Intravenous therapy is an infusion of treatments and fluids into vein

BACKGROUND IN THE STUDY

Intravenous therapy can be an infusion of medication and liquids into a vein. IV remedy is vital part of scientific use. There are also complications which included in IV infusion are local and systemic, local include thrombophlebitis, infiltration, extravasations, nerve injury and systemic include bacteremia, septicemia, emboli, thrombus, circulatory overload etc.

Thrombophlebitis, "Thrombo" means "clot" "Phlebo" means "vein" and "itis" means infection. Thrombophlebitis refers to the presence of an clot plus inflammation in the vein. Phlebitis is thought as the acute infection of internal lining of the vein Infusion Nursing Benchmarks of Practice (2000).

According to international relationship of pain (IASP) (1994), "pain is an annoying sensory experience associated with genuine and potential tissue damage".

The pain is classified as nociceptive, neuropathic, severe and serious pain. The nociceptive pain is induced due to damage to somatic or visceral tissue damage which pain from operative incision, a broken bone, or arthritis, the neuropathic pain is induced by harm to peripheral nerves or CNS such as trauma, swelling, metabolic diseases like diabetes mellitus, tumors, waste, and neurologic diseases such as multiple sclerosis and acute pain is dure to create operative pain, labour pain, and pain from stress and the long-term pain is perfect for longer periods credited to malignancy.

Pain is a highly upsetting and professional discomfort that can't be distributed to others. It could occupy all an individual thinking, direct all activities and change a person. Yet pain is a difficult concept for a client to converse. Pain is widespread experience its exact mother nature becomes secret. Unrelieved pain presents both physiological and internal hazards to health and recovery. Health care givers should include analysis of pain as a fifth vital sign to focus on its significance and to increase the consciousness among the health care professional of the importance of effective pain management. There are many non pharmacological options which is provided including rub, exercise, transcutaneous electrical power nerve arousal, percutaneous electric nerve arousal, accupunture heat therapy, cold therapies, and cognitive treatments including distraction, hypnosis and rest strategies.

Edema which is the build up of smooth in subcutaneous cells credited to extracellular amount expansion. There is swelling of cells which can be showed by pressing gently with the thumb over the bony prominence especially on dorsum of toes and around the ankles. The types of edema include hydrostatic edema, oncotic edema, inflammatory and distressing edema and lymphatic edema.

Phlebitis can be grouped into 3 three categories such as mechanical, chemical and bacterial where mechanised is because of the size of cannula is too large for the selected vein causing unneeded friction on the internal lining resulting in inflammation, chemical phlebitis is because of peripheral IV devices when the medication or solution irritate the endothelial lining of the tiny peripheral vessel wall membrane and bacterial phlebitis is usually precursor to contamination at the infection site. Thrombophlebitis is apparent by localized pain, inflammation, warmth, and swelling across the insertion site or along the road of the vein, immobility of the extremity because of soreness and swelling.

Non pharmacological treatment includes discontinuing the IV, making use of a warm compress, elevating of the extremity, and restraining the line in the contrary extremity. Within the presence of signs or symptoms of thrombophlebitis, you need to not attempt to irrigate the range.

Pharmacological and non pharmacological agencies are for sale to pain relief, edema and infection. The cost and side effects are comparatively high in modern medicine. The amount of client seeking unconventional treatment has increased considerably. Nonpharmocological remedies, natural treatments, cryotherapies, and aromatherapies can be found with less expensive and fewer side effects. In the same way in combact aloveragel is also very much used in reducing pain, edema and intensity of swelling.

For local treatment in order to alleviate pain, edema and intensity of inflammation alovera gel can be used. Since in the age of Old Egypt humans having using aloe. They used one of the ingredients of embalming fluid. Within the tenth century, the Europeans were unveiled, where it became an important ingredient in many herbal medicines. With the sixteenth century, aloe arrived in the West Indies, where still today it is gathered.

