Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Sanjay Gandhi institute of trauma and orthopedics,
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Dr. Mamta Gupta,
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An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

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Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
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In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
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Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Important Notice

Original article / research
Year : 2011 | Month : December | Volume : 5 | Issue : 8 | Page : 1585 - 1588

Knowledge of Nurses Towards Cardiopulmonary Resuscitation in a Tertiary Care Teaching Hospital in Nepal

Sita Parajulee, Valarmathi Selvaraj

1. MSc (Nursing), Nursing program, College of Medical Sciences, Bharatpur, Nepal 2. MSc (Nursing), MSc (Psy) Nursing program, College of Medical Sciences, Bharatpur, Nepal PLACE OF STUDY: 1. College of Medical Sciences, Bharatpur, Nepal 2. College of Medical Sciences, Bharatpur, Nepal

Correspondence Address :
Valarmathi Selvaraj MSc (Nursing), MSc (Psy)
Lecturer, Nursing program
College of Medical Sciences
Bharatpur, Nepal.
Phone: 00977-9816265311


Background: Nurses are knowledgeable in handling patients with life threatening conditions and hence are expected to be knowledgeable in performing cardio-pulmonary resuscitation (CPR) techniques.

Aims: To assess the knowledge of nurses towards CPR and to study the association between the nurses knowledge scores and selected demographic variables.

Settings and Design: A questionnaire-based, cross sectional study was performed at the College of Medical Sciences-Teaching Hospital, Bharatpur, Nepal, among the nurses who were working in the hospital during October, 2010.

Methods and Materials: A self-developed questionnaire containing 21 questions was distributed to the nurses and the filled questionnaires were analyzed as per the study objectives. A correct response was given a score of ‘1’ and the wrong responses were given a score of ‘0’.

Statistical Analysis Used: Descriptive statistics was used to calculate the mean and the standard deviation and the Kurskal- Wallis test was used to compare the mean scores of the respondents with their demographic variables.

Results: Among the total 175 nurses, 70 of them responded with a response rate of 40%. The mean ± SD age of the respondents was 22.07 ± 2.30 years and their mean ± SD duration of experience was 11.45 ± 2.67 months. The worksites of the respondents varied and there were more than 15 different sites. A relatively high number (n = 8; 11.43%) of the respondents were from the Department of Medicine. The mean± SD of the overall total knowledge scores was 11.45 ± 2.67 (the maximum possible score was 21). There was no significant association between the total scores and age (p = 0.823) and the duration of experience (p = 0.239). However, there was an association between the worksites and the total scores (p = 0.013).

Conclusions: In general, the knowledge of the nurses was found to be low, thus suggesting a need for educational interventions.


Cardio-pulmonary resuscitation, Knowledge, Nurses, Nepal

Nurses are an integral part of the healthcare system and are perceived to be knowledgeable in providing institutional care to the patients. Cardio-pulmonary Resuscitation (CPR) is an important medical procedure which is needed for individuals who face sudden cardiac arrest. It is a combination of rescue breathing and chest compressions which is delivered to the victims who are thought to be in cardiac arrest (1). Being important members of the healthcare team, nurses are deemed to possess the basic skills and expertise which are needed to perform CPR. It is documented that a timely performed CPR can largely prevent sudden death (2). and it is hence considered to be an important medical procedure. Many times, the doctor may not be present near the patient and hence the nurses are expected to provide this emergency care. To perform the procedure in a meticulous manner, the nurses should be knowledgeable and they should have expertise in the procedure. Contrary to their roles, studies from different countries have reported a poor knowledge among the nurses regarding CPR (3),(4),(5),(6). A study also reported that interventions can improve the nurses knowledge on CPR (7).

In Nepal, the basic nursing programs, the Diploma and Bachelor programs in Nursing lay adequate emphasis on the CPR tech-niques (8),(9). However, the retention of this knowledge among the nurses at the practitioner stage can be doubtful. The understanding of this knowledge by the nurses can help in planning for proper training and continuous nursing programs (CNE) for the practicing nurses.

The data regarding the nurses knowledge on CPR are lacking in Nepal. During literature review, we could not locate any studies which were related to this topic, carried out in Nepal. Hence, the present study was carried out.

The present study had the following objectives: 1. To assess the knowledge of nurses towards cardiopulmonary resuscitation 2. To study the association between the knowledge scores of the nurses and their selected demographic variables

Material and Methods

Study design: A cross sectional study which evaluated the knowledge of the nurses regarding CPR.

Study site: College of Medical Sciences-Teaching Hospital (CMS-TH), a 900 bedded tertiary care teaching hospital with various specialty and super specialty departments.

Study subjects: The subjects were the nurses who were working in various departments. They either had a Diploma or a Bachelor’s degree in Nursing.

Inclusion and exclusion criteria: All the nurses who were on duty during the study period were enrolled. The ones on leave were excluded from the study.

Study tools: A self designed questionnaire was used in the study. The questionnaire had 21 questions. This questionnaire was developed by the researchers in consultation with an expert in pharmacoepidemiology. The face and content validity was carried out through discussion among the researchers and the experts.

Method of data collection: The researchers personally went to the workstation of the study subjects and got the questionnaire filled by the nurses. Adequate time (nearly 30 minutes) was given to each respondent for filling the questionnaire.

Data analysis: The filled questionnaires were collected, the data were entered in a Microsoft Excel spreadsheet and they were analyzed as per the study objectives. The correct answers were given a score of ‘1’ and wrong answers were given a score of ‘0’, thus making the total possible score as ‘21’.

