Download RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA.
PROFORMA FOR REGISTRATION OF
SUBJECT FOR DISSERTATION
1. NAME OF THE CANDIDATE
AND ADDRESS
: Ms. SATHYAVATHI.P
1ST YEAR M.Sc. NURSING.
GOVERNMENT COLLEGE
OF NURSING, FORT,
BANGALORE-02
2. NAME OF THE INSTITUTION : GOVERNMENT COLLEGE
OF NURSING, FORT,
BANGALORE-02
3. COURSE OF STUDY &
SUBJECT
: 1ST YEAR M.Sc. NURSING.
CHILD HEALTH NURSING
4. DATE OF ADMISSION
: 19-06-2009
5. TITLE OF THE TOPIC
: TO ASSESS THE
KNOWLEDGE AND
ATTITUDE OF STAFF
NURSES REGARDING
BABY FRIENDLY
HOSPITAL INITIATIVE
POLICY IN SELECTED
BFHI HOSPITAL,
BANGALORE.
6. BRIEF RESUME OF THE INTENDED WORK
INTRODUCTION
”The more we know about human breast milk the more we
discover about its value in human nutrition and development”.
Breast feeding is a natural way of feeding the infant with the milk directly
from the mother’s breast. It is a living fluid and contains exactly the right amount
of nutrients required by a baby, in the right proportions, to ensure that the baby
gets the perfect balanced meal. No manufactured milk, no matter how fortified it
may be, comes even close to being as nutritious as breast milk. …..The benefits of
breast milk are incalculable and incomparable. It’s a complete mix of nutrients &
antibodies. Varying composition of breast milk keeps pace with the infant’s
individual growth and changing nutritional needs. Prevents many gastro-intestinal
disorders in infants. Reduces the risk of breast, ovarian, cervical, and endometrial
cancers in mothers. Helps delay return of
fertility and to space subsequent
pregnancies. Reduced health care costs; breast fed infants typically need fewer
sick care visits, prescriptions, and hospitalizations1.
The social change brought about by the nuclear type of family has forced
many to ask whether our practices, prejudices, recommendations, commensurate
with the scientific reality. With this background, world alliance for breastfeeding
promotion started the program appropriately BABY FRIENDLY HOSPITAL
INITIATIVE to promote, protect, and encourage exclusive breastfeeding in all
hospitals. In 1991, the UNICEF and the WHO launched this global campaign.
The initiative encourages health professionals to promote, protect, and support
breastfeeding as the optimal method of infant nutrition and enables families to
make an informed choice about infant feeding2.
The Baby Friendly Hospital Initiative was started in India in1993. The
Breast Feeding Network Of India (BPNI) is the agency responsible for
implementing this program in our country. Under this, the hospitals with
maternity services have to follow the Ten steps. These hospitals are assessed and
certified as Baby Friendly Hospital once they adopt the “Ten steps to successful
breastfeeding”.
Objectives of BFHI is to achieve the goal of promoting breastfeeding
practices in the hospitals both in government and private sectors, this is one of the
key interventions towards achieving the goal of reducing infant mortality rates.
Have a written breastfeeding policy that is routinely communicated to all the
health care staff, Train all health care staff in skills necessary to implement this
policy, Inform all pregnant women about the benefits & management of
breastfeeding, Help mothers to initiate breastfeeding within half an of birth, Show
mothers how to breast feed& how to maintain lactation even if they should be
separated from their infants, Give the infant no food or drink other than breast
milk, unless medically indicated, Practice rooming-in. Allow mother & infant to
remain together 24 hrs a day, Encourage breastfeeding on demand, Give no
artificial teats or pacifiers to breastfeeding infants, Foster the establishment of
breastfeeding support groups & refer mothers to them on discharge from the
hospital or clinic. In this context, to create awareness, the world breast feeding
week is celebrated every first week of August with a theme every year. The theme
for the year 2009 is ‘’Breast Feeding a vital emergency response, are you
ready?”3.
Recognizing the vital role of nurses as patient advocates and health
promoters, and their position as the largest group of hospital-based health care
workers, WHO and UNICEF are asking nurses to facilitate the implementation of
the initiative in their hospital. Hence nurses play a key role in the implementation
of the initiative in hospitals4.
6.1 NEED FOR THE STUDY
The benefits of breastfeeding are tremendous and the following benefits in
Baby Friendly Hospital Initiative hospitals are immediate, obvious and
substantial; decrease in infection rate, improved survival of low birth weight
infants, Easing of the hospital burden due to vast savings on infant formula
purchase, Reduction in nursing load as rooming in and demand feeding make
nursery care easier5.
Statistics from Infant Survival and Development Report Card Karnataka shows
that in our state, Initiation of breast feeding within 1hr is 35.7%, Exclusive breast
feeding 0-6months is 58%, Infant Mortality rate per 1000 live birth is 43.2%,
Children below 3yrs who are underweight is 37.6%. From the report it is clearly
stated that initiation of breastfeeding within 1hr of birth is not satisfactory.
In India, hospitals are still in the stages of joining this movement. The
National statistics shows that , more than 11 lakh babies die during first month of
life, and another 5 lakh during 2 to 12 months of age. Twenty two percent of all
neonatal deaths could be reduced if breast feeding is initiated within one of birth
by all mothers (March 2006; 117:380-386). More than 15% of 24 lakh child
deaths could be averted in India, if optimal breastfeeding practices were scaled up
to 90 %.( 2003). UNICEF’s, WHO’s, and World bank’s 2005 report- clearly
recognize the need to scale up optimal infant and young child feeding practices in
order to tackle child malnutrition and infant mortality6.
A study was conducted regarding Optimizing Breastfeeding in the
Newborn. The results show that the ‘Ten steps to successful breastfeeding’ and
the Baby Friendly Hospital Initiative are effective measures to increase
breastfeeding initiation, duration, and exclusivity. A recent national survey
reveals that significant health care workers are not providing evidence based
recommendations for breastfeeding guidance and support7.
A study was conducted regarding Policy on Breastfeeding Training of
doctors and nurses in Breastfeeding and lactation management results show that
almost all staff reported that they have a policy on breastfeeding in the hospitals.
Only 44% doctors and 30% nurses reported that they received ‘any length of
training’ in breastfeeding and lactation management. It varied from 1 hour to
more than 20 hours. Only 1/3 rd of those trained, received training of more than
20 hours. This is important as training of health care providers determines the
success of breastfeeding. If the staff is adequately trained they are more likely to
help women and support her to establish exclusive breastfeeding while she is in
the hospital and counsel breastfeeding for first six months at home8.
An article regarding Baby-Friendly Hospital Initiative (BFHI) which
attempts to check the cause of infant mortality and morbidity. Malnutrition,
infections, diarrheal disease, and particularly the effects of unhygienic feeding
practices have raised a global infant mortality. Infants and children are likely to
suffer from permanent growth and developmental impairment just because they
were not breast-fed. It has been determined that breast-feeding could prevent
deaths of at least 1 million children per year. BFHI services helped to turn the
health care providers and mothers to the real needs of the baby9.
Investigators personal experience from day to day staff’s practices in
hospitals, though nurses play a pivotal role in supporting and motivating mothers
regarding breastfeeding, many hospitals in India still are lagging behind in
implementing the policy either due to insufficient staff, excessive tasks performed
by nurses, lack of continuity in the health team work, out-of-context guidelines,
lack of commitment with the proposal, lack of continuing education program, of
the staffs regarding the policy. They find no time to educate mothers regarding the
policy. Hence it is required to timely evaluate knowledge and to bring about
positive attitude in the staffs regarding the implementation of ten steps of Baby
Friendly Hospital Initiative policy in their hospitals and thus contribute in the
reduction of infant mortality and morbidity.
6.2 REVIEW OF LITERATURE.
Review of Literature is mainly divided into two headings.
