RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA

PROFORMA SYNOPSIS FOR REGISTRATION OF SUBJECTS

FOR DISSERTATION

Mr.YASHIN MUHAMMED.C

FIRST YEAR M.Sc (NURSING)

MEDICAL SURGICAL NURSING

YEAR 2008-2010

THE KARNATAKA COLLEGE OF NURSING

NO.12, KOGILU MAIN ROAD,

YELAHANKA, BANGALORE-560064

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,BANGALORE, KARNATAKA

PROFORMA SYNOPSIS FOR REGISTRATION OF SUBJECTS

FOR DISSERTATION

1 NAME OF THE

CANDIDATE AND

ADDRESS

Mr.YASHIN MUHAMMED.CFIRST YEAR M.Sc (NURSING)

THE KARNATAKA COLLEGE OF NURSINGNO.12, KOGILU MAIN ROAD,

YELAHANKA, BANGALORE-560064

2 NAME OF THE

INSTITUTE

THE KARNATAKA COLLEGE OF NURSINGNO.12, KOGILU MAIN ROAD,

YELAHANKA, BANGALORE-560064

3 COURSE OF THE

STUDY AND

SUBJECT

FIRST YEAR M.Sc (NURSING)MEDICAL SURGICAL NURSING

4 DATE OF

ADMISSION TO

THE COURSE

29/11/2008

5 TITLE OF THE

STUDY

A DESCRIPTIVE STUDY TO ASSESS THE LEVEL OF KNOWLEDGE ON BARRIER NURSING TECHNIQUE AMONG NURSES IN INTENSIVE CARE UNITS OF SELECTED HOSPITALS AT BANGALORE.

1

6. BRIEF RESUME OF THE INTENTED WORK

6.1 INTRODUCTION

Alarming rise in the cost of health care delivery system, along with

newly emerging infectious diseases and drug resistant microorganisms,

compel the health care provider to implement various techniques to prevent

the origin and spread of infectious diseases. Micro organisms are necessary

for normal body function. Some micro organisms help to produce food and

maintain the planets ecology. Quite often, human being and micro organisms

live in harmony, the moment this harmony is upset, micro organisms are

capable of producing diseases.

Health care providers are focusing on providing a safe and therapeutic

environment to protect clients and their family. Medical science is trying to

control the various infections that arise in the community by a variety of

methods. Prevention of infection is a major focus for nurses. As primary care

givers, nurses are involved in identifying, preventing, controlling and teaching

the client about infection.

An infection acquired in hospital by a patient who was admitted for a

reason other than that infection . An infection occurring in a patient in a

hospital or other health care facility in whom the infection was not present or

incubating at the time of admission. This includes infections acquired in the

hospital but appearing after discharge, and also occupational infections

among staff of the facility.11

Nosocomial comes from the Greek word nosokomeion meaning hospital

(nosos = disease, komeo = to take care of). This type of infection is also

2

known as a hospital-acquired infection (or more generically healthcare-

associated infections). Nosocomial infections manifest Majority of such

infections become evident during their stay in the Hospital or some times only

after their discharge from the patient. 8

Infection is the entry and development (Multiplication) of a disease

producing agent in the body. It is the invasion of a susceptible host by

pathogens or microorganisms resulting in disease. An infection is a disease

state that results from the presence of pathogens in or on the body or it is an

entry and development of a disease producing agent in the body.5

Barrier nursing or isolation technique is intended to confine the

microorganisms within a given and recognized area. There are a number of

isolation techniques and precautions used to prevent the spread of infection.

According to ICN, “Nursing is the unique function of nurse, that is assist

the individual (who sick or well) in the performance of those activities

contributing to the health or its recovery (or to a peaceful death) that he would

perform unaided if he had the necessary strength, will or Knowledge.”14

The nurse follows certain principles and procedures to prevent infection

and control its spread. During daily routine care the nurses use of basic

medical aseptic techniques to break the infection chain. Because infections

are readily transmissible between clients and care givers, the nurse follows

isolation precautions as appropriate. 26

Practices or techniques that control or prevent transmission of infection

help to protect client and health care workers from disease. Clients in all

health care setting are at risk for acquiring infections. By practicing infection

prevention and control techniques, the nurse can avoid spreading

3

microorganisms to clients. By undertaking the chain of infection, the nurse can

prevent infection. The nurse is able to observe signs and symptoms of

infection.24

In 1988 the Body Substance Isolation (BSI) system was developed and

stressed general precautions for all clients (Jackson and Lynch 1992).The

system emphasizes the potential infectiousness of moist body substances.

Jackson and Lynch (1990) explained that BSI could prevent transmission of

colonized body substances as a source of infections.32

The success of the nurse who practices infection control techniques is

measured by determining whether the goals for reducing or preventing

infections are achieved. Improved hygiene practices reduce infection and

development of antimicrobial resistance.9

The agents that can cause infection are everywhere in the environment

on body surface, food, and products used in normal articles of daily living.

Intact skin and mucous membrane are major barriers against organisms in the

transmission of infections.10

The most important and most basic techniques in preventing and

controlling transmission of infection is hand washing. The US public health

service note that washing times of at least 10 to 15 seconds routine hand

washing may be performed with plain soap and water can physically remove a

certain level of microbes but antiseptic agents are necessary to kill micro

organisms.18

Hospitals in the developing world lack an awareness of infection control

programmes and also proper documentation methods of various infections

making it very difficult to investigate the spread of infections. There fore,

4

establishment of an infection control doctor and infection control nurse is

essential.29

Hospital nurses expose to blood born pathogens were associated with

the organizational characteristics and staffing levels on the hospital units

where they worked. Individual nurse’s risks of sustaining percutaneous

injuries with used sharp objects were related to aggregate level

characteristics. It’s by poor working climate was associated with increased

risk of injuries and near misses.1

Institutional waste disposal methods are important factors in infection

control programme. Infection control nurse play an important role in

assignment of a hospital infection rate with the help of surveillance. She

collaborates with medical and nursing staff to investigate the spread of

infection. She identifies the problems related to infection and reports to

infection control committee and management. In order to do so, she needs to

know about surveillance for her institute. So that errors can be minimized and

accurate data collection and calculation of infection rates can be done. 12

6.2 NEED FOR THE STUDY

Nurses are exposed to many kinds of infectious agents in their

working environment. Incidence of nosocomial infectious agents in their

working environments is increasing daily. The observation and discussion with

nurses gave investigator an idea about their lack of knowledge on barrier

nursing technique. While searching for related researches, investigator found

that the number of studies were limited. Hence investigator felt the

significance of conducting a study on the topic.

5

Barrier nursing technique is a corner stone of modern health care to

explore health care professional’s perceptions of infection control practices in

relation to the management of infection diseases.13

In1982 the centers of disease control and prevention (CDC) issued a

case of definition of AIDS often the 100 cases were reported. As of December

2001 there were 814,149 reported cases of HIV/ AIDS. In these 24 % injection

drug use in males but in females 44% reported in injection drug use. AIDS

reached epidemic proportions in some other places of world. According to

joint United Nations program on HIV more than 18.8million people world wide

have died of AIDS and 34.3 million people are infected with HIV with 5.4

million people newly infected in 1999 alone. Levin, bloom & Holl man 2001) in

united state most risk factors include people who inject drugs intravenously as

well as those who inject drugs intradermally. Blood and blood products can

transmit HIV to recipients.41

A study on meningitis between 1992 and 1996, there was a 28%

increase in number of new cases reported in 12-29years old age group

(Rosensteints Perkens, Stephen et al, 2001).25

eScienceNews.com report “Patients continue to enter home healthcare

‘’sicker and quicker,” often with complex health problems that may require

extensive nursing care. This increases the risk of needlestick injuries in home

healthcare nurses. While very few studies have focused on the risks of home

healthcare, it is the fastest growing healthcare sector in the U.S. In a recent

study, led by researchers at Columbia University Mailman School of Public

Health, the rate of needlestick-type injuries was 7.6 per 100 nurses. At this

rate, the scientists estimate that there are nearly 10,000 such injuries each

6

year in home care nurses. The findings, reported in the paper, “The

Prevalence and Risk Factors for Percutaneous Injuries in Registered Nurses

in the Home Health Care Sector,” were published in the September 2009

issue of American Journal of Infection Control. According to lead author

Robyn Gershon, DrPH, professor of clinical Sociomedical Sciences at the

Mailman School of Public Health and principal investigator, “although

professionally and personally rewarding for many, home care nursing can be

both physically and emotionally demanding. Our study findings suggest that

home healthcare work may be dangerous for nurses who work in this setting.

These types of injuries are serious as they can result in infection with

bloodborne pathogens, such as hepatitis and HIV.” A critical finding of this

study was the statistical correlation between needlesticks and exposure to

stressful conditions in the patients’ household. Nurses reporting household

stressors, such as cigarette smoke, unsanitary conditions, air pollution, and

vermin, were nearly twice as likely to report needlestick injuries. Most

significant was the fact that home healthcare nurses exposed to violence in

their patients’ households were nearly three and a half times more likely to

also report needlestick injuries, according to the study.” 46

Approximately 600,000 to 800,000 needle stick injuries occur annually.

A significant number of all needle stick injuries result from recapping needles

after their contact with blood from a client. Studies have documented a

decreased rate of needle stick injuries when needle less system are used. 23

Each year an estimated 2 million patients in United States acquire

nosocomial infections. Approximately 240,000 additional residence of long

term care facilities become infected each year, with the anticipated growth of

7

elderly population. This number may increase to approximately 750,000 by

2005 (Jarvis 2001). Staff nurses play an important role in risk reduction by

paying attention to hand hygiene. Unfortunately many hospitals not introduced

infection control programmes and only an estimated 9% of expected

infections are prevented (scheckler et al 1998).48

In1996 efforts were made by the CDC and its hospital infection control

practices advisory committee (HICPAC) to standardized procedures to reduce

risk for exposure .The universal precautions is body substance isolation

applied to all patients receiving care .The primary goals of standard

precautions is to prevent nosocomial infections. Large scale studies of

exposed health care workers conducted by the CDC and other groups in

November 2000. The needle stick safety and prevention act become law

mandating health care facilities to use devices to protect against injuries.

(Washington 2001) .31

Scabies is an infestation of the skin by the itch mite sarcoptes scabies.

Health care personnel who have prolonged hands on physical contact with an

infected patient may like wise become infected.24

In 1971, military began vaccinating. American academy of

pediatrics provides information to college freshmen and their parents about

risks of diseases and availability of vaccination (Bruce et al 2001: CDC 2001).

And people in close contact with patient with meningococcal meningitis should

be treated with antimicrobial chemoprophylaxis (CDC 2000).33

In March 2003, WHO issued a global warning about new type of

pneumonia, SARS (severe acute respiratory syndrome). The disease first

recognized in China. Before the disease came to the attention of WHO,

8

transmission to nurses and other health care professionals occurred

frequently. Once patient is isolated and using barrier precautions and cleaning

contaminated surfaces carefully, transmission was effectively reduced or

prevented.42

Nurses working in hospital with poor work climate and lower staffing

levels were substantially more likely to report the presence of risk factors

associated with needle stick injuries. Nurses on units with less adequate to

resources, lower staffing and less nurse leadership and higher level of

emotional exhaustion were typically twice as to report to the presence of risks

due to staff carelessness and inexperience, patient un cooperativeness,

frequent recapping of needles and inadequate knowledge of supplies. 16

CDC guidelines for preventing the transmission of tuberculosis in

health care facilities, recommendation for prevention of HIV transmission in

health care settings, sexually transmitted disease guidelines and standards

for pediatric immunization practices, occupational safety and health

administration (OSHA) are federal agencies involving in controlled prevention

of infection. 45

Doctors in New Zealand will soon have the option to test a patient’s

haemoglobin level without taking a drop of blood. Non-invasive and

continuous total haemoglobin monitoring technology uses a finger sensor to

measure a person’s haemoglobin or red blood cell levels.How it works: A

sensor is slipped onto a patient’s finger and multiple wavelengths of light and

advanced signal processing algorithms identify and quantify haemoglobin in

the blood. Blood measurements are then displayed on a monitor.39

9

A sad and thankfully rare incident. This nurse received a needlestick

injury and developed HIV after testing the blood sugar levels of a HIV positive

patient “The hospital room was not equipped with the specialist disposable

device usually used for HIV patients, so she used a different type of needle,

Southwark coroner’s court was told”.40

The New York Times report “A former hospital surgical technician who

may have infected dozens of surgical patients with hepatitis C by stealing their

pain medication and swapping back needles tainted by the virus she carried

pleaded guilty to federal drug charges. The woman, Kristen D. Parker, 26,

who could have faced up to life in prison on the most serious charges,

accepted a 20-year prison sentence in a plea agreement with federal

prosecutors. Ms. Parker admitted guilt to multiple charges of tampering with a

consumer product and obtaining a controlled substance by deceit. Twenty-

seven patients at two hospitals where Ms. Parker worked last year and this

year, in Denver and Colorado Springs, have tested positive for a strain of

hepatitis C and have been linked to her care, according to state health

records. Hepatitis C affects liver function and can have lifelong

consequences.”35

Infection control committee Should meet regularly to formulate and

update policies for the whole hospital on all matter which have bearing on

infection control and to mange outbreaks of Nosocomial infection. Infection

Control Team Which will function under the guidance of Infection control

Doctor. A Medically qualified Microbiologist, who will take responsibility of day

to day for the policies formulated. The Functions of the Committee to do

10

surveillance and infection monitoring of hygiene practices. Educate the

Medical and Paramedical staff on policies relating to prevention of infection,

and safe procedures.37

Infection Control Nurse Is the key member of the team Maintain the

close working relations between Microbiology Laboratory, different clinical

services and supportive services like laundry, pharmacy and engineering.25

There is a current tension in society regarding health and safety issues.

Criticisms of safety notices (‘Warning contents may be hot’, etc) reflect the

view that contemporary society has become over-concerned with removing

every aspect of risk from our lives. There is a corresponding view that such

approaches are less to do with ensuring individual or group safety and more

to do with protecting institutions from possible litigation. Nevertheless, we

should not forget that the Health and Safety at Work Acts originated in the

laudable aim of minimizing the risk of death or severe injury among the

workforce.

6.3 STATEMENT OF THE PROBLEM

A descriptive study to assess the level of knowledge on barrier nursing

technique among nurses in intensive care units of selected hospital at

Bangalore.

6.4 OBJECTIVES OF THE STUDY

The study objectives are the following,

To asses the knowledge of nurses regarding barrier nursing technique.

11

To find out the association between the levels of knowledge of nurses

on barrier nursing technique with selected variables.

6.5 OPERATIONAL DEFINITIONS

Assess

It refers to the evaluation of collected data.

Knowledge

It refers to the awareness of nurses on barrier nursing technique.

Barrier Nursing Technique

It refers to the technique used to prevent nosocomial infections.

Nurse

It refers to a person who applies practical nursing skills in intensive

care units.

Intensive care units

It refers to a unit, where we provide advanced care to critically ill

patients.

6.6 ASSUMPTIONS

All nurses are willing to participate in this study.

All nurses have basic knowledge on barrier nursing technique.

Nurses knowledge on barrier nursing technique may vary with selected

hospitals.

6.7 HYPOTHESIS

There will be a significant association between the level of knowledge

of nurses on barrier nursing technique with selected variables such as age,

sex, education, work experience and continuing nursing education

12

6.8 REVIEW OF LITERATURE

Review of literature is a key step in research progress. It refers to an

exclusive, exhaustive and systematic examination of publication

relevant to research project.

One of the most satisfying aspects of the literature review is the

contribution. It make to the new knowledge, insight and general scholarship of

the researcher. Its major goal is to develop strong knowledge base to carry

out research and other research scholarly activities in educational and clinical

practice settings.

This chapter includes the previous studies which seem to be

significant to support the present study.

REVIEW ON BARRIER NURSING TECHNIQUE

Saras Hendesson et al conducted a study “infection control practice is

a corner stone of modern health care”. The objective of the study was to

explore health care professional’s perception of infection control practices in

relations to infectious disease. They completed interview to workers with a

sample of 16 nurses and doctors at hospital in Western Australia. The

identified factors influence health professional’s level of compliance can be

used to develop strategies to support long term compliance with infection

control practices. 1998. This study has relevance in my study, because of the

knowledge of the nurses practice of barrier nursing technique.39

GAMMON BSc, MPhil, PhD, RGN,conducted a study on “The

psychological consequences of source isolation”,In this study conclude

that Source isolation can be an extremely frightening and anxiety provoking

experience. With the many epidemiological changes that are prevalent in the

13

UK today the need to care for individuals in source isolation is becoming

increasingly important to prevent the spread of infection in hospitals. This

study has relevance in my study, because psychological consequences to

nurses by the increased chance of cross infection.24

Haley R.W et al conducted “A study on Bone marrow transplantation,

laminar air flow, Barrier nursing, Graft verses host disease.” In this study, the

