M E S S A G E

It is a matter of extreme joy that our Department of Nursing is goingto publish a News Letter “Nursing – News Views” from 24th of July, 2013onwards. This publication will not only keep us updated with the latest trendsin the field of Nursing but will also provide us the various problems andprospects as regards Nursing profession.

Nursing is a profession that every human requires from time immemorialtill date and it will grow in manifold for days to come. From the time of FlorenceNightingale, our sisters are being adored and honoured by the societyboundlessly. It’s a profession, which is noble, prestigious and graceful. Further,we must remember the fact that our motto is “Service to Man is Service toGod” and how it can be fully implemented by our sisters for the good of thepoor, through this News Letter, we need to impart. I pray and wish theNewsletter a great success.

Phone : +91-33-2475 3636/37/38/39+91-33-2476 0631/80/81

Fax : +91-33-2475-4351Email : rkmspsm@gmail.com

rkmsp@rediffmail.comWebsite : www.rkmsevapratishthan. org

Ramakrishna Mission Seva Pratishthan(A General Hospital Recognised by M.C.I., West Bengal University

of Health Sciences & National Board of Examinationsfor Post-Graduate Teaching and Research)

99, Sarat Bose Road, Kolkata - 700 026(A Branch Centre of Ramakrishna Mission, P.O. Belur Math, Dist. Howrah, West Bengal 711202)

( Swami Satyadevananda)Secretary

Dated : July 17, 2013

Chief Advisor

Srimat Swami Satyadevananda, SecretaryRamakrishna Mission Seva Pratishthan, Kolkata.

Editorial Board

Ms. Sikha Banerjee, M.SC (N)Nursing Superintendent, R.K.M.S.P

Ms.Bharati Chatterjee, M.SC (N)Principal, Ma Sarada College Of Nursuing, R.K.M.S.P

Ms. Sujata Sengupta, M.SC (N)Vice Principal, Ma Sarada College Of Nursuing, R.K.M.S.P

Editor

Ms. Madhuchanda Guhathakurta, M.SC (N) Principal, School Of Nursuing, R.K.M.S.P

Co-Editor

Ms.Nupurkana Dutta Dy. Nursing Superintendent, R.K.M.S.P

Ms.Suchanda Sikdar, M.SC (N) Lecturer, Ma Sarada College Of Nursuing, R.K.M.S.P

Ms.Senjuti Mallick, B.SC (N) Tutor, School Of Nursuing, R.K.M.S.P

Editorial Address :Office of Nursing Superintendent,Ramakrishna Mission Seva Pratisthan99 Sarat Bose Road, Kolkata-700 026Phone No. - (033) 2475-3636

Research publication is done with due permission from the researcher. Articles published withreferences from books and websites.Number 1, July-October, 2013.

Quarterly News Letter for Promoting Excellence in Nursing

Contents

Page No.

1. Research Study on Patient’s Satisfaction in OPD-Services 4

2. Milieu - Therapy 6

3. Breast-Feeding Information Retrieval 7

4. World Health Day Theme 8

5. Natural Pain Relief Option In Labour 9

6. International Nurse’s Day Theme2013 10

7. Kangaroo – Care 11

8. What’s in a Cigarette? 12

9. A Case Report — Phenylketonuria 13

10. Attention — Nedle Stick Injury 14

“Patient don’t care how much you know until they know how much you care”

Patient satisfaction is a subjective judgmentof quality care. It is very important to improvepatient satisfaction levels, especially intoday’s competitive health care Environment.As a member of health care team, the nurseneeds to find the gap & act to bridge the gapto meet the goal of providing satisfaction tothe client.

A research study done in OPD to seeeffectiveness of planned discussion fornurses working in OPD to improvesatisfaction level of client attending OPD ofRamakrishna Mission Seva Pratisthan.

Abstract :

Evaluative study to find the effectiveness ofplanned discussion on patient satisfactionwith nursing staff working in OPD in aselected hospital R.K.M.S.P in Kolkata, westBengal was conducted by Sikha Banerjeethe investigator.

Objective of the study were :

1. To determine patient satisfaction withthe Nursing care received in a selectedOPD in terms of followings:

1.1 Information & communication & areasof nursing care.

1.2 To find the patient satisfaction withnurses behavior.

1.3 To determine patient satisfaction withthe behavior of other team member.

1.4 To identify patient satisfaction with theenvironmental factors of OPD.

2. To find association between patientsatisfaction and selected demographicvariables.

3. To find the mean difference of patientsatisfaction score between prior to andafter planed Discussion program.

The Study attempted to examine thefollowing hypotheses at 0.05 level ofsignificance .

H1: Patient satisfaction score after planeddiscussion program will be significantlyhigher than the patient satisfaction scoreprior to the planed discussion program asevident from structure interview scheduleat 0.05 level of significance.

H2: There will be significant associationpatient between patient satisfaction scorewith selected demographic variable.

