Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES BANGALORE, KARNATAKA. PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION : MRS.MARY ROSELINE SUNITHA 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 : CHILD HEALTH NURSING. 4. DATE OF ADMISSION : 21.05.2009 5. TITLE OF THE TOPIC : “A STUDY TO EVALUATE THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING PREVENTION OF CRACKER INDUCED EYE INJURIES IN CHILDREN AMONG MOTHERS AT SELECTED URBAN SLUM IN BENGALURU CITY”. 1. NAME OF THE CANDIDATE AND ADDRESS “EYES ARE PRECIOUS, KEEP THEM SAFE.” INTRODUCTION Ocular injuries are the most common cause of acquired uniocular blindness in children. It eventually leads to decrease in vision, morbidity due to associated facial injuries, cosmetic blemishes and resultant personality defects .Thus; it has a major impact on the development of the affected child. Children are the most precious resource of families and they represent the families’ future and their hopes. But, visually disabled child can be a tragedy to their families’. 1 Eye is like a camera. The external object is seen like the camera takes the picture of any object. Light enters the eye through a small hole called the pupil and is focused on the retina, which is like a camera film. Eye also has a focusing lens, which focuses images from different distances on the retina. The colored ring of the eye, the iris, controls the amount of light entering the eye. It closes when light is bright and opens when light is dim.2 Flying pieces of wood, metal, glass, stone and other material are notorious for causing much of the eye trauma. The games of young children such as bow-and-arrows and firecrackers are respectively common during Dussehra and Diwali festivals in India can lead to eye trauma. Road traffic accidents with head and facial trauma may also have an eye injury - these are usually severe in nature with multiple lacerations, shards of glasses embedded in tissues, orbital fractures, severe hematoma and penetrating openglobe injuries with prolapse of eye contents.3 The Chemistry of fireworks is based on the simple theory of combustion. The composition inside the firework must however contain 6 vital ingredients: Charcoal is the most common fuel used in fireworks. Normally, all fuels will contain an organic element such as charcoal or thermite. The function of the oxidizing agent is to produce the oxygen needed in order for the mixture inside the firework to burn. These oxidizers can be nitrates, chlorates or perchlorates. The second part to a firework is the reducing agent. These burn the oxygen provided by the oxidizing agents to produce hot gases. Common reducing agents are Sulphur and Charcoal. These react with the oxygen to form Sulphur dioxide and Carbon dioxide respectively different chemicals are used to produce different colored fireworks. Binders are used to hold what is essentially the mixture of the firework together in a paste like mixture. The most commonly used binder is known as dextrin. The binders do not actually begin to work until the firework has been lit as they are too unstable for storage within the firework and are hence potentially dangerous.4 HAPPY DIWALI WITHOUT CRACKERS 2009; Diwali today means: More 'air, noise, water, land & social' pollution due to use of lots of firecrackers. There are more patients for hospitals during & after the festival causing injuries/deaths. Children are the most common victims of firework accidents, with those fifteen years old or younger accounting for half of all fireworks eye injuries. Explosive injuries by fireworks, crackers may cause serious damage to the eyes. Ocular fireworks injuries are much more severe and dangerous in children than adults.5 6. BRIEF RESUME OF THE INTENDED WORK 6.1 NEED FOR THE STUDY. Eyes are the second most commonly injured part of the body as the result of fireworks. The greatest estimated numbers of eye injuries reported were associated with bottle rockets, firecrackers, and sparklers. Bruises and lacerations were the most common eye injuries, whereas burns were the most frequent injury to the rest of the body. Almost half of the injuries resulting from fireworks were to children age 15 and younger. Sparkers caused about one third of the injuries in children age 5 and younger. Sparklers burn at up to 1800 degrees Fahrenheit and are a leading cause of fireworks-related injuries. In addition, bystanders are more often injured by fireworks