sample selected in US general hospital and the results of the study suggest

that the incidence of graft verses host diseases may decrease with efficient

decontamination of the patients. 1984. This study is related my study,

because of the importance of direct contact to infected patient in barrier

nursing technique.19

Voegeli D conducted “A study that the effect of washing and drying

practices on skin barrier function.” The aim of the study was to explore the

potential contribution to skin damage caused by standard washing and

draying techniques used in nursing. The study shows the washing with soap

and water and towel drying has a significant disrupting effect on the skin’s

barriers function. The effect exists with damage increasing as washing

frequency increases. Drying the skin by patting with towel offers no

advantages to conventional gentle rubbing as it leaves the skin significantly

wetter and greater risk of frictional damage. 2007. This study has relevance in

my study, because washing is important in barrier nursing technique.27

Korniewicz D et al conducted a study on “Barrier effectiveness Of Latex

and Non Latex gloves”. The purpose of this study was to examine the effects

of glove stress, type of material, and manufactures on the barrier

14

effectiveness of medical examination gloves. This study is related my study,

because of the importance of gloves in barrier nursing technique.30

Carlbom D.J et al conducted “A study on Barriers to implementing

protocol, based sepsis resuscitation in the emergency department result of a

national survey.” The results is respondents identified lack of available nursing

staff to perform the procedure, the inability to monitor central venous pressure

in the emergency department and challenges in identifying septic patients as

the most frequent barriers. Busy emergency departments they identify

multiple barriers to implementing time: sensitive resuscitation to patients with

severe sepsis. 2007. This study has relevance in my study, because of the

knowledge and practice influence the barrier nursing technique.18

Elola-Vicente P et al conducted a study on “A hand hygiene

education program on a comparison between hand washing and the use of

alcohol solutions”. The objectives of the study was to analyze the results of a

hand hygiene education program in nursing staff and to compare the efficacy

of hand washing with and without the application of alcohol solutions. This

study is related my study, because of the importance of hand hygiene in

barrier nursing technique.15

REVIEW ON NOSOCOMIAL INFECTIONS

Hedder Wick SA et al conducted a study on “Infection control Hospital

Epidimol”. In this study, artificial nails were more likely to harbor pathogens,

especially gram negative bacilli, and yeast than normal nails. The longer

artificial nails were worn the more likely that a pathogen was

Isolated. 2000. This study is related my study, because of the importance of

hand hygiene in barrier nursing technique.27

15

Mokabel F, et al conducted a study on “infection control activities in six

hospitals: a comparison”. In this study,the aim of the research was to assess

and evaluate the activities of infection control departments in six hospitals.

The result of the study on hospital acquired infection is almost entirely

preventable by good standards of clinical practice. The findings of this study

have shown how the infection control staff in each hospital use an infection

control audit tool to identify those wards with particular problems and those in

need of additional educational activity. 1998. This study has relevance in my

study, because of the importance of infection control protocol in barrier

nursing technique. 24

MA Borg et al conducted “A study survey of infection control

infrastructure in selected southern and eastern Mediterranean hospitals.” The

study conducted in 45 hospitals they get results there were no significant

differences among hospitals in the two regions in surveillance activities. The

presence of an antibiotic policy or feedback of resistance data to prescribers,

all of which were at a low level. Only a minority of hospitals had published

antimicrobial resistance data to prescribers. This study has relevance in my

study, to assess variation in regional practice of barrier nursing technique.20

Tina Betton conducted a study on “The use of the elbow technique to

access neonatal incubators: can this reduce the risk of cross infection?” The

results show using the elbow methods in a very simple measure that can be

taken to improve patient care by reducing the risk of cross colonization or

cross infection. Inappropriate access to the incubator is putting neonates at

unnecessary risk. 2007. This study has a relevance in my study, because of

the relation of the cross infection to barrier nursing technique.29

16

Springer. L et al conducted a study in United States “Anticipated care

for HIV infected clients, nurse’s reactions” the purpose of the study was to

assess nurses, reactions to the possibility of working with HIV clients. This

study has relevance in my study, because of the severe chance of cross

infection from HIV patients.21

Larson et al conducted “A study on changes in bacterial flora

associated with skin damage on hands of health care personnel”. The

observed study of nurses, nurses with damaged hands did not have higher

microbial counts but did have a greater number of colonizing species. The

results to improve the condition of the hands are warranted because of skin

damage can change microbial flora and avoid the use of latex gloves and use

of glove powders. 1998. This study has relevance in my study, because of the

importance of practice of personal hygiene in barrier nursing technique.33

Brunner. S et al conducted a study on “Does Stratifying Surgical site

infection rates by the National nosocomial infection surveillance risk index

influence the rank order of the hospitals in a surveillance system?” A study to

investigate whether stratification of surgical site infection (SSI) rates according

