The study aimed to assess the quality of nursing services provided at B. P. Koirala Institute of Health Sciences, Nepal. Data was collected using questionnaires to evaluate ward in-charges' leadership qualities, functional capabilities, nursing care status, environmental sanitation, and documentation. The results showed that ward in-charges had average leadership skills (69.2%) and managerial performance (48.28%). Nursing care status (72.32%) and documentation (73.23%) were satisfactory. Environmental sanitation was also satisfactory (65.9%). The findings indicate a need for continuous nursing education to improve leadership skills and the quality of nursing services.
The Top 3 Benefits of Acuity-Based Staffing for Your OrganizationAPI Healthcare
In the past, acuity-based systems were known to be highly subjective, inconsistent and unreliable. Today, however, these systems can be much more consistent and accurate, based on scientific data, practice evidence and the ability to pull information directly from a single source of truth, the electronic health record (EHR).
Nursing audit assists in:
1. Evaluating Nursing care given,
2. Achieving deserved and feasible quality of nursing care,
3. Stimulating better nursing records maintenance,
4. Focuses on patient care provided and not on care provider,
5. Contributes to research in nursing.
Advanced practice nursing; an expanded nursing role on an international level Hanze University Groningen
Eduprof Expertmeeting 14-15 April 2011 Groningen.
Workshop Nursing
presentation on Advanced practice nursing; an expanded nursing role on an international level by Mrs. P. Roodbol, Hanze University of Applied Sciences Groningen. The Netherlands
With the objective of understanding more about the challenges that NPs face, we, at Godrej Interio, tried to understand the current work environment and work pattern of the nurses in India. To learn more, download our full paper by Godrej Interio.
With the objective of understanding more about the challenges that NPs face, we, at Godrej Interio, tried to understand the current work environment and work pattern of the nurses in India. To learn more, download our full paper by Godrej Interio.
The Top 3 Benefits of Acuity-Based Staffing for Your OrganizationAPI Healthcare
In the past, acuity-based systems were known to be highly subjective, inconsistent and unreliable. Today, however, these systems can be much more consistent and accurate, based on scientific data, practice evidence and the ability to pull information directly from a single source of truth, the electronic health record (EHR).
Nursing audit assists in:
1. Evaluating Nursing care given,
2. Achieving deserved and feasible quality of nursing care,
3. Stimulating better nursing records maintenance,
4. Focuses on patient care provided and not on care provider,
5. Contributes to research in nursing.
Advanced practice nursing; an expanded nursing role on an international level Hanze University Groningen
Eduprof Expertmeeting 14-15 April 2011 Groningen.
Workshop Nursing
presentation on Advanced practice nursing; an expanded nursing role on an international level by Mrs. P. Roodbol, Hanze University of Applied Sciences Groningen. The Netherlands
With the objective of understanding more about the challenges that NPs face, we, at Godrej Interio, tried to understand the current work environment and work pattern of the nurses in India. To learn more, download our full paper by Godrej Interio.
With the objective of understanding more about the challenges that NPs face, we, at Godrej Interio, tried to understand the current work environment and work pattern of the nurses in India. To learn more, download our full paper by Godrej Interio.
Nurses form the single largest group of health professionals. In all care delivery settings, they have a critical role to improve care, advance health, and provide value. To get more idea, read this PDF.
Quality and Cost of Accreditation's In Healthcare by Mahboob ali khan ,MHA,CPHQ Healthcare consultant
Accreditations and quality assurance systems have also been observed to reduce the average cost of hospitalization. This clearly indicates that accreditations and quality assurance systems help hospitals to streamline their functions and processes, minimize wastage and thereby aid in enhancing quality and reducing cost of care.
Nursing Practice - Nursing Health & EnvironmentCINPSInstitute
Nursing Health & Environment" is a comprehensive blog that delves into the vital aspects of nursing, focusing specifically on the interconnectedness between nursing, health, and the environment. This blog explores the multifaceted role of nurses in promoting and maintaining the well-being of individuals, families, and communities, while also addressing the influence of the environment on health outcomes. From discussing evidence-based nursing interventions and best practices to examining the impact of environmental factors on health, this blog aims to provide valuable insights and resources for both aspiring and seasoned nurses. Whether you are seeking information on the latest advancements in nursing practice or exploring the relationship between health and the environment, this blog offers a wealth of knowledge to enhance your understanding and practice in the field of nursing.
Effect of Clinical Supervision Program for Head Nurses on Quality Nursing Care iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care.
Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice
Has Accreditation made a difference in Healthcare Delivery in India by Dr.Mah...Healthcare consultant
There is consistent evidence that shows that accreditation programs improve the process of care provided by healthcare services. There is considerable evidence to show that accreditation programs improve clinical outcomes of a wide spectrum of clinical conditions. Accreditation programs should be supported as a tool to improve the quality of healthcare services.
