RAJIVGANDHIUNIVERSITY HEALTH SCIENCES, KARNATAKA,

BANGALORE

PROFORMA SYNOPSIS FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1 / NAME OF THE CANDIDATE AND ADDRESS / MRS. SARA ELIAS
W/O. JOLLY MATHEW,
KANDANATTU HOUSE,
ESTHOSE ROAD,
MUVATTUPUZHA,
ERNAKULAM DIST,
KERALA – 686661.

2 / NAME OF THE INSTITUTION / GOLDFINCHCOLLEGE OF NURSING, NO. 150/24, KODIGEHALLI MAIN ROAD, MARUTHINAGAR, BANGALORE-560 092.
3 / COURSE OF STUDY AND SUBJECT / 1st YEAR, M.Sc. NURSING, MEDICAL AND SURGICAL NURSING, DISSERTATION PROTOCOL
4 / DATE OF ADMISSION TO COURSE / 10th July 2008
5 / TITLE OF THE TOPIC / A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME REGARDING KNOWLEDGE AND PRACTICE OF FIRST AID FOR ROAD TRAFFIC ACCIDENT VICTIMS AMONG DRIVERS AT BANGALORE METROPOLITAN TRANSPORT CORPORATION DEPOT.

6. BRIEF RESUME OF THE INTENDED STUDY

INTRODUCTION

In this new millennium, the prevalence of road accidents is so frequent and fatal; it is an issue upper most in the minds of individuals, decision makers, governments and non-government organizations worldwide. The international Red Cross and Red Crescent movement is seeking to develop its commitment to the health and safety of all citizens by addressing this issue as part of its overall disaster preparedness and emergency response responsibilities.

First aid has always been a vital part of an effective emergency response and disaster preparedness strategy for the general population. The most vital and practical of these skills – first aid have been learnt and used by members of public effectively in times of emergency from the time of war time Voluntary Aid Detachments to modern day trained volunteers helping victims of disasters such as crashes, floods, earthquakes and explosions as these occur.

Globally and locally, statistics reflect one dear fact: young people (17-29) are most at risk, as they are amongst the highest number involved in accidents. Certainly there is already a perception that our roads are unsafe and young people including child pedestrians. Road accidents claimed 30 million lives world-wide in the last century. In one year above road accidents now amount for 700,000 deaths.

The global Burden of Disease study, undertaken by HarvardUniversity in 1996 on behalf of the World Health Organization and World Bank, showed road traffic accidents were the leading cause of death among men and the fifth likeliest cause of death for women aged 15-44 years. Most alarmingly, though, the study projected that over two decades after the report was published, road accidents could be the third leading burden on health worldwide, exceeding only by cardiovascular diseases and worldwide.

The XVIIth International conference of the Red Cross and Red Crescent held in 1999, proposed the goal of “improved health for vulnerable people based on strengthened co-operation between states and national Societies”. One of the specific areas the Red Cross movement turned its attention to in aiming to achieve this goal was the issue of road accidents, already a priority topic discussed in the movements world disasters Report 1998. Accordingly, the following point was set down in the plan, pledging: “States will respond to the growing global of road accidents through, for example, the further development of road safety measures in collaboration with all concerned partners, in particular their National Societies”.

Road safety is a shared responsibility. Reducing the risk of road traffic systems requires commitment and informed decision-making by government, industry, Non government organizations, professionals and communities, through a broad range of cooperative activities and interventions including enforcement of legislation to control speed and alcohol consumption, mandating the use of seat-belts and crash helmets, safer design and use of roads and vehicles and public education on road safety. Road traffic injury is a public health issue. The health sector is an important partner in this process. The roles of health sector are to provide appropriate pre-hospital and hospital care and rehabilitation for victims, improve data collection, contribute to policies, develop prevention activities, conduct advocacy, and contribute to the implementation and evaluation of interventions,Jimmy,M.L.(2006).

