RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES KARNATAKA,

BANGALORE.
ANNEXURE – II
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION.
01. NAME OF THE CANDIDATE Mr. SHRISHAIL.
AND ADDRESS M. Sc. [NURSING] Ist YEAR.
MEDICAL SURGICAL NURSING,
SHRI. B.V.V. SANGHA’S,
SAJJALASHREE INSTITUTE OF NURSING
SCIENCES, BAGALKOT. KARNATAKA.

02. NAME OF THE INSTITUTION SHRI. B.V.V. SANGHA’S,

SAJJALASHREE INSTITUTE OF NURSING
SCIENCES, NAVANAGAR, BAGALKOT.

03. COURSE OF STUDY AND M. Sc. [NURSING] Ist YEAR.

SUBJECT MEDICAL SURGICAL NURSING.

04. DATE OF ADMISSION TO 12th MAY 2007.

COURSE.
05. TITLE OF THE TOPIC “A STUDY TO ASSESS THE KNOWLEDGE
REGARDING INDWELLING CATHETER
CARE AMONG THE STAFF NURSES
WORKING IN B.V.V. SANGHA’S, HANAGAL
SHRI KUMARESHWAR MEDICAL
COLLEGE HOSPITAL AND RESEARCH
CENTRE, BAGALKOT, KARNATAKA”.

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6. BRIEF RESUME OF THE INTENDED WORK.

6.1 NEED FOR THE STUDY: -

Since the foley’s catheter was introduced in 1930 it has become one of the
primary source of hospital acquired infection and long term urinary catheter used in
community based patients account for 4% of community nurses time.

Each year al almost 25% approximate 96 million urinary catheters sold

worldwide in the united states. Where between 16% and 25% of hospitalized patients
have on indwelling catheters.

Nurses are very often responsible for the initiation of catheterization procedures
for patients within the hospital or community setting the nursing role requires
contemporary information on urinary catheter selection and problem solving in the
maintenance of urinary catheters.

The care of indwelling urinary catheter is a common procedure or practice for

nurses who are working in the hospitals therefore it is the duty of the nurses to know
about catheterization its complications and management of patients with catheterization.

Nurses are the primary managers of all the routine care and problem solving
associated with patients who have indwelling urinary catheters. The results revealed
knowledge deficits in catheter–related knowledge, and variation in client education and
documentation. The results also demonstrated the continued use of traditional
knowledge as well as unclear application of fundamental nursing principles. There is a
clear need for increased use of evidence–based practice and development of suitable
post–registration education.

Reducing Foley catheter device days in an intensive care unit : using the
evidence to change practice in USA. The prolonged use of indwelling catheter can lead
to many complications, the most prevalent being urinary tract infections. Staff nurses
were engaged in the development and implementation of the plan. Criteria – based
Foley catheter guidelines, a decision – making algorithm, and a daily checklist were
implemented that led to a significant reduction in Foley catheter device days and a
decrease in catheter associated urinary tract infection.

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 Urinary catheters should be used only when absolutely necessary. If a catheter
must be used, it should be discontinued as soon as medically feasible, since the longer
the catheter is in place, the greater the risk of developing an infection.

Bacterial colonization (bacterimia) will occur within 2 weeks in half of

catheterized patients, and in almost all patients within 4 to 5 weeks following insertion
of catheter, Catheters impede the natural defenses of the urinary tract by obstructing the
per urethral ducts, by irritating the bladder mucosa, and by providing an artificial route
of entry for the organisms to enter the bladder.
The following study will help the student investigator to assess whether the staff
nurses are working skillfully and to assess the competences level urinary catheter care.

6.2 REVIEW OF LITERATURE: -

A descriptive exploratory study in New Jersey, U.S.A., to determine if

registered nurses perceive the stabilization of indwelling urinary catheters as a necessary
aspect of care. The majority of nurses surveyed agreed that catheter stabilization is an
important aspect of nursing care, but this perception did not concur with current
practice.

