QUALITY OF NURSING CARE OF BALIUAG UNIVERSITY LEVEL IV

STUDENTS OF CLIENTS DURING LABOR AND DELIVERY:

A SELF-PERCEIVED ESTIMATE ON THE BASIS
OF CORE COMPETENCIES

A Research Study
Presented to
The Faculty of the College of Nursing
BALIUAG UNIVERSITY

In Partial Fulfillment
of the Requirement for the subject
Introduction to Nursing Research (NRS 401)

by:
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28 0ctober 2010
 C O N T E N T S

Pages

Title Page………………………………………………………..…………….i
Approval Sheet …………………..………………..…..……..….…………...ii
Dedication ………………………………………………………..…...……...iii
Acknowledgement ……………………………..………………..…….……...iv
Research Abstract ……………………………………………………………v
Contents ……………………………………………………………......…….vi
List of Tables and Figures ………………….……………….…………….....viii

CHAPTER
I. THE PROBLEM: ITS RATIONALE AND BACKGROUND

Background of the Study

Statement of the Problem
Purpose
Objectives
Significance of the study
Scope, Limitation and Delimitation
Hypothesis
Conceptual Framework
Operational Definition of terms

II. REVIEW OF RELATED LITERATURE

Related Legal Bases
Related Literature
Related Studies

III. METHODOLOGY

Research Design
Research Environment and Respondents
Tools for Data Gathering
Data Gathering Procedures
Statistical Analysis of the Data

IV. PRESENTATION, INTERPRETATION, AND ANALYSIS OF

DATA

V. SUMMARY, CONCLUSION, AND RECOMMENDATIONS

Summary
Conclusion
Recommendation
Bibliography

Appendices

Appendix A Letter to the Dean of the College of Nursing

Appendix B Cover Letter
Appendix C Questionnaire
Appendix D Curriculum Vitae
 CHAPTER 1

THE PROBLEM: ITS RATIONALE AND BACKGROUND

Background of the Study

Labor and delivery nurses provide care for pregnant women in a variety of situations in

addition to the actual birth process. From complications during pregnancy to postpartum

care, labor and delivery nurses provide nursing care plus the support and empathy

required for what can be the most exciting, yet sometimes frightening and painful time in

a woman's life.

Baliuag University College of Nursing, since it was offered in the university in

1974 has made phenomenal achievement in the history of professional nursing which

lead to the recognition of the university as an academic discipline and a profession. Being

one of the finest nursing hubs in Region III, the college has already produced qualified

nursing graduates in the Nursing Licensure Examinations.

Nursing has become increasingly involved in broader aspects of maternal, neonatal,

and women’s health care: and as members of the specialized health care team, we are

being constantly challenged to achieve better maternal-neonatal outcomes. Development

of a functioning human being from a fertilized ovum involves a complex process; hence,

it is a main responsibility of each member of the health team to safeguard the life both of

the mother and child. Also, pregnancy and childbirth are psychosocial events that deeply

affect the lives of partners and families. According to Aileen MacLaren, CNM,MSN,
Research Associate and Partner of the Johns Hopkins Nurse-Midwives, ‘’Nothing defines

the self concept of most men and women more than the challenges of bearing and raising

a child. Pregnancy and childbirth change parent’s lives irrevocably, therefore presenting

them with a long-term commitment that benefit from intellectual and emotional

preparation.’’ Therefore, care of the expectant family presents a nurse with special

immense amount of responsibilities and challenges. Impending labor and childbirth

typically trigger both excitement and apprehension in a pregnant mother. Whether the

patient is about to give birth for the first time (primipara) or is experienced from previous

childbirth (multipara), the nurse must be competent enough to understand that the patient

will always have many physical and psychological needs, and this can be attained

through a good foundation of the concept of labor and delivery. Because childbirth is a

stressful experience, steadfast support by a nurse can help ease emotional stress and

physical discomfort during this time. The nurse must facilitate the family’s normal

adaptation to and integration of the new family members by promoting self-esteem,

family integrity, and adaptive coping. As such, it may be right to gain insights on how

the Level IV Nursing Students of Baliuag University asses their level of competency

during labor and delivery on the basis of core competencies.

This research is intended to provide an opportunity for discussion and a medium for

a deeper level of investigation, as each student recognizes which areas present the

greatest individual challenges to learning.

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Statement of the Problem

This study aims to analyze the perception of Baliuag University Level IV Nursing

Students of Class 2011 on how they assess their level of competencies during labor and

delivery on the basis of core competencies.

