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Proposal

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Diane Deiparine

on 25 February 2013

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Transcript of Proposal

Quality Improvement Anything which causes a beneficial change in quality performance.

There are two ways of bringing about quality performance: One is better control and the other by raising standards. Is a process for changing standards. Is one of the core competencies required to a graduate nurse as defined by the Board of Nursing. This involves determination to meet patients' needs and exceed expectations of care and service. Background: Neuman Why study Quality Improvement in hospitals? make better recommendations for quality nursing

to meet expectations

to make plans for the better assessment of patient planning implementing care patient and family education I study also stress.. because stress affect Quality Improvement (Jennings) decreased motivation increased absenteeism role conflict overload I study leadership affect Quality Improvement (Adams) shape vision increase motivation No enough study to support especially in the Philippines, in Mindanao to make improvement above the standard Theories: Nursing- is assessing person to reduce stressors to assist nurse do Q.I Q.I investigate stress Nursing- is managing stimuli Roy adaptation Stress and Nursing leadership adaptation talks about Q.I behavior Deming Theory on Total Quality Management QM increased production, services Good management is do Q.I product and service improvement (Deming and BON) Conceptual Framework: Asssessment of stress (Neuman) Independent Variable Assessment of Leadership Management Skills (Roy) Quality Improvement (Effectiveness) Profile- nature of man Dependent variable: Statement of the Problem

The research aimed to determine the relationship between some factors and level of quality improvement behaviors of staff nurses assigned in government and private hospitals of Lanao del Norte

Specifically the researcher sought to answer the following questions:

1. What is the profile of staff nurses and nurse supervisors in terms of
*age
* sex
*civil status
* number of children
* highest educational attainment
* type of hospital employed
* level of hospital
* number of years of clinical experience
* position
* area of assignment?

2. What is the job stress level of staff nurses in terms of:
* interpersonal factors
* personal factors
* organizational factors?

3. What is the leadership style of nurse supervisors in terms of:
*decision and critical thinking skills
* interpersonal skills
* communication skills
* goal setting and vision casting ability
* staff development efforts?

4. What is the level of quality improvement behavior of staff nurses assigned in government and private hospitals in Lanao del Norte in terms of:
* assessment of patient?
* planning
* implementing care
* administration of medications and treatment
* therapy and documentation
* patient and family education
* continuing education and hoslistic enhancement?

5. Is there a significant relationship between personal profile of respondents to quality improvement?

6. Is there a significant relationship between job stress and the quality improvement behaviors of staff nurses?

7. Is there a significant relationship between leadership skill of nurse supervisors and level of quality improvement behaviors of staff nurses?

8. Based on the findings, what quality improvement program can be proposed? Significance of the study: Health Care Institution or Hospital Medical Directors/ Chief Nurses
Staff Nurses
Department of Health
City Health Office
Nursing schools
Nursing students
patients
future researchers Research Design: Quantitative method descriptive correlational Research Locale: Lanao del Norte Gregorio T. LLuch Memorial Hospital
Lanao del Norte Provincial Hospital Mindanao Sanitarium and Hospital
St. Mary's Maternity and Children's Hospital Part I deals with the socio demographic profile of respondents namely, the name of the respondent to be answered optionally, age, sex, civil status, number of children, highest educational attainment, type of hospital employed, level of hospital, number of years of hospital experience, position and area of assignment at LNPH/GTLMH/AMC/SMMCH. This is self made portion of the questionnaire

Part II contained the The Nursing Job Stress Level comprising of 30 questions divided into 3 factors with list of situations that commonly occur in a work setting and how stressful it has been for nurses. These are interpersonal, personal, and organizational factors. The questionnaire is prepared with management and stress books and management and stress tools used as references. The researcher constructed questions based on these references and interviews conducted. The hospital situation and set-up in Lanao del Norte was also considered in the construction of the questionnaire.

Part III contains The Leadership skills of Nurse Supervisors with 35 questions categorized into 5 skills that fits the current nurse supervisor. These skills are decision and critical thinking, interpersonal, communication, goal setting and vision casting ability, and staff development effort.

Part IV contains The Quality Improvement Behaviors Questionnaire having 35 questions and divided into 7 parts of a nursing process with 5 questions each. Nursing process as used and modified in this study were, assessment of patient, planning, implementing care, administration of medications and treatment, therapy and documentation, patient and family education, and continuing education and holistic enhancement.

In Part II, III, and IV, Likert scaled format will be used.

