A process of quality improvement for outcomes-based critical care nursing education

Dissertation (PhD) -- University of Stellenbosch, 2001. / ENGLISH ABSTRACT: A thoughtfully planned learning program provides a blueprint for critical care
nursing and gives direction to theory and clinical practice. The design of a
learning program for critical care nursing that is adaptive, learner focussed and
integrated, helps nurses acquire the necessary competencies (knowledge,
technical skills and attitudes/values) needed for critical thinking. It also enables
critical care nurses to grow professionally and to develop expertise in critical care
nursing. Outcomes-based education has become the "new buzz word" in South
Africa, and a paradigm shift from content-based to outcomes-based education
has become essential.
Institutions are concerned with efficient and effective approaches to critical care
nursing delivery. The institution (nursing department) proves its worth by
anticipating patient care needs and planning its learning program cognizant of
the need to correlate activities with the institution's (nursing department) mission
and outcomes. Planning that meets the learning needs of the critical care
nursing learners not only provides the ability to meet job expectations, but also
experiences for professional growth and satisfaction. In an age of nursing
shortage, a well planned, integrated and outcomes orientated critical care
learning program is essential.
The outcome of the research was identified as a process of quality improvement
for outcomes-based critical care nursing education, which included validated
standards to facilitate quality critical care nursing education. This was
researched by utilising an adapted Laing and Nish Model for Quality Assurance
(1981) as the research strategy. Seven (7) steps were identified, namely: Step
one included the identification and clarification of values; step two determined
criteria, established standards for outcome, structure and process; step three
ratified criteria and validated standards; step four identified and analysed factors
influencing the results; step five selected appropriate actions to maintain or improve critical care nursing education; step six implemented the selected
actions and in step seven, assessment (testing) was done.
In steps two and three of the quality improvement process the Muller's (1996)
Three Phase Model for Standard Development was implemented. Seven (7)
standards were identified and formulated, namely: Standard one - Quality
improvement; Standard two - Standard formulation; Standard three -
Philosophy; Standard four - Legislative framework; Standard five - Curriculum
development (learning program development); Standard six - Outcomes-based
education; and Standard seven - Critical care nursing education. During the
process of validation of the standards, standards five and six were combined and
became Standard five - Outcomes-based learning program development. In
step three the Delphi technique as part of the second phase of Muller's model
(1996), was utilised to gain expert opinions / validation of standards.
Operationalisation and assessment of the validated standards as part of a
process of quality improvement for outcomes-based critical care education were
done in a higher education institution. The results of this pilot study that was
done supported the central theoretical assumption, namely that outcomes-based
critical care nursing facilitates quality critical care nursing.
The uniqueness of the research lies in the fact that in outcomes-based critical
care nursing education there is no formal process of quality improvement for
outcomes-based critical care nursing education. In this research, standards were
developed and presented as part of a process of quality improvement for
outcomes-based critical care nursing education. These standards should guide
the developer of an outcomes-based critical care nursing education program
during the development of the learning program (meso curriculum) and could be
utilised to judge the quality of the current learning programs' quality. Five of the
six standards are generic and could be utilised with minor adjustments in any
higher education learning program. / AFRIKAANSE OPSOMMING: 'n Weldeurdagte leerprogram dien as 'n bloudruk vir kritiekesorg-verpleging, en
rig beide die teorie en die kliniese praktyk. Die ontwerp van 'n leerprogram vir
kritiekesorg-verpleging wat ge"integreerd,leerder-gefokus en aanpasbaar is, help
