Competency of Nursing Students Power Point

Competency of Nursing Students in Practicing Safe and Quality

Care among patients in Female Medical Ward at Dr. Jose Rodriguez

Memorial Hospital

GROUP 1BSN 103-A

CHAPTER 1

THE PROBLEM AND ITS BACKGROUND

INTRODUCTION

Competence in Nursing practice is defined in a multitude of ways; its relationship to nursing practice is inherently understood by those within the nursing profession. Nurses are expected to be competent as they deliver care to patients in a safety manner.

INTRODUCTION

For the past 20 years, the National Council of State Boards Nursing ( NCSBN ) has asserted its focus on continued competence , although only within the past 11 years have formally defined competence as “the application of knowledge and the interpersonal, decision-making and psychomotor skills expected for the practice role, within the context of public health, safety and welfare” ( NCSBN, 1996 )

Theorists hold that understanding the process of clinical competency acquisition and applying its result is to be used to develop a profession, to modify job description and employment, and to promote effective education.

The researchers prompted to conduct the study to assess the competency of nursing students in practicing safe and quality nursing care.

INTRODUCTION

INTRODUCTION

Moreover, the researchers want to identify if the nursing students is able to demonstrates knowledge based on the health/illness status of individual/groups, provides sounds decision making in the care of individual/groups considering their believes and values, promotes safety and comfort and patients, sets priorities in nursing care based on patients’

INTRODUCTION

needs, ensures continuity of care, administers medications and other health therapeutics, formulates a plan of care in collaboration with patients and other members of the health team, implements nursing care plan to achieve identified outcomes, evaluates progress toward expected outcomes, and responds to the urgency of patient condition.

INTRODUCTION

The evolution of progressive care nursing and practice has paralleled historical changes and demands for additional environments in which high-acuity, overflow critical care patients and patients requiring specialized surveillance could be safety cared for.

INTRODUCTION

Such areas have a variety of names including Operating Room, Intensive Care Unit, Delivery Room, Emergency Room, Out-Patient Department, Philhealth Ward, Female Medical Ward, and Male Medical Ward. The formation of these new patient care units created new challenges in the development of standards of practice, guidelines for care, and admission and discharge criteria.

INTRODUCTION

Since nursing is a unique healthcare profession that is composed of a unique body of knowledge, standard clinical practices, and healthy attitude towards caring, it is important to appreciate the importance of these attributes in understanding the many concepts related to the nursing profession.

INTRODUCTION

One should understand that the things nurses perform on, to, and for their patients are anchored on well-established facts and principles. It means that, in order for nurses to fully functional well, they should be well-equipped with all the knowledge with which they can rationalize their nursing actions in the clinical area.

INTRODUCTION

Knowledge is the anchor of our actions. Meaning, our actions are actually dictated by what we know. And eventually, help us to develop a more reassuring attitude towards our own competencies. It means that if we are knowledgeable about something, we tend to become proficient or skillful in its practical application.

BACKGROUND OF THE STUDY

Every member of the society would agree that all health care providers in practice should be competent. Although the idea of competence has always been with us, the publication of the Pew Health Profession Commission (1998) report “Strengthening Consumer Protection: Priorities for Health Care Workforce Regulation” created impetus for a wider discussion of what it means to be competent.


That report identified that the current system was not adequate to keep up with many changes taking the place in health care. They were particularly critical lack of many mechanisms to assure that health care professionals continued to be competent throughout their professional lives.


Some of the most important aspects of the competence in nursing are those identified in the NCSBN definition: interpersonal relationships, decision making, technical or psychomotor skills. Interpersonal Competence refers to having the ability to relate effectively with coworkers, client, family members, and members of the community. The nurse must communicate effectively with the client and family.


Technical Competence refers to the ability to carry out psychomotor skills effectively, safety and efficiently. Competence in technical skills required for entry into practice is determined by requiring that schools of nursing be approved. Decision-making competence refers to the ability to use critical thinking in solving patient care problems. Critical thinkers are open minded which means that they are open to different viewpoints, alternative interpretations of information, and willing to listen to and consider others.


