Professional Documents
Culture Documents
Theoretical Framework
Base on the theory of Benner, Novice to expert theory, each step
builds on the previous one as abstract principles refined and expanded by
experience and the learner to gain clinical expertise. In this theory, Benner
said that all of us have been through the novice level in which the person
has no background experience of the situation in which he or she is
involved but still can be able to provide what patients need until we
reached the expert level.
In general, this is a level in which nursing students belong.
However, Benner proposed that nurses at higher levels can be classified
as novice if they are placed in unfamiliar situation.
The unique function of the nurse is to assist the individual, sick or
well, in the performance of those activities contributing to health or
recovery that would perform unaided if had the necessary strength, will or
knowledge. And to do this in such a way as to help gain independence as
rapidly as possible. Vera M. (2014)
According to Hendersons theory of 14 Basic Nursing Care, one of
those is the Nurse-patient relationship which we can correlate to our topic.
There are three levels compromising the nurse patient relationship first is
the nurse as a substitute to the patient, the nurse as a helper to the
patient, the nurse as a partner of the patient. Another role of the nurse is
to help both the sick and well individual. The care given by the nurse, as
Henderson stressed, must empower the patient to gain independence as
rapidly as possible.
King theory is specialized with use of dynamic interactive
communication between the nurse and the client as proof. Professionals
Conceptual Framework
Expert
Competent
Advance Beginner
Novice
Clinical Performance of
student nurse in terms of :
Decision Making
Time Management
Providing Patient
Safety
Ethical Reasoning
10
Patient care outcome- it is the evaluation of the intervention that the health
care provider rendered.
Clinical performance- it is the intervention that the health care provider
performs.
11
12
13
14
Clinical
pathways
are
associated
with
reduced
in-hospital
The article describe recent empirical literature regarding nurserelated variables that impact patient outcomes. Multiple variables are
described,
15
including
the
work
environment,
magnet
status,
nurse-physician
16
17
18
19
20
research
Nursing
utilized
Care,
research-modified
Complications,
Checklist
Recovery
which
and
21
22
23
3.Make
clinical
judgments
using
evidencebased
practice
outcomes to
ensure safe
and effective
nursing care.
4.Modifies
nursing care.
6.66
16
56.66
11
36.66
3.33
13.33
14
46.66
10
33.33
6.66
5.Has
capability to
involve
others
meaningfully
and
appropriately
in
collaborative
decision
making.
20
18
60
16.66
3.33
Interpretation
Table 1
Table 1 shows that forty percent or 12 out of 30 students were very
satisfactory in terms of prioritizing the patients needs. Eight out of 26.66 %
of students were outstanding in prioritizing patients needs at all times.
24
25
Outstanding
Very
Satisfactory
Satisfactory
Needs
Improvement
Poor
1.Administer
Medications
on due time.
13
43.33
11
36.66
16.66
3.33
2.Performs
the
procedures
smoothly and
accurately.
30
12
40
23.33
6.66
3.Checks the
patient and
do the
rounds
earlier than
his/her duty
time.
11
36.66
10
33.33
23.33
6.66
4.Performs
morning care
on time.
13
43.33
30
23.33
3.33
5.Attends to
patients
needs
promptly.
11
36.66
11
36.66
20
6.66
Table 2
26
27
Outstanding
Very
Satisfactory
Satisfactory
Needs
Improvement
Poor
1. Administers
right dose of
appropriate
medications to
the right patient
at the right time
in the right
manner.
2. Always
checks and
identifies the
patient before
doing any
procedure.
3. Secures side
rails up at all
times.
13
43.33
30
23.33
3.33
14
46.66
30
20
3.33
12
40
11
36.66
20
3.33
4. Instructs the
relative to not
leave the
patient alone
especially when
unconscious.
23
76.66
20
3.33
28
5. Monitor
closely the IV
fluid to prevent
fluid overload.
13
43.33
26.66
26.66
3.33
Table 3
Table 3 shows that 43.33 percent or 13 out of 30 nursing students
were outstanding. However, 1 out of 30 student nurses needs
improvement.