verpleegkundiges om die nodige vaardighede (kennis, tegniese vaardighede en
houdings/waardes) vir kritiese denke te ontwikkel. Dit stel kritiekesorg
verpleegkundiges ook in staat om professioneel te groei en om kundigheid in
kritiekesorg-verpleging te ontwikkel. Uitkoms-gebaseerde onderrig is die "nuwe
wagwoord" in Suid-Afrika en het 'n paradigmaskuif van inhoud-gebaseerde- na
uitkoms-gebaseerde onderrig genoodsaak.
Instellings is begaan oor doeltreffende en effektiewe benaderings vir die lewering
van kritiekesorg verpleging. Die verrnoe van 'n instelling (departement
verpleging) om pasientsorq-behoeftes te voorspel en om die kritiekesorg
leerprogram se aktiwiteite in ooreenstemming met die instelling (departement
verpleging) se missie en verwagte uitkomstes te beplan, bewys die waarde
van die instelling (departement verpleging). 8eplanning wat aan die
leerbehoeftes van die kritiekesorg-Ieerders voldoen, bevredig nie aileen hul
werksverwagtinge nie, maar het ook professionele groei en genoegdoening
tot gevolg. In Goed-beplande, ge"integreerde en uitkoms-georienteerde
kritiekesorg leerprogram is essensieel in 'n tyd waar verpleegtekorte aan die orde
van die dag is.
Ten einde gehalte-verpleegonderrig te fasiliteer, is die uitkoms van die navorsing
as 'n proses van gehalteverbetering vir uitkoms-gebaseerde kritiekesorgverpleegonderrig,
wat gevalideerde standaarde insluit, ge"identifiseer. 'n
Aangepaste Laing en Nish Model vir Gehalteversekering (1981) is as
navorsingstrategie vir hierdie navorsing gebruik. Sewe (7) stappe is
ge"identifiseer, naamlik: Stap een sluit die identifisering en verduideliking van
waardes in; stap twee bepaal kriteria en skep standaarde vir uitkoms, struktuur
en proses; stap drie bekragtig en valideer die standaarde; stap vier identifiseer en ontleed faktore wat die resultate belnvloed; stap vyf selekteer toepaslike
aksies om kritiekesorg-verpleegonderrig te handhaaf of te verbeter; stap ses
implementeer die geselekteerde aksies en in stap sewe is assessering (toetsing)
gedoen.
Muller (1996) se Drie Fase Model vir Standaardontwikkeling is in stappe twee en
drie van die gehalteverbeteringsproses ge"implementeer. Sewe (7) standaarde is
ge"identifiseer en geformuleer, naamlik: Standaard een - Gehalteverbetering;
Standaard twee - Standaardformulering; Standaard drie - Filosofie; Standaard
vier - Wetlike raamwerk; Standaard vyf - Kurrikulumontwikkeling (Ieerprogramontwikkeling);
Standaard ses - Uitkoms-gebaseerde onderrig; en Standaard
sewe - Kritiekesorg-verpleegonderrig. Tydens die valideringsproses van die
standaarde, is standaarde vyf en ses gekombineer as Standaard vyf - Uitkomsgebasseerde
leerprogramontwikkeling. Gedurende stap drie is die Delphitegniek
tydens die tweede fase van Muller (1996) se model gebruik om
deskundige opinies te verkry I die standaarde te valideer. Operasionalisering en
assessering van die gevalideerde standaarde as deel van In sisteem van
gehalteverbetering vir uitkoms-gebaseerde onderring is in 'n hoeronderwysinstelling
gedoen. Die resultate van hierdie toetsstudie het die sentrale
teoretiese aanname, naamlik dat uitkoms-gebaseerde kritiekesorg-verpleging
gehalte kritiekesorg-verpleging fasiliteer, ondersteun.
Die uniekheid van hierdie navorsing is gelee in die feit dat daar in uitkomsgebaseerde
kritiekesorg-verpleegonderrig, geen formele proses van
gehalteverbetering vir uitkoms-gebaseerde kritiekesorg-verpleegonderrig is nie.
In hierdie navorsing is standaarde ontwikkel en aangebied as deel van In sisteem
van gehalteverbetering vir uitkoms-gebaseerde kritiekesorg-verpleegonderrig.
Hierdie standaarde kan tydens die ontwikkeling van die leerprogram
(mesokurrikulum), die ontwikkelaar van In uitkoms-gebaseerde kritiekesorgverpleegondderigprogram
begelei, en kan gebruik word om die gehalte van
huidige leerprogramme te beoordeel. Vyf van die ses standaarde is generies en
kan, met minimale veranderinge in enige hoer onderwys leerprogram gebruik
word.

Identiferoai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/52125
Date January 2001
CreatorsVan Belkum, Corrien
ContributorsKapp, C.A, van der Merwe, T.D., Stellenbosch University. Faculty of Education. Dept. of Curriculum Studies .
PublisherStellenbosch : Stellenbosch University
Source SetsSouth African National ETD Portal
Languageen_ZA
Detected LanguageUnknown
TypeThesis
Format341 leaves : ill.
RightsStellenbosch University

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