to the National nosocomial infection surveillance (NNS) risk index could lead

to a better basis for comparison of surgical units compared with simpler

methods. This study helps to comparison of various barrier nursing technique

methods.47

Forten Berry M et al conducted a study on “Relationship of stigma and

shame to gonorrhea and HIV screening”. The results focuses on at risk clients

who perceive that they will be judged adversely because of STDs are less

likely to seek appropriate care. 2002. This study has relevance in my study,

17

because attitude of the nurses influence practice of barrier nursing

technique.16

REVIEW ON PRACTICE OF BARRIER NURSING TECHNIQUE

Baker B. conducted a study on “Improving Safety for Nurses Providing

IV Therapy.” The objectives of the study is risk nurses face related to

exposure to blood borne pathogens associated with IV therapy are daily

challenges. Providing a product with the least risk of exposure is the

responsibility of the healthcare organization. Where the two meet creates an

environment that fosters a safe work environment and raises the awareness

that safety is everyone’s job. This study has relevance in my study, because

of the relation of safety practices of nurses and barrier nursing technique. 21

H.K. Mahmoud et al conducted a study on “Needle stick sharp injuries

among vocational school nursing students in Southern Taiwan.” In this

study,the research focuses on health care works, students in hospital

internships through the questionnaire, the results were 50% responders one

or more sharp injuries or needle stick injuries and 18.2% responders suffered

contaminated sharp injuries and needle stick injuries. The study conducted

that the nurses than health care workers. The young age of these nurses put

them at greater risk. 2004. This study has relevance in my study, because of

the Needle stick injuries are common cause of infection among nurses.35

Kelvin Miles conducted a study “The historical role and education of

nurses for the care and management of sexually transmitted infection in the

United Kingdom”. The result of the study was barriers to developing the role of

the nurse continue to exist as we move into the 21st century from specialized

genito urinary medicine clinics. This historical review looks at how the role of

18

the nurse has evolved the past 150 years and suggest how past lessons can

helps enhance the contribution nurses will make to the future of sexually

transmitted infection management and control. 2007. This study has

relevance in my study, because of the knowledge influence the practice of

barrier nursing technique.42

Bostrom A.M et al conducted “A study on Barrier to research

utilization and research use among registered nurses working in the care of

older people: Does the barriers scale discriminate between research users

and non research users on perceptions of barriers?” The barriers revealed

differences the perception of barriers between research users and non

research users. The identified barriers are generally wide ranging making at

difficult to design useful specific interventions. This study has relevance in my

study, because this gives the picture of attitude of nurses.36

Adetoyeje. Y Oyeyemi conducted a study on “AIDS care in Nigeria: are

nurse’s comfortable performing procedures”. The aim of the study is to assess

nurses’ level of comfort in providing care to patients living with AIDS and to

determine the social demographic variables that influence nurses’ comfort.

This study has relevance in my study, because of the severe chance of cross

infection from HIV patients.30

Zafar A.B et al conducted a study on “How Do Nurses Determine the

Effectiveness of infection Control Practices?” In this study the researchers

studied the use of a bacteriostatic soap to reduce the nosocomial

transmission of methicillin resistant staphylococcus aureus (MRSA). This

study has relevance in my study, because this study explores the methods of

barrier nursing technique.48

19

Wolf R et al conducted a study on “Nursing staff perceptions of

methicillin – resistant staphylococcus aureus and infection control in a long

term care facility.” The objectives of the study to assess perceptions of

nursing staff regarding methicillin – resistant staphylococcus aureus (MRSA)

Infection Control (IC) and perception strategies, barriers to infection control

and infection control resources. This study has relevance in my study,

because of the knowledge on micro organism influence the practice barrier

nursing technique.28

Yano S et al conducted a study on “Quantiferon (tuberculosis) TB-2G

among nurses with a history of working is our tuberculosis word”. The purpose

of the study to investigate the infection rate of tuberculosis among nurses with

a history of working is our hospitals tuberculosis word. This study has

relevance in my study, because tuberculosis is one of the major infectious

diseases in the world.23

7. MATERIALS AND METHODS

7.1 SOURCE OF DATA

The data will be collected from the nurses who are working in intensive

care units of selected hospitals at Bangalore.