than the operator. Fireworks can explode in the hand, throw sparks in the face, cast hot fragments onto limbs, and ignite clothing.6 Globally, more than half a million blinding eye injuries occur every year. Eye injuries account for approximately 8-14% of total injuries in children and are most common type requiring hospitalization. The most important aspect of pediatric ocular trauma is prevention. Parents, caretakers, teachers, media and nurses can help prevent eye injuries by teaching and advocacy for safer practices. The goal of treating eye injuries is to preserve remaining sight and prevent further injury. The majority of injuries occur in young children who cannot be fully responsible for their actions; hence parents and caretakers need education and should direct their attention towards the potential dangers. Children require supervision and education and fireworks if possible should be discouraged or at least burnt with adult supervision.1 Injuries related to the use of fireworks can be the most devastating of all ocular traumas that occurs in children.Atleast 1/5 of emergency room visits for fire related injuries are for ocular trauma. Most occur despite adult supervision. About 1/3 of all blindness in children results from trauma. Children and adolescents account for disproportionate number of episodes of ocular trauma. Boys’ age 11-15years are the most vulnerable .Their injuries out number those in girls by a ratio of about 4%.The majority of injuries are related to fireworks. They cause particularly devastating ocular and orbital injuries. Much of the trauma is avoidable.7 Ocular trauma eventually lead to decrease in vision, cosmetic blemishes and are associated with psychosocial problems .Most pediatric trauma is preventable by simple measures .Increased literacy and health awareness is vital. The irreversible nature of loss of vision and immense morbidity associated with it needs to be emphasized and publicized. The prevention of trauma therefore, is of paramount importance.8 It is estimated that eye injuries related to fireworks accounts for around 15.7% of total population .The incidence is growing over the years more than 60%.About 75 cases were treated in Narayana Nethralaya of which majority were children, most children under 15years of age. About 65/132 cases were treated in Minto Eye hospital of which the most common victims were boys below 14years of age.9 Eye injuries are usually preventable. They occur frequently and can happen anywhere. It is estimated that 80-90% of all eye injuries are preventable. During Deepavali, Dussehera and Holi prevention is the first and most important step for avoiding eye injuries during the festivals to save sight.10 Bottle rockets and sparklers are two of the most common fireworks associated with eye injuries. Bottle rockets can cause serious eye injuries because they are very unpredictable and tend to fly erratically which can cause injury to bystanders. They can also break the can or bottle used to shoot them off throwing shards of glass or metal into the air. Many children enjoy sparklers; however, they also send numerous children to the emergency room. Parents may not be aware that sparklers can easily burn children since they heat up to 1800 degrees (hot enough to melt gold). In addition, the sparks given off can damage the eye.11 According to the most recent data each year; fireworks are responsible for thousands of injuries in children. Many injuries affect eyesight, causing permanent damage and in some cases blinding the victims.12 Another related study says boys between 6-12years age group were more affected. It can be due to their adventurous and exploratory nature coupled with poor perceptions of risks associated with handling of fireworks. Under supervised ignition of fireworks by children was another aspect responsible for eye injuries.6 Fireworks can be captivating, but parents and children need to be knowledgeable of fireworks safety and the risks of injury and should exercise caution when working with them. Younger children should never be involved in these activities, and older children should have parental supervision at all times when working with fireworks.13 Diwali is synonymous with crackers, especially for children who wait for joys of the fireworks of that unique day. But as much as happiness lies in crackers, as does incipient tragedy. The accidents that can occur with crackers can cause great trauma in one's life.14 The investigator during her clinical experience has come across children with related eye injuries .The mothers of children have less knowledge regarding prevention of cracker induced eye injuries and its complications. So, to know the current knowledge of mothers regarding prevention of cracker induced eye injuries, some research studies are needed to carry on with structured teaching programme on mothers. Hence, the investigator thought that imparting knowledge regarding prevention of cracker induced eye injuries will help to and maintain healthy vision. 