6.1. NEED FOR THE STUDY:

Road traffic injury has become a major health problem globally causing over one million deaths each year. Although road traffic injury is often considered to be a problem of countries with high income only, 90% of deaths caused by Road Traffic Injury occur in countries with low or middle incomes. Moreover, rates of mortality caused by road traffic injury are increasing rapidly in most low-income and middle-income countries.

The alarming facts about road traffic accidents include:

  1. The global annual cost of RTA is almost 230 billion dollars.
  2. 1.2 million People die every year due to road traffic accidents.
  3. Everyday, there are 3300 deaths and 6600 serious injuries on the road in the world.
  4. Approximately 850,000 deaths occur in those who are under 45 years of age in developing countries.
  5. Every tenth bed in the hospital is occupied by an accident victim.
  6. Road traffic accidents cause injury to about 50 million people in the world.
  7. The average cost of RTA in developing countries is estimated at 65 billion dollars.
  8. Trauma related death occurs in India every 1.9 minutes.
  9. Almost 120,000 people die on the road in India and a majority of them are pedestrians.
  10. 1.27 million People in India sustain serious injuries due to Road Traffic Accidents.
  11. Although India has only 1% of the world’s motor vehicles, but it accounts of 6% of the total global Road Traffic Accidents deaths.
  12. The cost of these accidents and death is Rs.550 Crores or 12.5 billion dollars every year.
  13. A majority of major accidents survivors are either confined to the bed or wheel chair bound for the rest of their lives.
  14. Alcohol intoxication causing Road Traffic Accidents is present in 15-20% of all traffic accidents.

India has the second largest road networks in the world with over 3 million kilometers of roads of which 46% are paved. The road traffic contains an incredible mix of pedestrians, animal drawn vehicles, bicycles, motorcycles, cars, buses and trucks. On the whole the facilities for the large number of non-motorized road users are poor and the 40 million vehicles using the roads have a terrible toll on human life, killing over 80,000 people with over one third of a million victims requiring hospital treatment.

Today one person dies every 6 minutes on Indian roads; by 2020 the rate is expected to be more than 1 every 3 minutes. According to India injury report 2005, Injury is the third cause of mortality in India. Trauma victims occupy 10 – 30% of India’s Hospital Beds.

With nearly 700 deaths and 7000 injuries (as per official reports) on Bangalore Roads, road safety does not have any systematic directions. The road side survey revealed that the extent of drivers under the influence of alcohol varied from 11% as detected by older methodology of police testing drivers selectively on suspicion to 40% as detected by newer methodology of random checking.

The city of Bangalore has been progressing at a significant pace during the last one or two decades. The city has witnesses increasing motorization, urbanization, migration and changing values of people. An accompanying effect of these changes has been an increase in road accidents in the city of Bangalore.

Personal experience of witnessing brutal road traffic accidents by the researcher and taking care of post traumatic patients after road traffic accidents the investigator is motivated to analyze the effectiveness of first aid teaching programme for road traffic accident victims among workers in Bangalore Metropolitan Transport Corporation.

6.2 .REVIEW OF LITERATURE.

Review of Literature provides with the current theoretical and scientific knowledge about a particular problem and resulting synthesis of what is known and not known. Current information is received by regularly searching the literature on topics of particular interest. The review of literature in quantitative search is conducted to direct the planning and execution of a study. The major literature is performed at the beginning of the research process and a limited review provides a basic understanding of the study problem and evidence that the study conducted was appropriate as indicated by the current knowledge of this problem.

A study conducted byArbon Paul., Hayes Jo (2000) with the aim on first aid and Harm minimization for victims of road Trauma. A population study was conducted in Western Australia and Sweden among 12,500 potential people. 77% of participants has had some type of first aid training at some stage in their lives, with 28% of sample holding a current first aid qualification. Having first aid training increased the likelihood of intervention along with owning a first aid kit and mask. These findings indicate that first aid training, even if it is not current, is as enabler of providing first aid at Road Traffic Accidents.