Norzagaray College was started as a General Education in June 2007. Being a students’ of the college we observed that in the past three years the institution focusing to develop new competent nurses in the future.

THEORETICAL FRAMEWORK

According to Benner, clinical nursing requires theoretical knowledge and practical knowledge. Theoretical knowledge can be acquired in an abstract fashion through reading; observing and discussing. On the other hand, the development of practical knowledge requires actual experience in a situation because it is contextual and transactional.


Benner stated that, “Knowledge development in a practice discipline consist of extending practical knowledge ‘know-how’ through theory-based scientific investigation and ‘know-how’ develop through clinical experience in practice in practice of that discipline.” Clinical embodies the notion of excellence by studying practice, nurses can uncover new knowledge.


Benner’s Dreyfus model of skill acquisition and skill developments are novice, advanced beginner, competent, proficient and expert.


Stage 1: Novice

Beginners have had no experience of the situational in which are expected to perform. Novices are taught rules to help them perform. The rules are context-free and independent of specific cases; hence the rules tend to be applied universally. The rule-governed behavior typical of the novice is extremely limited and inflexible. As such, novices have no “life experience” in the application of rules.


Stage 2: Advanced Beginner Advanced Beginner is those who can

demonstrate marginally acceptable performance, those who have coped with enough real situations to note, is to have pointed out to them by a mentor, the recurring meaning situational components. These components require prior experience in actual situations for recognition. Principles to guide actions begin to be formulated. The principles are based on experience.


Stage 3: Competent Competence, typified by the nurse who has

been on the job in the same or similar situations two or three years, develops when the nurse begins to see his or her actions in term of long-range goals or plans of which he or she is consciously aware. For the competent nurse, a plan establishes a perspective, a the plan is based on considerable conscious, abstract, analytic, contemplation of the problem, The Conscious, deliberate Planning that is characteristics of this skills levels help achieve efficiency and organization.


The competent nurse lacks speed and flexibility of the proficient nurse but dose have a feeling of mastery and the ability to cope with and manage the many contingencies of clinical nursing. The competent person dose not yet have enough experience to recognize a situation in terms of an over all picture or in terms of which aspects are most silent, most important.


Stage 4: Proficient The proficient performer perceives situations as

whole rather than in terms of chopped up parts or aspects, and performance is guided by maxims. Proficient nurses understand a situation as a whole because they perceive its meaning in terms of long term goals. The proficient nurse learns from experience what typical events to expect in a given situation and how plans need to be modified in response to these events.


The proficient nurse can now recognize when the expected normal picture dose not materialize. The holistic understanding improve the proficient nurse’s decision making; it becomes less labored because the nurse now has a perspective on which of the many existing attributes and aspects in the present situation are the important ones.


Stage 5: The Expert

The expert performer no longer relies on an analytic principle (rule, guideline, and maxim) to connect her or his understanding of the situation to an appropriate action. The expert nurse, with an enormous background of experience, now has an intuitive grasp of each situation and zeroes in the accurate region of the problem without wasteful consideration of a large range of unfruitful, alternative diagnosis and solutions. The expert operates from a deep understanding of the situation.

CONCEPTUAL FRAMEWORK

STATEMENT OF THE PROBLEM

The present study aims to assess the competency of nursing students in practicing safe and quality care in Male Medical Ward at Dr. Jose Rodriquez Memorial Hospital during their clinical duty.


1. Profile of the students in terms of:1.1 Age

1.2 Gender

1.3 Religion

1.4 Marital Status


2. How does competence as a student nurse relate in Practicing Safe and Quality Nursing Care:

2.1 Demonstrate knowledge based on health/illness status of individual/groups

2.2 Provides sound decision making in care of individual/group considering their beliefs,

values

2.3 Promotes patient safety and comfort


2.4 Priority setting in nursing care based on patients’ needs

2.5 Ensures continuity of care 2.6 Administers medications and other health

therapeutics 2.7 Utilizes nursing process as framework for

nursing. Performs comprehensive, systematic nursing assessment


2.8 Formulates care plan in collaboration with patients, other health team members

2.9 Implements NCP to achieve identified outcomes

2.10 Implements NCP progress toward expected

outcomes

2.11 Responds to urgency of patient’s condition


PURPOSE:

The present study will assess the competency of Nursing Students in Practicing Safe and Quality the Nursing Care. Specifically the following are the grand tour questions that were used to guide the researchers in their search for significant themes of the competency.