6.2 REVIEW OF LITERATURE One of the most important early steps in a research project is the conducting of the literature review. A literature review is an account of what has been published on a topic by accredited scholars and researchers. In writing the literature review, your purpose is to convey to your reader what knowledge and ideas have been established on a topic, and what their strengths and weakness are. A literature review discusses published information in a particular subject area and sometimes information in a particular subject area within a certain time period. Puri V, Mahendru S, Rana R, Deshpande M. (2009) A study was conducted on prevalence, period of occurrence, sex and age variation, adult supervision, causative fireworks, mode of lighting, age groups prone to injury, patterns of injury caused by individual fireworks, and the body parts injured. One hundred and fifty-seven cases (92 retrospective, 65 prospective) with injury due to fireworks were studied. The maximum number of injuries (35%) was seen in the age group 5-14 years; 92% of these children were unsupervised. The commonest cause of injury was firework misuse (41% of cases), followed by device failure (35%).. concluded that, over a 10-year period, Aggressive awareness campaigns by government and nongovernment organizations, We can minimize the number and severity of accidents by raising awareness regarding safety precautions, encouraging professional displays and motivating manufacturers to adhere to strict quality control.15 Knox FA, Chan WC, Jackson AJ, Foot B, Sharkey JA, McGinnity FG.( 2008) A surveillance study to assess the nature, management and visual outcomes of serious ocular injuries from fireworks was conducted. New cases of serious ocular injuries from fireworks were prospectively ascertained through the monthly active surveillance system. Information on demographic detail, type of injury, management, and visual outcome was sought through an incident and 6-month follow-up questionnaire: Eighty-one per cent of the injuries occurred were less than 18 years old Eight patients (17%) required enucleation or evisceration and four (9%) required a cosmetic shell for phthisis. 53% (21/40) of cases had a visual acuity of 6/60 or worse. This prospective national survey confirms that firework injuries are an important cause of preventable visual disability particularly to young males. It is likely that such injuries occur year on year and as such represent an important public health concern in addition to the burden placed upon the health service.16 Edwin AF, Cubison TC, Pape SA. (2008) A retrospective study was conducted on children still being injured by fireworks. Reviewed 54 firework-injured children over the last 10 years and assessed the impact. Study outlines past British firework legislation and reviews the literature. The Fireworks Act 2003 and the Fireworks Regulations 2004 limited the sale of fireworks to the 3 weeks surrounding bonfire night, and banned fewer than 18s from purchasing or possessing fireworks. In series, noticed, 83% of children's firework injuries happened in the 3 weeks surrounding Bonfire Night. And concluded that legislation has had an impact, but stricter enforcement of the existing laws and further education of children and the general public into the dangers of fireworks is needed, as children are still being injured.17 Witsaman RJ, Comstock RD, Smith GA. (2006) A retrospective analysis on pediatric fireworks-related injuries among children aged 19 years and younger was conducted by using a nationally representative sample. 85800 pediatric fireworks-related injuries were treated emergency departments during the 14-year study period. Injured children had a mean age of 10.8 years, and 77.9% were male. Injuries were most commonly caused by firecrackers (29.6%), the most commonly injured body sites were the eyeball (20.8%). A national restriction of consumer fireworks, in accordance with the policy recommendations of the American Academy of Pediatrics, should be implemented to reduce the burden of fireworks-related injuries among children.18 Singh, Deependra Vikram MD, Sharma, Yog Raj MD, Azad, Raj Vardhan MD. (2005) A prospective observational study was conducted on all fireworks-related ocular injury visiting trauma clinic during a 1-year period. Eyes were graded by ocular trauma classification and followed for 6 months at least. Best corrected visual acuity (BCVA) at 6 months was considered the final visual outcome. Data were analyzed. Twenty-five (96%) of a total of 26 patients enrolled during study period were male patients and 13 (50%) were younger than 15 years. The type of fireworks involved was a bottle rocket in 38.5%.Besides poor visual outcome, bottle rocket injuries were more frequently associated with; fireworks-related ocular injuries commonly affect young male subjects of northern India. Visual outcome is better in eyes having better initial closed globe injury and if relative afferent pupillary defect, bottle rocket injury, intraocular foreign body, and endophthalmitis are absent.19 Barhanpurkar S, Kumar P, Kapadia P. (2005) This study was conducted at Surat, Rajkot and Vadodara. Forty four cases reporting with FROI were included in the study. Detailed history of each case was obtained that included type of firework, mode of injury, other associated injuries etc. For children (< 12 years), enquiry was made whether the FROI occurred when the child was under the adult supervision. Depending on the severity; cases were treated on outdoor/indoor basis. In this study, bombs were the main culprit of the FROI. It emphasizes the need for some quality check for the fireworks especially bombs. Combination fireworks are dangerous due to their uncertainty of time of explosion. Unsupervised ignition of fireworks by children and consequent FROI in study was another aspect responsible for many injury cases. 20 Kuhn FC, Morris RC, Witherspoon DC, Mann L, Mester V, Modis L. (2005) Retrospective review was conducted to analyze and compare epidemiological and clinical information on serious fireworks-related eye injuries .In the Eye Injury Registry 185 of the 4150 injuries (4.4%) were caused by fireworks 23 feet away. No injured person wore eye protection. Bottle rockets caused 80% of the 185 injuries. The rate of fireworks-related serious eye injuries has not decreased in the last 16 years; most patients are young males. Since bystanders are at a measurable risk even at a distance of 100 feet, wearing eye protection is recommended to both bystanders and operators. Bottle rockets cause most of the injuries and the more severe ones, and should be the prime target for prevention. The benefit of a strict and enforced legislative ban on private fireworks.21 Arya SK, Malhotra S, Dhir SP, Sood S.(2000) This prospective study was planned to evaluate, the types of fireworks-related ocular injuries and visual outcome in these patients. Twenty patients who were given first aid and were not admitted had 6/6 vision. These patients had either lid laceration involving globe or had one or two corneal foreign bodies, which were removed The patients who had open globe injury with posterior segment involvement had poor visual outcome while patients with anterior segment injuries involving the conjunctiva and cornea regained vision up to 6/6 Fireworks injuries occur in most societies. Fireworks-related injuries usually affect boys as observed in our study as well. In India, most fireworks related injuries are reported during Diwali, and Gurupurva.22 STATEMENT OF THE PROBLEM A STUDY TO EVALUATE THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING PREVENTION OF CRACKER INDUCED EYE INJURIES IN CHILDREN AMONG MOTHERS AT SELECTED URBAN SLUM, IN BENGALURU CITY. 6.3 Objectives of the Study (a) To assess the knowledge of mothers regarding prevention of cracker induced eye injuries in children. (b) To evaluate the effectiveness of structured teaching programme regarding prevention of cracker induced eye injuries in children. (c) To find out the association between post test knowledge score and the selected demographic variables. 6.3.1 Hypothesis (a) H1 - There will be significant difference between pre test and post test knowledge scores of mothers regarding prevention of cracker induced eye injuries in children. (b) H2 – There will be significant association between post test knowledge scores of mothers regarding prevention of cracker induced eye injuries in children with selected demographic variables. 