Thesis (M.S.)--University of Michigan, 1989.

Thesis (M.S.)--University of Michigan, 1989.

The purpose of this study was to evaluate the quality of professional practice by the registered nurses midwives as reflected in clinical nursing care records for postlaparotomy patients in public central hospitals in Malawi. The set process standards by Nurses and Midwives Council of Malawi (NMCM) were addressed in relation to clinical care of post-laparotomy patients. The hypothesis for this study was that the quality of professional practice by the registered nurse midwives as reflected in clinical nursing care of post-laparotomy patients in public central hospitals in Malawi is inadequate and non-compliant with the process standards set by the NMCM. The researcher used quantitative, evaluative, descriptive, contextual survey and participatory observations to collect data. A three-point rating scale consisting of compliance (C) = 1, partial compliance (PC) = 0.5 and non-compliance (NC) = 0.0 was used to evaluate the state registered nurse midwives’ compliance with process standards. The results showed partial compliance with the set NMCM process standards by the state registered nurse midwives in public central hospitals in Malawi. / Health Studies / M.A. (Health Studies)

Although I was trained as a nurse, I became curious about the views of psychiatric nursing staff as to what they feel would create a clinical learning environment for them. This was as a result of having my dearly beloved father admitted to a medical ward, and being on the receiving side of care. This created a fear in me that surprised me. I was scared at how my father would be treated if I was not present to witness his care. As a nurse, strangely, I felt that I could not trust the nurses to provide safe clinical care for/with my father. I began to feel concerned about the competencies of nurses as I observed the care that was being offered to him. My observation and experience was that the ward environment generated an atmosphere that needed a form of nursing care that was collaborative and transparent where the hand-over between professionals communicated the needs of the patients in their care – from making sure that patients’ bedding is comfortable, to checking whether they are trying to communicate something, to being sure that their medication has been properly given. This aroused my curiosity as to whether nursing staff themselves had views as to what is needed to have, or to create, an environment that sustained their original urge to take up nursing in the first place. I thus became curious to investigate the views and experiences of both qualified and non-qualified psychiatric nurses with the aim of improving the clinical learning environment within acute adult inpatient wards, as well as secure adult and male adolescent mental health inpatient wards, as these wards raise crucial issues to do with control, power, seclusion, rights and responsibilities, issues that are not easy for nurses to learn to deal with in their classroom training. For this study I interviewed sixteen staff members of wards within the National Health Service and the private sector. The staff varied in their experiences and qualification, from qualified mental health nurses to non-qualified nurses. My findings show that: (1) Nurses often felt the ward organisation had hindered their learning through the way in which it worked to organise them. (2) Nurses would have liked to experience a different kind of learning. However they were not sure in what way or how they would like the learning experience to be. (3) The expert nurses were able to work in a competent manner despite the sense of the organisation organising their practices, as they were able to sense which of the limited number of organisational possibilities were open to them so that their choices allowed for their practices to be learning experiences as well as providing sound clinical care. (4) Learning dialogues happen in contexts where nurses feel supported and where the episode of care in which they are engaged is also supported by a team approach and resourceful pulling together of skills and abilities. (5) There was a lack of space(s) for the nurses to use for reflection. (6) Nurses also expressed the need for supervision after an episode or critical event had taken place. (7) Throughout all the areas I inquired into, what was strongly echoed was that the psychiatric nurses all felt that they needed a voice within the organisation and its hierarchy of team structures within these wards. There was a felt sense that the nurses wanted and at times needed more expert nurses working in the teams. Overall, I was struck by the abilities which were brought to the forefront as the nurses shared their views and experiences of how they felt organised by the organisation. They were able to explore the factors that they felt would improve the quality of care that nurses provide and were able to share what they believe will help them in co-creating standards for how the clinical environment could become a learning environment for the nurses.

Thesis (M.S.)--University of Michigan, 1990.

Thesis (M.S.)--University of Michigan, 1990.