7.2 METHODS OF DATA COLLECTION

I. RESEARCH DESIGN

Research design refers to the researcher’s overall plan for answering

the research questions or testing the research hypothesis. In this non

experimental study, the researchers have opted for descriptive survey design.

The purpose of descriptive study is to observe, describe and document a

situation.

20

II. RESEARCH VARIABLES

1. Dependent variable: Knowledge level of nurses.

2. Independent variables: Barrier nursing technique

3. Demographic variables: Age, sex, education, work experience, and

continuing nursing education

III. SETTING

During the planning phase the researchers have identified a study site

that is consistent with research topic. In this study the researcher selected the

settings as intensive care units of selected hospitals at Bangalore.

IV. POPULATION

A population is an entire aggregation of cases that meets specified

criteria. Accessible population will be the nurses working in intensive care

units of selected hospitals at Bangalore.

V. SAMPLE

A sample is a subset of population. The investigators decided to take a

sample of 30 nurses in intensive care units of selected hospital at Bangalore

for main study and sample of 3 nurses for pilot study.

VI.CRITERIA FOR SAMPLE SELECTI0N

1. Inclusion criteria

All nurses who are working in intensive care units of

selected hospital at Bangalore.

All nurses those who are willing to participate in this study.

All nurses those who know English

2. Exclusion criteria

Those who are not willing to participate in this study.

21

Those who are not attending duty during the period of data

collection.

VII. SAMPLING TECHNIQUE

Sampling technique is used to select a portion to represent the entire

population. Convenience sampling technique is quite appropriate for this non

experimental study.

VIII. TOOL FOR DATA COLLECTION

The tool consists of the following sections:

Section A: Demographic data which gives baseline information obtained from

the nurses such as age, sex, education, work experience, and continuing

nursing education.

Section B: self-administered questionnaire to assess the level of knowledge

of nurses regarding barrier nursing technique.

IX. METHOD OF DATA COLLECTION

Formal permission will be obtained from the selected hospitals at

Bangalore. The investigator will be selecting the sample from the intensive

care units of selected hospital by using convenient sampling technique. After

obtaining the informed consent from the samples the investigator will

distribute the self administered questionnaire to subjects for 30 minutes to

assess the knowledge on barrier nursing technique.

Duration of the study: 4-6 weeks

X.PLAN FOR DATA ANALYSIS

The data collected will be analyzed by using descriptive and inferential

statistics.

Descriptive statistics: Frequency, percentage distribution of demographic

22

variables and mean will be used to assess the knowledge of nurses on barrier

nursing technique.

Inferential statistics: Chi-square test will be used to associate the

knowledge of nurses on barrier nursing technique with selected demographic

variables.

XI. PROJECTED OUTCOME

After the study the investigator will evaluate the level knowledge of

nurses on barrier nursing technique and associate these with selected

variables. The result of the study will enable the investigator to prepare the

health education material on barrier nursing technique, which can be used by

nurses and teachers as to improve the knowledge and to reduce the

incidence of nosocomial infections.

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATIONS OR

INTERVENTIONS TO THE PATIENT OR OTHER HUMAN BEINGS

OR ANIMALS?

No, there is no active manipulation on the subjects.

7.4 HAS ETHICAL CLEARANCE OBTAINED FROM YOUR

INSTITUTION?

After obtaining ethical clearance from the institution, permission will be

obtained from the consent authority of selected hospitals and informed

consent from subject to conduct the study.

23

8. LIST OF REFERENCES

1. Alyifice GAJ “Control of hospital infection”, 3rd edition, Chapman and

hall publication, 1993

2. Bannet J “Hospital infection” 4th edition, Lippincott, Raven

publication, 1998.

3. Barbara MS “Infection and nursing practice”, 1st edition, Mosby

Publication, 1995.