Forty six percent or fourteen out of 30 student nurses were
outstanding in terms of always checking and identifies the patient before
doing any procedure. While, 1 out of 30 student nurses needs
improvement.
Forty percent or 12 out of 30 student nurses were outstanding in
terms of securing the side rails up at all times and only 1 out of 30 student
nurses it needs improvement.
When it comes to instructing the relative to not leave the patient
alone especially when unconscious, 76.66 or 23 out of 30 student nurses
were very satisfactory while only 1 out of 30 needs improvement.
In terms of monitoring closely the IV fluid to prevent fluid overload,
43.33 percent or 13 out of 30 student nurses were outstanding while 1 out
of 30 student nurses needs improvement.
Learning in the clinical practice is an important component of
nursing
education
profession.Time
in
considering
simulation
that
nursing
enhanced
clinical
is
practice-based
performance,
as
29
Outstanding
F
1. Plans patient
care with
information
from other
health care
team members
for optimal
patient care
within an ethical
legal
framework.
2. Participates
in complex
nursing
procedures for
assigned
patients.
3. Assists
others to
provide patient
Very
Satisfactory
Satisfactory
Needs
Improvement
F
Poor
%
30
F
11
%
36.66
F
13
%
43.33
%
0
F
0
16.66
13
43.33
11
36.33
2.33
08
26.66
12
40
30
3.33
30
care to groups.
4. Collaborates
with
interdisciplinary
team to deliver
patient care
while
maintaining
cost of effective
use of
resources and
safe
environment.
5. Respects
culture, races
and beliefs of
the patients.
23.33
13
43.33
26.66
6.66
14
46.66
26.66
26.66
Table 4
Table 4 shows that 43.33 or 11 out 30 student nurses were
satisfactory on planning patient care with information from other health
care team members for optimal patient care within an ethical legal
framework. However, only 6 out of 30 student nurses were outstanding on
this matter.
Forty three percent or 13 out 30 student nurses were very
satisfactory on participating in complex nursing procedures for assigned
patients. While, only 1 out of 30 student nurses needs improvement.
31
32
NURSING CARE
1. Each
nursing
procedure
was well
explained to
me before it
was done.
2. I feel
comfortable
to the
environmen
t provided
to me.
3. I am
satisfied of
the privacy
provided to
me.
4. I am well
informed
about my
state of
health
conditions
and
treatments.
YES
f
25
%
%
83.33
NO
f
2
%
%
6.66
SOMETIMES
f
3
10
28
93.33
3.33
3.33
29
96.66
3.33
26
86.66
13.33
%
%
33
5. All my
22
73.33
4
13.33
4
needs was
timely
attended by
the nurses.
Total:
130
26%
7
1.4%
13
Table 5 - Summary of the values showing Mean & Verbal
Interpretation of Patient Care Outcome in Mary Chiles General
13.33
2.6%
Interpretation:
Table 5 shows that 83.33% or 25 out of 30 respondents said that
student nurses explained each nursing procedure before performing it but
6.66% of the respondents said that student nurses did not. 93.33% of the
respondents verbalized that they feel comfortable to the environment but
33.33% of the respondents said No. 96.66% of the respondents said that
they were satisfied to the privacy given to them and 3.33% said
sometimes only. Next, 86.66% of the total respondents said that student
nurses informed them well about their state of health conditions and
treatments however, 13.33% said sometimes only. Lastly, 73.33% of the
respondents reported that all their needs was timely attended by the
student nurses and 13.33% said it took sometimes only. Overall, the table
5 shows that most of the respondents were satisfied to the performance of
student nurses in terms of Nursing Care.
NO
SOMETIME
34
MEDICATION/
TREATMENT
1. Accurate
identificatio
n were done
before
medication
and
treatments
are given.
2. Name of
medication
and its
indication
were
explained
before it
was given
to me on
due time.
3. I was
checked if I
had signs
and
symptoms
of adverse
effects of
medication
given to me.
4. I was taught
and
assisted
how to use
nebulizer.
