Journal of Farkhanda Institute of Nursing And Public Health (JFINPH)

Quality Assurance in Nursing and Midwifery Education in Pakistan; Issue and Challenges

2023-05-20T06:27:57-05:00

Quality is a subjective term that means excellence and reliability of performance. Quality assurance (QA) is concerned with reviewing the performance of services after the utilization of the services. QA is the systematic process of determining whether the services meet specified requirements. The concept of QA is rooted in middle ages, and its practices became more indispensable and popular in the USA during World War II.¹ It is disclosed by current research that QA develops and maintains a set of requirements for manufacturing steadfast products or services. Indeed, the QA system considerably enhances customer confidence and credibility as well as the productivity of the organization which improves work process and efficacy.^2,3In higher education, the term quality assurance is increasingly used to refer to academic standards; that is, the level of academic excellence achieved by graduates not only maintained but improved consistently. Ensuring quality in higher education is critical for production of competent graduates.⁴Nursing is considered the backbone of any health system; therefore, maintaining an optimum number of competent nurses is one of the key priorities of any health system. Pakistan is facing a critical shortage of nurses for its rapidly growing population, and the country is estimated to have a shortfall of up to 1.3 million nurses as per the nurse population ratio.⁵ To cope with this huge shortage, Pakistan has recently allowed the opening of more nursing colleges; however, this has posed certain challenges to the system, including assuring and maintaining quality in these new schools. World Health Organization, Eastern Mediterranean region, has identified six standards for nursing and midwifery education; these include; a governance structure that encourages autonomy, an administrative structure with the responsibility to carry out the policies of the institution, a conducive teaching and learning environment, graduates of the programs must be prepared for professional practice according to standards, a sufficient number of faculty and sufficient infrastructure and teaching learning strategies.⁶There is a need to ensure quality in nursing and midwifery education in Pakistan to ensure graduates possess the required competencies and can work competently at local, national, regional, and international level.⁷ The challenges to ensure these standards are strengthening regulatory bodies, ensuring an optimum number of faculty and infrastructure, induction of quality students, and provision of optimum clinical training facilities for students.⁸

QA is recognized as increasingly essential for nursing education to ensure high-quality nursing delivery to sick patients. It is established that there is little evidence to endorse the existence and implementation of a comprehensive and vigorous QA system in Pakistan. Pakistan Nursing Council (PNC), as a regulatory body of Nursing in Pakistan, is mandated to establish minimum criteria for establishing nursing, midwifery, or a public health school institute.⁹ PNC is the country’s key regulator of nursing and midwifery education. Along with this, with the establishment of BSN programs across the country, the health sciences universities are also one of the key stakeholders of nursing and midwifery education regulation. Likewise, the Higher Education Commission of Pakistan sets the curriculum for undergraduate nursing programs in liaison with the Pakistan Nursing Council. To ensure minimum quality, there is a need for strong coordination among key regulatory bodies. There is a need to develop a robust mechanism for ensuring minimum standards in nursing and midwifery education nationwide.

Barriers to Reporting Medication Administration Errors among Nurses in Private Hospitals in Peshawar

2023-01-28T03:47:49-06:00

OBJECTIVES

To assess the barriers to reporting medication administration errors among nurses in Private tertiary care hospitals.

METHODOLOGY

A cross sectional-descriptive design was used. Data was collected through self-generated questionnaire from of two hundred and twenty-three nurses working in private tertiary care hospitals of Peshawar. Data was calculated for mean and standard deviation (age), frequencies, percentages (education, nurses, age, gender etc.), and presented in graphs, tables, and charts. Prior to this study approval was taken from Ethics Review Board of Prime Foundation Pakistan.

RESULTS

The study revealed that the strongest barrier was fear (group mean=18.76). The nurses tended to have the highest level of agreement with “being blame for medication administration errors results and adverse consequences from reporting”. The weakest perceived barrier was the administrative barrier (13.86). Nurses tended to have the highest level of agreement with “No positive feedback”.

CONCLUSION

The study revealed that the reporting with medication administration error is low in Peshawar. Proper awareness is very necessary to improve error reporting. Education programs may help in bringing awareness among nurses.

Perception of Health Care Provider Regarding Covid-19 Vaccination: A Qualitative Study in Peshawar Khyber Pakhtunkhwa

2023-02-28T05:12:02-06:00

OBJECTIVES

To explore the perception of health care providers regarding covid-19 vaccination.

METHODOLOGY

A phenomenological qualitative study was carried out in tertiary care government hospitals of Peshawar. Data from 15 health care providers were collected via interviews. Permission from the university ethical review board and hospital administration was granted. Consent forms were granted from the participants before data collection.

RESULTS

The mean age of the participants was 34.31 years. Overall, 117 codes were identified after the initial analysis. A total of 15 codes were identified after omitting the unnecessary codes. These 15 codes were arranged into 4 themes as “Information”, “Potential Benefits”, “Responsibility”, and “Hesitancy”.

