Describe about the Essay in Midwifery for The Child Mortality.
One of the leading reasons behind the child mortality in various hospitals can be designated as a result of the knowledge gaps of the midwives and the nurses of the pediatric ward that has raised the issue as a concern. Studies conducted have shown that the registered nurses in lots of hospitals have not gained complete knowledge about different practices that has to be considered in declaring a person as the nurse. Moreover, an increased amount of theoretical knowledge in comparison to that of practical works have also been a major concern for the lack of skill and knowledge in the fields of nursing. Different models of tools and questionnaires have been prepared in various reaseaches that often help to know about the gaps in the practice and knowledge of the nursing students. A good deal of change can be brought about by the nursing schools if the the nursing trachers and the authority alters the course in a way that would involve a good amount of clinical practices. Workshops held to provide knowledge in the technologies that are newly introduced into the market should be a help for the nurse. A thorough data analysis have been done through statistical tools to identify the percentiles of the gap as well as the skill levels to prove the condition of the basic knowledge of medication, skill and other parameters.
Nursing in the pediatric ward is a critical task, which requires continuous vigilance over the patient and a good amount of concentration and patience for the job requires handling of children from their infancy to the toddler stage. This field requires excessive knowledge about the way of handling kids and medication. It should also have up to date knowledge about the different medical discoveries as well as the machines that are coming in to the use (Monaghan, 2015). However, this is not the scenario that is observable in the country. The nurses are often ill-treated by the doctors and officials of the higher rank due to their lack of knowledge in the maintained domains. The nurses are seen having no complete knowledge of medication as the medication part in their curriculum only covers a small part of the rubric system (Gallipeau et al., 2015) In these ways different issues can be identified which results in compromises in the knowledge field of the nursing education. As a result, different reforms should be made so that the nurses of the present generation can prepare themselves for excellence in various fields and can carve out a respectable position in the society and take part in a valuable change (Mowry & Crump, 2015).
Knowledge and Practice Gaps among Pediatric Nurses at a Tertiary Care Hospital Karachi Pakistan
A qualitative study is made on the present status of the nurses accounting about their skills and knowledge in respective field. This had helped to analyze the condition of the present day nurses in their fields. This study would help to ascertain the gaps present in their skill and knowledge in their respective areas that needs to be critically looked upon. It also helped to provide a clear scenario where changes to be made in the nursing education for the betterment of the education of the nurses so that they can be fully experienced in their job fields when they become graduated (Wright, 2013).
Five variables were selected based on the areas such as medication, skills, knowledge, code blue handling as well as in the field of operational instruments and knowledge required for it. These five variables that they chose are concrete and apt for assessing our data. In the medical field, gaps in the medication mainly covered the arenas such as compatibility of a particular drug with the system of the patient, or proper dilution that would not be harmful or be less effective to the patients and as well as proper dosage and calculation of the drug (Wall et al., 2014). In case of skills and practice, nasogastric tube insertion, suctioning, catheter fixing and cannulation are the prime fields where the assessment was made. Knowledge included aspects such as proper knowledge about the discoveries and new techniques that are published with the new diagnostic procedure along with a thorough knowledge of each and every disease (DeSilets et al., 2013). Code blue handling mainly involves the handling of different emergencies. The ability to handle modern instruments are mainly concerned with handling modern equipments that are engaged in different analysis in the health sectors (Aziato & Adejumo, 2014). The paper described every variable in a detailed manner that covered every arena of nursing thereby making the survey quite helpful for analysis.
The experimental survey that has been conducted was placed in the hospital consisting of 550 beds in various wards whose campus also had training school as well as a medical college in Karachi. A set of questionnaires were prepared and allotted for a pilot experiment. Conducting a pilot experiment is a plus point of the study ( Roche et al., 2013). After success, some faculty members of the nursing schoolteachers as well a clinical nurse instructor. Samples were about 45 nurses out of which 40 nurses were ready to take part in the education.
This study has adopted the technique of the Quantitative study design so that a proper analysis could be done in knowing the knowledge gap of the nurses. It is unique in the sense that it was the first kind of study conducted in the country as claimed by then. So these efforts need to be praised.