The purpose of this study was to evaluate the quality of professional practice by the registered nurses midwives as reflected in clinical nursing care records for postlaparotomy patients in public central hospitals in Malawi. The set process standards by Nurses and Midwives Council of Malawi (NMCM) were addressed in relation to clinical care of post-laparotomy patients. The hypothesis for this study was that the quality of professional practice by the registered nurse midwives as reflected in clinical nursing care of post-laparotomy patients in public central hospitals in Malawi is inadequate and non-compliant with the process standards set by the NMCM. The researcher used quantitative, evaluative, descriptive, contextual survey and participatory observations to collect data. A three-point rating scale consisting of compliance (C) = 1, partial compliance (PC) = 0.5 and non-compliance (NC) = 0.0 was used to evaluate the state registered nurse midwives’ compliance with process standards. The results showed partial compliance with the set NMCM process standards by the state registered nurse midwives in public central hospitals in Malawi. / Health Studies / M.A. (Health Studies)

Colorectal rectal cancer (CRC) is the 3rd most common cancer in men, the 2nd most common cancer in women, and the 4th leading cause of cancer death. Lack of screening or delayed screening for CRC is the major cause of undiagnosed cancers that become malignant and eventually become fatal. Nurses at the project site are not in compliance with CRC screening guidelines due to inadequate knowledge of the screening guidelines recommended by the American Cancer Society, which creates a gap in practice. The purpose of this project was to develop staff education on CRC screening guidelines. The practice focused question addressed if evidence-based education regarding CRC screening could be an effective means for nurse education, according to a panel of local experts. A pre-test evaluation of knowledge regarding CRC screening was administered to nursing staff from the site. The John Hopkins evidence-based practice model guided the development of the staff education program, using the results of the pre-test, evidence-based practice literature and guidelines. The project team, consisting of a physician and medical support staff, evaluated the education program, plan for delivery, and plan for evaluation of learning through an anonymous Likert-style evaluation survey. The 3 team members also completed program evaluation surveys, and 100% agreed or strongly agreed that the program objectives were met. The project was limited to planning only and the education program materials, along with plans for later implementation and evaluation of learning through pre- and post-tests, were handed over to the project site for delivery at a later date. The CRC screening education will become part of the yearly staff competencies, leading to appropriate screening of the site’s patient population. This education project has the potential to promote positive social change by saving lives and improving the quality of those lives.