Abstract— If job satisfaction is there in employees, work done by these employees is usually of better quality in comparison where the employees are not satisfied with their jobe. So this study to assess job satisfaction and influence of demographic variables on job satisfaction, this study was carried out on 105 doctors of teaching hospitals. Questionnaire method of data collection was adopted. Job satisfaction was measured by six domains: Organizational functioning, Interpersonal relationship, Financial incentives, Non-financial incentives, Physical facilities and Working conditions. Study observed that over all, doctors were moderately satisfied with their job. Domains such as Interpersonal relationship and Working conditions, doctors were highly satisfied, whereas rest of the domains: Organizational functioning, Financial incentives, Non-financial incentives, and Physical facilities doctors were moderately satisfied. It is important to note that even though overall satisfaction is moderate, there were few components, where doctors were highly satisfied were - Communication system between patients and doctors, Involvement in decision making in the department, Rules and regulations of the institution, relationship between the department colleagues and other department colleagues, Provision for leave encashment, reward given for research work, workload of clinical aspect and workload of teaching aspect. Age and sex both shown significant association on level of satisfaction where as experience, designation and marital status of the doctors have not shown significant association.
Pros and cons of mandatory continuing nursing educationKaren.docxbriancrawford30935
Pros and cons of mandatory continuing nursing education
Karen DeFilippis, Idalmis Espinosa
Lasharia Graham, Ijeoma Igbokwe
Karan Kortlander, Jessica McGillen
October 01, 2017
objectives
Discuss the pros and cons of continuing education in nursing in the following areas:
Impact on competency.
Impact on knowledge and attitudes.
Relationship to professional certification.
Relationship to ANA Scope and Standards of Practice.
Relationship to ANA Code of Ethics.
Impact on competency
Pros: Cons:
Increased personal knowledge Time
Increased use of EBP treatments Cost
Improved patient outcomes
Increased confidence
Developing and maintaining skills
Professional Networking
“Currently in many states, a nurse is determined to be competent when initially licensed and thereafter unless proven otherwise. Yet many believe this is not enough and are exploring other approaches to assure continuing competence in today’s environment where technology and practice are continually changing, new health care systems are evolving and consumers are pressing for providers who are competent” (Whittaker, Carson, & Smolenski, 2000).
“The ultimate outcomes of continuing nursing education (CNE) activities are to improve the professional practice of nursing and thereby the care that is provided by registered nurses to patients” (American Nurses Credentialing Center’, 2014)
Effective workplace learning, based on current evidence, appears to show potential to prevent errors, support health professional reflection on practice and performance, foster ongoing professional development, and sustain improved individual and organization performance outcomes.
Cost- “Continuing education can be costly. For instance, it is costly to pay employees to attend a nursing lecture or conference and to be away from the patients’ bedside. Additionally, purchasing videos or subscribing to magazines does require an associated payment. Lastly, implementing a change is costly it requires training and often new equipment. Without question, cost is a confounding variable” (Ward, 2013)
Time- This can be time away from work and family. For the employer ‘implementing a change in practice does require time, as does completing continuing education credit hours. This could mean time away from the patient which, in most instances, is frowned upon” (Ward, 2013)
3
Pros of higher education in nursing
Enhance patients’ outcome.
Reduces medication errors.
Update with new trends.
Increased knowledge on technology use.
Treatment evaluation and recovery.
Enhance collaboration and networking.
Widens employment opportunities for nurses (University of Saint Mary,2017).
Higher nursing education prepares nurses to make a difference in delivering safe and effective care to patients, nurses gain the skills needed to safely administer medication while eliminating or reducing medication errors, monitoring and assessing the patien.
Similar to Quality of nursing service in bpkihs (20)
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
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CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
CDSCO and Phamacovigilance {Regulatory body in India}
Quality of nursing service in bpkihs
1. Quality of Nursing Service in B. P. Koirala Institute of Health Sciences, Nepal
Ram Sharan Mehta, Asst. Professor
Medical-Surgical Nursing Department
College of Nursing
B.P. Koirala Institute of health sciences
Dharan, Sunsari, Nepal
E-mail: ramsharanmehta@yahoo.com
Abstract:
Quality nursing service means offering a range of nursing service as per the hierarchical
needs of the clients in various settings. The success should be appropriate, safe, effective,
and economical and should satisfy clients in all dimensions of health. Nursing with other
health workers all over the world are facing difficult challenges. The public's expectation
of them continues to rise. Nurses are asked to provide higher quality health services with
fewer resources and different constraints. At the same time, the knowledge and skills-
base needed to perform effectively in their chosen fields of endeavor continues to grow
and change rapidly. Health care personnel will continue in the workforce for many years,
while the information that they acquired during their education may rapidly become
obsolete.