5. I was given
S
f
25
83.33
3.33
13.33
25
83.33
6.66
10
25
83.33
6.66
10
17
56.66
20
23.33
23
76.66
20
3.33
35
oxygen
when I
needed it.
Total:
109
21.8%
17
3.4%
18
3.6%
Interpretation:
Table 6 shows all about providing and giving correct medications
and treatments. In terms of identifying accurate identification, 83.33% of
25 out of 30 respondents said Yes and the rest 3.33% of respondents said
No. The 83.33% of the respondents agreed and said Yes in terms of
explaining the name of medication and its indication before giving it to
them but 3.33% of the respondents said No. In terms of if the patient was
checked if she/he had signs and symptoms of adverse effects of the
medications given, 83.33% said Yes and 3.33% said No. Almost half of the
respondents 56.665 said that they were taught and assisted how to use
nebulizer but 20% of the total respondents said No. Lastly, in terms of
giving oxygen when the patients needed it, 21.8% of the 17 out of 30
respondents said Yes and 3.4% of the respondents said No. In overall,
table 6 shows that student nurses was competent in terms of giving and
providing medications and treatments to the patient.
NO
SOMETIME
S
36
RECOVERY
1. I am
instructed to
eat
appropriatel
y food for
my health
condition.
2. I am advised
to walk as
my exercise
at least thirty
minutes
every
morning to
avoid
constipation.
3. I am
instructed to
change
position at
least every 2
hours to
prevent bed
sores.
4. I am advised
to do the
breathing
exercise to
lessen the
pain.
5. I am well
instructed
with my take
home
medications
f
22
%
73.33
f
2
%
6.66
f
6
%
20
16
53.33
26.66
20
18
60
20
20
19
63.33
16.66
20
24
80
10
10
37
99
19.8
%
24
4.8%
27
5.4%
Interpretation:
In the table above 73.33% of the patient answer yes that they are
instructed to eat appropriate food for their health condition and 20% of the
patients answers no. 53.33% of the patient are advised to walk as their
exercise at least thirty minutes every morning to avoid constipation,
26.66% of patient are not advise to walk.60% of the patient answers yes
that they are instructed to change position at least every 2 hours to
prevent bedsores and 20% answers no and sometimes. In advising to do
deep breathing exercise to lessen pain, 63.33% answers yes while 20%
answers sometimes. And 80% of the patient are instructed well in their
take home medications and follow-up check-up and 10% of the patient
answers no and sometimes.
COMPLICATION
1. I developed
wound
infection five
YES
f
2
%
%
6.66
NO
f
28
%
%
93.33
SOMETIMES
f
0
%
%
0
38
2.
3.
4.
5.
days after
surgical
operation.
I developed
Urinary Tract
Infection after
catheterization
.
I had allergic
reaction during
blood
transfusion..
I developed
pneumonia
after surgery.
I developed
fluid overload
after IVF
infusion.
Total:
30
100
30
100
30
100
3.33
27
90
6.66
0.5%
145
29%
0.4%
Interpretation:
The table above shows that 93.33% of the patient did not
developed wound infection after the surgical operation and 6.66% of the
patient develop wound infection. 100% of the patient did not developed
Urinary Tract Infection after catheterization, did not have allergic reaction
during blood transfusion and they did not developed pneumonia after
surgery it shows that the student nurses are effective in terms of
complication. And lastly 90% of the patient did not have fluid over load
after IVF infusion while 6.66% have developed fluid over load.
39
40
Conclusions
A. The result for Clinical Performance of student nurses are
as follows:
In terms of decision making student nurses prioritizes the
administer
41
care to groups.
Respects culture, races and beliefs of the patients makes
student
nurses
knowledgeable
enough
to
follow
it
appropriately.
nursing procedure.
The patient respondents feel comfortable to the environment
provided to them.
The patient respondents also satisfied to the privacy
provided.
42
given.
Name of medication and its indication were explained before
nebulizer.
Oxygen was given by the student nurses when needed.
In terms of recovery student nurses instructed patient
respondents to eat appropriately food for their health
condition.
Changing position at least 2 hours to prevent bed sores were
student nurses.