Submitted by Fabíola Silva (fabiola.silva@famerp.br) on 2017-02-21T13:29:42Z No. of bitstreams: 1 kethicristinadorsalexandre_dissert.pdf: 1989268 bytes, checksum: ae2265c64c325257b52258ca4fd69eec (MD5) / Made available in DSpace on 2017-02-21T13:29:42Z (GMT). No. of bitstreams: 1 kethicristinadorsalexandre_dissert.pdf: 1989268 bytes, checksum: ae2265c64c325257b52258ca4fd69eec (MD5) Previous issue date: 2014-08-08 / Introduction: The background and the pedagogical practice of teachers have an essential role to the former nursing student and for construction of educational action. Objectives: This study aimed to identify, analyze and relate the training and pedagogical practice in Undergraduate Nursing private and public institutions. Methods: A descriptive, correlational cross-sectional study using a quantitative approach using a questionnaire, which was answered by 107 teachers from private and public institutions of the inland of São Paulo State. Respondents were 60 teachers from private institutions and 47 teachers from a public institution. Data collection occurred from June to August 2013. Statistical analysis used the Statistical Package for Social Sciences (SPSS) for Windows ® version 22 and the chi-square and Fisher exact statistical tests were applied. Results: In the private institutions the teachers are predominantly female (76.7%) without a spouse (51.7%) age ranging from 31 to 50 years (60%), with more than one job (58.3%), master’s degree (41.7%), weekly working hours from 11 to 30 class load/hours with activities centered on education (40%) and planning of the discipline individually (55%). As for the difficulties in teaching practice reported by the teachers of private institutions, we found 26 (43.3%) institutional difficulties, with a prevalence of low pay, lack of support for research and infrastructure; 24 (40%) related to students, such as lack of interest and basic knowledge; 10 (16.7%) related to teaching, they reported lack of appropriateness of the content to the undergraduate student, excessive workload and another job. Regarding the types of evaluation, we found that 60 (100%) teachers of private institutions apply written tests. In the public institution, the teachers were women (100%), married (66%) aged over 50 years (63.8%) without another job (76.6%), working over 31 hours weekly classes (74.5%), doctors (61.7%), activities focused on education (68,52%), collective planning of the discipline (86%) and written exam as an assessment (89.4%). The difficulties of the teachers from the public institution, 36 (76.6%) were related to the teaching (lack commitment, interdisciplinary and theory-practice dichotomy), 8 (17%) about the lack of student interest, and only 3 (6 4%) reported institutional difficulties. There were significant differences in the background and pedagogical practice of teachers of private and public institutions regarding age, duration of teaching, workload, more than one job, degree, course planning, teaching techniques and diverse types of reviews. There was a similarity in relation to the participation of teachers in continuing education, teacher training and more hours devoted to teaching. Conclusion: The private and public institutions, despite being from the same area showed different work processes. The results of this study provide grants to institutions of educational interventions for improvement of teachers in improving the quality of nursing education. / Introdução: A formação e a prática pedagógicas dos docentes têm um papel fundamental para o egresso de enfermagem e na construção de ação educativa. Objetivos: Este estudo teve como objetivos identificar, analisar e relacionar a formação e a prática pedagógicas em Cursos de Graduação em Enfermagem de Instituições privadas e pública. Métodos: Estudo descritivo, correlacional, de corte transversal e abordagem quantitativa que utilizou um questionário respondido por 107 docentes de instituições particulares e pública de uma cidade do interior paulista. Os respondentes foram 60 docentes de instituições particulares e 47 da pública. A coleta de dados ocorreu no período de junho a agosto de 2013. Para análise estatística utilizou-se o software Statistical Package for the Social Sciences (SPSS) for Windows®, versão 22 e foram aplicados os testes estatísticos qui-quadrado e exato de Fisher. Resultados: Nas instituições particulares houve predomínio do sexo feminino (76,7%), sem acompanhante (51,7%), com idades de 31 a 50 anos (60%), mais de um emprego (58,3%), mestres (41,7%), carga horária semanal de 11 a 30 horas/aula, atividades centradas em ensino (40%) e planejamento da disciplina individual (55%). Quanto às dificuldades na prática pedagógica relatadas pelos docentes das instituições particulares encontramos: 26 (43,3%) foram institucionais, com prevalência de baixa remuneração, falta de apoio à pesquisa e infraestrutura; 24 (40%) relacionadas aos estudantes, falta de interesse e de conhecimento básico; 10 (16,7%) quanto à docência, reportamos falta de adequação do conteúdo ao alunado, carga horária excessiva e outro emprego. Em relação aos tipos de avaliação, constatamos que 60 (100%) docentes das instituições particulares aplicam prova escrita. Na instituição pública, o corpo docente era composto por mulheres (100%), casadas (66%), com idade de mais de 50 anos (63,8%), sem outro emprego (76,6%), carga horária acima de 31 horas aulas semanais (74,5%), doutoras (61,7%), atividades concentradas em ensino (68,52%), planejamento coletivo da disciplina (86%) e prova escrita como avaliação (89,4%). As dificuldades dos docentes da instituição pública, 36 (76,6%) relacionavam-se à docência (falta comprometimento, interdisciplinaridade e dicotomia teoria-prática), 8 (17%) quanto à falta de interesse dos estudantes e, apenas 3 (6,4%) relataram dificuldades institucionais. Verificaram-se diferenças significativas em relação à formação e a prática pedagógicas dos docentes das instituições particulares e pública quanto à idade, tempo de docência, carga horária, mais de um emprego, titulação, planejamento da disciplina, técnicas didáticas e tipos de avaliações diversificadas. Houve semelhança em relação à participação dos docentes na educação permanente, formação pedagógica e maior carga horária dedicada ao ensino. Conclusão: As instituições particulares e pública, apesar de serem da mesma área, apresentaram processos de trabalho distintos. Os resultados deste estudo fornecem subsídios às instituições para intervenções de aperfeiçoamentos pedagógicos dos docentes na melhoria da qualidade do ensino de enfermagem.