A study conducted by Eva M.Larsson., Niklas L. Martensson., Kristina A.E. Alexanderson (1998) on First Aid Training and Bystander Actions at Traffic Crashes – A population study among 2800 persons aged 18-74 years. A questionnaire was administered randomly among selected persons. The response rate was 67.5% with 39% of the population receiving first aid training at a higher rate among younger individuals and those with a higher education. After training, 30% of the respondents had used their skills, and 41% took fewer risks in traffic, 14% of them were bystanders at a traffic crash and at 20% of the crashes, a bystander had administered first aid. The study concluded that intensified first aid training of the general public could lead to citizens who are more cautions in traffic and to bystanders who provide more immediate and adequate first aid at traffic crashes and other emergencies.

A study by CLB Liberatti., SM Andrade, DA Soares, (1997) on the new Brazilian Traffic Code and some characteristics of victims on southern Brazil. The study population was car and motorcycle occupants seen in pre hospital care service in Londrina, Perana state before the introduction of the new Brazilian traffic code, from 22nd January to 21st July 1997, and after its implementation during the same period in 1998. The results were use of seat belts increased from 45% to 62.6% and of helmets from 31.2% to 66.2%. There was 20% decline in car occupant injuries along with a 9% reduction in motorcycle related injuries. The study concluded that the results favor the hypothesis that rigorous legalization increases safer practices in traffic, at least during the first months of its implementation.

A study by Gupta S., Roy Chowdhury U.B., Deb P.K., et al (2003), on demographic study of fatal cranial-cerebral Road Traffic Injuries in North Bengal Region during August to December, 2003. The total number of autopsies conducted during the five months was 698 out of which 213 was fatal Road Traffic Injuries. Out of this study, cranial-cerebral injury was the cause of death in 100 cases. The study concluded that majority of the fatal victims of cranial-cerebral injury of road traffic accidents died on the spot or within twenty four hours of accident highlights the poor traumatic management.

Gilroy (1985) conducted a study to determine whether many of the people dying from road traffic accidents before reaching the hospitals were doing so as a result of remedial lesions. The review showed that when death due to a road traffic accident occurs before arrival at the hospital, it is usually as a result of overwhelming injury. Gilroy discusses 11 cases whereby the victims died from less severe head injuries. The study concluded that improvement may be achieved with maintenance of clear airways.

STATEMENT OF THE PROBLEM:

A Study To Assess The Effectiveness Of Structured Teaching Programme Regarding Knowledge And Practices Of First Aid For Road Traffic Accident Victims Among Drivers At Bangalore Metropolitan Transport Corporation Depot.

6.3 OBJECTIVES OF THE STUDY:

  1. To assess the knowledge of workers regarding first aid for road traffic accident victims before structured teaching programme.
  2. To assess the practices of workers regarding first aid for road traffic accident victims before structured teaching programme.
  3. To evaluate the knowledge of workers after the structured teaching programme on first aid.
  4. To evaluate the practices of workers after the structured teaching programme on first aid.
  5. To find out the effectiveness of structured teaching programme regarding knowledge and practices of first aid for Road Traffic Accident Victims with the demographic variables.

6.4 OPERATIONAL DEFINITIONS

  1. Assess:

Refers to the method of evaluating knowledge and practices of the workers in Bangalore Metropolitan Transport Corporation Depot with the help of a structured questionnaire.

  1. Effectiveness:

Refers to the desired change brought about by structured teaching programme on knowledge and practice regarding first aid for road traffic accident victims among drivers in Bangalore Metropolitan Transport Corporation Depot.

  1. Structured Teaching Programme:

Refers to well prepared teaching programme with systematic developed information on knowledge and practice regarding first aid for road traffic accident victims.

  1. First Aid:

Refers to Emergency treatment administered to an injured or sick person before professional medical care is available.

  1. Road Traffic Accident Victims:

Refers to the individual involved in the accident which take place on the road between two or more objects, one of which must be any kind of moving vehicle.

  1. Bangalore Metropolitan Transport Corporation Depot:

Refers to the bus transport corporation set up by the government of Karnataka to cater to the transportation needs of the people.

