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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA.
ANNEXURE-I
PROFORMA FOR REGISTRATION OF SUBJECT FOR
DISSERTATION
1
2
NAME OF THE
KLES’ INSTITUTE OF NURSING SCIENCES,
ADDRESS
VIDYANAGAR, HUBLI – 580031. KARNATAKA.
NAME OF THE
INSTITUTE
3
Mr. ENDLA. SRINIVASA RAO
CANDIDATE AND
KLES’ INSTITUTE OF NURSING SCIENCES,
VIDYANAGAR, HUBLI-580031. KARNATAKA.
COURSE OF THE
M.Sc. (NURSING) 1st YEAR
STUDY AND
MEDICAL-SURGICAL NURSING
SUBJECT
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DATE OF ADMISSION
TO THE COURSE
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TITLE OF THE TOPIC
28 TH JULY 2012
“EFFECTIVENESS OF PLANNED TEACHING
PRORAMME(PTP) ON KNOWLEDGE AND
PRACTICES
MECHANICS
1
REGARDING
AMONG
STAFF
BODY
NURSES”
6
BRIEF RESUME OF THE INTENDED WORK.
6.1. NEED FOR THE STUDY
"Attention to health is life's greatest hindrance."
-Plato
Human body is a multi-functioning unit, comprised of the kinetic chain. The
kinetic chain is the combination of the nervous, muscular and skeletal systems.
All systems must work together to produce movement.1The normal movements
and stability of human body is the result of intact musculoskeletal system. Body
movements require coordinated muscle activity as it will involve four basic
elements: body alignment (posture), joint mobility, balance and coordinated
movement.2
Functional mobility of the body is governed by body mechanics. Body
mechanics refers to purposeful and coordinated use of body parts and positions
during activity. Learning good body mechanics can help to correct problems with
posture and prevent back pain and injuries to the spine. Use of proper body
mechanics maximizes the effectiveness of the efforts of the musculoskeletal and
neurological systems and reduces the body’s exposure to strain or injury during
movement.3
Many occupations place workers at high risk for back injury. Information
from the World Health Organization's International Labour Office reveals that this
problem is global. The organization lists "musculoskeletal diseases" as common
and part of 268 million non-fatal workplace accidents in which employees miss at
least 3 workdays. To compile the list of risky occupations, two occupations lead
the list of jobs placing workers at highest risk for neck and back injury;
construction and nursing home workers, including nurses, and other profession at
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risk for back injuries are dentists and surgeons, landscapers, gardeners, airline
crew , assembly line workers, bakers, bus and cab drivers etc.4
Direct and indirect costs associated with back injuries in the healthcare
industry are estimated to be $20 billion annually. Additionally, nursing aides and
orderlies suffer the highest prevalence (18.8%) and report the most annual cases
(269,000) of work-related back pain among female workers in the United States.
In 2000, 10,983 registered nurses (RNs) suffered lost-time work injuries due to
lifting patients. Twelve percent of nurses report that they left the nursing
profession because of back pain.5
Nursing is a healthcare profession focused on the detail-oriented care of
individuals, families and communities in attaining, maintaining and recovering
optimal health and functioning. The goal of nursing is healing the sick, so it’s
ironic that nursing as a profession sees some of the highest rates of musculoskeletal injuries. A musculo-skeletal injury might disrupt a nurse’s career. There
are many nurses who love direct patient care but have been forced to either leave
nursing or leave the type of nursing they enjoy because of injury. Many injuries
can be avoided by the conscious use of proper body mechanics when performing
physical labor.6
Proper body mechanics are as important to the nurse as to the client. The
purpose of proper body mechanics is prevention of strain and injury to the
muscles, joints, and tendons. It also helps prevent fatigue. Nurses that use good
body mechanics on the job avoid injuring themselves, other staff members and
patients.3
Taking care of back is a lifelong project. The use of proper body mechanics
is an effective way to prevent back injury. When incorporated into activities of
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daily living, body mechanics help to decrease the amount of stress on the spine.
Education in body mechanics is therefore, essential in preventing the occurrence
of back pain and musculoskeletal disorders.7
A study reports that the nurses were also encouraged to be knowledgeable
about ergonomic principles and to be active in identifying and using these
principles.8 Nursing requires incorporating knowledge and skills into practice.
One component of knowledge and skill is body mechanics. Many nursing
activities require muscle exertion by the nurse. The nurse must know and practice
proper body mechanics to reduce the risk of injuries to the nurse. 5
A study was conducted at Kerala reported that the prevalence of three
components of workload namely role overload, role stagnation and self role
distance were 75.26%, 55.62% and 12.04% respectively. 10
The investigator while working in many units observed that the nursing
personnel in general do not practice body mechanics while performing patient
care and related procedures. Nowadays low back pain, back injuries and other
problems related to improper body mechanics are commonly seen in staff nurses.
Still some nurses are unaware about body mechanics and its importance during
handling and taking care of the patients. The previous experience and the review
of literature concerned recommended that there is strong need to upgrade nurse’s
knowledge. Hence the researcher felt the need to assess the effect of improper
body mechanics among staff nurses and felt the need to prepare as well as
administer the planned teaching programme, which will be certainly helpful in
developing skills and also upgrading the knowledge of nurses regarding body
mechanics which will help to reduce the complications in the future.
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6.2 REVIEW OF LITERATURE
A descriptive correlation study conducted to assess the knowledge and
practices of body mechanic techniques among 30 staff nurses who were from preoperative, post operative, ICU, neurology, surgical, orthopaedic, and gynaecology
units in Mangalore District. The study findings revealed that 13 staff nurses
(43.33%) had good knowledge, 13 staff nurses (43.33%) had average knowledge
and 4 staff nurses (13.34%) had poor knowledge on body mechanics and only 13
staff nurses (43.34%) performed body mechanic technique satisfactorily. Thus
the study concluded that most of the nurses are having poor knowledge on body
mechanics and there is a need to educate the nurses on the use of proper body
mechanics.11
A cross-sectional study was conducted to assess the prevalence of low back
injury and associated risk factors among 1600 hospital staff in Turkish University.
The result revealed that most respondents (65.8%) had experienced low back pain.
The highest prevalence was reported by nurses (77.1%) and lowest among the
hospital aides (53.5%). In majority of the cases (78.3%) low back pain began after
respondents started working in the hospital, 33.3% of the respondents seeking
medical care for moderate low back pain, while 53.8% had been diagnosed with
a herniated lumbar disc. The study concluded by emphasizing that preventive
measures should be taken to reduce the risk of lower back pain such as arranging
proper rest periods, educational programmes to teach the proper use of body
mechanics.12
An explorative study was conducted to identify the usage of body
mechanics in clinical settings and the occurrence of low back pain among 56
nurses in Turkey. The results showed that majority of the nurses (87.5%)
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experienced low back pain at sometime in their lives. The majority of nurses used
body mechanics while sitting (53.6%), standing (58.7%), carrying (64.3%),
pulling or pushing (79.4%), moving patient to a sitting position in bed (71.4%)
and assisting the patient to a standing position (66.6%). However 57.1% of nurses
lifted, 82% extended incorrectly. This study concluded that some of the nurses do
not use body mechanics correctly and majority has low back pain.13An epidemiological study was conducted to identify the prevalence and risk
factors for low back pain (LBP) among 1226 nursing personnel from northern
Iran. The findings of the study revealed that prevalence of LBP in nurses was over
50%. Lifting was the most common mechanism for LBP (30.4%). Prolonged
standing and rest were found to be the significant aggravating and relieving
factors i.e. 57.6% and 59.2% respectively. Absence from work because of LBP
was 33.7% of the sample. This study concluded that LBP among nursing
personnel appears to be high and therefore more resources should be allocated to
prevent such an injury occurring in the nursing profession.14
A cross-sectional study was conducted to investigate prevalence of LBP
as well as the potential risk factors ( individual characteristics, job duration, type
of work, and manual handling knowledge and practices) associated with LBP
among 30 nursing persons and 46 administrative workers at Trisakti University.
