaching Vs Preoperative Self Instructional Booklet on Postoperative Anxiety, Depression and Physiological Parameters among Patients subjected to CABG, at KMCH, Coimbatore

The present study entitled” the effectiveness of Video Assisted Preoperative Teaching Vas Preoperative Self Instructional Booklet on Post Operative Anxiety, Depression and Physiological Parameters among patients subjected to CABG at KMCH, Coimbtore. was undertaken by Ms.Jincy George during the year 2011-2012 in the partial fulfilment for the degree of Master of science in nursing at KMCH college of nursing Coimbatore, which is affliated to The Tamilnadu Dr. M.G.R. Medical University, Chennai. OBJECTIVE: To find out the effectiveness of Video Assisted Preoperative Teaching Vs Preoperative Self Instructional Booklet on Postoperative Anxiety, Depression and Physiological parameters among patient subjected to CABG. DESIGN: Post test only experimental design. SETTING: The Cardiothoracic surgical ward of Kovai Medical Centre and Hospital, Coimbatore. SAMPLE SIZE: 60 patients both male and female above the age of 18 years with CABG were recruited for the study, of which 30 were in Video Assisted Preoperative Teaching Group and remaining 30 were in Self Instructional Booklet Group. CONCEPTUAL FRAME WORK: Betty Neuman’s systems model was adopted for the study. DATA COLLECTION: After collecting the demographic data, the educational interventions were administered. After administering the intervention, on the 3rd postoperative day Anxiety and Depression were measured by using Hospital Anxiety Depression Scale for both the groups and Physiological Parameters also were measured. INTERVENTIONS: For the group-1 Video Assisted Preoperative Teaching given on the day before the surgery for 30 minutes and for the group-2 Preoperative Self Instructional booklet given on the day before the surgery. RESULTS: Subjects who received Video Assisted Teaching had shown a significant reduction in Postoperative Anxiety and Depression (P<0.0001). There was a positive correlation between Postoperative Anxiety and Depression and also with Postoperative Anxiety and Blood pressure. There was no significant association found between the demographic variables with Postoperative Anxiety and Depression. CONCLUSION: The excavated results supported that administration of Video Assisted Preoperative Teaching in nursing care for the patient subjected to CABG was an effective intervention to relieve the Postoperative Anxiety and Depression after the surgery

Evaluation of appropriateness of prescription and polypharmacy in the geriatric population: a cross sectional study at a comprehensive geriatric clinic in a tertiary care hospital

Objective: To assess the prescription quality in a comprehensive geriatric clinic and to determine the frequency of inappropriate prescription and polypharmacy.Methods: Both males and female patients above the age of 60 y attending a comprehensive geriatric clinic of a tertiary care hospital were included in the study. Medications taken by the patients, excluding vitamins, minerals and herbal medications were counted in each patient and analyzed by considering their medical history and using universally accepted tools like medication appropriateness index, START, STOPP &amp; Beer's criteria. In this study, polypharmacy was considered as having 6 or more medications per prescription. Results: A total of 120 patients were included in the study. Around 82 (68.33%) patients had less than 6 prescribed medications and 38 patients (31.66%) were on 6 or more than 6 medications. The number of medications used by the patients is 4.37±2.33. Around 21 (17.5%) were on medications that are not indicated, 25 patients (20.83%) were receiving medications which are to be avoided in elderly as per the Beer's and STOPP criteria. Medication was underused in 24 patients (20%) as per START criteria. When both overused drugs and drugs to be avoided were considered for assessment of inappropriateness, 39 patients (32.5%) were found to be receiving inappropriate medication. Among the drugs to be avoided in elderly, amitriptyline was the most common drug and was used in 15 (12.5%) patients. Antihypertensives were the most common potential prescribing omissions in geriatric patients.Conclusion: Polypharmacy is seen in a significant proportion of geriatric patients. Inappropriate prescription and potential prescribing omissions were observed in a significant proportion of geriatric patients.Keywords: Polypharmacy, Geriatrics, Beer's criteria, STOPP criteri

Improving cancer caregiver support through a focused caregiver preparedness program

Background: It is estimated that there are four million cancer caregivers (CG) in the United States. A majority (69.1%) of them experience various emotional burdens. Cancer CGs face various unmet emotional and psychological needs and are often expected to manage cancer patient symptoms for which they are largely unprepared. Since they are an integral part in cancer patients’ treatment planning and care, it is important to reduce CG emotional burden and improve their self-efficacy. The purpose of this quality initiative is to determine if a structured treatment specific program can reduce emotional burden, improve self-efficacy for patient care demands, and improve CG support group enrollment among CGs of patients receiving brain radiation treatments at CNS-RO clinic at MDACC. Design and methods: CGs were screened and enrolled followed by administration of a pre-intervention assessment of the CG burden and selfefficacy using Zarit Burden Interview and CG Self-Efficacy Scale respectively. During the intervention phase, the project director provided interactive teaching sessions regarding patient symptom management, coping strategies, and CG support group enrollment. After the intervention, each CG received an assessment of CG burden, self-efficacy, and CG group enrollment. Findings: CGs had significant reduction of burden (p = 0.0004), improvement of self-efficacy (p = 0.0152) and improvement in CG support group enrollment. While the sample size is considered small, the clinical results support using a standardized treatment-specific CG preparedness program to ensure best possible care for both the patient and the cancer CG.Nursing PracticeCollege of Nursing and Health Science

Challenges Faced by Parents of Children with Learning Disability

Learning Disability is a neurological disorder and it affects an individual in such way that their brain works differently from others. Hence the processing that occurs in an individual’s brain functions differently in people with Learning Disability. This can cause serious challenge to the individual and family physically, socially and emotionally. The study is of descriptive in nature and describes the various challenges faced by the parents of children with Learning Disability in all these aspects. The study is conducted among 65 parents of children with Learning Disability in Trivandrum

International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module

•We report INICC device-associated module data of 50 countries from 2010-2015.•We collected prospective data from 861,284 patients in 703 ICUs for 3,506,562 days.•DA-HAI rates and bacterial resistance were higher in the INICC ICUs than in CDC-NHSN's.•Device utilization ratio in the INICC ICUs was similar to CDC-NHSN's. Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central line-associated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically