Journal of Advanced Practices in Nursing

Introduction: An evaluative survey was carried out for the assessment of practice of AMTSL (Active Management of Third Stage of Labor) protocol, as recommended by WHO (World Health Organization), as well as to determine the gap in ongoing practice.

Objective: This present study was conducted to assess the practice of AMTSL protocol by nursing personnel and to find out the gap between ongoing practices and practices recommended by WHO.

Methods: Evaluative Survey research design was selected for this study. This study was carried out in selected hospitals, West Bengal, India. Participants were nursing personnel, working in different labor unit in selected hospitals. Among them 53 nursing personnel were selected as subject sample and 159 deliveries, conducted by the subjects were selected as event sample. Non- probability convenience sampling technique was adopted for sampling. Semi- Structured Interview Schedule and Structured Observation Rating Scale were used for data collection.

Results: The findings revealed that 57.81% participants were practicing Step I administration of uterotonics, whereas 73.18% participants were practicing Step II controlled cord traction and only 30.15% participants were practicing Step III uterine massage, following WHO recommended AMTSL protocol. It also revealed that, 42.19% gap present in practicing Step I, 26.82% gap present in practicing in Step II and maximum 69.85% gap present in Step III, between ongoing practice of AMTSL protocol by nursing personnel and the practices of AMTSL protocol, as recommended by WHO.

Conclusion: This article is intended to help administrators and policy makers who are involved in planning, directing or evaluating the programs, protocols, personnel, products, institutions or systems.

Striae gravidarum are a form of scaring on the skin with an off colour hue. Striae gravidarum found during pregnancy may be indicative of poor skin elasticity. Patients with striae gravidarum are at higher risk for lacerations at the time of vaginal delivery than patients who do not have abdominal stretch marks. A observational study was undertaken to find out the association of striae gravidarum score with perineal trauma among primi-para mothers. The conceptual framework adopted for this study was based on the Erikson, Tomlin, Mary Ann’s model of Adaptive Potential Assessment Model. In this study consecutive sampling technique was used to select 372 primi mothers who are meeting sampling criteria. Atwal numerical scale was used to assess the total striae gravidarum score and Observation for perineal trauma among primi-para mothers was done in labour room of District Headquarter Hospital, Khurda. Descriptive and inferential statistics were used to analyze data in the study. Chi-square test was performed to find out the association between total striae gravidarum score with perineal trauma. The findings of the study revealed that total striae gravidarum was significantly associated with episiotomy given or not given. The study was come to an end that risk for perineal trauma during delivery is associated with total striae gravidarum score.

Aim: The purpose of this study was to develop a Geriatric Early Warning Instrument (GEWI) able to prematurely identify subtle physical changes that lead to negative health outcomes, such as hospitalization and death. Methodology: The study was a prospective cohort study where vital signs were assessed over a seven week period of time nursing home residents ages 65 and older living in Antwerp, Belgium. Furthermore, medical records were consulted to register the number of hospitalizations, deaths and Katz-scores. Findings: Residents encountering a negative outcome (hospitalization or death) had a lower mean systolic blood pressure and a lower blood oxygen level (p<0,05). In those residents, systolic blood pressure and blood oxygen level showed a significant but very weak correlation (0,30>r>-0,30). Systolic blood pressure, heart rate and blood oxygen level were significant predictors for negative outcomes and hospitalization, whereas a higher heart rate and lower blood pressure were significant predictors for premature death. Conclusion: While the initial results were promising, a general conclusion was difficult to generate. Initial findings indicated that systolic blood pressure and blood oxygen level may possibly predict negative outcomes, hospitalization and death. Future large multi-centered research is needed to expand the database in order to confirm these findings.