1. Studies related to Baby friendly hospital initiative
2. Studies related to Knowledge and Attitude of Nurses regarding BFHI policy.
Studies related to Baby friendly hospital initiative
A study was conducted in the year 2009 regarding Evaluation of lactation support
in the workplace or school environment on 6-month breastfeeding outcomes in
Yolo County, California. Six-month breastfeeding outcomes (almost exclusive
breastfeeding, partial breastfeeding, and not breastfeeding) were analyzed for 201
infants born to Yolo County, California, mothers who returned to work or school.
Twenty-two percent of workplaces and 17% of schools did not provide a lactation
room. Although part- or full-time status, knowledge of breastfeeding rules, and
support from colleagues were independently associated with the outcome, they
were not significant in the multivariate analysis. In the selected model, maternal
age (odds ratio [OR] = 2.3; 1.3-3.9 for a 10-year difference), college or above
versus <or= high school education (OR = 9.1; 4.2-19.6), and exclusive breast milk
feeding in the hospital (OR = 2.1; 1.1-4.0) were associated with better
breastfeeding outcomes at 6 months postpartum. Receipt of discharge gift packs
containing formula (OR = 0.5; 0.3-1.0) was inversely associated with the degree
of breastfeeding exclusivity. The 2 latter findings underscore the importance of
hospitals adhering to specific guidelines of the Baby-Friendly Hospital
Initiative10.
A descriptive study was conducted in the year 2008 at USA to explore the
association between the Ten Steps of the Baby Friendly Hospital Initiative (BFHI)
of the World Health Organization Geneva, Switzerland and breastfeeding at 2
days and 2 weeks. A 65-question institutional survey assessing compliance with
the Ten Steps was used to determine an overall breastfeeding Support Score for
each of Oregon's 57 birthing hospitals. Hospital breastfeeding outcomes were
obtained from the newborn metabolic screening forms. Results show that
increases in overall hospital breastfeeding Support Scores were associated with
increases in breastfeeding percentage at 2 days (p = 0.021) and at 2 weeks
postpartum (p = 0.011). In analyzing each Step individually, however, only the
presence of a written hospital policy was independently associated with
breastfeeding percent (p = 0.028). They concluded hospitals with comprehensive
breastfeeding policies are likely to have better breastfeeding support services and
better breastfeeding outcomes. Hospitals may consider using these results to
prioritize breastfeeding support services through development of hospital
breastfeeding policies and to utilize institutional surveys as a component of
breastfeeding quality improvement initiatives11.
A Cross-Sectional study was conducted in the year 2007 to evaluate the
impact of the Baby-Friendly Hospital Initiative on the breastfeeding practices of
mothers from the urban area of Montes Claros, MG, Brazil. A comparative
analysis was performed of two cross-sectional breastfeeding indicator studies with
randomized samples of children under 2 years of age. One study was carried out
before and the other after the Baby-Friendly Hospital Initiative had been
implemented throughout all public pregnancy and childbirth care services in the
city. Kaplan-Meyer survival curves were constructed for different breastfeeding
patterns. Log rank testing was used to calculate the level of significance of
differences between curves for before and after the Initiative. The survival curves
demonstrate that breastfeeding rates increased during the study period. The log
rank test detected significance for increases in all patterns of breastfeeding
(p < 0.000). Median overall breastfeeding duration increased from 8.9 to 11.6
months and median duration of exclusive breastfeeding rose from 27 days to 3.5
months. They concluded that, Implementation of the Baby-Friendly Hospital
Initiative in all public maternity units in Montes Claros significantly increased
breastfeeding rates in the city. Since the ideal state of affairs has not yet been
reached, further strategies must be implemented to promote and support
breastfeeding practices12.
A descriptive study was conducted in Pierto Rico in 2007 regarding Full
breastfeeding during the postpartum hospitalization and mothers' report regarding
baby friendly practices. 200 postpartum women age 20 or greater who had
delivered a healthy full-term baby 37 weeks gestation participated in the study.