Student nurses are effective and efficient in caring patients in
preventing complications.
43
Recommendation
Based on the findings and conclusions formulated in this research study,
the following recommendations are hereby proposed:
Clinical Performance:
1. We encourage the students to prioritize their studies first to have a
better outcome in both academic and clinical performance.
2. The students must have a good academic performance both in
lecture and RLE.
3. We encourage the students to always use their clinical eye in the
area to have a better assessment when handling patients.
4. We suggest that the students should adhere to the teachings,
advices, and modifications, given by their clinical instructors to
apply the procedures in a right way.
Patient Care Outcome:
1. We recommend that even students feel comfortable during
procedure; they should have a further review of the procedure to be
demonstrated in the area.
44
2. The students should not hesitate to ask questions in the area when
handling patients to ensure safety.
3. The students must be sensitive and knowledgeable about the
culture of the patient.
4. We encourage the students to know how to prioritize nursing care
based on the patients needs.
APPENDICES
45
APPENDIX A
46
2 Needs Improvement The student perform the skill with errors even
with frequent guidance and supervision
47
1 Poor The student does not perform the skill even under close
supervision and guidance.
Outstanding Very
Satisfactory
5
1. Prioritize the
patient needs
all the time.
2. Implements
the plan of
care.
3. Makes
clinical
judgements
using
evidencebased practice
outcomes to
ensure safe
and effective
nursing care.
4. Modifies
nursing care
based on
evaluation of
Satisfactory
Needs
Poor
Improvement
2
48
interventions
and outcomes.
5. Has
capability to
involve others
meaningfully
and
appropriately in
collaborative
decision
making.
Clinical Performance of Student Nurse
Questionnaires for Clinical Instructors
Time
Management
Outstandin
g
Very
Satisfactor
y
Satisfactor
y
Needs
Improvemen
t
Poor
1
5
1. Administer
medications on
due time.
2. Performs the
procedure
smoothly and
accurately.
3. Checks the
patient and do
the rounds earlier
than his/her duty
time.
4. Performs
morning care on
49
time.
5. Attends to
patient needs
promptly.
Clinical Performance of Student Nurses
Outstandin
g
Very
Satisfactor
Satisfactory y
Needs
Improvemen
t
4
5
1. Administers right
dose of appropriate
medications to the
right patient at the
right time in the
right manner.
2. Always checks
and identifies the
patient before
doing any
procedure.
3. Secures side
rails up at all times.
Poor
1
3
50
4. Instructs
relatives to not
leave the patient
alone especially
when unconscious.
5. Monitor closely
the IV fluid to
prevent fluid
overload.
Very
Satisfactory
Satisfactor
y
Poor
1
3
1. Plans patient
care with
information from
other health care
team members
for optional
patient care within
an ethical legal
framework.
2. Participate in
complex nursing
Needs
Improvemen
t
2
51
procedures for
assigned patients.
3. Assists others
to provide patient
care to groups.
4. Collaborates
with
interdisciplinary
team to deliver
patient care while
maintaining cost
effective use of
resources and
safe environment.
5. Respects
culture, races and
beliefs of the
patients.
Questionnaire for Patient Reported Outcome
Direction: Place check () the corresponding boxes if the following are
attended or not.
(Panuto: Lagyan ng tsek () ang mga sumusunod na kahon kung
nadadaluhan o hindi.)
Nursing Care
1. Each nursing procedure
was well explained to me
before it was done.
( Lahat ng proseso sa
paggamot ay naipaliwanag ng
mabuti bago ito gawin sa
akin.)
2. I feel comfortable to the
Yes
(Oo)
No
(Hindi)
Sometimes
(Minsan)
52
Yes
(Oo)
No
(Hindi)
Sometime
s
(Minsan)
53
Yes
(Oo)
No
(Hindi)
Sometimes
(Minsan)
54
Yes
(Oo)
No
(Hindi)
Sometimes
(Minsan)
55
56
APPENDIX B
57
In this connection, we would like to ask permission from your good office
to conduct our study to the 30 selected patients at the third-left of Mary Chiles
General Hospital. We will assure that we will observe proper decorum and
confidentiality.