A study conducted to asses the new graduates of registered nursing programs in

Israel perceive themselves as technically competent. The research was conducted on 256
recent graduates of four different types of nursing programs in Israel, with respect to 53
technical skills. Results show graduates generally perceive themselves as competent,
although levels of competence varied for the different skills. Types of nursing program,
opportunity for skill practice in nursing school, and employment in a healthcare facility
were found to be related to competency.

A study conducted in U.K. on knowledge of female bladder care among medical

staff, nurses and midwives: results of a questionnaire survey. Knowledge was similar on
urethral length, bladder capacity, daily fluid intake, ideal size of catheter, catheter
balloon size, and the maximum time of use of a short-term catheter. Correct responses
for normal daily fluid intake, duration of both short and long-term catheterization were

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given by fewer than half the respondents.
The parts from evidence based project in U.S.A., designed to define best practice
for the technique of inserting male catheters. A series of nursing care variances related to
the procedure of catheterizing male patients stimulated an evidence-based practice
project was designed. Results indicate current knowledge may be inadequate.

A study conducted at UK on urinary catheterization, and its audit findings on the

use of urinary catheters. 51 patients had a urinary catheter inserted during their hospital
stay. Urinary incontinence meant catheterization in 37.5% (n = 27) of cases, 64.7% (n =
33) catheterized by nurses. The study highlighted the need for accurate documentation
and care planning.

A descriptive survey conducted with a questionnaire sent to registered and

enrolled nurses (N=709) within an Australian metropolitan area health service was
undertaken to determine their current knowledge level in relation to catheter care
practices. There was a general lack of knowledge of current catheter costs that would
have major implications for unit budgets. The apparent gaps in nursing knowledge of
catheter care suggest the need for urgent educational programs on catheter care practices
for nurses within this service and the initiation of an area-wide standardized policy in
catheter selection and management.

6.3 STATEMENT OF PROBLEM: -

“A STUDY TO ASSESS THE KNOWLEDGE REGARDING
INDWELLING CATHETER CARE AMONG THE STAFF NURSES WORKING
IN B.V.V. SANGHA’S, HANAGAL SHRI KUMARESHWAR MEDICAL
COLLEGE HOSPITAL AND RESEARCH CENTRE, BAGALKOT,
KARNATAKA”.

6.4 OBJECTIVE OF THE STUDY: -

1. To assess the knowledge about indwelling catheter care among the staff nurses.
2. To associate the knowledge regarding indwelling catheter care & Socio
demographic variables.

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 6.5 OPERATIONAL DEFINITIONS: -

1. Knowledge:-In this study, knowledge refers to the information of nursing about

catheter care, measured by knowledge questionnaire, and it is categorized as
above average, average and below average.
2. Indwelling catheter care:-In this study, indwelling catheter care refers to
selected activities carried out by the staff nurses to provide urinary catheter care
in patients with urinary indwelling catheter in order to prevent complications
arising due to catheterization for example urinary tract infections, urinary tract
injuries. Etc.
3. Staff Nurses : In this study staff nurses refers to the nursres working in Shri.
B.V. V. Sangha’s, Hanagal Shri Kumareshwar Hospital and Research center
Navangar, Bagalkot.

6.6 ASSUMPTIONS: -
1. Staff nurses have since knowledge regarding urinary catheter care.
2. The staff nurses possess skill while practicing urinary catheter care.
3. The knowledge regarding urinary catheter care is measurable.

6.7 PROJECTED OUT COME: -

The result of the study will help the Staff Nurses about the importance of quality
Nursing Care in the maintenance of professional standards.

7. SOURCE OF DATA: -
Research Design: - Descriptive design.
Research Setting: - The Study will be conducted on staff nurses at Hanagal
Shri Kumareshwara hospital and research centre, Navanagar, Bagalkot.
Population of the study : - The population selected for this study on Staff Nurses
Hanagal Shri Kumareshwara hospital and research centre, Navanagar, Bagalkot.

Sample Size: 50 to 60 Staff Nurses.