Statistical analysis: The SPSS version 16 was used to carry out the statistical analysis. The mean and standard deviation were calculated for the demographic variables and the Kruskal Wallis test was used to compare the mean scores with the respondents demographic variables.


Demographic details of the respondents: Among the total 175 nurses, 70 of them filled the questionnaire (response rate of 40%) and all of them were females. A high percentage (84.29%; n=59) of them belonged to the age group of 20-25 years and the mean ± SD age of the respondents was 22.07 ± 2.30 years. The duration of experience of the respondents varied and the mean ± SD duration of experience was 11.45 ± 2.67 months. Further details regarding the demography of the respondents are mentioned in (Table/Fig 1).

Comparison of the respondents total scores with demography: The mean ± SD of the overall total scores was 11.45 ± 2.67. There was no association between the knowledge scores of the respondents and ‘age’ (p=0.823) and ‘duration of experience’ (p=0.239). However, there was a statistically significant association between the knowledge scores and the ‘worksites’ of the respondents (p=0.013). The details regarding the comparison of the respondents’ total scores with demography are listed in (Table/Fig 2).

Responses of the nurses to individual statements: A high percentage (94.29%; n=66) of the respondents knew the components of ‘ABC’ as ‘airway, circulation and breathing’. However, only 31.34% (n=22) of the respondents knew the CPR ratio of the infants. The detailed responses of the nurses to the individual questions are listed in (Table/Fig 3).


Nurses are important members of the healthcare team. They play a vital role in the institutional care of the patients, including the ones who undergo emergency and intensive care. The patients at the emergency and intensive care units are likely to develop a cardiac arrest that can occur even in a normal individual who does not even have a cardiac problem. The present study evaluated the knowledge of nurses towards CPR (a technique that needs to be mastered by any nurse) in a Nepalese tertiary care teaching hospital. In general, the knowledge was found to be low, as was suggested by a mean ± SD total score of 11.45 ± 2.67; the maximum possible total score being 21. The findings showed a low percentage of knowledge among the respondents.

Many times, nurses take care of the patients when the doctor is not present in the ward and also in the community settings, the nurses have to play a major role in the emergency handling of the patients. Thus, CPR becomes a fundamental requirement of any nurse.

In general, the knowledge scores of the nurses were found to be low. Only very few nurses could answer the questions like the ‘CPR ratio of an adult’, the ‘CPR ratio of an infant’ , etc. Our findings were similar to the findings from few other countries as well. A study from Bahrain had documented a poor knowledge among the nurses regarding CPR. It was also found that the ones with less qualification and experience had poor knowledge (3). However, in our study, we could not compare the knowledge scores with theeducational qualifications of the respondents. Another study from Kuwait evaluated the nurses knowledge, attitude and experience regarding CPR (4). This study also documented a poor knowledge among nurses regarding CPR. In addition, this study also pointed out an association between the years of experience and knowledge (4). In our study, there was no association between the duration of experience and the knowledge scores. These suggest the absence of in-service education that might have helped in improving the knowledge of the Bahraini and Kuwait nurses unlike the Nepalese ones. In general, an in-service education for the nurses may be helpful in improving their knowledge towards the basic requirements and skills that are needed for handling specialized techniques. Another study from the Hainan province of China evaluated the community nurses knowledge on CPR and found them lacking in the essential knowledge. The authors also found the nurses from the rural areas to possess a still lower knowledge (5). However, our study was conducted only in a single hospital and hence cannot be compared with the findings of this study.

The present study had a few limitations. Only 40% of the nurses who were working in the hospital were included, thus giving it a low response rate.


The present study identified the nurses to have poor knowledge regarding the CPR techniques and it suggests the need for regular CNE programs. There was an association between the knowledge scores and the ‘worksites’ of the nurses. Although this study had few limitations, it is the first study to evaluate such an initiative in Nepal. The results of this study need to be discussed with the nursing educators and appropriate training in the vital areas has to be instituted for the practicing nurses.


Cardiopulmonary resuscitation. American Heart Association. Available at
Madden C. Undergraduate nursing students acquisition and retention of CPR knowledge and skills. Nurse Educ Today 2006; 26:218-27.
Marzooq H, Lyneham J. Cardio-pulmonary resuscitation knowledge among nurses who work in Bahrain. Int J Nurs Pract 2009; 15 (4): 294-302.
Al Kandary S, Al Jeheildi A, Ghayath T, Al Haid N. Perceived competence in cardio-pulmonary resuscitation, knowledge and practice among qualified nurses in Kuwait. Bull Alex Fac Med 2007; 43:2 .
Xiu zhen C, Rui lian Z, Yan mei F, Tao W. Survey of the knowledge of cardio-pulmonary resuscitation in the nurses of community-based health services in the Hainan province. Al Ameen J Med Sci 2008; 1:93 -8.
Hamilton R. Nurses knowledge and skill retention following cardiopulmonary resuscitation training: a review of the literature. Journal of Advanced Nursing 2005; 51: 288-97.
Baksha F. Assessing the need and the effect of updating the knowledge about cardio-pulmonary resuscitation in experts. Journal of Clinical and Diagnostic Research 2010; 4:2512-14.
Certificate in Nursing curriculum. Institute of Medicine, Tribhuvan University, Kathmandu, Nepal. Revised in 2007.
Curriculum of BSc nursing. Kathmandu University, School of Medical Sciences, 2008.

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