4. Carol Taylor, Carol Lillis, Priscilla Le Moue Lippincott,

“Fundamentals of Nursing”, 4th edition

5. Forten M Berry and et al “Relationship of stigma and shame to

gonorrhea and HIV screening”.

6. Janet weber, Jane Kelley “Health assessment in Nursing” Lippincott

Learmy System

7. K.S Nagi PhD “Biostatistics with latest MCQ’s AIT BS Publisher

8. Kozier ERB “Fundamentals of Nursing” 5th edition, Addison Wesley

publication

9. Lewis,Sharanmantick ”A Text Book of Medical and Surgical

Nursing” 6th edition, Lewis, Mosby publication, 2004.

10.Potter and Berry “Fundamentals of Nursing, infection control”, 5th

edition

11.Ruth.F.Craven, Constance J Hirnle “Fundamental of Nursing”

Human health and function, 5th edition, Lippincott, Williams and

Wilkins publication

12.Sorenson and Lackman’s, Basic Nursing, A Psycho physiologic

Approach, 3rd edition

24

13. Sr. Nancy, “Principles and Practices of Nursing arts procedures”

Volume I, 6th edition, NR brother Publications

14.Suzanne C Smeltzer, Brunner and Suddarth “Text Book of Medical

and Surgical Nursing”, 10th edition, Lippincott publication

JOURNALS

15. American Journal of Nursing 101 (3): 104

16.Archives of Internal Medicine. 169(18), p.1705-171

17.AMT Publications health 92 (3) 378, 2002, The effect of social

18.British Journal of Midwifery. 17(3), p.192.

19.Centers stigma and shame on STD isolated area. for disease

control and prevention 1600 up from RD, Atlant, GA 3033 (404) 639

– 3311

20.Hidden wick S.A et al “Pathogenic organism associated with

critical fingernails worth by health care workers”, infection

control hospital epidmol on 21 (2008) 05/05/2000

21. Indian Journal of Pediatrics, Dr. K C Chaudhuri Foundation, co-

published by Springer India, Volume 13, Number 4 / October, 1946,

0019-5456 (Print) 0973-7693 (Online)

22. International Journal of nursing practices, volume -14, Issue – 1,

Journal competition, Black well publishing, Asia Private Limited,

Page No. 11 – 17, February 2008

23.JAVA. 13(4), p.188-189

24.Journal of Clinical Nursing, Volume 8 Issue 1, Pages 13 – 21,

Published Online: 24 Dec 2001

25

25.Journal of Hospital Infection, Volume 66, Issue 1, Page 1

26.Journal of trained nurses association of India, may 2004, Page No.

54

27.Korniewicz D.el-masri, Broyels and O.Connel K P “Performance

of latex and non latex medical examination gloves during simulated

use”, American Journal of Infection, 30(2), 133-138, 2002.

28.Nutrition in Clinical Practice, Vol. 20, No. 6, 597-606 (2005)

DOI: 10.1177/0115426505020006597

29.PMID: 17040550 [PubMed - indexed for MEDLINE]1: Worldviews

Evid Based Nurs. 2005;2(1):4-13; discussion 14-5.

30.PMID: 15492360 [PubMed - indexed for MEDLINE

31.PMID: 18199943 [PubMed - indexed for MEDLINE]

32.PMID: 19805958 [PubMed - in process]

33.PMID: 19797303[PubMed - as supplied by publisher]

34.The Nursing Journal of India, Hospital Infection Control, volume-5,

2002.

35. Washington k (2001), you have been stuck; what do you do?

WEB SITES

36. www.bmb.leeds.ac.

37. www.cdc.gov

38. www.ciap.health.nsw.gov.au/hospolic

39. www.google.com.

40. www.google. co.in/search?hl=en&q=barrier+nursing&meta

41. www.internurse.com

42. www.internurse.com/cgi-bin/go.pl/library/article.

26

43. www.medical-colleges.net/pediatric.htm - 38k

44. www.publish.csiro.au

45. www.pubmed.com

46. www.pubmedcentral.nih.gov/articlerender.fcgi?artid=184

47. www.pubmedcentral.nih.gov/articlerender

48. www.yahoo.co.in

27

9 Signature of candidate

10 Remarks of the guide

11 Name and designation of

11.1 Guide

11.2 Signature

11.3 Co-guide (if any)

11.4 Signature

11.5 Head of department

11.6 Signature

12 12.1 Remarks of the Principal

12.2 Signature

28