Volume 11 | Issue 8 |

 Abstract

Aim: The main aim of the current research was to evaluate the effectiveness of changing position and early ambulation on pain, fatigue and bleeding among patients undergone cardiac catheterization at selected hospital, Panipat. Methodology: Researcher had adopted true experimental design to assess the effectiveness of changing position and early ambulation on pain, fatigue and bleeding among patients undergone cardiac catheterization. Settings of the study was Dr. Prem Hospital and Ravindra Hospital - Panipat. Samples were selected through simple random sampling technique. Sample size was estimated as 60 among these 30 samples were selected in experimental group and other 30 samples were placed for control group. Tools for assessing the pain of the subjects were done through visual analogue scale (VAS), fatigue severity scale (FSS) and to assess bleeding, modified WHO bleeding assessment score were used. The pilot study was conducted in Cygnus hospital, Panipat. With 6 subjects from 19/03/2022 to 24/03/2022 to determine the study feasibility. Main data were collected from the subjects in Dr Prem hospital and Ravindra hospital. Data were collected from 02/05/2022 to 02/06/2022, among the subjects who had undergone cardiac catheterization. Followed by the pre-test assessment of pain, fatigue and haemorrhage among the subjects in both group the researcher provided positioning and early ambulation according to the protocol which was mentioned earlier under research methodology data collection procedure. Post - test was done on the day - 2 from the cardiac catheterization procedure. The collected data were analysed through SPSS by using descriptive and inferential statistics. Results: Among subjects in experimental group, the post-test mean and standard deviation pain score was 3.97 + 0.86. in the control group, the post - test mean and standard deviation pain score was 7.73 + 0.90. the independent 't' test value was 13.59 for the degree of freedom 58. Which was significant at the 'p' value < 0.001. this shows that, there was a significant difference in pain level between the subjects in two groups. Among subjects in experimental group, the post-test mean and standard deviation fatigue score was 19.67 + 5.30. in the control group, the post - test mean and standard deviation fatigue score was 48.37 + 8.10. the independent 't' test value was 1.716 for the degree of freedom 58. Which was significant at the 'p' value < 0.001. this shows that, there was a significant difference in fatigue level between the subjects in two groups. Among subjects in experimental group, the post-test mean and standard deviation hemorrhage score was 1.57 + 0.47. in the control group, the post - test mean and standard deviation hemorrhage score was 3.23 + 0.67. the independent 't' test value was 10.79 for the degree of freedom 58. Which was significant at the 'p' value < 0.001. this shows that, there was a significant difference in hemorrhage level between the subjects in two groups. Conclusion: The results of this study showed that the levels of pain, fatigue and haemorrhage after positioning and early ambulation have been reduced among the subjects in experimental group, when compared with those who were in control group. Changing patients' position accompanied by early ambulation after cardiac catheterization are associated with increasing comfort and satisfaction levels and decreasing the level of pain and fatigue without increasing the amount of bleeding and hematoma.

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 Keywords

Effectiveness, Changing position, Early ambulation, Pain, Fatigue, Haemorrhage, Cardiac catheterization

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Creative Commons Attribution 4.0 and The Open Definition