1. What does it meant to be a competent student nurse?

2. Does apply knowledge and skills required for practicing safe and quality nursing care?

3. Demonstrate responsibility and accountability for practice?

4. How competency can be determined?

5. Are the different aspects of competency?

SCOPE AND LIMITATION

This study aims to assess the competency of nursing students in practicing safe and quality nursing care. The researches have chosen Norzagaray College to be the source of the data because of the accessibility.

SIGNIFICANT OF THE STUDY

This study is designed to assess the competency of Nursing Student’s in Practicing Safe and Quality Nursing Care. It is very important on each student nurses to practice and maintain his or her own competencies in practicing safe and quality nursing care. It also plays an important role to all respondents to help them to become aware of what they are practicing and to know what will be the effects of this study to their competency.


The result of this study will be useful valuable to the following:

Student, this study will give knowledge and background about the importance of competency in their practice during exposure in the clinical setting.

Faculty, Educators would be given ideas on what is the current level of competency of Nursing Student regarding in practicing Safe and Quality Nursing Care. Educator must display the knowledge and skills required to enhance nursing student competency, which will optimize high standards of patient care.


Future Researcher, this study will provide additional information and new insight as well as on such topics in Student Nurse Competency, which hopefully, will be developed by future researchers to make it more responsive and updated to the needs of others with similar situation.

CHAPTER IIREVIEW OF RELATED LITERATURE

FOREIGN LITERATURE

According to Chitty and Black (2011), Benner, a nurse, was curious about how nurses made the transition from inexpert beginners to highly expert practitioners. She describes a process consisting of five stages of nursing practice, on which she base her 1984, from Novice to Expert. The stages Benner describe are novice, advance beginner, competent practitioner, proficient practitioner and expert practitioner.

FOREIGN LITERATURE

Advancing from stage to stage occurs gradually as nurse’s gain more experience in patient care. Clinical Judgment is stimulated when nurses preconceived notions and expectations collide with or confirmed by, the realities of every proactive.

FOREIGN LITERATURE

IOM defined quality as the “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.”

FOREIGN LITERATURE

Patient Safety was defined by the IOM as “the prevention of harm to patients.” Emphasis is placed on the system of care delivery that (1) prevents errors; (2) learns from the errors that do occur; and (3) is built on a culture of safety that involves health care professionals, organizations, and patients.

FOREIGN LITERATURE

According to the IOM, the essential elements of an effective safety culture include the commitment of leadership to safety and empowering and engaging all employees in ongoing vigilance through communication, nonhierarchical decisionmaking, constrained improvisation, training, and rewards and incentives.

FOREIGN LITERATURE

A quality health care system provides good health to the public in forms that are delivered in the most convenient on “client friendly”, cost-efficient and most effective system possible (Hutcherson and Williamson, 1990). The nursing education, therefore, need to address those expectations in the light of changing environment. Today’s population is so diverse in terms of the nature and the prevalence of illness and diseases requiring changes in nursing practice from purity clinical.

FOREIGN STUDIES

Programs experiences focus ethnographic approach capable of providing safe and competent care in uncertain, rapidly changing and complex situations Nurses should be able to manage the extensive workload of patient care. Make effective clinical judgments and decisions relevant to patient care has minimum entry requirement, there is increasing trend among the Nurse leaders of developing countries to endurance the entry level of Nursing Skills (Journal of Professional Nursing vol 24 #4 2009).