Data were gathered by means of a semi-structured questionnaire in the Spanish
language. Descriptive and inferential statistics (Chi-square) were used for data
analysis. Results show that, Full breastfeeding was being practiced by 43.5% of
the mothers in the study, whereas 53.0% were breastfeeding partially. Compliance
with the Ten Steps was perceived as deficient by 52% of the mothers, whereas
only 5.5% perceived compliance as excellent. The perceived level of compliance
with the Ten Steps is significantly associated with the type of breastfeeding (full
or partial) in the inferential analyses (X(2) [3, n = 193] = 33.74, p = 0.00) and in
the multiple logistic regression analyses (OR = 1.27, confidence interval [CI] =
1.14 - 1.43, p = 0.00). As the level of perceived compliance with the Ten Steps
increases, the probability of full or exclusive breastfeeding also increases. They
concluded that compliance with the Ten Steps of the Baby Friendly Hospital
from the perspective of the postpartum mother has an impact on the type of
breastfeeding13.
Studies related to Knowledge, and Attitude of staff nurses regarding
BFHI policy
A study was conducted in the year 2009 at Boston, USA, regarding
Closing the quality gap: promoting evidence-based breastfeeding care in the
hospital in the United States. Evidence shows that hospital-based practices affect
breastfeeding duration and exclusivity throughout the first year of life. However,
a 2007 CDC survey of US maternity facilities documented poor adherence with
evidence-based practice. Of a possible score of 100 points, the average hospital
scored only 63 with great regional disparities. Inappropriate provision and
promotion of infant formula were common, despite evidence that such practices
reduce breastfeeding success. 24% of facilities reported regularly giving nonbreast milk supplements to more than half of all healthy, full-term infants. Metrics
available for measuring quality of breastfeeding care, range from comprehensive
Baby-Friendly Hospital Certification to compliance with individual steps such as
the rate of in-hospital exclusive breastfeeding14.
A study was conducted in the year 2009 at Montreal, to examine the
experiences on mothers with regard to the breastfeeding support and management
provided by healthcare professionals on an acute care postpartum unit in a
multiethnic obstetrical referral center in Montreal, Canada. The study survey was
largely based on the UNICEF/World Health Organization's (1998) ten steps to
successful breastfeeding. The convenience sample included 60 recently-delivered
mothers. Findings indicated that primiparous women and women who delivered
by caesarean section consistently received more information about breastfeeding
management than multiparous women and women who delivered vaginally.
However, the study does suggest that all women, regardless of parity or type of
delivery, have information and support needs related to breastfeeding. A total of
29 mothers (67%), who intended to breastfeed exclusively, supplemented with
artificial baby milk. Of these mothers, 16 (55%) stated 'milk insufficiency' as their
primary reasons for supplementing. Overall, respondents perceived healthcare
professionals to be encouraging of breastfeeding, and 48 mothers (80%) were
'moderately' to 'very' satisfied with the breastfeeding education and support
received. These findings suggest that overall adherence to breastfeeding best
practices in the current study hospital are below targets set by the World Health
Organization for 'Baby Friendly' status. Results from the study can be used to
target areas for improvement15.
A quasi experimental study was conducted in 2008, at Korea to investigate
the effects of the professional nurse's postpartum breast-feeding support on breastfeeding prevalence for mothers who delivered in Baby-Friendly Hospitals (BFH).
The subjects of this study were 55 mothers who were hospitalized in the delivery
room of a university hospital which was selected as a BFH in Daegu from October
1, 2005 to June 30, 2006. Twenty nine mothers were assigned to the experimental
group and 26 mothers to the control group. Postpartum breast-feeding support by
nurses' telephone calls to the experimental group was provided once a week for 4
weeks postpartum and then once a month for 16 weeks postpartum. Four post tests
were given at postpartum week 4, 8, 12, and 16. The control group was given a
telephone call at postpartum week 4, 8, 12, and 16. Results showed that the
breastfeeding prevalence of the experimental group was significantly higher than
that of the control group for each period. They concluded that Postpartum breastfeeding support by nurses may be a useful intervention to increase breast-feeding
prevalence16.
A study conducted in 2007 in de Saúde do Município does Rio Grande,
regarding promotion of breastfeeding by the nursing staff of a Children-friendly
hospital. This study derived from the observation of the difficulties in
breastfeeding experienced by mothers dismissed from a university hospital.
