Perception and Participation in Clinical Practice Among Student Nurses in UCTH Calabar
CHAPTER ONE
Aim and objectives of the Study
The aim of the study is to find out the perception and participation in clinical practice among student nurses in UCTH. Specific Objectives
The following objectives were made to achieve the aim of the study;
- To assess the level of knowledge of clinical practice in the care of patient by the nurses at UCTH.
- To determine the barriers to the successful utilization of clinical practice in UCTH.
- To find out if clinical practice can be effectively utilized as a tool for providing holistic, scientifically based care for patients.
CHAPTER TWO
LITERATURE REVIEW
Introduction
This study is carried out on utilization of clinical practice in the promotion of health among student nurses in University of Calabar Teaching Hospital (UCTH). This chapter gives a review of related literature to the study. This chapter is treated under conceptual review, theoretical review and empirical review.
Conceptual Review
Conceptual Analysis of Clinical practice
The term clinical practice seems to be a new one and at first glance, it may be assumed to mean the same as research-based practice but there is a difference. The major difference between the two practices is the type and quality of research evidence use in the clinical decision-making process. Described intuition as a hallmark of expert nursing practice. This means that the nurse may not have scientific explanation from her clinical decision and may not know more than she can tell, but her clinical practice is of expert standard. In present day nursing, the clamor for scientifically based nursing practice necessitates a paradigm shift from practice based on intuition and tradition to practices that can be scientifically verified. But a quite large number of professional nurses are yet to develop research mindedness and appreciate the importance of research findings in nursing practice. Despite the length of time that research has featured in nursing and the bodies involved, only a few proportions of nurses use research as basis for practice according to Jones (2015).
Clinical nursing practice is a type of clinical health care, drawing on some of the traditions of clinical medicine. It involves identifying solid research findings and implementing them in nursing practices, in order to increase the quality of patient care. The goal of Clinical nursing practice is to provide the highest quality and most cost efficient nursing care possible.
Clinical nursing practice is a process founded on the collection interpretation and integration of valid, important and applicable research (Lobiondo and Haber, 2016).
In order to practice Clinical nursing practice, practitioners must understand the concept of research and know how to accurately evaluate this research. These skills are taught in modern nursing education and also as part of professional training. Restas (2014) opined that for nursing profession to advance, the use of clinical practice (CP) knowledge and skills in this area must be enhanced, and misconception about how to implement practice based on scientific evidence must be corrected. Achieving this expectation requires strategies that simultaneously educate, stimulate and support all nursing staff in identifying Clinical nursing practice questions and searching for Clinical nursing practice intervention to address that question.
CHAPTER THREE
RESEARCH METHODOLOGY
Research design
The study employed a quantitative descriptive survey design, using a semi-structured questionnaire for nurses in University of Calabar Teaching Hospital UCTH. Descriptive research involves gathering data that talks about events and then organizes, tabulates, depicts and describes the data collection (Glass & Hopkins, 1984). Quantitative descriptive design is a formal, objective, logical process for obtaining quantifiable information about the world, presented in numerical form and analyzed through the use of statistics that is used to describe the test relationship (Polit&Hungler, 2019).
Setting
The setting for this study is University of Calabar Teaching Hospital. University of Calabar Teaching Hospital has a working capacity of 400 staff comprising of Doctors, Nurse-midwives, Physiotherapists, Radiologist and non-medical staff. The hospital is made up of sub-units such as medical wards, surgical wards, pediatrics unit outpatient department, accident and emergency (casualty), theatre, obstetrics and gynecology units and psychiatric unit. The department of nursing science is integrated with 250 bedded University of Calabar Teaching Hospitals so that nursing education, service and research are closely combined with quality patient/client care.
CHAPTER FOUR
RESULTS
Introduction
This study is carried out on adherence to or implementation of bedside nursing in promotion of quality care among student nurses in University of Calabar Teaching Hospital (UCTH). This chapter shows the results collected and analyzed using the secondary source of data.
Sociodemographic data of respondents
Table 4.1 represented the sociodemographic data of the respondents. The table showed that a majority of the respondents at UCTH, 103 (91.7%) were female. Also, 56 (51.1) of the respondents fell within the age range of 26 – 35 years. The table also showed that 64 (56.4) of the respondents were married while a minority of the respondents; 2 (1.5%) were divorced. 100 (91%) of the respondents were Christians, 3% were Muslims while 6% had other religions. The table above also showed that 69 (62.4%) of the respondents had a working experience within the range of 0 – 5 years, 36 (33.1%) and 5 (4.5%) of the respondents had a working experience of 6 – 10 years and over 10 years respectively. Moreover, professional qualifications of the nurses shows that 2.7% of them were registered nurses (RN only 12.7% were Registered Midwife (RM), only 49.1% were Registered Nurse with other Post basic qualification while those who have degree in nursing were 35.5% of the population sampled.
