The attitude of nurses towards nursing process in four selected hospitals in Batangas / prepared by Edgar L. Bautista. 6

Thesis (M.A.) -- Pamantasan ng Lungsod ng Maynila, Intramuros, Manila, 1997.;A thesis presented to the faculty of Graduate School of Arts, Sciences, Education, and Nursing, Pamantasan ng Lungsod ng Maynila in partial fulfillment of the requirements for the degree of Master of Arts in Nursing. 56

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INTRODUCTION. Background of the Study. Nurses have a more defined discipline and have been able to articulate the major assumptions and the major concepts that reflect the true nature of nursing. Over the years, and through theory, research and practice, the descriptive accounts of nurses helped in defining and identifying the nature of phenomena that are the crux of nursing domain. It can be said that nurses have a discipline with a unique perspective on the daily lives and activities of clients experiencing both health and illness situations, and it deals with therapeutic interventions and actions that are designed to help human beings experience a sense of well-being and quality of life, whether well or sick. Having established a firm foothold on one front, nurses have redeployed to meet the next challenge. Two driving forces have emerged in the 1990's that impact nursing practice: emphasis on quality and emphasis on cost containment. Nurses, like all health care providers, are responding to consumer demand for quality service. Nurses are continually seeking ways to improve their practice and the satisfaction of the client they serve. If nursing is to survive the competitive challenges of the decade, it must continue to provide a quality of service that clients value. The nursing process is the systematic, rational method of planning and providing the nursing care. It's goal is to identify a client's health status, actual or potential health care problems, to establish plan to meet the needs, and to deliver specific nursing interventions to meet those needs. Nursing process provides a tool for the nurse to use in continually evaluating and improving the quality of nursing care. The second force is the cost containment. Nurses have always been accountable for their professional practice. This means that nurses need first to be aware of the resources used in caring for clients and then be in control of allocating the resources. Resources include not only the supplies but the time nurses spend in providing care. The uses of the nursing process helps to avoid the duplication and the omissions that result in the unnecessary use of resources. Nursing education emphasizes the utilization of nursing process in all aspects of learning. Beginning skills in nursing process as basis of health care delivery system is introduced in the Level II of BSN Program. The revised curriculum for the four year course in Bachelor of Science in Nursing aims to produce a fully-functioning nurse who has developed a research attitude through the use of nursing process. Despite the academic preparation the nurse have, nursing process in some ways is not properly used in the actual practice of the profession. Even though it is mandated in the Article 5, Section 27 of the Philippine Nursing Law that in the scope of nursing practice, nursing process should be utilized as the nurse initiates and performs nursing services to individuals, families and communities in various stage of development. During the summer convention of the Association of Deans of the Philippine College of Nursing held at St. Paul's College, Manila, May 1994, it was identified that one of the weaknesses of nurses today is their incompetence in the implementation of nursing process in their practice. This brings a considerable concern to the researcher to undertake a study concerning nursing process because it can be a blessing and a curse in the nursing profession. A blessing because history will tell us that it gives us the opportunity towards autonomous practice of our profession as it systematizes the and art inherent of nursing. A curse, as it threatens to farther widen the gap of the already existing diversity in nursing practice. Attitude of nurses toward nursing process is the focus of the study since the researcher believes that this is the modifying factor for a successful use of the process. As research has become a trend in Nursing in the Philippines, it has explored substantial areas of interests in highly urbanized settings like Metro Manila. Higher Education Centers in Nursing, being based in major cities, have consequently enriched the research endeavors of graduate students with focus on these accessible localities. The researcher, however, feels the responsibility mixed with research curiosity, of understanding nursing issues in the perspective of those nurses who are based in the provinces. The nursing process, being a modern cornerstone of nursing practice, has to be accounted in a more general approach and wider perspective. Hence, the researcher chose to conduct the study in Batangas. The researcher selected the four training hospitals in Batangas. A training hospital is expected to project an image of excellence to affiliating students. On the other hand, it should be dynamic enough to integrate modern, innovative and current trends into the basic and traditional practices. While affiliating students are tasked to utilize the nursing process in their related learning experience, these training hospitals should set forth an example and should make the learning environment favorable for the attainment of these learning objectives. This was a strong basis for the selection to conduct the study in the four training hospitals, namely: Batangas Regional Hospital and Batangas Provincial Hospital, both are government hospitals; and St. Patrick's Hospital and Golden Gate Hospital, which are private hospitals. In this manner, the researcher can compare the attitudes of nurses toward nursing process in two types of hospital. Statement of the Purpose This study analyzed nurses' attitude towards nursing process in four selected hospitals in Batangas in relation with their demographic variables. Specifically, this study seeks to answer the following questions: 1. What is the demographic profile of the nurses in four selected hospitals in Batangas in terms of: a. age b. gender c. civil status d. duration of hospital experience e. position in hospital f. type of hospital where the nurse is working g. area of assignment 2. What is the nurses' attitude towards nursing process in terms of: a. general care planning b. nursing diagnosis c. client's involvement 3. What are the barriers perceived by the nurse in the use of nursing process? 4. What are the supports perceived by the nurse in the use of nursing process? 5. Is there are a significant relationship between the nurses' attitudes toward nursing process and: a. age b. gender c. civil status. d. duration of hospital experience e. position in hospital f. type of hospital where nurse is working g. area of assignment 6. What Retraining Program in Nursing Process can be developed which may be most applicable for the nurse based on the result of the study? Significance of the Study The study is significant to the following: Respondents. After answering the questionnaires, this study helps them to be aware of their attitudes toward nursing process as a result of some internal and external factors. Similar to the principle of self-awareness, these identified attitudes can be channeled constructively which in turn would help them improve quality of patient care. Nurses. As healthcare providers, the result of the study serves as motivation towards improved patient care. The factors identified, relevant to the provision of quality nursing care will be readily available for nurses to either enhance or eliminate, as it is deemed necessary to improve their practice and the satisfaction of the clients they serve. Hospital Administrators and Nurse Managers. Provision of quality care is the main concern of hospital administrators and nurse managers. The findings of this study will be available for them who have always sought to measure, maintain, and improve the quality of patient care. This study can provide them a better understanding of the care they measure and help them identify several conditions existing in their institution that affect the provision of care through nursing process. Nursing Education. This work acknowledges the role of nursing education in providing inputs about nursing process, and applications of the process into a learning experience.

Through this study, nursing educators will be able to determine the adequacy and appropriateness of these inputs and the learning experiences they are providing to their students. Staff Development Educators. Since professional growth is their concern, they design programs for nurses to restructure healthcare workforce as they respond to the existing demands in their profession. A retraining program in nursing process will be developed as the result of the study. This study will also provide them a tool for future staff development sessions to consider the topic on nursing process since it is viewed as the core process by which all purposes of nursing are fulfilled. Patients. The researcher believes that this study is of significance to the welfare of the patients, being the consumer of nursing care. Since the study attempts to improve the quality of nursing care it will consequently benefits its end-users. Therefore, with the improvement in the provision of nursing care, which maybe sequel of the findings of this study, faster recovery is an assurance. Scope and Limitations The study was conducted in January 1997 among registered nurses of the four selected hospitals in Batangas, namely: Batangas Regional Hospital, Batangas Provincial Hospital, St. Patrick's Hospital, and Golden Gate Hospital. All registered nurses from these hospitals were considered respondents of the study, including those in supervisorial and managerial positions for their attitudes toward nursing process have a direct as well as indirect effect on the provision of care. Trainees or nurse volunteers which are also

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