An overview of musculoskeletal ultrasound – A thirteen years experience in Pakistan

SummaryObjective(1) To provide an overview on 13 years experience on patients with musculoskeletal disorders in Pakistan. (2) To assess accuracy of ultrasound in musculoskeletal disorders. (3) To determine percentage of different regional pathologies referred for musculoskeletal ultrasound.Material and methodsWe scanned 25,437 patients coming from all over Pakistan including 18,715 males and 6722 females from 1 month to 85 years of age.We used two ultrasound equipments with a multi-frequency (6–14MHz) linear probe to perform studies in patients with possible musculoskeletal system problems.ResultsAll patients with different joint or specific problems of musculoskeletal system were scanned, the total number of patients of any specific disorder was calculated and the accuracy of ultrasound was compared with MRI in a given percentage of patients.DiscussionIn all musculoskeletal disorders ultrasound was found to be accurate in about 84.8%. It was 83.5% accurate in the cases which went for MRI, its accuracy with other lab tests was 81.2% and that with surgery was 93.3%.ConclusionMusculoskeletal ultrasound is a very useful tool in almost all disorders of musculoskeletal system and shall be a necessary tool of a physicians, specially a family physician, orthopedic surgeon, physiotherapist and rheumatologist

Evaluation of Nurses Competency about Surgical Hand Scrubbing

Objective:  Hands play a significant role in organism transmission. Poor hand hygiene practices in health care settings lead to nosocomial infection. Aseptic practice is the cornerstone of current surgery, thus rigid adherence to prescribed sterile techniques in the operating room is essential.The objective of this study was to evaluate nurses’ competencies regarding surgical hand scrubbing. Material and Methods: Cross sectional observational design was used. The study was conducted in operating rooms in a tertiary care hospital, Lahore, Pakistan.This setting contains total seven operating rooms with 250 registered nurses. Sample size calculated through Slovin’s formula. Sample size was 154. Convenient sampling technique was used. An adopted checklist was used for observing the nurses’ practices of hand scrubbing. Data was analyzed in Statistical Software of Social Sciences (SPSS) version 25. Results:  Majority of nurses (72.7%) were between 21-30 years age group. Only 38.3% participants wore a face mask and surgical cap correctly and 61.7% did not wear correctly. Majority participants, 76% had short nails.All participants (100%) removed nail polish, artificial nails, and jewelry before scrubbing. Majority of participants applied a proper amount of Povidone iodine. Conclusion:  Operational hand scrub is very vital component of operative procedure. Results of this study showed inadequate practices of nurses in the operating room, which was overall 77%. There is a need to improve nurses’ practices so, periodically audit, manager supervision and feedback, workshops should be organized

The Role of Nursing Leader Empowering Behavior on Work Engagement and Intent to Stay in Hospital

Introduction: The expanding interest of medical attendants is putting forth new chances to all attendants in private and government part healing facilities. Medical caretakers are in working distinctive healing centers and are the primary power of those doctor's facilities Leader engaging conduct is a facilitative procedure where representatives see their pioneer to permit self-administration and self-authority of representatives. Pioneer enabling and their level of work commitment and aim to remain in their association of business. practices can be seen by representatives as either empowering or oppressive. The reason for this examination was to look at the connection between the staff medical caretaker's view of their pioneer's utilization of engaging practices. Method: Descriptive correlation study design was used. A convenience sample of nurses (N = 200) employed in various nursing units within three hospitals completed survey related to perceived leader empowering behaviors, and the nurse’s level of work engagement and intent to stay in his/her organization of employment. Result:, No critical contrasts were found between the staff attendant's age gatherings. No noteworthy contrasts were found in LEB when the example was separated into the staff attendant's age gatherings, instruction level a very long time in current office/unit, years in current healing facility, years in nursing, business status, and move worked., Conclusion: The aftereffects of the investigation feature the essentialness of pioneer enabling practices on staff nurture strengthening, work commitment, and plan to remain in their association. Keywords- Nursing Leader,Empowering behavior,intent to stay,Staff Nurses.