Alovera is one of the healing natural remedies as a treatment place. The uses of aloe of popularized in 1950's itself. You will find over 300 different kinds of aloe, but just a few were used usually as an natural and organic medicine. In the centre age groups the yellowish water found inside the leaves was a favorite as purgative. Aloevera gel is the mucilaginious gel produced from the centre (the parenchyma) of the herb leaf. It includes 400 species. The gel part of the place is made by peeling the exterior portion of the skin and the pericap away. It is preparation which is called real aloevera gel in commerce. Aloevera is thick, tapered with spiny leaves expand from a brief stalk near walk out. It is not a cactus, but an associate of the tree Lilly family known as Aloe Barbandesis. Some varieties, specifically Aloevera are being used in alternative drugs and in home medical. Both translucent interior pulp and the resinous yellow exudates from wounding the Aloe herb are being used externally to relive epidermis discomforts. The gel found in the leaves is employed for soothing minor burns, wounds and various skin area conditions like eczema and ringworm.

Aloevera gel has both antimicrobial and anti-inflammatory effects. The constituents include gibberlin, lectins, lignins, glucose, mannose, glucuronic acid other polysaccharides including galctogalacturans and galactoglucoarabinomannas. Probably the most considerable constituents is water(99%). The aloevera gel contain anti-inflammatory agent gibberlin and polysaccharides which effectively lower irritation and promote therapeutic. Aloevera effectively relieves pain because it contain salicylic acid. Aloevera contain ligin which really helps to permeate deeply into skin to deliver its therapeutic results.

Most of the medical interventions fit comfortably within the real of the natural therapy's the illness healing paradigm switch and converge, and role of nurses shifts can offers to the healer. Therefore aloevera gel is actually a suitable intervention which helps the nurse to lessen pain, edema and phlebitis.

NEED FOR THE STUDY

IV therapy has become a pervasive world wide as a boring therapy. Nurses annually still put, use and monitor millions of peripheral venous catheters (PVC). To diagnose and evaluate phlebitis severity is essential in an effort to prevent a bunch of severe problems such as septic phlebitis, bacteremia, septicemia, arthritis, osteomyleitis eventually resulting in death. Nonetheless it is still prone to associated complications, which phlebitis is most common, with prevalence differing between 20% to 80% Workman (2000).

Villicampa (2008)Spanish review a countrywide multicentric epidemiological research having the institutional participation of 10 centres. In this particular study 381 problems looks in the 2701 peripheral catheters examined which represents an incidence level of 14. 11%. They reviewed 8700 treatment information this study proven that implementation of strategies to improve the quality of attention reduces non instrumental complication continual pain at the access point, extravasations of edema, second or third level phlebitis and an infection associated with catheters.

Nassaji Zaveareh (2007) conducted a prospective review on peripheral interventions catheter related factor. In this particular analysis 300 patients accepted to medical and surgical wards from April 2003 to Feb2004 were participated. Parameters evaluated were years, gender, site and size of catheter, kind of insertion and underlying condition were discovered for 3 days continuously. Out of this 26 % took place phlebitis. There were no significant romance between get older catheter bore size stress and phlebitis. Related risk factors were gender, ie. , female site and kind of insertion of catheter, diabetes mellitus and burns. Important role of nurse is to control pain that of thrombophlebitis.

The quality of care and attention received in a healthcare facility was often reflected in client care. Among paramedical occupation, medical personals were placing intravenous brand, monitoring, administering intravenous essential fluids and administering drugs. Maintenance of peripheral intravenous cannulae and removal of peripheral cannulae was an intrinsic component of nursing care.

Nordell, et al. , (2002)in a study of 52 patients, found 5 diagnosed instances of thrombophlebitis (10% ). Out of fifty-two patients twenty six hand or wrist venipunctures, he found 3 with thrombophlebitis. Also he previously done Fifteen forearm punctures produced the other 2 conditions of phlebitis while of the eleven patients undergoing antecubital fossa venipuncture, nothing were found to have developed thrombophlebitis.