CONCLUSION

The findings of the study concluded that health care providers need information regarding the protentional benefits and they accept that it’s the responsibility of them to smoothly proceed the process of vaccination. The study highlighted that information regarding covid-19 vaccination is very important for health care workers. Similarly, potential benefits of vaccination are highlighted and vaccination hesitancy was also described in this study.

KEYWORDS: Perception, Covid-19, Vaccination, Health Care Workers, Tertiary Care Hospital

Nursing Interns Perception Regarding Their One-Year Clinical Practicum

2023-02-01T04:23:43-06:00

OBJECTIVES

The objective of this study was to measure experiences of nursing interns in their internship period.

METHODOLOGY

Cross sectional study design was adopted. Total 141 Bachelors of Science in Nursing interns participated in the study from a university hospital. The structured self-administered questionnaire containing items related to organizational commitment, professional commitment, role ambiguity, role overload, workplace support and workplace bullying were used for data collection. SPSS v25.0 was used for analysis.
RESULTS

The mean score of organizational commitment was 3.14, 42% interns showed week commitment. Perceived ambiguity mean was 3.14, 54% reported it negative. The perception of role overload’ mean was 3.50, 66% perceived adverse effects. The professional commitment mean score was 3.06, 58% showed low commitment. Overall workplace support mean score was 3.12, colleagues 3.47 and nurse manger’s support was 2.31 lowest. Varying frequency of bullying was experienced by 90% interns. Significant difference among gender concerning organizational commitment, workplace support and workplace bullying was found (p-value <0.05). Comparison between three cohorts revealed organizational commitment, role ambiguity, role overload and professional commitment mean score decreased (P-Value < 0.05). While workplace support and bullying score remained consistent.

CONCLUSION

The unclear role, increased workload, perceived bullying and low support could negatively impact professional and organizational commitment. Internship program requires improvement.

Prevalence of Dysmenorrhea and Its Effects on Quality Of Life among Student Nurses

2023-02-18T03:50:21-06:00

OBJECTIVES

The objective of this study was to determine the prevalence of dysmenorrhea and its effects on quality of life of nursing students at a nursing school.

METHODOLOGY

A descriptive cross-sectional survey was carried out at one nursing school in Peshawar, Pakistan. A sum of 179 student nurses participated in this research. Censes method was used following the inclusion and exclusion criteria. Approval for conducting this study was obtained from Ethics Review Board of Khyber Medical University. Data was collected by pre tested validated questionnaire WHOQOL BREF scale. SPSS version 22 was used to analyze the data.
RESULTS

The participants average age was 25.58 years. The majority (60.3%) of the participants reported having Dysmenorrhea. A great portion (63.5%) of respondents reported Dysmenorrhea in age group 18-25 years. 63.4% Participants reported Dysmenorrhea among unmarried participants. Participants with Dysmenorrhea had scores in the Generic BSN, PRN, and MSN education categories of 78(64.5%), 21(48.8%), and 9(60%) respectively. There was no correlation between dysmenorrhea and QOL (p-value =.377).

CONCLUSION

Dysmenorrhea is quite prevalent among nursing students, along with severe lower abdomen pain, however there is no correlation between dysmenorrhea and Quality of Life.

Assessment of Knowledge Regarding Endotracheal Suctioning Among Nurses Working At Critical Care Units of Tertiary Care Hospital Peshawar, Pakistan

2023-03-07T04:54:40-06:00

OBJECTIVES

To assess the knowledge of endotracheal suctioning among nurses working in Critical Care Units of Tertiary Care Hospital.

METHODOLOGY

This descriptive cross-sectional study was conducted from October 2019 to December 2019. A total of 110 nurses were selected from Critical Care Units of Tertiary Care Hospital Peshawar. Consecutive sampling technique was used for selecting sample. The knowledge was assessed by using a 25 items knowledge questionnaire.

RESULTS

The mean knowledge score was 11.06 with a standard deviation of 3.22. Score ranged from 2-25. Knowledge categories were based on percentage score. Among the participants 70.9% had poor knowledge, 22.7% had good knowledge, and 4.5% had very good knowledge while only 1.8% had excellent knowledge. There was no statistically significant difference in the mean knowledge score between different groups made on the bases of age, gender, and experience.

CONCLUSION

This study was designed to assess the knowledge of endotracheal suctioning among nurses working in the critical care units. Based on the findings of the study majority of nurses had poor knowledge about ET suctioning.

Maternal Knowledge and Practices Related to Childhood Diarrhea at A Tertiary Care Hospital In District Mardan

2023-04-13T05:48:44-05:00

OBJECTIVES

To assess the mother’s knowledge, and practices regarding the prevention and home-based management of diarrhea in their children.

METHODOLOGY

This cross-sectional study was conducted on a sample of 271 mothers, using convenient sampling technique. The study population was mothers of under-five year age children recruited from a tertiary care hospital in Mardan. Data were collected through questionnaire and analyzed through SPSS version 24. The study was approved from the institute and data collection permission was granted by the hospital administration. Written consents were obtained from the participants.