Leadership Practiece Among Nurses in Tertiary Care Hospital Lahore

Introduction: The planned role of leadership can be used to examine on how to engage leadership models and use leadership behavior to progress organizational performance. The intangible assets such as leadership styles, culture, skill and competence, and motivation are key sources of strength in firms that can combine people and processes and organizational performance. Methodology: Leadership Practices - Self assessment and Leadership Practices – Observer: The data collection tool was used for this study is self-assessment scale. It was designed in 1987 to be utilized by a leader to self-evaluate them in how frequently they engage in leadership practices. The thirty descriptive statements are given and a Likert scale was used. The five practices are identified as challenge the process, inspire a shared vision, enable others to act, model the way, and encourage the heart same repeatedly question asked from nurses to assess the perception (Posner & Kouzes, 1988). Results: The study revealed that the managers moderately performed the leadership practices. A significantly positive relationship was found between the manager and subordinate's assessment of challenging the process and inspiring a shared vision (p=.345). Discussion: the results of this study support the existence of a relationship between the self-assessment and the subordinate's assessment. This study also indicates that the managers in this study moderately exhibited the leadership practices as identified in Kouzes and Posner's (1987) research. DOI: 10.7176/JHMN/60-06 Publication date:March 31st 201

Determine the Association Between Nurses Self-Concept and Clinical Performance Among Nursing Students

Self-concept in clinical performance had an important role in applying competencies and self-concept in clinical performance influenced to quality care of nursing students. Self-concept is the key point for patient care by the student nurses which is established with continues education, gaining knowledge, learning skills and making attitudes. The purpose of the study is to determine the association between nurses self concept and clinical performance among nursing students. Descriptive cross sectional study was conducted in the school of nursing at Jinnah hospital Lahore. The study data were collected using a questionnaire which consisted of Nursing Self Concept Questionnaire (NSCQ) and Six Dimension Scale of nurse performance 6-(DSNP). Pearson Correlation test was used to explore the relationship of variables. The results of the study show that clinical performance and professional self-concept are related. These findings can be helpful to teachers, authorities at nursing colleges, and nursing managers. Keywords: Professional Self concept; clinical performance; nursing students. DOI: 10.7176/JHMN/61-09 Publication date: April 30th 201

Relationship Between Clinical Learning and Classroom Learning with the Perspective of Confidence Level on Patient Safety Among Baccalaureate Nursing Students

Patient safety is a global issue in these days. Nurses play important role in patient safety through monitoring the patient in front line of health care team. The international nursing group and global health were growing the essential ability to improve patient safety. To make nurses more confident in patient safety, early training with protection of affected person as a prominent feature of the nursing curriculum is necessary. The objective of study to check the Relationship between Clinical Learning and Classroom Learning with the perspective of Confidence level on Patient Safety among Nursing Students. . Descriptive cross sectional study conducted in the Lahore school of nursing, the University of Lahore. The study data collected using a questionnaire, Health professional Education in Patient Safety Survey (HPESS), which consisted on 7 subscales.   The target population 170 and the study was conducted on Baccaular of Science in Nursing (Hones) and Baccaular of Science in Nursing (Post RN) students.  The results of this study have given the picture of the association of classroom learning with that of the implementation of the clinical practice. By incorporating the higher level of objectives about patient safety in objection in learning in nursing curriculum, students will be able to gain more knowledge about the importance of patient safety issue, which will increase the confidence level in classroom and clinical learning on patient safety among nursing students. Keywords: Patient Safety, Nursing Curriculum, Confidence Level. DOI: 10.7176/JHMN/62-04 Publication date:May 31st 201

Assess the Nurses Knowledge and Standard Practice Regarding the Prevention of Infection in Neutropenic Patients

Neutropenia-associated infections can prolong hospitalization, increase re-admission, mortality and morbidity rates. Aim of research is to determine nurses' knowledge and infection control care practices in neutropenic patients. This descriptive study was conducted between January 2020 and April 2020, at tertiary hospital Lahore, Pakistan. Sample consisted of 150 staff nurses. Data were collected by a form included socio-demographic characteristics, neutropenia knowledge questions, and infection control care practices. Each nurse was observed by researcher for infection control care practices. For observation hand hygiene adherence was found low both in medication preparation, administration and vital signs assessment. Sterility disrupted in almost all preparation of parenteral medications. Even nurses' knowledge related with neutropenia and care of neutropenic patient was found above average their infection control care practices were found insufficient.Infected patients are a source of infection transmission to other patients, health care workers and visitors, in health care facilities. Healthcare-related infections have a significant influence on the morbidity and mortality rates in the hospital environment, resulting in an increase in the time spent in hospitalization, and are thus recognized as a serious world public health problem Neutropenia is one of the most common risk factors of serious infections in immune suppressed patients and can be the result of a variety of consequences, including from certain types of drugs, environmental toxins, vitamin deficiencies, metabolic abnormalities, as well as cancer or infections. In spite of the way that neutropenia bring about contaminations, numerous preventive treatment and care conventions are demonstrated to decrease the disease rates, and improve personal satisfaction. The counteraction and control of diseases are critical for a well-functioning health system. World Health Organization in 2011 defined infection control as infection prevention and control measures that aims to confirm the defense of those who might be susceptible to obtaining an infection both in the general community and in hospitals while obtaining care due to health problems. Keywords: Nurses, Knowledge, practice, prevention, neutropenic patients. DOI: 10.7176/JHMN/77-05 Publication date:July 31st 202