The reported incidences of thrombophlebitis vary from a low of 2% 21 up to 15%. 33. One well-controlled Swedish analysis of over 1000 cases reported venous difficulties of several types at 31% is having thrombophlebitis.

Singh, Bhandary ( 2007), Dhulikhel Medical center Kathmandu University Coaching Hospital, Nepal carried out a potential observational study to determine the event of peripheral intravenous catheter related phlebitis and to the possible factors associated to its development. A complete 230 patients under intravenous catheter were preferred peripheral infusion site was analyzed for symptoms of phlebitis once a day using jackson Standard visible phlebitis size and the effect obtained was 136(59. 1%)patients developed thrombophlebitis. Related risk factors as within the present study were insertion site (forearm), size of catheter (20G) and dwell time (>=36 hours). There were higher occurrence of phlebitis among your client with Intra venous drug administration and especially between age range 21 - 40 years. Therefore more attention and care are needed in these areas by the treatment provider.

In another analysis the overall phlebitis rate was 39%. Phlebitis developed in 53% of patients with brief lines, in 41% of patients with midsized lines, and in 10% of patients with long lines, and these catheters remained in place an average (± SD) of 3. 0 ± 2. 4 days, 4. 6 ± 3. 4 days, and 7. 8 ± 6. 6 days and nights, respectively. The variables that influenced the introduction of phlebitis, as dependant on multivariate analysis, kind of catheter, blood vessels hemoglobin levels, and IV therapy with either corticosteroids or erythromycin

Lutter et al. , conducted a retrospective review to identify the complication of venous catheterization in the left lower limb and right lower limb for 1, 143 patients. Patients happened phlebitis in 56% in left lower limb 51% in right lower limb.

Aloevera has salicylic acid which include in analgesic results, it contains ligin which helps to penetrate deeply into pores and skin to provide the therapeutic effects, it contain anti-inflammatory agent gibberlin and polysaccharides which lower irritation and promote recovery.

Netherlands, conducted a prospective study on treatment of superficial thrombophlebitis with aloevera gel in minimizing the local pain, bloating and redness. In this particular 116 patients were selected with thrombophlebitis and requested an interval of 3 days and nights. The efficacy of aloevera was documented. There's a drastic improvement in patient received aloevera gel as treatment than the control group Winchers IM (2005).

The investigator determined this research because during her clinical experience has discovered the countless patients who got admitted in a healthcare facility with cannula, developed the catheter related problems such as blockage, pain, redness and thrombophlebitis. This occurrence insists the investigator to do some intervention to overcome this issue. Nurses have to be prepared with current interventional skills in alleviating the pain, edema seriousness of inflammation also to prevent and treat problems. Hence the investigator enthusiastic about assessing the potency of aloveragel in thrombophlebitis patients in reducing pain, edema, and intensity of swelling.

STATEMENT OF THE PROBLEM:

A research to assess the potency of aloveragel in minimizing pain, edema and intensity of irritation among thrombophlebitis patients in particular nursing homes at Kanyakumari District May 2010.

OBJECTIVES

To determine the pretest degree of pain, edema and severeness of infection for the experimental and control group.

To assess the post test level of pain, edema and intensity of infection in experimental and control group.

To compare the pre test degree of thrombophlebitis between experimental and control group.

To compare the posttest level of thrombophlebitis between your experimental and control group.

To compare the pre and post test level of thrombophlebitis for both experimental group.

To compare the pre and post test level of thrombophlebitis for both control group.

To connect the post test degree of thrombophlebitis of the experimental and ontrol group using their selected demographic variables.

OPERATIONAL DEFINITION

Assess

Systematically and collecting, validating and interacting the patient data.

Effectiveness:

In this research effectiveness means reduced amount of pain and edema and severity

of irritation of thrombophlebitis patients after the supervision of aloveragel.

Pain

Refers the pain and irritability thought by the patient intravenous infusion

site anticipated to inflammation of vein and it is assessed by numerical pain size.

