Knowledge And Practice Of Quality Assurance Among Nurses Working In Accident And Emergency Unit Of Modibbo Adama University Teaching Hospital Yola

Project and Seminar Material for Nursing (Science)

Abstract

This study was carried out on the knowledge and practice of quality assurance among nurses working in accident and emergency unit of Modibbo Adama University Teaching Hospital Yola. The survey design was adopted and the simple random sampling techniques were employed in this study. The population size comprise of nurses in Modibbo Adama University Teaching Hospital Yola. In determining the sample size, the researcher conveniently selected 70 respondents and all were validated. Self-constructed and validated questionnaire was used for data collection. The collected and validated questionnaires were analyzed using frequency tables. While the hypotheses were tested using Chi-square statistical tool. The result of the findings reveals that the nurses in the emergency room have adequate knowledge of quality assurance. The study also revealed that the practice of quality assurance among nurses working in Emergency unit include; the use of nursing process, nursing audit, self evaluation, documentation. Further findings showed that the level of awareness of quality assurance among nurses working in Emergency unit in on the average level. Therefore, it is recommended that basic knowledge of emergency preparedness should be obtained by all new and existing staff members of the hospitals, especially those involved in the management of emergencies. To mention but a few.

Table of Content

Chapter One:

Introduction

1.1 Background of the Study
1.2 Statement of the Problem
1.3 Objective of the Study
1.4 Research Questions
1.5 Research Hypothesis
1.6 Significance of the Study
1.7 Scope of the Study
1.8 Limitation of the Study
1.9 Definition of Terms
1.10 Organization of the Study

Chapter Two:

Review of Literature

2.1 Conceptual Framework
2.2 Theoretical Framework
2.3 Empirical Review

Chapter Three:

Research Methodology

3.1 Research Design
3.2 Population of the Study
3.3 Sample Size Determination
3.4 Sample Size Selection Technique and Procedure
3.5 Research Instrument and Administration
3.6 Method of Data Collection
3.7 Method of Data Analysis
3.8 Validity of the Study
3.9 Reliability of the Study
3.10 Ethical Consideration

Chapter Four:

Data Presentation and Analysis

4.1 Data Presentation
4.2 Analysis of Data
4.3 Answering Research Questions
4.4 Test of Hypotheses

Chapter Five:

Summary, Conclusion and Recommendation

5.1 Summary
5.2 Conclusion
5.3 Recommendation
References
APPENDIX
QUESTIONNAIRE

Chapter One

Introduction

1.1 Background of the Study

Nursing as a profession is vested with the knowledge and responsibility of providing holistic and quality care at every level of service delivery. The major challenge of nurses is to ensure that quality nursing care is provided to all patients. Quality nursing care is the established target of nursing intervention and actions to ensure that each patient receives the agree level of care. According to Cronenwett, Sherwood, Bamsteiner, Disch, Johnson, Mitchell, Taylor, Sullivan & Warren (2007) states that, the nurse as chief architect of patient care, sets the tone for the practice environment. This implies that health providers seek workplaces that embrace quality and places were good work is recognized.

Ensuring quality nursing care is a challenge because of limited financial resources, inadequate number of nurses and the fast growing population as well as increased attendance in hospitals especially in teaching hospital Calabar, Inadequate supply of drugs, poor leadership and control on the part of the nurses, lack of equipment and materials to use, and filthy environment, all these leads to low quality nursing care. The knowledge and practice of quality nursing care cannot be over emphasized. It is the right of the patients of health services to demand the best of knowledge of quality nursing care from nurses. Quality was defined by the institute of medicine as the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge (Lohr &Schroeder 1990).

It is widely recognized that nursing care is very important so that any slight mistake from nurses while rendering treatment and care may result in death of the patients. This is why the management of Modibbo Adama University Teaching Hospital Yola(UCTH) are so worried concerning the type of quality care that is render to our patients now took it upon themselves to always remind nurses of their obligations through continuing education, workshops, seminars, and conferences.

Inspite of that, the situation still remain the same, observation has shown that, the nurse is expected to provide preventive, promotives, curative and rehabilitative care to individual and their families or groups within the community, thereby enhancing quality nursing care which is not found always among most nurses in Modibbo Adama University Teaching Hospital Yola.

The depth and the extent of this problem shows that quack nurses will take over the profession as nurses do not know that they are the builders of clinical settings. On every report of dissatisfaction as low as 5% should be taken seriously as that will improve upon the nurses’ knowledge concerning what the patients want and the negative outcome will be seen by the patients.

The fact remains that knowledge practice and outcomes is one of the most important findings that nurses will need to know about from their individual patients. This is because in today’s competitive environment with high production and service standards, patients expect nurses to perform at a satisfactory level as group of people who have the knowledge and care to practice well with a positive outcome in order to facilitate the quality of nursing care among nurses. Besides, nurses should be encouraged on self-development so that they can continue to be clients advocate.

This is why the researchers are interested to investigate on knowledge practice and outcome of quality nursing care among nurses in Modibbo Adama University Teaching Hospital Yola.

1.2 Statement of the Problem

Knowledge is a subjective measure of quality nursing care, and is often criticized by patients because a patient hospitalized for surgery may receive excellent health care with good outcome but may be dissatisfied with the interpersonal care received from nurse as well as the food and facilities provided. Therefore knowledge with nursing care however is increasing recognized as an important dimension of quality nursing care.

Besides, many factors have prevented nurses from carrying out quality nursing care such as poor working environment, inadequate drug supply, nurses’ shortage, high increase attendance of patients in the hospital with few nurses, poor leadership and control on the part of nurses, lack of equipment and material to use and poor sanitation of the environment all this, lead to low quality nursing care and the need for the study on knowledge practice and outcome of quality nursing care among nurses in Modibbo Adama University Teaching Hospital Yola.

1.3 Objectives of the Study

The main aim of this study is to examine the knowledge and practice of quality assurance among nurses working in accident and emergency unit of Modibbo Adama University Teaching Hospital Yola. Other aims of this study are:

To determine whether nurses have adequate knowledge of quality assurance in the Emergency unit.
To ascertain the practice of quality assurance among nurses working in Emergency unit.
To determine the level of awareness of quality assurance among nurses working in Emergency unit.
To investigate the factors affecting the implementation of quality assurance among nurses in the Emergency unit.

1.4 Research Questions

This study will answer the following research questions:

Does the nurses have adequate knowledge of quality assurance in the Emergency unit. (Yes, No, Undecided)
What are the practice of quality assurance among nurses working in Emergency unit? (the use of nursing process, nursing audit, self evaluation, documentation).
What is the level of awareness of quality assurance among nurses working in Emergency unit? (High, Average, Low)
What are the factors affecting the implementation of quality assurance among nurses in the Emergency unit? lack of instruments, poor human resources, poor supervision, lack of training.

1.5 Research Hypotheses

The following null hypotheses will validate this study:

H01: Nurses are not knowledgeable on the quality of nursing care in Modibbo Adama University Teaching Hospital Yola.

H02: Nursing care rendered to patients in Modibbo Adama University Teaching Hospital Yola is not quality.

1.6 Significance of the Study

The study might be of benefit to the following nurses’ patients and researchers.

Nurses:

It may help health workers to appreciate where the problem is related to low quality nursing services or care.

Patients:

Patients might be assure that health workers found in the hospital are able to render quality nursing care.

Researchers:

It will reveal gaps in the knowledge practice and outcome of quality nursing care among nurses in the hospital.

1.7 Scope of the Study

This study focuses on the knowledge and practice of quality assurance among nurses working in accident and emergency unit of Modibbo Adama University Teaching Hospital Yola. The study borders on nurses knowledge of quality assurance in the Emergency unit, the practice of quality assurance among nurses working in Emergency unit, the level of awareness of quality assurance among nurses working in Emergency unit, and the factors affecting the implementation of quality assurance among nurses in the Emergency unit. The respondents for this study will be obtained from nurses in the accident and emergency unit of Modibbo Adama University Teaching Hospital Yola.

1.8 Limitations of the Study

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. However, the researcher were able to manage these just to ensure the success of this study.

Moreover, the case study method utilized in the study posed some challenges to the investigator including the possibility of biases and poor judgment of issues. However, the investigator relied on respect for the general principles of procedures, justice, fairness, objectivity in observation and recording, and weighing of evidence to overcome the challenges.

1.9 Definition of Terms

Knowledge:

Facts, awareness, familiarity, information and skills acquired through experience or education, the theoretical or practical understanding of a subject.

Practice:

The actual application or sue of an idea, belief or method as opposed to theories relating to it or the customary, habitual or expected procedure or way of doing of something.

Nurses:

A Nurse is an individual who has a specialized training and skill in the care of patients either within a hospital selling or without.

Quality Assurance:

The maintenance of a desired level of quality in a service or product, especially by means of attention to every stage of the process of delivery or production.

1.10 Organization of the Study

The study is categorized into five chapters. The first chapter presents the background of the study, statement of the problem, objective of the study, research questions and hypothesis, the significance of the study, scope/limitations of the study, and definition of terms. The chapter two covers the review of literature with emphasis on conceptual framework, theoretical framework, and empirical review. Likewise, the chapter three which is the research methodology, specifically covers the research design, population of the study, sample size determination, sample size, and selection technique and procedure, research instrument and administration, method of data collection, method of data analysis, validity and reliability of the study, and ethical consideration. The second to last chapter being the chapter four presents the data presentation and analysis, while the last chapter(chapter five) contains the summary, conclusion and recommendation.

Chapter Five

Summary, Conclusions and Recommendations:

5.1 Introduction

This chapter summarizes the findings on the knowledge and practice of quality assurance among nurses working in accident and emergency unit of Modibbo Adama University Teaching Hospital Yola. The chapter consists of summary of the study, conclusions, and recommendations.

5.2 Summary of the Study

In this study, our focus was on the knowledge and practice of quality assurance among nurses working in accident and emergency unit of Modibbo Adama University Teaching Hospital Yola. The study is was specifically set to determine whether nurses have adequate knowledge of quality assurance in the Emergency unit, ascertain the practice of quality assurance among nurses working in Emergency unit, determine the level of awareness of quality assurance among nurses working in Emergency unit, and investigate the factors affecting the implementation of quality assurance among nurses in the Emergency unit.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 70 responses were validated from the enrolled participants, where all respondent are nurses in Modibbo Adama University Teaching Hospital Yola.

5.3 Conclusions

Based on the findings of this study, the researcher made the following conclusion.

The nurses in the emergency room have adequate knowledge of quality assurance.
The practice of quality assurance among nurses working in Emergency unit include; the use of nursing process, nursing audit, self evaluation, documentation.
The level of awareness of quality assurance among nurses working in Emergency unit in on the average level.
The factors affecting the implementation of quality assurance among nurses in the Emergency unit include; lack of instruments, poor human resources, poor supervision, and lack of training.

5.4 Recommendations

Based on the findings of the study, the following recommendations are proffered.

Basic knowledge of emergency preparedness should be obtained by all new and existing staff members of the hospitals, especially those involved in the management of emergencies.
Emergency plans and drills should be made and held on a regular basis, hence instilling emergency preparedness. This being done, the hospital is adequately prepared should an emergency upsurge.
There should be high level of commitment to providing best quality care to the patient by the nurses.
The hospital management should be committed to training all nurses on the concept.
The government should set up professional standard of care in all health care facilities.

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