CHAPTER FIVE
DISCUSSION OF FINDINGS
This study analyzed the perception and participation in clinical practice among student nurses in University of Calabar Teaching Hospital. This chapter begins by reviewing the findings of the study followed by the key findings. The study also documents the study limitations, recommendations for nursing managers and nurses, future research, and the conclusion.
Key findings
Sociodemographic data
The sociodemographic data of the respondents showed that a majority of the respondents at UCTH, 103 (91.7%) were female. Also, 56 (51.1) of the respondents fell within the age range of 26 – 35 years. The table also showed that 64 (56.4) of the respondents were married while a minority of the respondents; 2 (1.5%) were divorced. 100 (91%) of the respondents were Christians, 3% were Muslims while 6% had other religions. The table above also showed that 69 (62.4%) of the respondents had a working experience within the range of 0 – 5 years, 36 (33.1%) and 5 (4.5%) of the respondents had a working experience of 6 – 10 years and over 10 years respectively. Moreover, professional qualifications of the nurses shows that 2.7% of them were registered nurses (RN) only 12.7% were Registered Midwife (RM), only 49.1% were Registered Nurse with other Post basic qualification while those who have degree in nursing were 35.5% of the population sampled.
Research Question 1: What is the knowledge of clinical practice in the care of patient by the nurses at UCTH?
The data analysis showed that 4.5% of the nurses were rated low, 18.2% belonged to the medium class and 77.3% were rated high. Also, 95.5% of the nurses were aware of the concept of clinical practice. 85.5% of the nurses were of the opinion that clinical practice enhances delivery of highest quality of care and individualized care. This study revealed that the nurses at UCTH showed high level of Knowledge of clinical practice. In relation to this study, Stether (2013) conducted a study on the knowledge and attitude of clinical practice among student nurses in selected hospitals in Malaysia. The study showed that the nurses had a high level of knowledge of clinical practice. This however contradicts the findings of Royal (2018) which observed that 69.0% of the population studied had low knowledge of clinical practice.
Research Question 2: What are the barriers to the successful utilization of clinical practice in UCTH?
The present study showed that the various barriers hindering the successful utilization of clinical practice were poor attitude of nurses to change (70.0%), lack of knowledge of clinical practice (81.8%), inadequate organizational support (65.5%), inadequate resources for utilization of clinical practice (79.1%) and lack of continuing education for nurses (66.4%) Unavailability of relevant research (54.5%) and workload on staff (65.5%). This is supported by the findings of Restas (2014) who identified lack of time which did not allow time for other researching and applying research based-practice. Also, Salmond (2017) identified various barriers hindering utilization of clinical practice. Among were inadequate amount of research evaluation skills, access to journals and work load pressures.
Research Question 3: Can clinical practice be effectively utilized as a tool for providing holistic, scientifically based care for patients?
The study attested that clinical practice can be effectively utilized as a tool for providing holistic, scientifically based cure for patients (91.8%). Those who agreed that nurses knowledge is required to utilize this concept were 92.7% while 88.2% of the nurses observed that clinical practice make nursing more scientific. Also, 80.9% agreed that it gives autonomy to nursing while 88.2 indicated that it enhanced accountability and promotes quality assurance in patient care. This is in line with the findings of Taylor and Allen (2017) who identified efficiency of clinical practice. They observed that it enhances highest quality of care, it combines research with knowledge and theory, it fills the gap between research and theory and allow for individualized care.
Implication of the study
According to the current study, it is evident that the practices of health educators and professionals in influencing perception and participation in clinical practice among student nurses is very vital following the knowledge levels which were moderate in the study (Dilie and Mengistu, 2015). Therefore, the health facilities should strictly observe health educators and professionals to ensure proper information and health awareness campaigns (Gedamu et al., 2014). Also, knowledge and practice of educators and health professionals should be updated through continuing in-service educational programs so that they can in turn educate the nursing students (Adegoke et al., 2013).
Implication to nursing practice
The study had implications, guidelines and suggestions for nursing practice, nursing education, nursing administration and nursing research.
The findings of this study revealed that the nurses’ knowledge about clinical practice was high, there were various barriers to the successful utilization of evidence – based nursing practice in UCTH. However, it was discovered that clinical practice can be effectively utilized as a tool for providing holistic, scientifically based cure for patient. The nurse, therefore, should endeavour to put their knowledge of clinical practice to use, emphasize more on use of clinical practice in UCTH. The nurses and the hospital management should work on barriers hindering the use of clinical practice in Hospitals, especially, in the study area.