Edema

Refers to the bloating in the infusion site and evaluated by edema level.

Phlebitis:

Refers to the inflammation which is occurred due to the intravenous infusion and it is evaluated by phlebitis scale.

Aloeveagel:

Refers to inexperienced leaves when it is teared that have semi solid water which is applied in affected site.

ASSUMPTION

Pain, edema and intensity of irritation among thrombophlebitis can be low in adults through the use of Aloveragel.

Patient with thrombophlebitis at intravenous infusion site have pain, edema and swelling.

HYPOTHESIS

RH1 - There is a significant difference in pre test level of pain, edema and severeness of

inflammation between experimental and control group.

RH2 - There's a factor in post test level of pain, edema and severity of

inflammation between experimental and control group.

RH3 - There's a factor in pre and post test degree of pain, edema and

severity inflammation among thrombophlebitis patients in experimental group.

RH4 - There is a factor in pre and post test level of pain, edema and intensity of irritation among thrombophlebitis patients for control group.

RH5 - There is a significant relationship of post test level of pain, edema and intensity of

inflammation among thrombophlebitis patients using their selected demographic

variables (age, sex, site, duration etc).

DELIMITATION

The research is delimited for four weeks of data collection.

The study is limited to a sample of 60 individuals.

CONCEPTUAL Body WORK

Conceptual model presents certain views of phenomena on earth that have deep influences on our understanding of this world. A model is a simplification of reality or representation of truth. Ideas in the model develops consider relevant so when aids to understanding.

The study is principally focused to discover the effectiveness of aloeveragel in lowering pain, edema and severeness of inflammation among thrombophlebitis patients. In order to decrease pain, edema and intensity of swelling aloveragel was applied.

The investigator adopted the King's Goal Attainment theory (1980) as basics for producing the conceptual framework. Imogene King's Goal attainment theory is based on the employees and interpersonal systems, including relationship, perception, communication, purchase, role, stress, development and development, time and action.

PERCEPTION:

Refers to person representation of truth. It is universal yet highly subjective and unique to each person. Hence the investigator understanding was peoples may have pain, edema and seriousness of inflammation

JUDGEMENT:

The investigator judged that program of aloeveragel reduces pain, edemaand seriousness of irritation thrombophlebitis patients. The investigator to guage the need to reduce the level of pain, edema and severity of infection.

ACTION:

The investigator applied aloeveragel. The thrombophlebitis patient determination to simply accept aloeveaagel and take part in the study.

REACTION:

The investigator also to asset mutual goal setting.

INTERACTION:

Refers to verbal and non verbal habit of individual and the environment or two or more individual with an objective to achieve goal. It offers the goal aimed notion and communication. Here the investigator interacts with the thrombophlebitis patient giving aloeveragel applied three times each day.

TRANSACTION:

Refers to the observable, purposeful action of individual conversation with their environment to attain the desired goal. At this time the investigator examination the pain, edema and severeness of swelling among thrombophlebitis patients in order to administer aloeveragel request. The positive results in post test is the reduction of pain, edema and intensity of irritation which indicate the aloeveragel request.

OUT TYPE OF THE REPORT

The article is split into 6 Chapters:

Chapter I - dealt with track record of the study, need for the analysis,

statement of the problem, objectives, operational definitions, research hypotheses, assumptions, delimitations of the study, conceptual platform and format of the report.

Chapter II - relates with review of related literature pertaining to

various areas of study.

Chapter III - includes with the study design, variables, preparing of the

study, population, test, sample size, sampling strategy, criteria for sample selection, development and description of the tool, content validity, reliability of the tool, pilot research, procedure for data collection and evaluation of the analysis.

Chapter IV - presents the data research and interpretation of data

Chapter V - relates with discourse predicated on the conclusions of the study.

Chapter VI - includes overview, conclusions, nursing implications,

limitations and advice of the analysis.

The article ends with bibliography and appendices.

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