Specifically, the study aims to answer the following questions:

1. What is the profile of Level IV Nursing students of Baliuag University in

terms of:

• Age

• Sex

• Civil Status

• Number of Actual Deliveries and Assisted Deliveries handled

2. What is the quality of nursing care of Level IV nursing students of clients

during labor and delivery?

3. What is the mean competency level of Level IV nursing students in caring of

mothers during labor and deliver using the 11 Key areas of responsibility and

Core Competencies?

4. What are the strengths and weaknesses of the Level IV Nursing Students of

Baliuag University in caring of clients during labor and delivery?

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 5. What are the factors that contribute to a successful learning of concepts on the

Care of clients during labor and delivery?

Purpose

The purpose of this study is to gain insights from Baliuag University Level IV Nursing

Students on how they assess themselves on their level of competency during labor and

delivery.

The result of this study will benefit the subjects by giving them what are the things

that they or possess or lack and the problems that they can anticipate once they set foot

on the labor and delivery rooms as registered nurses. By this means, the said beneficiaries

can prepare themselves if a particular problem will come their way.

Objectives

The researchers aim to provide an analysis on the Level of competence of Level IV

Nursing students in caring of Clients during labor and delivery.

The researchers had the following objectives:

1. To determine the profile of Level IV Nursing students of Baliuag

University in terms of:

• Age

• Sex

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 • Civil Status

• Number of Actual Deliveries and Assisted Deliveries handled

2. To know the quality of nursing care of Level IV nursing students of

clients during labor and delivery?

3. To discover the mean competency level of Level IV nursing students in

caring of mothers during labor and deliver using the 11 Key areas of

responsibility and Core Competencies?

4. To identify the mean number of cases of level IV nursing students in:

• Actual Deliveries

• Assisted Deliveries

• Cord Dressing

5. To find out the strengths and weaknesses of the Level IV Nursing

Students of Baliuag University in caring of clients during labor and

delivery?

6. To identify the factors that contribute to a successful learning of concepts

on the Care of clients during labor and delivery?

Significance of the study

The need for quality health care providers continues to increase nationwide as the population

continues to grow and there is a greater emphasis on medical assistance and prevention. Labor
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and Delivery (L and D) registered nurses, in addition to their educational training, require a

number of different personal traits. For example, they must be able to make fast decisions, cope

well with high-stress situations and handle emotionally upsetting circumstances that come with

delivery complications.

It is takes therefore a long process to acquire the necessary knowledge, skills, and

attitude. Thus, the study is found significant to Nursing students, Faculty members,

Nursing administrators, and Registered nurses. The study attempts to analyze the

competencies of level IV nursing students as a basis of the effective delivery of

curriculum particularly maternal and child health.

To staff nurses, this will indicate the aspects of nursing care they should

strengthen so that the care they may render becomes more holistic. For clinical

instructors, this may guide them as to what aspects of care they should emphasize more

as to assist and better guide their students in delivering quality nursing care to their

patients. For nursing administrators, this will help them in their endeavor to train nurses

to develop the ability to render quality nursing care to their patients. This could also be a

basis for planning seminars that concern nursing care. To nursing education, this will

help deans in enriching the curriculum with activities that may better prepare student

nurses to become competitive nurses in the long run.

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Scope, Limitation and Delimitations

The study entitled, ‘’ Quality of Nursing Care of Baliuag University Level IV Students of

Clients during Labor and Delivery: A Self-Perceived Estimate on the basis of Core

Competencies’’ is an analysis of the level of competence of Level IV nursing students of

Baliuag University in the care of clients during labor and delivery. It also involves the

immediate care of the newborn. It covers the senior nursing students of Class 2011.

However, this research study is delimited to those who have no actual experience

in assisting in delivery and doing cord care.

Furthermore, the study to be conducted will be greatly affected by the availability

of the respondents. The researchers have little or no control on the judgment of the

respondents about the factors that can affect their answers. The veracity of the answers

they will give to each question is their personal choice to withhold.

Hypothesis:

There is a relation between the number of cases being handled in the labor and delivery

area to the level of competency of Level IV Nursing students of Baliuag University.