6.3.2 Variables (a) Independent variable: Structured teaching programme regarding prevention of cracker induced eye injuries in children. (b) Dependent variable: Mothers knowledge regarding prevention of cracker induced eye injuries in children. (c) Attribute variables: Mothers age education, qualification, occupation, place of residence and income. 6.3.3 Operational Definitions (a) Evaluate: Refers to the measurement of differences of knowledge of Mothers regarding prevention of cracker induced eye injuries in children after structured teaching programme. (b) Knowledge: It refers to the correct responses of mothers to structured teaching programme. (c) Effectiveness: It refers to the significant gain in Knowledge as determined by significant difference in pre test and post test knowledge scores. (d) Mothers: It refers to mothers having children aged between 6-12 years of age. (e) Cracker induced Eye injuries: It refers to any damage to the globe, eye Surface, lids, bones, skin and other structures of the eye caused by crackers. (g) Structured Teaching Programme: Refers to systematically organized teaching and discussion regarding prevention of cracker induced eye injuries in children. (h) Children: It refers to the school children aged between 6-12 years of age who are studying in the higher primary school. 7. MATERIALS AND METHODS 7.1 Source of Data : Mothers residing at selected urban slum in Bengaluru city. 7.2 Method of Collection of Data 7.2.1 Definition of the Study Subject : Mothers residing at selected urban slum in Bengaluru city. 7.2.2 Inclusion and Exclusion Criteria (a) Inclusion Criteria: 1. Mothers who are having school children aged between 6-12 years of age residing at selected urban slum. 2. Mothers willing to participate in the study. 3. Mothers who can understand Kannada or English. (b) Exclusion Criteria : 1. 7.2.3Research Design Mothers who are sick. : Pre-experimental; single group pre test and post test design. 7.2.4 Setting : Selected urban slum in Bengaluru city. 7.2.5 Sampling Technique : Purposive sampling technique. 7.2.6 a) Sample Size : 50 Mothers. b) Duration of the Study 7.2.7 Tools of Research : 4 weeks : Structured interview schedule will be used to collect data from the samples which consist of two parts. Part 1: Demographic variables. Part 2: The investigator will develop structured interview schedule for assessing knowledge of the mothers regarding prevention of cracker induced eye injuries in children. 7.2.8 Collection of data : 1. The investigator herself collects the Pre test knowledge data using Structured Questionnaires from mothers regarding prevention of cracker induced eye injuries and conducts structured Teaching Programme on Prevention of Crackers induced Eye Injuries. 2. The investigator will collect the post test knowledge data, 7 days after conducting Programme Structured using same Teaching Structured Questionnaires. 7.2.9 Method of Data Analysis : A. Descriptive Statistics: (i) Frequency and percentage distribution will be used to analyze the demographic data of mothers. (ii) Mean percentage and standard deviation will be used to assess the level of knowledge of mothers. B. Inferential statistics: (i) Paired‘t’ test will be used to assess the effectiveness of planned teaching programme. (ii) Chi-square test will be used to find the association between post test knowledge scores and demographic variables. C. Analyzed data will be presented in the form of tables, graphs and diagrams based on the findings. 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 the study will be conducted on Mothers regarding prevention of cracker induced eye injuries in children at selected urban slum, Bengaluru city. 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. Anamika k kelshikar, Chhaya A Shinde. Review of Penetrating Eye injury in Pediatric age group. Bombay hospital journal. 2009; 51(1): 1-3. 2. Montgomery TM. Anatomy Physiology and Pathology of Human Eye. [Cited on 2009 Nov 25]; Available from: URL: www.tedmontgomery.com/the-eye/. 3. Encyclopedia home page, Fire Works. {Serial online} 2009 :{ cited on Nov 25 2009}; Available from: URL: www. Encyclopedia.4U.com/f/fireworks.html. 4. Reema Gondhia. The Chemistry of Fireworks. {Serial online} 2008 :{ cited on Nov 2009}; Available from: URL: http://www.ch.ic.ac.UK/local/gondhia/ composition.html. 5. Editorial, Happy Diwali without crackers 2009-V1O. doc. Oct 21 2009. 