Measurement of Knowledge and Performance of Pediatric ICU Nurses about Endotracheal Suctioning

Introduction: Safe and aseptic endotracheal suctioning has been a major health challenge in ICU setting, Endotracheal suction is a procedure to insert a suction catheter into the endotracheal tube to remove the secretion. Where endotracheal tube suctioning is essential for a patient with mechanical ventilation to keep their airway clean and infection free, it has also been associated with some adverse effect like hypoxia and ventilator associated pneumonia.in this regard ICU nurses knowledge and competences should be according to set criteria of ETT suctioning procedure. Methods: Target population of this study was ICU nurses of one of the children hospital, Lahore. Sample size was 98.Results: The findings of this research was beyond our expectation as nurses practices was good and their knowledge was fair. Conclusions: This study gives an overview of the ICU nurses knowledge and performance related to ETT suctioning and demonstrates that intensive care nurses' performance regarding endotracheal suctioning is good enough despite fair knowledge. With concerning to these finding there is a need for educational courses, especially theoretical education and motivational session to follow the standard protocol for ETT suction. Keywords: Pediatric, ICU, Knowledge, Performance DOI: 10.7176/JHMN/73-09 Publication date: April 30th 202

Initials Impact of Nursing Manager Perception of Empowerment and Years of Experience on Resistance to Change in Practice

Introduction:  Nurse Managers play a vital role to maintain an organization. They are responsible for nursing employment, ward management and other routine managerial activities. The nation is divided between knowledge and ignorance.  Human resources management plays a significant role in any organization. The main challenge in human resources management is capable and knowledgeable employee. Today it is a world of competition and day by day new policies are made and implemented in any business. Changes are inevitable in any organization. During the process of change every organization has to face resistance by the employees.Objective: The objective of study to check Impact of Nursing Manager Perception of Empowerment and Years of Experience on Resistance to Change in PracticeMaterial and methods: a descriptive correlational study was conducted to the impact of nursing manager perception of empowerment and years of experience on resistance to change in practice. The target population 150 and the study was conducted on head nurses of different hospitals. Participants were asked to fill demographic and conditions for work effectiveness questionnaire (CWEQ-II) and resistance to change scale. Conclusion: according to this study the perception of empowerment in nursing managers has significant relationship with resistance to change. As the perception of empowerment increases the degree of resistance decreases. In current health system, it is necessary to develop perception empowerment that has proven to effective to decrease resistance to change in practice among nurses. Keywords: Nursing Manager, Empowerment, and Experience and Resistance to Change DOI: 10.7176/JHMN/62-11 Publication date:May 31st 2019

The Relationship Between Nurse Attitude and Students Self-Efficacy in Nursing Students Perceptive

Background: Clinical education is the methods by which nursing students are offered chances to apply the theories and learning of nursing, and work on nursing abilities that are basic to practice as a proficient staff nurse. For the competent clinical self efficacy, a caring relationship is necessary and essential for student learning in clinical setting. According to a study the clinical learning environment and supervision impact on clinical competency of nursing students.  There is significant impact of supervisory relationship on clinical experience of students. The relationship between clinical faculty and nurse teacher also has impact in clinical self efficacy of the nursing student.Method: a descriptive co relational study design used in this study. The study conducted in The University of Lahore on 117 students of Nursing. The sample size calculated through Solvens formula. Clinical learning environment supervision and Nurse Teacher evaluation scale (CLES+T) and nursing clinical self efficacy scale (NCSES) questionnaire used in study. Results: there is positive correlation between clinical learning environment and self efficacy of students. The overall co relational value is r=.336, p=.000 at the level of 0.01.Conclusion: It is concluded that the attitude of clinical staff has great impact on student clinical self efficacy. The creation a good clinical environment the clinical self efficacy of the student can be enhanced Keywords: Relationship, Attitude, Clinical Self Efficacy, Nursing students, Perception DOI: 10.7176/JHMN/62-02 Publication date:May 31st 201