We are hoping for your kind consideration.
Thank you and God bless.
Respectfully yours,
BSN- III
Borre, Jessa Anne R.
Gervacio, Jonah Micah N.
Mangalus, Maribel T.
Pastrana, Izza Mae F.
Noted By:
Research Instructor
Chief Nurse
January 21,2016
Rosie L. Cabaero
Chief Nurse
58
Noted:
Approved by:
Research Instructor
Chief Nurse
59
Approved by:
Research Instructor
60
Dear Madam,
The undersigned are BSN III students of Mary Chiles College currently
conducting research study entitled Clinical Performance Of Student Nurses
Approved by:
Research Instructor
REFERENCES
BOOKS
1. Octaviano E. etal (2008) Theoretical Foundations of Nursing: The
Philippine Perspective
2. Udan J. (2009) Fundamentals of Nursing Third Edition
61
JOURNALS
Foreign
1. Li, S., (2007). The Role of Simulation in Nursing Education: A
Regulatory Perspective. Date retrieved: July 10, 2012.
WEBSITE
http://www.nursecredentialing.org/Accreditation/ResourcesServices
/Evaluating-the-Impact-CNE-Outcomes.pdf
http://www.academicjournals
.org/app/webroot/article/article1379488330_Awuah-Peasah%20et
%20al.pdf
http://article.sapub.org/10.5923.j.nursing.20150502.05.html
http://www.rrh.org.au
http://dx.doi.org/10.1155/2013/628679
http://ojni.org/issues/?p=2037
http://article.sapub.org/10.5923.j.nursing.20150502.05.html
http://www.sciedu.ca/journal/index.php/jnep/aricle/viewFile/716/746
http://hrmars.com/hrmars_papers/Preparedness_of_Nursing_Intern
ational_Students_for_their_Clinical_Learning_in_the_Philippines
.pdf
Deshpande et al (2011). Patient reported Outcomes-A new Era in
Clinical Research
http://www.scribd.com/doc/26046673/Patient-reported-Outcomes-
A-New-Era-in-Clinical-Research
Butcon (2011). Learning Through Caring
http://infonomics-society.org/IJCDSE/Learning%Through%Caring
%20Clinical%20settings.pdf
62
http://journals.lww.com/simulationinhealthcare/Abstract/2011/10000
/The_Effect_of_Simulation_on_Clinical_Performance_3.aspx
http:/www.krepublishers.com/02-Journals/S-EM/EM-07-0-000-13Web/S-EM-07-3-000-13-Abst-PDF/S-EM-07-3-181-13-293-UsehU/S-EM-07-3-181-13-293-Useh-U-Tt.pdf
63
CURRICULUM VITAE
CURRICULUM VITAE
Birthplace: Daet,
Camarines Norte
Status: Single
Educational Attainment:
Primary: Saint Francis Of Assissi College
2001-2006
64
2007-2010
2010-2012
2014-present
Sampaloc, Manila
CURRICULUM VITAE
Name: Joy Mariel Isadora U. Burgos
Nickname: Joy
Birthplace: Sampaloc,
Manila
Status: Single
Educational Attainment:
Primary: Saint Rita College, Manila
Plaza del Carmen, Sampaloc, Manila
1998-2004
65
2004-2008
2008-2010
2010-present
Sampaloc, Manila
CURRICULUM VITAE
Name: Maribel T. Mangalus
Nickname: Bel
Pampanga
Status: Single
Educational Attainment:
Primary: Montessori De Sagrada Familia
Tangos, Baliwag, Bulacan
2008-2009
66
2012-2013
2013-present
67
CURRICULUM VITAE
Name: Izza Mae Pastrana
Nickname: Samae
Birthplace: Banton,Romblon
Age: 20
Status: Single
Educational Attainment:
Primary: Banton Central Elementary School
2008-2009
Banton,Romblon
Secondary: Banton National High School
2012-2013
Banton,Romblon
Tertiary: Mary Chiles College
Sampaloc, Manila
2013-present