HYPOTHESES:

  • Ho1: There is no significant difference between pre-test and post-test assessment scores of knowledge on first aid.
  • H02: There is no significant difference between pre test and post test assessment scores on practices of first aid.
  • Ho3: There is no effectiveness of structured teaching programme between findings of study and selected demographic variables.

7. MATERIALS AND METHODS:

7.1. SOURCES OF DATA

  • Drivers of Bangalore Metropolitan Transport Corporation Depot who are willing to participate.

7.2.METHODS OF DATA COLLECTION

7.2.1. Type of Study:Quasi Experimental study

7.2.2. Research Design: One group pretest -posttest research design

O1 x O2

7.2.3. Variables under Study

Dependent Variables:knowledge and practice regarding first aid

For road traffic accident victims.

Independent variables:structured teaching programme on knowledge

And practices of drivers regarding first aid for

Road traffic accident victims.

7.2.4. Sampling Techniques: convenient sampling technique.

7.2.5 Sample size: 60 subjects

7.2.6 Follow up: Post test assessment will be done 7 days

After the structured teaching programme.

7.2.7 Duration of Study: One month.

7.2.8. Inclusion Criteria and Exclusion Criteria

a) Inclusion Criteria: Drivers present during the time

Of sampling with age group between 25

And 50 years.

b) Exclusion Criteria: Workers who are not willing to participate.

7.2.9. Instruments: Sec A:demographic data.

Sec B:knowledge questionnaire.

Sec C:practice check list.

Sec D:structured teaching programme.

7.2.10. Data Collection : After obtaining prior permission from the

Procedure concerned authorities. A brief introduction will

be given to the subjects about self and the

Study. Pre-test will be conducted and a

Structured teaching programme is given on

First aid for road traffic accident victims.

Post-test will be conducted after 7days

Of structured teaching programme.

7.2.11. STATISTICAL METHOD USED:

Descriptive Statistics:

1)Frequency and percentage distributions of demographic variables.

2)Mean and standard deviation of pre-test and post-test assessment score.

Inferential Statistics:

1)Paired‘t’ test to compare pre-test and post-test findings.

2)Chi-square test to find association between findings of the study.

7.3. Does study require any investigation to be conducted on patients / humans / animals?

Yes, assessment of workers of Bangalore Metropolitan Transport Corporation Depot will be done using structured questionnaire.

7.4. Has ethical clearance been obtained from institution?

Yes, ethical clearance will be obtained from concerned authorities and consent will be taken from the subjects. Confidentiality and Anonymity will be maintained.

REFERENCES

1)Hussain, L.M., &Redmond,A.D.(1994).Are pre hospital deaths from accidental preventable?,. British Medical journal, 308, 1077-1080.

2)Ainsworth smith,M.(2006).Offering assistance at road traffic accident. Nursing times, 102(37), 32-33.

3)Brown,L.H.(2006).Senior drivers:risks,interventions,and safety. The Nurse Practioner, 31(3), 38-40, 43(4), 4-9.

4)Mc Gregor,D.(2002) Driving over 65:procced with caution. Journal of gerontological nursing, 22(8), 22-6.

5)Pileggi,C.,Nicotera,G.,& Anglillo,I F.(2005),Attendance at hospital emergency

Department by drivers involved in automobile accidents.

Emergency Medical Journal, 22(4), 246-250.

6)Liberatti, C.L.B., Andrade, S.M.,& Soares,D.A.(2001).The new Brazilian traffic

Code and some characteristics of victims in southern Brazil.

Injury Prevention,7,190-193.

7)Andreasson,R.(1979).First aid at the scene of an accident . Journal of traffic

Medicine, 7(3), 14-15.

8)Lewis, B.(1983). Death in first ten minutes.

British medical journal, 286, 1768-1769.

9)Traffic and Safety Department.(1983).Compulsory First aid training for

Drivers.Australia;Christie,R.

10)Madan,V.S.(2006).Road traffic Accident: Emerging Epidemic. Indian Journal of Neurotrauma, 3(1), 1-3.

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