Limitations of the study
During the execution of this study, the researcher encountered a number of constraints that impeded the completion of the study. One of the constraints in this study was lack of co-operation from some of the respondents in giving answers to the questionnaire items. This was because they saw it as exposing the activities in their school. Some of the students were fearful as they do not know how the school authority would see some of their answers. Some students were on clinical experience which has different time schedules.
Also, this project was conducted in only one area (University of Calabar Teaching Hospital). This limited the number of nurses and thus the number of respondents of the survey. Another limitation of this project was the use of the paper survey. Even though the paper survey was the most effective way to get responses from nurses, using an electronic survey would have been beneficial to reach nurses that were not present on the days that the researcher distributed the surveys to the units.
Summary of the study
This study was carried out on the perception and participation in clinical practice among student nurses in University of Calabar Teaching Hospital, Calabar, Cross River state. Clinical practice (CP) is the conscious, explicit and judicious use of the best current evidence in making decisions about the care of individual patients and the integration of the best research evidence with the clinical experience and values of the patient. This study was structured in five (5) chapters.
Chapter one introduced the topic. It presented a background to the issue of clinical practice among student nurses in University of Calabar Teaching Hospital, Calabar, Cross River state, problem statement, three (3) research objectives and questions, significance of the study, scope of the study and operational definition of terms.
Chapter two presented the literature review of the study. The literature review was designed under conceptual review, theoretical review and empirical review. The study relied on three theories, namely; Modified theory of diffusion of innovations by Everett Rogers (2015), Iowa Model by Titler (2001 and ARCC model by Levin (2011).
Chapter three presented the research methodology employed in this study. The study employed a descriptive survey research design. The chapter showed the population of the study, sampling technique, instrumentation of the study, validity and reliability, method of data analysis and ethical consideration.
Chapter four presented the result of the study. The findings in this study can be summarized as follows:
- The nurses had high knowledge of clinical practice.
- The nurses’ level of utilization of clinical practice was high.
- There were various barriers hindering the utilization of clinical practice in UCTH.
Chapter five discusses the findings and summary of the study.
Conclusion
The result of findings in this study revealed that nurses in UCTH, Ilorin have high knowledge of clinical practice, their utilization of Clinical nursing practice was low, there were various barriers hindering utilization of clinical practice in UCTH. However, it was discovered that clinical practice can be effectively utilized by nurses in the Hospital. It was observed from the result of findings that there is no significant relationship between nurses’ knowledge and practice of clinical practice. There is no significant relationship between professional qualification of nurses and utilization of clinical practice. On the other hand, there is significant relationship between nurses’ attitude and utilization of clinical practice. Efforts by the management to ensure effective utilization of clinical practice cannot be over emphasized.
Recommendation
Based on the findings in this study, the following recommendations are made:
- Nurses should endeavour to put their knowledge of clinical practice to use.
- Nurses should be educated more on the use and importance of clinical practice.
- Hospital management should make concerted effort to eliminate barriers hindering perception and participation in clinical practice among student nurses.
- Hospital management should organize seminars for nurses on utilization of Clinical nursing practice from time to time.
Suggestions for further studies
Based on the findings of this study, it is suggested that the same study should be carried out in other hospitals. A comparative study of General and Teaching Hospitals knowledge and utilization of evidence–based nursing practice should also be carried out.
REFERENCES
- Agency for Healthcare Research and Quality (2018). Preventive Service task force. Retrieved July 24, 2011 from http://wwwabng.gob/clinic cuspstfix.htm.
- Centre for Clinical practice: University of Toronto Health Network (2013). Retrieved March 16, 2011 from http://www.cebin.u.torontocal/ syllas/ nur/intro/htm
- David, E. (2015). Reflecting practice. A focus for caring. Journal of Nursing Education. Vol. 34. No. 2.
- Donna, M. (2010). Doubt about the credibility of research and implication for clinical practice. Clinical nursing practice 2010 18: 38 – 39.
- Gordon, D. r. and Lock, M. (2014). Tenacious assumptions in western biomedicine, London Kluwer Academic Press.
- Haynes, P. B., and Sackett, D. (2016). Need for Clinical Medicine, EBM 1: 5 – 6.
- Heater, G. Becker, I. and Olson, J. (2016). Nursing research method and critical appraisal for Clinical practice. St. Louis Missouri, Mosby Elsevier.
- Idang, N. O. Ukaegbu, C. E. and Ebong, R. (2012). Nurses perception of Clinical practice. West African Journal of Nursing 2012: vol. 23 (1) 22: 30.