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Conceptual Framework
11 KEY AREAS
OF
RESPONSIBILIT
Y
COMPETENCY LEVEL 5 K A
N S T
COMPETENCY LEVEL 4 O K T
W I I
COMPETENCY LEVEL 3 L
L T
E
D L U
COMPETENCY LEVEL 2 G S D
E E
COMPETENCY LEVEL 1

CORE PERFORMAN
COMPETENCY CE
INDICATORS
The conceptual framework was inspired from Patricia Benner’s Novice to Expert

Theory which says that that in the acquisition and development of a skill, a student passes

through five levels of proficiency: novice, advanced beginner, competent, proficient, and

expert. These different levels reflect changes in three general aspects of skilled

performance (1) One is a movement from reliance on abstract principles to the use of past

concrete experience as paradigms, (2) a change in the learner's perception of the demand
situation, in which the situation is seen less and less as a compilation of equally relevant

bits, and more and more as a complete whole in which only certain parts are relevant, (3)

a passage from detached observation to involved performer.

A novice is one who has no experience of the situations in which they are

expected to perform. Novices are taught rules to help them perform.

An Advanced Beginner is one who can demonstrate marginally acceptable

performance, those who have coped with enough real situations to note, or to have

pointed out to them by a mentor, the recurring meaningful situational components.

A Competent one is one who has been doing the same things for more than twice

or thrice, and can establish a plan based on considerable conscious, abstract, analytic

contemplation of the problem.

A Proficient one is defined as someone who perceives situations as wholes rather

than in terms of chopped up parts or aspects, and performance is guided by maxims. The

proficient nurse learns from experience what typical events to expect in a given situation

and how plans need to be modified in response to these events.

 Finally, the Expert is one who no longer relies on an analytic principle (rule,

guideline, maxim) to connect her or his understanding of the situation to an appropriate

action.

In relation to the core competencies, a student is expected that with regards to the

11 core competencies is able to perform age-specific safety measures and comfort

measures, utilizes nursing process as framework for nursing, performs

comprehensive,

systematic nursing, formulates care plan in collaboration with patients, and other

health team members, determines the resources needed to deliver patient care, maintains

safe environment, assesses the learning needs of the patient and the family, develops

Health Education plan based on assessed and anticipated needs, implements the health

education plan, adheres to practices in accordance with the nursing law and other relevant

legislation including contract and informed consent, respects the rights of individual/

groups, accepts responsibility & accountability for own decisions and actions, identifies

own learning needs , projects a professional image of nurse, contributes relevant

information about patient condition as well as unit condition and patient current

reactions, shares with the team current information regarding particular patients

condition, and maintains good interpersonal relationships with patients, colleagues and

other members of the health team.

Operational Definition of Terms:

EFFECTIVE STUDY

• Refers to the retention of acquired materials that it may be applied

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BALIUAG UNIVERSITY

• A University situated at the town of Baliwag , Bulacan

LEARNING

• Refers to the mental processes by which the knowledge, skills, habits, attitudes,

virtues and ideas are acquired, retained, and utilized resulting in the progressive

adaption and modification of conduct and behavior.

NURSING

• Is a profession focused on assisting individuals, families and communities in

attaining, re-attaining, and maintaining optimal health and functioning. Modern

definitions of nursing define it as a science and art that focuses on promoting

quality of life defined by persons and families throughout their life experiences

from birth to care at the end of life.

PROFESSION
 • Refers to a calling which requires specialized knowledge and often long and

intensive preparation including instruction in skills and method.

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SKILLS

• Refers to the ability to use one’s knowledge effectively and readily in execution

or performance.

STUDENT

• Refers to a person who is engaged in studying something

STUDY

• The act of examining and reading in order to learn and to understand. It involves

gathering ideas and facts to be able to answer questions.

SUCCESS

• The accomplishment of hat is desired or aimed.

PREGNANCY
 • Is a time of profound psychological, social, and biological changes that affect the

parents; responsibilities, freedoms, values, priorities, social status, relationships

and self-images.

CHILDBIRTH

• Is the culmination of pregnancy, the emergence of a child from

its mother's uterus. It is considered by many to be the beginning of a person's life,

and hence the opposite of death.

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CORD DRESSING

• This refer to the process/activity of providing umbilical cord care immediately

after birth by keeping the cord clean to promote drying of the cord and prevent

infection as well.

ACTUAL DELIVERY

• This refer to the actual experience of personally handling a normal delivery by

delivering the neonate from the pregnant mother.

ASSISTED DELIVERY

• This refers to the delivery case attended with the exception of actually delivering

the neonate.

CORE COMPETENCIES
• Refer to the most important or the most integral components /skills in nursing

which serves as the foundation in establishing a well-developed plan of carefor

patients.

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