Independent variable was a planneddiscussion program related to patientsatisfaction related to communication,nurses behavior, doctors’ behavior,environment factors. Which is the indicatorof quality care.

Dependent Variable- Patient satisfactionon quality care received in OPD. Theconceptual frame

Work of study was based on input, Process,output model.

The research design adapting one grouppretest posttest.

Research Study on Patient Satisfact in OPD SeminerMs. Sikha Banerjee

Nursing Superintendent, RKMSP

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Design- Data were collected adapting nonprobability sampling. The sample consistedof 150 patients attending in OPD. The Toolsincluded in study were

Tool I – The demographic data to know thesample characteristics.

Tool II – Structured questionnaire onsatisfaction score the care of OPD patient’swas prepared on the basis of review ofliterature and experts opinion. Six experts

established content validity of the planneddiscussion on patient satisfaction.

The significant findings of the study were:

‘t’ value of df 148 is 3.36 which crosses thetable value of ‘t’ (1.98)

There is significant difference betweenpatient satisfaction score after planneddiscussion program than prior to discussionprogram at 0.05 level of significant.

Milieu Therapy

A scientific structuring of the environment inorder to effect behavioural changes and toimprove the psychological health andfunctioning of the individual (Skinner, 1979).It is considered therapeutic for mentallydeprived where the client learns adaptiveinteractions and relationship skill and thatcan be generalized to other aspects of hisor her life with autonomy. The programmewithin the milieu therapy includes structuredmeeting, work therapy, monetary reward.

The client can choose the type of work andinvolve themselves in variety of activities.The nurse participating in the setting shouldemphasize on the therapeutic physicalenvironment e.g. to display art work andpictures, colour, sound, texture, temperatureand odour etc. She should take interest indeveloping communication pattern like fanpattern, chain pattern, ring pattern, wheelpattern and all channel patterns for all theclients.

Ms. Mousumi SamantaClinical Instructor, School of Nursing

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Bottle fills his stomach but breastfeeding fills his soul”.

— Diane Wiessinger

Breast-Feeding Information Retrieval

Ms. Amrita Bhattacharjee Clinical Instructor, School of Nursing

The scientific findings concerning breastfeeding andthe mother-child relationship during this special time.

Two commonly told stories about breast milkare that (1) it has very little iron and (2) itlacks vitamin D. But the fact is that breastmilk does contain sufficient amounts of bothnutrients, providing the mother with abalanced diet and boost her daily caloricintake to about 3,500cals.Babies fed on

substitutes get anemic around six monthsof age if they don't receive supplementaliron. This is not true of breastfed infants.A study shows that a group of babies inJapan were totally breastfed for two yearswithout any difficulties.

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WORLD HEALTH DAY THEME 2013

HYPERTENSION

Student Nurses of School of Nursing conducted “A Survey Among

Patient Who Attended OPD” of Ramakrishna Mission Seva Pratishthan

including children (6 - 12 years) on 06-04-2013.

Findings :

Known case of Hypertension — 11.48%

Newly Identified Hypertension — 9.48%

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Water

Water immersion in labour offers significantbenefits for the labouring woman, includingpain relief, relaxation and comfort. Showersare also great, as women can remain uprightand direct the shower head at your lowerback if you have back pain.. AndrewDavidson is an Obstetrician at John FlynnHospital in Queensland who says that around40% of women at the hospital use waterimmersion for labour, birth satisfaction veryhigh.

Environment

Natural Pain Relief Option for LabourMs. Sruti Acharjya

Clinical Instructor, School of Nursing

The environment in which a woman givesbirth can help with relaxation, hence painrelief and comfort.

Turn the lights off or down. Bring familiarobjects from home if in hospital, like pillows,blankets and other things that have hersmell on it – the smells of familiarity, safetyand home.

l Music – favourite CD’s for differentmoods are great, from uplifting tosoothing sounds, music can groovesome pain away!

l Keep it quiet. Avoid talking unnecessarilywhen things get serious and asking herlots of questions.

Aromatherapy

Aromatherapy in labour has many greatuses. If women are giving birth in hospital,it can provide a nice smell to mask the smellof the hospital, enabling them to relax a littlemore. Approximately one third of labouringwomen experience severe lower back painduring labour.

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The Millennium Development Goals(MDGs) are eight international developmentgoals that were officially established followingthe Millennium Summit of the United Nationsin 2000, following the adoption of the UnitedNations Millennium Declaration. The MDGsconsist of eight goals, backed up by 18targets, and beneath that a set of indicatorsto measure the targets. The targets arequantitative, global and time bound – theaim was to achieve all the MDGs by 2015,taking 1990 levels as the baseline forprogress.

l Goal 1: Eradicate extreme poverty andhunger

l Goal 2: Achieve universal primaryeducation

l Goal 3: Promote gender equality andempower women

l Goal 4: Reduce child mortality

l Goal 5: Improve maternal health

l Goal 6: Combat HIV/AIDS, malaria andother diseases

l Goal 7: Ensure environmentalsustainability

l Goal 8: Develop a global partnership fordevelopment

International Nurses Day 12th May 2013Theme for 2013: Closing the Gap : Millennium Development Goals 8, 7, 6, 5, 4, 3, 2, 1

Three goals numbers 4, 5 and 6 – arespecifically related to health, and theirachievement is closely linked to the othergoals including those focused on poverty,hunger, gender equality and women’sempowerment.