In addition, there will be 5 optional questions for journal writing to extract narrative comments from the respondents to better understand their experiences and to discover theories that can be used to strengthen the result of the study. CORRELATES OF AFFECTING QUALITY IMPROVEMENT BEHAVIORS OF STAFF NURSES IN SELECTED HOSPITALS OF LANAO DEL NORTE continuing education and holistic enhancement *Age
*Sex
*Civil Status
*Number of children
*Highest educational attainment
*Type of hospital employed
*Level of hospital
*Number of years of hospital experience
*Position
*Area of assignment Nursing Job Stress
*Interpersonal factors
*Personal factors
*Organizational factors *Decision and critical thinking skills
*Interpersonal skills
*Communication skills
*Goal setting and vision casting ability
*Staff development efforts Quality Improvement behavior of staff nurses:
*Assessment of patient
* Planning
* Implementing care
*Administration of medications and treatment
*Therapy and documentation
* Patient and family education
*Continuing education and holistic enhancement triangulation procedure administration of medication and treatment Results: Nursing job stress: Leadership management skills Quality Improvement
Behavior of Staff Nurses Relationship between personal profiles of respondents to quality improvement Relationship between job stress and the quality improvement behaviors of staff nurses Significance between leadership skill of nurse supervisors and level of quality improvement behaviors of staff nurses Quality Improvement Program
The results of this study prompted the proposal of quality improvement program. This incorporates activities that need to be experienced by staff nurses to actualize the objectives. The researcher aimed to address the problem regarding quality improvement so that staff nurses will not only go duty to render care to patients but also to think outside the box, participate and coordinate with nurse supervisors on ways to achieve quality improvement in the unit and institution. The proposed programs are presented below.

Persons involved: Staff Nurses and Nurse Supervisors

Objectives:
After every quarter of assessment, staff development activities and lectures, the nursing service department will be able to formulate plans on how to improve the quality of services offered, physical set-up, and documentation of patient data. The quality improvement program is conceptualized according to the result on the study and hospital set-up.

Actions to be taken:
Nursing service department must have a quarterly assessment of all staff nurses and nurse supervisors. In this way, the quality improvement behaviors are monitored and results are recorded by the head nurse/ director of nursing service. If there are notable changes on results every quarter, then there is a need to call the attention of certain nurses. Tool used to assess utilize the Quality Improvement Behavior Questionnaire formulated by the researcher.

Offering of self-awareness and team building activities scheduled quarterly and nurse are grouped comprising of nurses assigned on different areas. With this, participants will develop the innate abilities on aspiration for quality improvement that are hidden and not used properly.

Offering of continuing educational units monthly such as lectures on latest trends of health services and common issues of treatment modalities encountered on daily working hours of nurses.

Expected Outcome:
Determining the factors that affects on quality improvement behaviors and correction of the factors to promote and enhance the quality improvement of services offered, physical set-up, and documentation of patient data. Conclusions
In the light of the findings, the following conclusions were drawn:

1. Majority of typical staff nurses and nurse supervisors in Lanao del Norte were female, within the age bracket of 21- 58 years old, Bachelor of Science in Nursing graduate, employed on private and tertiary level hospitals, bears minimum of one to 5 children, 1- 31 years on hospital experience and assigned mostly on ward, emergency and operating rooms.

2. Staff nurses occasionally get stressed and experienced average stress level on interpersonal, personal and organizational factors.

3. Staff nurses often felt the leadership skills namely decision and critical thinking skills, interpersonal skills, communication skills, goal setting and vision casting ability and staff development efforts of nurse supervisors which acquired high interpretation from the data gathered.

4. Staff nurses often possess the behavior for quality improvement with high interpretation on assessment of patient, planning, implementing care, therapy and documentation, patient and family education, and continuing education and holistic enhancement. Similarly, staff nurses frequently possess the behavior for quality improvement with regards to administration of medications and treatment with very high interpretation from the data gathered.

5. Significance of personal profile of respondents to quality improvement.
5a. The type of hospital has highly significant relationship to assessment of patient, planning, implementing care, administration of medication and treatment, and continuing education and holistic enhancement.

5b. Area of assignment has highly significant relationship to assessment of patient.

5c. The level of hospital, sex, and number of children indicates highly significant relationship to patient and family education.

5d. The type of hospital, civil status, age and number of years of hospital experience has significant relationship to patient and family education.

5e. The null hypothesis: There is no significant relationship between the personal profile and the level of quality improvement behavior of respondents is stated earlier on Chapter one. Likelihood Ratio Test of Chi-Square results show that type of hospital, civil status, age, and number of years of hospital experience has significant relationship to patient and family education. For these variables, the hypothesis is rejected at = 0.05. For the variable education, the null hypothesis is accepted at = 0.05.

6. Significance between job stress and quality improvement behaviors of staff nurses.
6.a There is no significance between job stress level (interpersonal, personal and organizational factors) to the quality improvement behaviors of staff nurses (assessment of patient, planning, implementing care, administration of medication and treatment, therapy and documentation, patient and family education, and continuing education and holistic enhancement).

6b. The null hypothesis: There is no significant relationship between job stress and the level of quality improvement behavior of respondents. Pearson correlation values analysis results show that there is no significant relationship between job stress to the level of quality improvement behavior of respondents. For these variables, null hypothesis is accepted at = 0.05.

7. Significance of leadership skill of nurse supervisor and level of quality improvement behavior of staff nurses.
7a.There is no significance on leadership skills of nurse supervisors ( decision and critical thinking skills, interpersonal and communication skills, goal setting and vision casting ability, and staff development effort) to the quality improvement behaviors of staff nurses (assessment of patient, planning, implementing care, administration of medication and treatment, therapy and documentation, patient and family education, and continuing education and holistic enhancement).

7b. The null hypothesis: There is no significant relationship between leadership skill of nurse supervisors and level of quality improvement behavior of staff nurses. Pearson correlation values analysis results show that there is no significant relationship between leadership skill of nurse supervisors to the level of quality improvement behavior of respondents. For these variables, null hypothesis is accepted at = 0.05.
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