Nurses were interviewed, and observations were made to identify problems and
possible strategies in order to make the proposal of becoming a children-friendly
hospital feasible. The identified problems were insufficient staff excessive tasks
performed by nurses, lack of continuity in the health team work, out-of-context
guidelines, lack of commitment with the proposal. Health professionals suggested
the following strategies: health team meetings, better articulation of tasks,
systematic assessments, and higher commitment of all workers of the maternity
ward.17
STATEMENT OF THE PROBLEM
TO ASSESS THE KNOWLEDGE AND ATTITUDE OF STAFF
NURSES REGARDING BABY FRIENDLY HOSPITAL INITIATIVE
POLICY IN SELECTED BFHI HOSPITAL, BANGALORE.
6.3
Objectives of the Study
1. To assess the knowledge of staff nurses regarding Baby Friendly
Hospital Initiative policy.
2. To assess the attitude of staff nurses regarding Baby Friendly
Hospital Initiative policy
3. To find the co- relation between knowledge, and attitude regarding
Baby Friendly Hospital Initiative Policy among staff nurses.
4. To find the association between knowledge, and attitude regarding
Baby Friendly Hospital Initiative Policy among staff nurses with
selected demographic variables.
6.3.1 Assumptions
: 1. Staff nurses may have some knowledge
regarding BFHI policy
2. Staff nurses may have favorable attitude
towards BFHI policy
6.3.2 Variables
Demographic variables ; Age, sex, marital status, type of family,
General qualification, Professional qualification, designation, religion, total years
of experience, total years of experience in BFHI hospital, In-service education
program
.
6.3.3 Operational Definitions
a)Assess; It refers to the statistical measurement of knowledge and
attitude among staff nurses regarding Baby Friendly Hospital Initiative
Policy
b) Knowledge: It refers to correct response of the staff nurses to the
structured knowledge questionnaires regarding Baby Friendly Hospital
Initiative Policy
c) Attitude: Attitude in this study refers to an expressed opinion of staff –
nurses to attitude Scale regarding Baby Friendly Hospital Initiative Policy
d) Staff nurses: A registered nurse with requisite professional
qualification, working in selected BFHI hospital.
f) Baby Friendly Hospital Initiative Policy: It is a ten step policy
adopted by a Baby friendly hospital to initiate, encourage, promote, and
support breast feeding practices in hospital.
7. MATERIALS AND METHODS
7.1 Source of Data
: Data will be collected from Staff
nurses of Selected BFHI
Hospital, Bangalore.
7.2 Method of Collection of Data
7.2.1 Definition of the Study Subject : Staff nurses of Selected BFHI
Hospital, Bangalore.
7.2.2 Inclusion and Exclusion Criteria
a) Inclusion Criteria
: 1.Staff nurses of Selected BFHI
Hospital
2. Staff nurses who are willing
participate in the study.
3. Staff nurses who are present a
the time of data Collection.
b) Exclusion Criteria
: 1.Staff nurses who are not
willing to participate in the
study.
7.2.3 Research Approach
: Non-Experimental Research
approach
7.2.4 Research Design
: Descriptive Research design
7.2.5 Setting
: The study will be conducted
In Selected BFHI Hospitals,
Bangalore.
7.2.6 Sampling Technique
: The investigator will use
Convenient Sampling technique
to draw the Samples
7.2.7 a) Sample Size
: The sample of the study consists
of 50 staff Nurses.
b) Duration of the Study
7.2.8 Tools of Research
: 4 weeks
:1) Structured Knowledge
questionnaire will be
constructed in two parts
Part I – Socio-demographic
data
Part II—Knowledge based
Questions regarding BFHI
policy
2) Attitude based questions using
Modified Likerts-5 Points
Attitude Scale
7.2.9 Collection of data
: The data will be collected from
staff nurses using
1) Structured Knowledge
questionnaire To assess the
knowledge regarding Baby
Friendly Hospital Initiative
policy.
2) Modified Likerts-5 Points attitude
Scale to assess the Attitude of staff
nurses regarding Baby Friendly
Hospital Initiative policy.