CLOSING THE GAP: Nurses are often theonly health professionals accessible to manypeople in their lifetime and across the carecontinuum, and so are particularly wellplaced and innovative in reachingunderserved and d isadvantagedpopulations. The International Council ofNurses (ICN) has made a significantcontribution towards achievement of theMDG. ICN has been actively engaged ininfluencing policies and programme globallyand has participated in decision makingforums as well as international meetingsand events.

The MDGs have provided a clear globalfocus for action and resource allocation.

In the run-up to 2015, nurses areencouraged to break through barriers andchallenges to deliver the MDGs and meetthe health needs of the poorest, mostmarginalised and underserved communitiesin the world .

(Web : www.inc.ch)

Ms. Suchanda Pal Lecturer, Ma Sarada College of Nursing

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Where there is no warmer

switch over to kangaroo

mother care for L.B.W.

Neonates.

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What's in a Cigarette?Ms. Madhuchanda Guhathakurta

Principal, School of Nursing

l Cadmium Carbon Monoxide – releasedin car exhaust fumes active.

l Carbon Monoxide – released in carexhaust fumes component in batteryacid.

l Formaldehyde – embalming fluid

l Hexamine – found in barbecue lighterfluid

l Lead – used in batteries

l Naphthalene – an ingredient in mothballs

l Methanol – a main component in rocketfuel

l Nicotine – used as insecticide

l Tar – material for paving roads

l Toluene - used to manufacture paint

There are approximately 600 ingredients incigarettes. When burned, they create morethan 4,000 chemicals. At least 50 of thesechemicals are known to cause cancer, andmany are poisonous.

Many of these chemicals are also found inconsumer products, but these products havewarning labels. While the public is warnedabout the danger of the poisons in theseproducts, there is no such warning for thetoxins in tobacco smoke.

Here are a few of the chemicals in tobaccosmoke, and other places they are found:

l Acetone – found in nail polish remover

l Acetic Acid – an ingredient in hair dye

l Ammonia – a common household cleaner

l Arsenic – used in rat poison

l Benzene – found in rubber cement

l Butane – used in lighter fluid

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Ms. Monika Chakraborty, 32 yrs. old femalewhose father was Indian and mother wasGerman by birth admited in RKMSP hospitalin January 2013, as a known case ofPhenylketonuria with malnutrition and severemental retardation.Phenylketonuria (PKU) is an in born error ofmetabolism this is an inherited traits. In thisdisorder, Phenylalanine is not metabolismto Phenylalanine hydroxylase.Her PKU was detected during infancy andfrom this she was on successful medicalnutrition therapy which was the basictreatment of this disorder. Low Phenylalaninefoods and suplement were the only dietarytreatment of this disease. Low Phenylalaninesupplements were given by German Govt.They came back in India after her motherdied and she has lost help from German.Low Phenylalanine foods and supplementare not available in our country and she wastaking normal diet without any restriction.

Phenylketonuria — A Short Case ReportMs. Soma KunduDietician, RKMSP

For these she was more mentaly retarded,malnourished with severe complications.

Her dietary treatment was started fromJanuary 2013 where she was admitted inour hospital.

After dietary counseling we gave her verylow protein diet (Low in Phenylalanine). Milkand meat were totally excluded from herdiet.

Carbohydrate from variety of sources likewhite bread, rice, sago, sucrose, differentkind of vegetables and fruits were given toher.

High fat was given to increase the energyof the patients. Fat was provided fromdiferent sources like butter, oils and mediumchain triglycerides (MCT) as supplementarynutrition.

Her condition was gradually improved andduring discharge she was stable on diet aswell as on medicines.

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l Crisis management — RemainCALM

l Dispose the needle appropriately

l Do not squeeze or suck

l Wash the exposed site thoroughlywith soap and running water, donot scrub.

l Do not use antiseptic or skinwashes.

l Report to appropriate authority

Accidental Exposure To HIV Needle Stick Injury NACO* ProtocolMs. Bharati Chaterjee

Principal of Ma Sarada College of Nursing

l Get evaluated for PEP (PostExposure Prophylaxis) and baseline testing for HIV

l PEP should be started within 2hours of exposure and not laterthan 72 hours.

l PEP must be taken for 4 weeks(28 days)

l Follow up HIV testing - 6 weeks -3 months - 6 months

l Follow up counseling and care.

INFORM DOCTOR IF PREGNANT ORBREAST FEEDING

* National Aids Control Organisation

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