6. Editorial, Medical news today. Fireworks and Eye Injuries. July 05 2009. 7. Nelson. Text book Pediatrics. 16th ed.2009. WB Saunders Company. p. 1935. 8. Apjit Kaur and Ajay Aggarwal. Pediatrics Ocular Trauma. India. Jul 10 2009 9. {Cited on October 2009} Vol 89. No 1. Available at URL: http; /www/pub med.com. Editorial. The Hindu. Diwali fallout: Eye Injuries Mount Wednesday. October. 21 2009 .Available from; www.google.com 10. Government of India. Ministry of Health. Prevent Eye Injuries: New Delhi, Government of India press. 2009 12. Susan Thomas. American Optometric Association. Washington DC. {Serial online} June, 27 2009; [Cited on November 2009] Available from: URL: www.aoa.org. 13. Dhir SP, Munjal VP, Malhotra S .Fireworks Injuries of the Eye-a-Preventable Hazard. Indian journal of preventive and social medicine. 2001, 32:31-34 14. Diwali Dangers. {Serial online} 2009 Nov: {cited on 2009 Nov 18}; Available from:URL;http://trak.innews.com 15. Puri, Mehendur S, Rana R, Deshpande M. Fireworks; A Ten Year Study. Published by King Edward Memorial hospital. Mumbai.2009 Sep; 62(9):1103-11 16. Knox FA, Chan WC, Jackson AJ, FootB,Sherky JA,Mc Ginnity FG.A Study on Serious Ocular Injuries fireworks in the UK.2008 Jul;22 (2):319-20 17. Edwin AF, Cubison TC, Pape SA. The impact of recent legislation on pediatric fireworks injuries.2008 Nov; 34(7):953-64 18. Witsaman RJ, Comstock RD, Smith GA. Pediatric fireworks-related injuries in the United States: Pediatrics. 2006 Jul; 118(1):296-303 19. Singh, Deependra Vikram MD, Sharma, Yog Raj MD, Azad, Raj Vardhan MD. Visual Outcome after Fireworks Injuries. The Journal of Trauma: Injury, Infection, and Critical Care. July 2005; 59(1):109-11 20. Barhanpurkar S, Kumar P, Kapadia P.Profile of Fireworks Related Ocular Injuries from Western India. Indian J of Community Med {serial online} 2005 Jun {cited 2009 Nov 19}; 30:98-9 21. Kuhn FC, Morris RC, Witherspoon DC, Mann L, Mester V. Serious fireworksrelated eye injuries. US Ophthalmic Epidemiol.2000 Jun; 7(2):139-48 22. Arya SK,Malhotra S,Dhir SP,Sood S.Ocular fireworks injuries Clinical features and visual outcomes. Indian J of ophthalmol {Serial online} 2001 Oct {cited 2009 Nov 19th}; 49:189-90 9. Signature of the Candidate : 10. Remarks of the Guide : Eye injuries caused by crackers are preventable in children. The study will enrich the knowledge of mothers regarding accidental eye injuries. 11. NAME AND DESIGNATION OF 11.1 GUIDE : Sri.R.K.MUNISWAMY, M.Sc. (N) LECTURER DEPARTMENT OF PEDIATRIC NURSING, GOVERNMENT COLLEGE OF NURSING, FORT, BANGALORE-02. 11.2 SIGNATURE : 11.3 CO-GUIDE (IF ANY) : Smt .N. RENUKA, M.Sc. (N) LECTURER AND HOD DEPARTMENT OF PEDIATRIC NURSING GOVERNEMTNT COLLEGE OF NURSING, FORT, BANGALORE-2. 11.4 SIGNATURE : 11.5 HEAD OF THE DEPARTMENT : 11.6 SIGNATURE : 12.12.1 Remarks of the : Principal 12.2 SIGNATURE Smt N. RENUKA, M.Sc. (N) LECTURER AND HOD DEPARTMENT OF PEDIATRIC NURSING, GOVERNMENT COLLEGE OF NURSING, FORT, BANGALORE-02. The topic selected for the study is relevant and forwarded for needful action. : ETHICAL COMMITTEE CLEARANCE : “A STUDY TO ASSESS THE 1. TITLE OF THE DISSERTATION EFFECTIVENESS OF PLANNED TEACHING PROGRAMME ON KNOWLEDGE REGARDING PREVENTION OF CRACKER INDUCED EYE INJURIES IN MOTHERS AMONG SCHOOL CHILDREN AT SELECTED URBAN SLUM, BANGALORE CITY” 2. NAME OF THE CANDIDATE ADDRESS : Mrs. Mary Roseline Sunitha 1st Year M.Sc. Nursing. Government College of Nursing. Fort, Bangalore-560 002. 3. SUBJECT : CHILD HEALTH NURSING 4. NAME OF THE GUIDE : Sri.MUNISWAMY.R .K, M.Sc. (N) LECTURER DEPARTMENT OF PEDIATRIC NURSING. GOVERNMENT COLLEGE OF NURSING. FORT, BANGALORE-02. 5. APPROVED/NOT APPROVED (If not approved, suggestion) : Smt.LALITHA HOSAMNE Principal and HOD Department of OBG Nursing. Government college of Nursing. Fort, Bangalore-560 002 Smt. RENUKA. N Head of the Department Pediatric Nursing. Government college of Nursing. Fort, Bangalore-560 002 Sri.BASAVARAJU.G Head of the Department Medical Surgical Nursing. Government College of Nursing. Fort, Bangalore-560 002 Sri. O.PRASANNA KUMAR Head of the Department Community Health Nursing. Government College of Nursing. Fort, Bangalore-560 002 Sri.REVANNA Head of the Department Psychiatry Nursing. Government College of Nursing. Fort, Bangalore-560 002. LAW EXPERT .