7.2.10 Method of Data Analysis : 1) The investigator will use
And Presentation
descriptive statistical techniques
such as mean median, mode,
standard deviation and
inferential statistics like
Chi-square test,Karl Pearson’s
co- relation test and relevant
statistical techniques
2) The analyzed data will be presented
in the form of tables, diagrams, &
graphs
7.3 Does the study require any investigation to be conducted on
patients or other human or animals? If so please describe briefly?
Yes, with prior consent from samples the study will be conducted on staff nurses
regarding knowledge and attitude regarding Baby Friendly Hospital Initiative
policy in selected BFHI hospitals, Bangalore.
7.4 Has ethical clearance has been obtained from your institution
in case of 7.3?
Yes, permission will be obtained from the concerned person and authority of the
institution before the study.
Privacy, confidentiality and anonymity will be guarded.
Scientific objectivity of the study will be maintained with honesty and
impartiality.
8. LIST OF REFERENCES
1. Parul Datta. Pediatric Nursing. 2nd edition. New Delhi: Jaypee publishers;
page no. 24, & 51
2. RamanTSR, Parimala.V, Iyengar A. Baby friendly hospital initiative
experiences from a service hospital
Medical Journal Armed Forces
India(serial online) 2001 Jan; 57(1):23-5
3. Gupte suraj. The short textbook of Pediatrics. 11th edition. NewDelhi:
Jaypee publishers; page no. 80
4. Jones F, Green M,. Baby friendly care. Can Nurse (serial online)
1993;89(9):36-9.Available from: URL: http://www. pubmed.com
5. Ghai OP. Essential of Pediatrics. 6th ed. Delhi: Dr. O.P Ghai Publications;
2005. Page no;
6. WHO. Country Profile: Atlas, Geneva.(serial online) 2006 Mar; 117:380386.
7. Cramton R, Zain-Ul-Abideen M, Whalen B, Optimizing successful
breastfeeding in the newborn. CurrOpinPeditr(serialonline)2009Jun.;
21(3):38696,Availablefrom:URL:http://www.Pubmed.com.
8. Dr. Arun Gupta, Dr. G.P. Mathur, Dr. Jagdish C. Sobti & Dr. (Mrs.) Rita
Gupta, etal, Policy on Breastfeeding Training of doctors and nurses in
Breastfeeding and lactation management. Breastfeeding Promotion
Network of India (BPNI) Available from
[email protected], Website:
www.bpni.org
9. Sial
IP.
Redefining
infant
care
the
Baby-Friendly
Hospital
Initiative.HealthAug;25(4):38.
Availablefrom:URL:http://www.pubmed.com
10. Dabritz HA, Hinton BG, Babb J. Evaluation of lactation support in the
workplace or school environment on 6-month breastfeeding outcomes. J
Hum
Lact
(serial
online)
2009
May;25(2):182-93.
Available
from:URL:http://www.pubmed.com
11. Rosenberg KD, Stull JD, Adler MR, Kasehagen LJ, Crivelli-Kovach A,
etal, Impact of hospital policies on breastfeeding outcomes, Breastfeed
Med.
(serial
online)
2008
http://www. pubmed.com.
Jun;3(2):110-6.
Available
from:URL:
12. Caldeira AP, Gonçalves E. Assessment of the impact of implementing the
Baby-Friendly Hospital Initiative. J Pediatr (serial online)2007 MarApr;83(2):127-32. Available from: URL: http://www. pubmed.com.
13. Rivera-Lugo M, Parrilla-Rodríguez AM, Dávila-Torres RR, Albizu-García
C, Rios-Motta R, etal, Full breastfeeding during the postpartum
hospitalization
and
mothers'
report
regarding
baby
friendly
practices.Breastfeed Med (serial online) 2007 Mar;2(1):19-26., Available
from:URL: http://www. pubmed.com.
14. Bartick M, Stuebe A, Shealy KR, Walker M, Grummer-Strawn
LM,Closing the quality gap: promoting evidence-based breastfeeding care
in the hospital, Pediatrics.(serial online) 2009 Oct;124(4):e793-802.