FOREIGN STUDIES

A joint position statement by the Canadian Association of Schools of Nursing and the Canadian Nurses Association (2004) stated that “educational institution and nurse educators have the responsibility to prepare new graduates with the competencies necessary to provide safe, competent and ethical nursing care”. Therefore, excellence in nursing education is and will continue to be central in excellence in nursing practice and optimal patient care in the years to come (Journal of Professional Nursing vol.25 #5 2009).

LOCAL LITERATURE

The review of literature on the competencies of a dean by the UPM-CN (2005), reveals that in the Philippines where the nursing school has become a demand driven enterprise, the changing environment puts constant\pressures on the education management to adopt, innovate or perish. For one, this requires continuous learning and redesigning of education program to meet contemporary nursing practice in the interest of public good and global competition.

LOCAL LITERATURE

In response to global need for developing and maintaining the quality of Nursing Education in the Philippines the University of the Philippines Manila College of Nursing serving as a World Health Organization Collaborating Center for Leadership and Nursing Development entered into a collaborative partnership with the Association of Deans of Philippines Colleges of Nursing in order to develop, implement and evaluate training program as sustainable initiative to maintain the quality of nursing education in the country while strengthening the individual capabilities of the deans for leadership role ( WHOCC-UP-ADPCN, 2006 ).

LOCAL LITERATURE

AACN – (Association of Critical-Core Nurses) has endorsed the first standard of skilled communication as the foremost skill a team must possess in order to work effectively. These standards suggest, “Nurses must be as proficient in communication skills as they are in clinical skills.

LOCAL STUDY

Infante (2005) stated that, the amount of time the nursing students should spend in the Clinical Laboratory has been the subject much debate among nurse educators. He proposed that when instructors schedule a certain amount of time for clinical learning activities, it will be insufficient for some students and unnecessary long for others to acquire a particular skill. The length of time spent clinical activities is not a guarantee of clinical expertise.

CHAPTER IIIRESEARCH METHODOLOGY

This chapter of the study shows the method and procedures that were utilized during the research. In this chapter includes research design, locale and population, research instrument, data gathering procedure and statistical treatment of the data.

Research design

The researchers utilized the quantitative research in the systematic investigation to develop and incorporate theories and hypothesis pertaining to the effectiveness of Related Learning Experience in the clinical setting.

Locale and Population

The research was conducted at Norzagaray College situated at the municipal compound of the town, province of Bulacan. The subject in this study was thirty-one (31) nursing students. They, the researcher used the Clinical Instructor of the fourth year nursing students to evaluate the student’s clinical performance. The total number of fourth year students of Norzagaray College in Norzagaray, Bulacan is thirty-one (31). The target population was one hundred percent (100%) composed of (31) nursing students.

Research Instrument

Questionnaire using 4 point likert scale was utilized to the facilitation data gathering. It was used in both sex of participants and offered in English form that is understandable by the respondents. The 25 items questionnaire is consists of four categorized parts. The first part includes the profile of the respondents.

Research Instrument

Second part consists of questions about the knowledge acquired of the respondents in clinical setting. The third part includes questions regards with the skills familiarized by the respondents in clinical area. The last part consists of questions about the developed attitude in clinical area of the respondents.

Research Instrument

The questions about were reviewed for correctness of grammar, choice of word and relevance of each question to variables. The instrument was pilot tested in STI, Poblacion, Sta.Maria, Bulacan to 20 participants to measure the validity of the questionnaire.

The respondents of the study were thirty one (31) fourth year nursing students.

Research Instrument

The Likert scale is used to asses’ concurrent exposure of fourth year nursing students to Related Learning Experience: Catalyst to Care Planning.

4 Strongly agree3 Agree 2 Disagree1 Strongly disagree

Data Gathering Procedure

The following steps will\be followed by he researcher in order to collect data.

That researchers gave a letter of permission to the President of Norzagaray College,Dr. Ermelito V. Dela Merced, and also to the Dean of Nursing Mrs.Myrna Nueva España,RN,MAN to conduct a survey to the fourth year BSN student of Norzagaray College. The researcher designed the questioner were reviewed for the correctness of grammar. Choices of the word sought to modify the questioners.