The study showed that the overall point prevalence rate of LBP was 42.1%, while
the overall 12-month prevalence rate was 69.7%. Nurses with frequent manual
handling practices had a 2.917-fold higher risk of developing a point prevalence
of LBP. The study concluded
that although this risk was statistically not
significant but an association exists between manual handling practices and LBP
prevalence.15
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A cross-sectional study was conducted to determine the relationship
between low back pain and physical activity levels as well as other confounding
factors that lead to low back pain among 133 nurses in Kanombe Hospital, Kigali.
The result revealed that 78% had low back pain and female nurses were more
affected than their male counterparts (84%). Higher job-related physical activity
(84%) and lower leisure-time physical activity (5%) were reported among nurses..
This study concluded that there is a need for leisure-time physical activity to be
promoted to nurses , as this would reduce the risk of back injury due to the high
level of job-related physical activity.16
A study to evaluate the effectiveness of planned teaching programme
regarding assessment of low birth weight (LBW) infants in terms of knowledge
and skills of nursing personnel working in neonatal care unit in selected hospital
of Delhi.50 nursing personnel were sampled. The study result showed that the
mean post test knowledge score(44.47) and skill score were significantly higher
than the mean pre-test knowledge scores and skill score (17.91) (p<0.01).there
were significant positive
coefficient of correlation (0.41) between post-test
knowledge score and skill score (p<0.05). the study concluded that the planned
teaching programme (PTP) was effective in enhance knowledge as well as skill of
nursing personnel assessment of LBW infants.17
6.3 STATEMENT OF THE PROBLEM :
" A Study to evaluate the effectiveness of planned teaching program (PTP)
on knowledge and practices regarding body mechanics among staff nurses
working at selected hospitals, Hubli ”
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6.4 OBJECTIVES OF THE STUDY
1.
To assess the knowledge regarding body mechanics among staff nurses.
2.
To assess the practices regarding body mechanics among staff nurses
3. To evaluate the effectiveness of planned teaching program on knowledge and
practices regarding body mechanics among staff nurses in terms of gain in
knowledge and practices score.
4.
To determine the correlation between the pre test knowledge and practices
score regarding body mechanics among staff nurses.
5. To find out an association between the pre test knowledge score regarding
body mechanics among staff nurses with their socio-demographical variables.
6. To find out an association between the pre test practices score regarding body
mechanics among staff nurses with their socio demographical variables.
6.5 OPERATIONAL DEFINITIONS
1. Effectiveness: refers to the extent to which the planned teaching programme
on body mechanics achieves the desired effect in improving the knowledge
and practices of body mechanics among staff nurses as evident from gain in
knowledge and practices scores.
2. Planned teaching program: It refers to the pre-planned teaching program
prepared and administered by the investigator to educate the staff nurses
regarding body mechanics.
3. Knowledge: refers to the correct responses obtained from staff nurses
regarding body mechanics through a structured knowledge questionnaire.
4. Practices: refers to the correct responses obtained from staff nurses
regarding body mechanics through a structured knowledge based practices
questionnaire.
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5. Body mechanics: refers to the coordinated efforts of the musculoskeletal
and nervous system to maintain balance, posture, and body alignment during
shifting, lifting, handling, bending, moving, and performing activities of daily
living/nursing care.
6. Staff nurses: refers to the registered nurses with diploma or degree
qualification working at selected hospitals in Hubli.
7. Socio-Demographic variables:
refers to variables like age, gender,
educational qualification, work experience, area of working, working hours
and previous exposure to in-service education regarding body mechanics.