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ABSTRACT The knowledge-based theory of the firm suggests that knowledge is the organizational asset that enables sustainable competitive advantage in hypercompetitive environments. The emphasis on knowledge in today's organizations assumes that barriers to transferring and replicating knowledge endow it with strategic importance. The growth in the number of HEIs in India in the last decade has increased competition and the pressure for performing better. This has forced the institutions to recognize the need for knowledge management (KM) initiatives, a key asset. KM in HEIs involves the discovery and capture of the knowledge created by filtering and encapsulation and mapping it to the needs of the organization to derive value from its sharing throughout the organization. A competitive edge over others depends largely on the quality of KM that organizations are able to apply to their operations. The paper explores the functional domains of HEIs and the indicators that determine these domains. The rapid growth of data and technologies triggers data transformation into useful information, known as knowledge. Nowadays, people are aware of the worth of knowledge and the styles to obtain, recognize, capture, save, and leverage it, so that knowledge can be shared without losing it; in other words, know how to manage knowledge. In this way, the term KM is created. KM has increased in popularity as a management device over the past decade. There have been concerns about whether KM is simply a fad, and researchers and academics have debated its faddish-like characteristics. As Stankosky indicates KM certainly is not a fad, because the knowledge-based economy is here to stay. While there is no universally accepted definition of KM, most are extremely similar. According to Rumizen, KM is a systematic process, by which knowledge needed for an organization to succeed is created, captured, shared,and leveraged. Many of us simply do not think in terms of managing knowledge, but we all do it. Each of us is a personal store of knowledge with training, experiences, and informal networks of friends and colleagues, whom we seek out when we want to solve a problem or explore an opportunity. Essentially, we get things done and succeed by knowing an answer orknowing someone who does. This study provides an analysis of current practices and outcomesof KMS and the nature of KMS as they are evolving in five organizations. The findings suggest that interest in KMS across a variety of industries is very high, the technological foundations are varied, and the major concerns revolve around achieving the correct amount and type of accurate knowledge and garnering support for contributing to the KMS.

Licence: creative commons attribution 4.0

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Creative Commons Attribution 4.0 and The Open Definition

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Knowledge Management, Educational Institutions

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Creative Commons Attribution 4.0 and The Open Definition

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In Bangladesh, effective water resources schemes were mostly small-scale and locally constructed and managed. The government of the people's republic of Bangladesh has taken many projects and sub projects for water resources management. Through these projects and sub projects Bangladesh government has achieved many positive things. However the present study has conducted to explore challenges of operations and maintenance of Small Scale water resource management in Bangladesh. The study was documentary analysis type. Information and data were collected from secondary sources. Information and data were collected from books, research reports, journals, different annual reports, different government and non government websites and different websites. A literature review was conducted by using the internet search, Google databases with the operation and maintenance of water resources in Bangladesh. A hand search was also undertaken to relevant journals identified by the electronic search and additional articles identified from the reference list of the key articles. A number of articles have been found on virtual classroom. From the study it was found that there were low irrigation service collection which is inadequate to support system O&M. There were no systematic procedure for asset management and to identify O&M needs so there should have systematic procedure for asset management. There were limited participation and consultation with beneficiaries on O&M requirements so participation should be increased. There were lacks of asset inventory and condition survey on which to develop maintenance budget so asset inventory and condition survey should be increased. Proposed annual budgets for O&M are curtailed due to insufficient funds which should be increased. Funds released for O&M do not reflect requirements for annual, periodic or emergency maintenance of a system. There are lacking of enforcement of cost recovery or contribution to O&M costs in particular for annual maintenance the lacking should remove. So, from the study it was recommended that in Upazila and district LGED office, WMCA monitoring, operations and maintenances issues needs to be more emphasized and included as one of the reporting agenda in monthly meeting. This will increase experiences and understand on SSWRD by concerned engineers in the field in terms of better water resource management. LGED can take necessary step to include WMCA in Upazila Level Water Management Committee and Union level water resources Management committee formed as per Water Rule-2018. It is urgent to continue these Union and Upazila level meeting regular monthly basis. Member Education Programme (MEP) of all members should be continuing at least twice a year. Members should be aware about Operation and Maintenance and Service Charges. More motivational work at WMCA member level should necessary. More Good Governance should practice in WMCA and record keeping, and more transparency should practice in WMCA. Operation and Maintenance Plan Book preparation (following Joint Visit) should be mandatory to each WMCA which already included in grading data.

Licence: creative commons attribution 4.0

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Creative Commons Attribution 4.0 and The Open Definition

 Keywords

Water resource, Monitoring, Operation, Maintenance, Evaluation, Irrigation, Drainage, Infrastructure, Flood, Embankment, Canal, Water control structures, Projects

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Creative Commons Attribution 4.0 and The Open Definition