The pilot study was also conducted prior to implementation of the study. It was conducted with thirty one (31) fourth year BSN students of Norzagaray College to be able to discern the effectiveness of the questionnaire that was utilized through the evaluation of their Clinical Instructors.

After the approval of the pilot testing, the researchers personally distributed the questionnaire to the fourth year BSN students of Norzagaray College.


A cover letter was provided on the questionnaire for guidance and instruction in precise accomplishment of the tool. In order to provide anonymity of the respondents, the researchers explained to them that the indication of name was optional. Researchers also rest assured that the confidentiality of the results is observed all throughout the study.


The results were tabulated and collated according to the frequency of the conducted data was ready for interpretation and statistical treatment. Data was presented including the analysis and interpretation of the results.

STATISTICAL TREATMENT OF DATA

The data collected in this study were organized and classified based from the research and design and the problems formulated. They were coded, tallied add tabulated to facilitate the presentation and interpretation of results using the following:


1. Frequency and Percentage

The percentage and frequency distribution were use to classify the respondents according to personal background variables such as age, gender and religion. The frequency also presented `the actual response of the respondent to the specific question or item in the questionnaire. On the other hand the percentage of that item is computed by dividing it with the sample total number of respondent who participated in the survey. The formula use in application of this technique is:


%=( f/n) x 100

Where % = Percentage

f= frequency

n= number of cases total


2. Ranking

This is a descriptive measure to describe numerical data in addition to percentage ranking was used in the study of comparative purpose and for sharing the importance of item analyzed.


3. Weighted Mean

Another statistical technique use by the researchers was the weighted mean. It was used to determine the average responses of different option provided in the various part of the survey questionnaire use. The method is used in conjunction with the Likert Scale. It was solved by the formula:


x = S fx / n

Where x = weighted mean

S fx = the sum of the products of f and x, f being the frequency of each weight and x as the

weight of each operation.

n = total no. of respondents.


4. T-test

For this study, the researchers utilized T-test to determine if there is significant relationship between the two means. To test the hypotheses, the following formula was utilized:


= mean of group 1 = mean of group 2 = sum of group 1 squares deviation scores

= sum of group 2 squares deviation scores= number of subjects in group 1

= number of subjects in group 2


This formula was used in determining the significant relationship between the respondent’s perception in concurrent exposure and catalyst role in care planning. In getting the mean of the responses of the control and experimental group, the formula:


Where:S = the sum ofx = each individual raw scoren = the number of cases/ population


5. Pearson r

It was used to determine the significant differences in the respondents’ perception to concurrent exposure and catalyst to care planning when grouped according to profile.

Thus, the formula used for computing the Pearson r values is presents below:


Formula:

Where:n = to number of casesSxy = sum of the products of x and ySx = sum of xSy = sum of ySx2 = sum of the squares of xSy2 = sum of the squares of y


A. Hypotheses

Ha = there is no significant variation between the obtained or actual and expected

frequencies.

Ho = there is significant variation between the obtained or actual and

expected frequencies.


B. Decision RuleReject Ho if computed x2 > x2. .05; where x2 .5

is = critical value with df.

Liker Scale. The Likert scale method of summated rating was use in the study. The Likert scaling technique assigns one scale value of each of the different responses. To analyze responses to a Likert scale, each category is assign to a numerical value such as, Strongly Agree is = to $ and Strongly Disagree is = to 1.


The total assigned value will be determined by using the weighted mean. The scoring system for each item must be such a high score consistently reflects a favourable response and a low score consistently reflects an unfavourable response.

The consolidated points from the respondent’s answers to each item over a four-point scale where follows:


WEIGHTED MEAN SCALE VERBAL INTEPRETATION

3.51 – 4.0 4 strongly agree

2.51 – 3.0 3 Agree

1.51 – 2.0 2 Disagree

1.0 – 1.5 1 strongly disagree

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Competency of Nursing Students Power Point

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