6.6 HYPOTHESES
H1: The mean post-test knowledge scores of staff nurses regarding body
mechanics who have exposed to planned teaching programme (PTP) will be
significantly higher than the mean pre test knowledge scores at 0.05 level of
significance.
H2: The mean post-test practice scores of staff nurses regarding body mechanics
who have exposed to planned teaching programme (PTP) will significantly
higher than the mean pre test practice scores at 0.05 level of significance.
H3: There will be a correlation between pre-test knowledge and practice scores
of staff nurses regarding body mechanics at 0.05 level of significance.
H4: There will be an association between pre test knowledge scores of staff
nurses regarding body mechanics with their selected socio demographic
variables at 0.05 level of significance.
H5: There will be an association between pre test practices scores of staff nurses
regarding body mechanics with their selected socio demographic variables at
0.05 level of significance.
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6.7 ASSUMPTIONS
1. Staff nurses will have some knowledge regarding body mechanics.
2. Planned teaching program (PTP) is an effective method to improve
knowledge among staff nurses regarding body mechanics and this
educational strategy will motivate to practice proper body mechanics among
staff nurses.
6.8 DELIMITATION
The study is delimited to staff nurses who are working at selected hospitals in
Hubli.
6.9 PROJECTED OUTCOMES

The findings of the study will throw a light on nurse’s knowledge
practices regarding body mechanics

Finding of study will support further use of planned teaching programme
(PTP) as source of knowledge for nurses in clinical settings.
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MATERIALS AND METHOD
7.1 SOURCES OF DATA
Primary source
: Staff nurses
Secondary sources
:
Staff nurses records maintained at selected the hospitals,
Hubli
Research approach :
Evaluative
Research design
:
Pre experimental; one group pre test –post test design
Research setting
:
Selected hospitals, Hubli
Population
:
Staff nurses working at selected hospitals Hubli.
Sample size
:
50
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Inclusion criteria
: The staff nurses who;
 have completed their basic nursing education (diploma or
degree) and presently working at selected hospitals.
 are available at the time of data collection
 are willing to participate in the study
Exclusion criteria: The staff nurses who are;
 sick at the time of data collection
 working at managerial level /supervisory /administrator
level
7.2 METHOD OF DATA COLLECTION.
Sampling technique : Non -probability, purposive sampling
Instrument
:
Structured questionnaire
Section I
:
Socio demographic variables.
Section II
: Structured knowledge questionnaire
Section III
:
Structured knowledge based practice questionnaire
Steps of data collection
Step I
: The investigator obtain prior permission from respective authority to
conduct the study.
Step II : Selection of subjects by using non –probability, purposive
sampling
Step III : Investigator introduces himself to the staff nurses and notifies about
his aims, objectives and steps of the study and takes written consent
Step IV : Conduct pre-test for nurses by using structured questionnaire.
Step V : Administration planned teaching programme (PTP)
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Step VI : Conduct post -test for nurses by using same structured questionnaire
Step VII : Data will be analyzed and interpreted by using descriptive and
inferential statistics .
7.3 Does the study require any interventions or investigations to be conducted
on patients or other humans or animals? If so please describe briefly.
YES.(planned teaching programme)
7.4 Has permission obtained from your institution?
YES.
7.5 Has ethical clearance been obtained from your institution?
YES.
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LIST OF REFERENCES
1. Hudson A. Body mechanics. The Journals for RNS and Patient Advocacy
2002 (5): 31
2.
Foundations in nursing related learning experience. Body mechanics [online]
[cited on 12-11-12] Available at http://www.slideshare.net/lezzoj/bodymechanics-4459656.
3.
Danserean.V. Importance of proper body mechanics, [online][cited on 21-1112] Available at
http://www.answerbag.com/q_view/1904305#ixzz2BRJJbqUq.
4.
Spinasanta.S. High-risk Jobs: Is Your Job Putting Your Spine at Risk?