RESULTS

The majority (59.4%) of the participants were from the age group of 30 to 40 years. Most (82.7%) of the participants were house wives where 61.3% of them were illiterate. The majority (75%) of the mothers reported average Knowledge, followed by Good (17%) and Poor Knowledge (8%). The major part (74%) of the participants was reported to have satisfactory practices regarding diarrhea prevention and management while 26% of the mothers reported unsatisfactory practices.

CONCLUSION

It was concluded from the study findings that parents had average knowledge and satisfactory practices regarding diarrhea among children. Efforts are required to further enhance mothers’ knowledge and improve their practices regarding diarrhea and its management among children.

Prevalence of Personality Traits in Undergraduate Dental Students with Respect to Gender

2023-03-11T05:23:33-06:00

OBJECTIVES

To study the personality traits of undergraduate dental students with respect to gender.

METHODOLOGY

A Cross-sectional descriptive study was conducted at the College of Dentistry, Sharif Medical and Dental College, Lahore, over 5 months, from July to November 2021. Data was collected using the Ten Item Personality Inventory scale which was a pre-validated questionnaire.

RESULTS

There was a statistically significant association between gender and the personality of trait of emotional stability (p=0.017). There was a non-significant association between gender and the personality traits of extraversion (p=0.273), agreeableness (p=0.416), conscientiousness (p=0.147) and openness to experience (p=0.184).

CONCLUSION

The personality traits of extraversion, agreeableness, conscientiousness and openness to experience were more prevalent in the females in comparison to the males.

Assessment of Pregnant Women Knowledge Regarding Anemia during Pregnancy at Selected Hospitals of Peshawar

2023-03-11T04:58:40-06:00

OBJECTIVES

The purpose of this study was to assess knowledge of pregnant women regarding anemia during pregnancy.

METHODOLOGY

A descriptive cross-sectional study design was used in this study. The study was conducted during 6 months (15^th April-15^thSeptember 2022). By using non probability convenience sampling technique, 100 pregnant women admitted in gynecology department of tertiary hospitals of Peshawar were selected for this study. Informed consent was secured from the participants and permission was taken from tertiary hospitals administration. Data were collected by self-administered questionnaire and analyzed through SPSS version 22.0.

RESULTS

In a sample of (n=100), 78% of the participants were within the age limit of 20 -30 years and 21% were within 30-40 age limit. Out of the total respondents 35% had weak knowledge, 61% of the participants had fair knowledge, and 4 % of the participants had good knowledge regarding anemia during Pregnancy.

CONCLUSION

Majority of participants had insufficient knowledge regarding anemia during pregnancy. Health education about foods with a high concentration of Iron is an essential step towards reducing iron deficiency anemia in pregnant women.

Assessment of Intensive Care Unit Nurses Knowledge Regarding Pressure Ulcers in a Tertiary Care Of Hospital Karachi

2023-05-08T17:02:06-05:00

OBJECTIVES

The objective of the study was to assess nurses Intensive Care Nurse’s knowledge regarding pressure ulcers.

METHODOLOGY

A cross-sectional study design was used to collect data from a convenient nonprobability sample of 50 nurses at a tertiary care Hospital in Karachi. The data collection period was from September to December 2022. The pressure ulcer knowledge assessment tool was used to gather data, which was self-constructed. Approval was secured from respective department. SPSS version 26 was used to analyze the data.

RESULTS

Study findings show that 18% of the sample have a low level of knowledge, 44% have moderate, and 38% have a high level of knowledge regarding pressure ulcers.

CONCLUSION

Based on the study findings, most participants with a significant proportion (44%) fall under the moderate category. However, it is concerning to note that 18% of the nurses had a low level of knowledge about pressure ulcers, highlighting the need for targeted educational interventions to improve their knowledge.

The Acceptance and Hesitancy of Covid-19 Vaccine among Nurses in Public Sector Tertiary Care Hospitals of Peshawar

2023-04-27T04:59:10-05:00

OBJECTIVES

To assess Covid-19 Vaccine Acceptance and Hesitancy level among Nurses in the Public Sector Tertiary Care Hospitals of Peshawar.

METHODOLOGY

This descriptive cross-sectional study was conducted from 1 September to 31 December 2021 at public sector tertiary care hospitals of Peshawar Khyber Pakhtunkhwa. Three hundred forty staff nurses were included in this study using convenient sampling techniques. A modified questionnaire was used for data collection, and consent was taken from the participants. Data were analyzed through SPSS software version 25.0.

RESULTS

The study’s findings showed that 92.4% of the participants agreed to receive the vaccine, and 3.9% disagreed to get it. And most of the participants were hesitant for the reasons of the effectiveness of the COVID-19 vaccine 48.3%, worried about the adverse effects of the vaccine 62.3%, fear of being infected with COVID-19 after getting the vaccine 50%, and COVID-19 vaccine not give permanent protection to the vaccinated people 61.1%.

CONCLUSION

Despite overall acceptance among nurses, others express fear of being vaccinated and consider the vaccine non-effective. Forthcoming vaccination must address this hesitancy that the vaccine is safe and provide immunity to get adequate results.