Available from:URL:http://www.pubmed.com.
15. Sarasua I, Clausen C, Frunchak V, Mothers' experiences with
breastfeeding management and support: a quality improvement study,
Breastfeed
Rev.
2009
Mar;17(1):19-27.,
Available
from:
URL:
http://www. pubmed.com.
16. Jang GJ, Kim SH, Jeong KS. [Effect of postpartum breast-feeding support
by nurse on the breast- feeding prevalence] Taehan Kanho Hakhoe Chi
(serial online) 2008 Feb;38(1):172-9.
Available from : URL: http://www. pubmed.com.
17. Bulhosa MS, Lunardi VL, Lunardi Filho WD, Gonçales SA. Promotion of
breastfeeding by the nursing staff of a children-friendly hospital. Rev
Gaucha Enferm (serial online) 2007 Mar;28(1):89-97.
Available from: URL: http://www. pubmed.com.
9. Signature of the Candidate :
10. Remarks of the Guide
: The present study helps the staff nurses to
improve their knowledge and develop
positive attitude in implementing BFHI
policy in hospital which improves the
quality of nursing services.
11. NAME AND DESIGNATION OF
11.1 GUIDE
11.2 SIGNATURE
: Smt. RENUKA. N, M.Sc. (N)
LECTURER AND HOD
DEPARTMENT OF
PEDIATRIC NURSING,
GOVERNMENT COLLEGE OF
NURSING, FORT, BANGALORE-02.
:
11.3 CO-GUIDE (IF ANY) : Mr. R.K. MUNISWAMY, M.Sc. (N)
LECTURER
PEDIATRIC NURSING
GOVERNEMTNT COLLEGE OF
NURSING, FORT, BANGALORE-2.
12.
11.4 SIGNATURE
:
11.5 HEAD OF THE
DEPARTMENT
: Smt. RENUKA .N, M.Sc. (N)
LECTURER AND HOD
DEPARTMENT OF
PEDIATRIC NURSING,
GOVERNMENT COLLEGE OF
NURSING, FORT, BANGALORE-2.
11.6 SIGNATURE
:
12.1 Remarks of the
: The topic selected for the study is relevant
Principal
12.2 SIGNATURE
and forwarded for needful action
ETHICAL COMMITTEE CLEARANCE
1. TITLE OF THE DISSERTATION
2. NAME OF THE CANDIDATE
AND ADDRESS
: “TO ASSESS THE KNOWLEDGE AND
ATTITUDE OF STAFF NURSES
REGARDING BABY FRIENDLY
HOSPITAL INITIATIVE POLICY IN
SELECTED BFHI HOSPITAL,
BANGALORE”.
: MS. SATHYAVATHI. P
1st Year M.Sc. Nursing.
Government College of
Nursing. Fort,
Bangalore-560 002.
3. SUBJECT
: CHILD HEALTH NURSING
4. NAME OF THE GUIDE
: Smt N. RENUKA, M.Sc. (N)
LECTURER AND HOD
DEPARTMENT OF PEDIATRIC
NURSING. GOVERNMENT COLLEGE
OF NURSING FORT,
BANGALORE-02.
5. APPROVED/NOT APPROVED
(If not approved, suggestion)
Smt. LALITHA HOSMANE
Principal and HOD
Government College of Nursing,
Fort, Bangalore-2
Smt. RENUKA. N
Head of the Department of
Child Health Nursing,
Government College of Nursing,
Fort Bangalore-2
Sri. BASAVARAJU
Head of the Department of
Medical Surgical Nursing.
Government College of Nursing
Fort Bangalore-2
Sri. PRASANNAKUMAR.O.
Head of the department of
Community Health Nursing
Government college of nursing
Fort Bangalore-2
Sri. REVANNA.T.V
Head of the Department of
Psychiatric Nursing.
Government college of Nursing
Fort, Bangalore-2
LAW EXPERT
Smt. LALITHA HOSMANE
Principal
Government College of Nursing,
Fort, Bangalore-2