Workplace Ergonomics; [online][cited on 28-11-12] Available at
http://www.spineuniverse.com/wellness/ergono0mics/high-risk-jobs.
5. Gillmore A. Nurses' lifting injuries: research shows good body mechanics are
not enough. Available at: http://find article.com/p/articles/mi-qa4102/is-/ain9272813
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6. Aiken L H, Fagin CM. Charting Nursing’s Future. 1992; New York: Lippincott
Company.
7. Jensen RC. Disabling back injuries among nursing Personal: research needs
and justification. Research Nurses Health 1999 Feb; 10(1): 29-38
8. Kalnitsky A. Body mechanics 101.2008;[online][cited on12-11-12]. Available
at: URL:http://www.spineuniverse.com/display_article.php/article 836.html.
9. Kozier & Erb. Fundamentals of nursing concepts and procedure P. 191 – 193
10. Kannan, Srinivasan and Sarma, P.Sankara: Study on workload of public
health nurses and other women health workers in India. Unpublished.
11. Pinto M. Body Mechanics. Nurses of India 2008 Aug; 23:4-5
12. Engkvist IL, Hjelm EW, Hagberg M, Menckel E, Ekenvall L.; Risk indicators
for reported over-exertion back injuries among female nursing personnel
[online][cited on 10-11-12] Available at
http://www.ncbi.nlm.nih.gov/pubmed/10955403.
13.
Ridwan H, Diana S, Purnamawati T, Magdalena W; Manual handling as
risk factor of low back pain among workers, universal medicina, SeptemberDec, 2009,Vol.28 – No.3
14. Mohammad A M, Moulod Fakhri, Masumeh B N, Marjan A S, Ali Reza K,
Masoud S A ,ocuupational back pain in Iranian nurses ;a epidemiology study
British journal of nursing ,volume 5,issues 17,sep 2006, 914-917.
15 Hartvigsen J, Lauritzen S, Lings S, Lauritzen T ;
Intensive education combined with low tech ergonomic intervention does
not prevent low back pain in nurses.[online] [cited on 12-11-12] Available at
URL; http://www.ncbi.nlm.nih.gov/pubmed.
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16.
Lela M., Frantz J.M. The Relationship between Low Back Pain and Physical
Activity Among Nurses in Kanombe. AJPARS Vol. 4, Nos. 1 & 2, June
2012, pp. 63 – 66.
17. Sarin j. Nursing assessment of LBW infants, The Nursing journal of India
[online].1997 sep.[cited 2012 Dce 15];2(9):32-8:[about 7 p.] available at
http://119.82.96.197/gsdl/collect/dissert/index/assoc/HASH0dc0.dir/doc.pdf.
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SIGNATURE OF THE
CANDIDATE
10
REMARKS OF THE
Study is feasible and of genuine interest of the
GUIDE
student. Similar type of study is not conducted in
Hubli , Dharwad district.
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11.1 NAME
AND
DESIGNATION OF
GUIDE
Prof. SANJAY M. PEERAPUR M.Sc (N)
Principal & HOD
Dept of Medical Surgical Nursing ,
KLE Institute Of Nursing Sciences ,
Vidyanagar ,Hubli-580031
11.2 SIGNATURE
11.3 CO-GUIDE
Mrs. ASHA H. BHATAKHANDE. M.sc(N)
Asst Professor,
Dept of OBGY Nursing.
KLES’ Institute of Nursing Sciences,
Vidyanagar, Hubli-580031
11.4 SIGNATURE
11.5 HEAD OF THE
DEPARTMENT
Prof. SANJAY M.PEERAPUR M.Sc (N)
Principal & HOD
Dept of Medical Surgical Nursing ,
KLE Institute Of Nursing Sciences ,
Vidyanagar ,Hubli-580031
11.6 SIGNATURE
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12.1 REMARKS OF THE
PRINCIPAL
The topic was discussed with the members of
research committee & finalized. He is permitted to
conduct the study
12.2 SIGNATURE
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