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7.1 INCLUSIVE CRITERIA: -
1. Staff Nurses who are working at Hanagal Shri Kumareshwara hospital and
research centre, Navanagar, Bagalkot.
2. Staff Nurses who are willing to participate.
3. Staff nurses who are available at the time of data collection.
EXCLUSIVE CRITERIA: -
1. Staff nurses posted in operation theatre.
2. Staff nurses who are not willing to participate in the study.
[[

7.2 METHOD OF COLLECTION OF DATA: -

1. Formal permission from the Dean of the Hanagal Shri Kumareshwara hospital
and research centre, Navanagar, Bagalkot.
2. Investigator introduces himself to the subject.
3. Administer the questionnaire to assess the knowledge among Staff Nurses of
Hanagal Shri Kumareshwara hospital and research centre, Navanagar, Bagalkot.

7.3 DATA COLLECTION TOOLS: -

INSTRUMENT :
1. Structured interview schedule to collect socio demographic data of staff nurses.
2. Multiple choice questionnaire to assess the knowledge of staff nurses regarding
urinary catheter care.

SAMPLING TECHNIQUE: Purposive sampling.

DATA ANALYSIS PLAN: Descriptive & inferential statistics.
7.1 Does the study require any investigation or inferential interventions to be
conducted on participants?
- No.
[

7.2 Whether the permission is obtained from the concerned institution.

- Yes.
7.3 Whether the ethical clearance has obtained from the concerned institution in case
of 7.3.
- Yes.

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 8. LIST OF REFERENCES :
1. Bagshaw.SM.et al (2006) Epidemiology of intensive care unit- acquired urinary
tract infections, “Current opinion on infectious diseases”, Feb;19(1):67-71.

2. Srinivasan.A.et al (2006) A prospective trial of a novel- silicone based ,silver

coated foley catheter for the prevention of nosocomial urinary tract infections,
“ Infection Control Hospital Epidemiology”, Jan;27(1):38-43.

3. Yoon.HJ.et al (2005) Outbreaks of Serratia marcescens bacteriuria in a neuro-

intensive care unit of a tertiary care teaching hospital: A clinical, epidemiologic
and laboratory prospective.”American journal of Infection
control”,Dec;33(10):595-601.

4. Yoshida T,et al (2005) Risk factors for hospital-acquired bacteremia, “

International medicine”, Nov;44(11):1157-1162.

5. Neelam Taneja,et al (2005) Nosocomial urinary tract infection due to

Leuconostoc mesentroides at a tertiary care center at north India, “Indian
journal of medicine”,Aug;pp 178-179.

6. Neil-Weise BS, et al ( 2005) Antibiotic policies for term bladder drainage in

adults, “Cochrane data base systemic Review”, July;20(3):CD005428.

7. Cetin BD, et al (2005) Epidemilogy and etiology of catheter-related nosocomial

infections in a Turkish hospital, “Infez Medicine”,13(3):152-159.

8. Deep A,et al, (2004) Clinical and microbilogical profile of nosocomial

infections in the paediatric intensive care unit’ “ Indian peadiatrics”,
Dec;41(12):1236-1246.

9. SIGNATURE OF THE
CANDIDATE

10. REMARKS OF THE GUIDE This study is feasible and I forward it for
acceptance.

11. NAME AND DESIGNATION OF Prof. Maruti. S. Chalawadi,

11.1 GUIDE. Professor & HOD

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 Dept. of Medical Surgical Nursing,
Shri B.V.V. Sangha’s Sajjalashree Institute of
Nursing Sciences, Bagalkot .

11.2 SIGNATURE

11.3 CO – GUIDE Smt. R. Ramsubbmal,

Asso Prof.
Dept. of Medical Surgical Nursing,
Shri B.V.V. Sangha’s Sajjalashree Institute of
Nursing Sciences, Bagalkot .

11.4 SIGNATURE

11.5 HEAD OF THE DEPT. Prof. Maruti. S. Chalawadi,

Professor & HOD
Dept. of Medical Surgical Nursing.

11.6 SIGNATURE

12. REMARKS OF THE The topic is discussed with the members of the
CHAIRMAN & PRINCIPAL research committee and is finalized.
He is permitted to conduct the study.

12.1 SIGNATURE