Professional Documents
Culture Documents
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 )
INTRODUCTION
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
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, OutPatient 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 wellequipped 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.
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.
THEORETICAL FRAMEWORK
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.
THEORETICAL FRAMEWORK
Benners Dreyfus model of skill acquisition and skill developments are novice, advanced beginner, competent, proficient and expert.
THEORETICAL FRAMEWORK
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.
THEORETICAL FRAMEWORK
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.
THEORETICAL FRAMEWORK
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.
THEORETICAL FRAMEWORK
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.
THEORETICAL FRAMEWORK
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.
THEORETICAL FRAMEWORK
The proficient nurse can now recognize when the expected normal picture dose not materialize. The holistic understanding improve the proficient nurses 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.
THEORETICAL FRAMEWORK
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
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What does it meant to be a competent student nurse? Does apply knowledge and skills required for practicing safe and quality nursing care? Demonstrate responsibility and accountability for practice? How competency can be determined? Are the different aspects of competency?
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 nurses 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. Todays 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.
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.
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 3 2 1 Strongly agree Agree Disagree Strongly disagree
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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 Espaa,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.
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.
Where % = Percentage
f= frequency n= number of cases total
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.
For this study, the researchers utilized Ttest 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
Where: S = the sum of x = each individual raw score n = the number of cases/ population
Where: n = to number of cases Sxy = sum of the products of x and y Sx = sum of x Sy = sum of y Sx2 = sum of the squares of x Sy2 = sum of the squares of y
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.