O objeto do presente estudo é o reflexo da enfermagem no espelho, a partir das concepções sobre as especializações em enfermagem e sobre a própria profissão, a formação e a prática profissional, conforme apresentadas na Revista Brasileira de Enfermagem, ano de 2003. Houve uma primeira fase exploratória, onde o trabalho de campo não se mostrou satisfatório, uma vez que não foi suficiente para responder às indagações ou fornecer as explicações sobre a atuação e as atribuições profissionais de enfermeiros com titulação de especialistas no mercado de trabalho. Por isso, partiu-se para um outro tipo de estudo, desta vez, descritivo, contemplando uma abordagem qualitativa por meio de uma revisão bibliográfica, baseada no método de análise de conteúdo. Desta forma, o estudo tem por objetivo geral analisar as imagens refletidas pela enfermagem ao olhar-se no espelho, a primeira a partir de um panorama geral da profissão e suas especialidades e, a segunda a partir das concepções que ela tem a respeito da própria profissão, da formação e da prática profissional, tal como são vistas na Revista Brasileira de Enfermagem, ano 2003. Os objetivos específicos são: descrever os principais pontos de vista encontrados sobre as características da profissão, sobre o processo de formação e sobre a prática profissional e contextualizar o panorama das especialidades à luz dos pontos de vista descritos. Dentre os principais resultados do estudo, destacamos a elaboração de um panorama geral da enfermagem no Brasil e as especialidades e de quatro categorias de análise: o que é a profissão de enfermagem; formação profissional da enfermagem; prática profissional da enfermagem e a enfermagem em processo de construção. A nós parece que a enfermagem tem apresentado dois reflexos diferentes neste espelho, as quais não se comunicam entre si. A primeira imagem refletida no espelho é a de uma enfermagem que busca definir especialidades da profissão voltadas para o aperfeiçoamento técnico, numa tentativa de se auto-afirmar no mercado de trabalho, que vem ficando cada vez mais específico e seletivo. A segunda imagem é a de uma enfermagem em busca de encontrar sua identidade enquanto ciência, e para isso, ela reflete, investiga e debate sobre o cuidado e sobre as teorias que sistematizam este cuidado. A questão é que estes dois reflexos apresentam fortes diferenças entre si, o que gera uma imagem distorcida para a profissão. / This study aims to reflect Nursing in the mirror, based on the concepts about Nursing specialities and the profession itself, the formation and professional practice, according to the Revista Brasileira de Enfermagem (2003). There was a first investigative phase, but field work was not satisfactory since questions were not fully answered nor explanantion on the professional performance and attributions of specialized nurses were given. Then a descriptive study was developed, a qualitative approach with a bibliographical review based on the content analysis method. So the general objective of this study is to introduce images Nursing reflects in the mirror, starting with an overview of the profession and its specilities and the scond image is based on Nursings own concepts on the profession, on the formation and on professional practice, according to the Revista Brasileira de Enfermagem (2003). The specific objectives are: to describe the main viewpoints on the professions characteristics, on the process of formation and professional practice, contextualizing the specialities scenario based on these overviews. Among the main results of the study, we point out the ellaboration of a general overview of Nursing in Brazil and its specialities, and of four analysis categories: what is the Nursing profession; professional formation; professional practice; and Nursing under construction. It seems that Nursing has two different reflections in this mirror, which do not talk to each other. The first image reflected in the mirror is Nursing trying to define professional specialities concerned with technical improvement searching for self-assertion in a more specific and selective labor market. The second image is Nursing in search of its destiny as science, so it reflects upon, examines and debates on healthcare and theories which systematize this care. The point is that one reflection is very different from the other, what creates a distorted image about the profession.