This study was entirely conducted without any breaches in ethics and codes. Before the onset of the experiment permissions were taken from the concerned authorities to avoid legal complicacies. The samples were made to sign a consent form expressing their appraisal to the survey. A complete freedom was provided to any nurses if ever they felt insecure about the survey or feel unsafe. Their names and identities were completely concealed from the survey and were promised not to be revealed. The data that was obtained from the study was kept safely in locked cabinets. It was clearly mentioned to them that this study would not help them in their personal front but would act as a contribution to the overall development of their nursing profession. This again would ultimately come back to them as a boon. The researchers have done their utmost in order to prevent any legal issues as well as no objections can be made later on during the experiment (Short, 2016).
The version 14 of the software called SPSS software were utilized for the correct statistical analysis. Frequencies were calculated on the variables that were mentioned earlier. The statistical grouping was so prepared that it would be easier for understanding the entire scenario of the condition. Skills and the knowledge gaps among the respondents were assessed on terms of the frequencies and the percentages.
As the purpose of the research was to explore the nurse knowledge and practice gap in nursing, a descriptive exploratory method was adopted using universal sampling to know about practice gap in pediatric nurse working at hospital in Karachi. The choice of method is appropriate for the study as exploratory research is conducted to find problem which is not clearly known (Van, 2013). It relies on informal interview or discussion with the employees or consumers. In this quantitative research to identify the knowledge gap in nurse, a questionnaire was developed to know about their knowledge in key areas like medications, skills like catheterization and oral tube insertion, updated knowledge in patient assessment, emergency handling and skill in operating medical device. The strength of the study is the questionnaire as it has covered almost nursing skills that a competent nurse must have in their daily practice.
The findings of the qualitative research were useful due to strategic sample selection criteria. It restricted the sample to those who are more competent and have at least two years of nursing experience. This helped to reduce bias in the results. Firstly, the results of the study showed that about 34% majority of nurse had knowledge gap in medication practice. This results was significant as it revealed that medications for certain purpose continue to change and thus there was a need to make nurse aware about the current list of intravenous drugs in nursing practice regularly. A research by Chuang & Tsao, (2013) gave solution to this problem by suggesting that learning materials regarding new medications should be given to nurse by mobile or by email twice every day for 10 days. This approach worked for the nurses in the study and similar approach can be used to increase the satisfactions level of nurse with new learning materials (Rosenzweig, 2013). Other knowledge gap was seen in the skills required in nursing and gap in knowledge about health assessment and understanding disease process. This was serious trend noted in the research as nurse need to be expert in this area to carry out their nursing duties efficiently. The deficiency in nursing education process was also identified when many nurse reported that they were not taught about intubation and handling immediate cardiac arrest (Williamson et al., 2015). Hence, this research finding made it clear that immediate action is required to address the knowledge in nurses in Karachi hospital setting.
The discussion section of a quantitative research demonstrates the level of analysis of the results of the research and new information gained by carrying out the research. The discussion of the research on knowledge gap in nursing practice is commendable as it gave answer to why gap in particular areas were found. For example, in case of lack of knowledge in medications, the explanation for the gap in skill was that course on medication dosage and dilution techniques carries only four credit hours in nursing diploma program and therefore there is greater chance of this incompetency in practice (Pilcher, 2016). Hence theory-practice gap was identified and the researcher also compared the results with other similar literature. The research by Hayes et al., (2015) is also a proof regarding incident and errors committed by nurse during medicine administration. The discussion section also highlighted the impact on knowledge-practice gap in nurses. For example if paediatric nurse do not have understanding of child development, their quality of nursing care will be compromised. In the event of increased medical error, they will also lose confidence and develop burnout, stress and depression. The discussion was appropriate as it not only mentioned the cause of problem but also gave relevant recommendation to tackle the situation and improve nursing education. Few useful recommendations included increasing credit hours for pediatric practice and special focus for paediatric specialize knowledge for at least six months. Duke et al., (2013) suggests pain management practice and changing attitude of nurse to tackle medical emergencies.
Although the research was consistent with findings of other research on similar topics irrespective of country or location, the limitation identified in the research is not adequate. The researcher mentioned about the challenges faced in the conducting research as a limitation, but he did not mention about the limitation in study findings. On analysis of the complete research, it can be said that knowledge gap occurs not just due to inefficient nursing diploma program, but also due to insecurities and anxiety present in nurses. The research by Sørensen & Brahe, (2014) is also a proof that insecurities among nurses is a reason for interruptions in efficient nursing practice.
Conclusion:
Overall, from analysis of the entire paper one can easily find that it perfectly reflects the present condition of the nurses and the midwives working in the hospitals and other medical centers. The various loopholes that are present in the training procedures of nursing as well as lack of proper workshops to provide information about the present day technology is also marked in the study (Chen & Hsu, 2014). It provides information about the exact fields where authorities need to work upon to bring out the best out of the nurses. Only then the country would receive care that would help the children to live well and recover from ill health.
Reference:
Aziato, L., & Adejumo, O. (2014). Determinants of nurses’ knowledge gap on pain management in Ghana. Nurse education in practice, 14(2), 195-199.
Chen, S. Y., & Hsu, H. C. (2014). Nurses’ reflections on good nurse traits Implications for improving care quality. Nursing ethics, 0969733014547973.
Chuang, Y. H., & Tsao, C. W. (2013). Enhancing nursing students’ medication knowledge: The effect of learning materials delivered by short message service. Computers & Education, 61, 168-175.
DeSilets, L. D., Dickerson, P. S., & Lavin, S. (2013). More on gap analysis.The Journal of Continuing Education in Nursing, 44(10), 433-434.
Duke, G., Haas, B. K., Yarbrough, S., & Northam, S. (2013). Pain management knowledge and attitudes of baccalaureate nursing students and faculty. Pain Management Nursing, 14(1), 11-19.
Galipeau, J., Moher, D., Campbell, C., Hendry, P., Cameron, D. W., Palepu, A., & Hébert, P. C. (2015). A systematic review highlights a knowledge gap regarding the effectiveness of health-related training programs in journalology. Journal of clinical epidemiology, 68(3), 257-265.
Hayes, C., Jackson, D., Davidson, P. M., & Power, T. (2015). Medication errors in hospitals: a literature review of disruptions to nursing practice during medication administration. Journal of clinical nursing, 24(21-22), 3063-3076.
Monaghan, T. (2015). A critical analysis of the literature and theoretical perspectives on theory–practice gap amongst newly qualified nurses within the United Kingdom. Nurse education today, 35(8), e1-e7.
Mowry, M. J., & Crump, M. D. (2013). Immersion Scenarios Bridge the Education–Practice Gap for New Graduate Registered Nurses. The Journal of Continuing Education in Nursing, 44(7), 319-325.
Pilcher, J. (2016). Learning Needs Assessment: Not Only for Continuing Education. Journal for Nurses in Professional Development, 32(4), 122-129.
Roche, J., Schoen, D., & Kruzel, A. (2013). Human patient simulation versus written case studies for new graduate nurses in nursing orientation: A pilot study. Clinical Simulation in Nursing, 9(6), e199-e205.
Rosenzweig, M., Giblin, J., Morse, A., Sheehy, P., & Sommer, V. (2012, March). Bridging the gap: A descriptive study of knowledge and skill needs in the first year of oncology nurse practitioner practice. In Oncology Nursing Forum-Oncology Nursing Society (Vol. 39, No. 2, p. 195).
Short, M. A. (2016). Nursing Perspectives: Neonatal Nurses: Key Stakeholders in the International Neonatal Consortium. NeoReviews, 17(6), e305-e310.
Sørensen, E. E., & Brahe, L. (2014). Interruptions in clinical nursing practice.Journal of clinical nursing, 23(9-10), 1274-1282.
van Riemsdijk, M. (2013). Everyday geopolitics, the valuation of labour and the socio-political hierarchies of skill: Polish nurses in Norway. Journal of Ethnic and Migration Studies, 39(3), 373-390.
Wall, P., Andrus, P., & Morrison, P. (2014). Bridging the theory practice gap through clinical simulations in a nursing under-graduate degree program in Australia. International Journal of Learning, Teaching and Educational Research, 8(1).
Wright, N. (2013). First-time knowledge brokers in health care: the experiences of nurses and allied health professionals of bridging the research-practice gap. Evidence & Policy: A Journal of Research, Debate and Practice, 9(4), 557-570.
Wright, N. (2013). First-time knowledge brokers in health care: the experiences of nurses and allied health professionals of bridging the research-practice gap. Evidence & Policy: A Journal of Research, Debate and Practice, 9(4), 557-570.
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