Health care institutions and their managers are also confronted with these realities. The
challenge is to continue to maintain or improve the quality of the care and the
comprehensiveness of health service converges, while introducing changes in care
delivery system. Finally governments at local, regional and national levels are attempting
to obtain greater value for the money they spend on health care. Faced with growing
expectations of quality they are being asked to be more accountable for the results of
their health care expenditures. Thus, they also have an important role to play in ensuring
and improving the quality of health services provided in both the public and private
sectors.1
The main objectives of this study were to assess the quality of nursing service provided
by ward in-charges and nurses. It was hospital based descriptive exploratory study
conducted in all the 28 wards of BPKIHS using five sets of Performa (tool) to evaluate
their leadership qualities, functional capabilities, nursing care status, environmental
sanitation of the unit and the documentation of clients. The data was collected in May and
June 2006 by trained nurses, nurses working in the unit by participative observation
methods. It was found that in average the ward in-charges were middle range performers
(69.2%), performance level of ward in-charges are average (48.28%), nursing care status
is satisfactory (72.32 %), cleanliness level is also satisfactory ( 65.9 %), and the level of
documentation is above average ( 73.23 %).
The findings of the study clearly illustrate the need of continuous in-service education on
managerial aspects of nurses so that quality of nursing service can be improved.
Key Words: Quality, Nursing, Service
2. Introduction:
Knowledge, like muscles, must be nourished constantly and used frequently to
retain function. Learning like motion, is more easily maintained if it's momentum
has not been interrupted.
Quality of care simply means that what is done for the patient is necessary, and that what
is necessary is done. Coordination of care is displayed when the different parts of the
care on different days by different caregivers, and care from various departments are
harmonized into the whole patient care
Leadership qualities: The quality of technical care consists in the application of
medical science and technology in a way that maximizes its benefits to health without
correspondingly increasing its risk. The degree of quality is, therefore, the extent to
which the care provided is expected to achieve the most favorable balance or risks and
benefits. Proper performances of interventions are known to be safe, affordable to the
society and produce an impact on mortality, morbidity, disability and malnutrition.
The dimensions of quality are: Technical competence effectiveness (correct manner),
efficiency (maximum benefit to client, use of available resources, cost affective,
continuity service delivery, interpersonal relations (respect, confidentiality, courtesy,
responsiveness and equality), safety (maximum risk of injury; infection and side effect),
and Amenities.
Some of the important quality assurance mechanism, which is considered, for providing
health care in our country is: Licensure, credentialing (granting authorization to provide
specific patient care and treatment), Accreditation, standards, indicators, continuous
education, procedure and infection control.
Functional capabilities: In recent years, acquired a new philosophy of health, which
may be stated as: Health is human fundamental rights, an essence of productive life, and
not the result of ever increasing expenditure of medical care. Health is intersectorial, and
integral part of development, health is counter to the concept of quality of life, involves
individuals, states and international responsibility. Health and it's maintenance is a major
social investment and health is world-wide social goal.
Nursing care status: Factors like overflow of patients, imbalanced nurse patient ratio,
ineffective work distribution, inadequate facilities for in-service education training,
inadequate supply of equipment and facilities, first contact care provider, unknown about
diagnosis, advances in disease pathogens, new trends of disease, twenty four hour station
duty etc. effects the health of nursing personnel14. Therefore, it's necessary to evaluate
whether these factors are helping or hindering nursing care in the institute or not.
With the ongoing emphasis on resource management, cost control, efficiency in patient
care, quality improvement, and accountability, we are required to provide quality patient
care and documentation at the same time. Nurses are expected to fulfill major and
sometimes conflicting responsibilities with reduced staffing. When we cannot fulfill both
3. the responsibilities, we try to satisfy ourselves by fulfilling the one with the higher
priority.
Documentation: Documentation must be accurate, clear, concise, complete, and
timely. Speed is of the essence when working in healthcare, but accuracy and
completeness are imperative when documenting. Do not let the patient’s health
be compromised by worrying about the speed; make sure it gets done right the
first time. Documentation must have meaning today, tomorrow, and in the
unforeseen future. One of the difficulties with documentation is that we never
know when what we document will be needed. You want to make sure the right
information gets documented and that documentation is done correctly. Nursing
documentation is important and not just for legal purposes. The results and
benefits of nursing documentation are greater than the sum of the tasks
themselves. It isn’t an easy task, but it is necessary and it is a way of giving high-
quality patient care. The lack of proper documentation can negatively impact
patient care and can ultimately cause other problems.7
Transitions in health care have sparked public and professional concern regarding the
status of inpatient hospital nursing and its effect on the quality of care in hospitals,
prompting the Institutes inquiry into this issue. It has been well documented that the work
environment affects nurse satisfaction and turnover; which in turn influences the
organizational lost of replacing nurses. Theoretically, the environment in which care is
delivered affects patient, nursing and institutional outcome. Nursing can be though of as
an organization's surveillance system, in those nurses is present around the clock. In
addition, nurses functioning in such an environment can apply resources as appropriate
for best meeting patient needs and for communicating problems to the physician in a
timely manner. Theoretically, these environmental factors are responsible for better
patient, nurse and organizational outcomes.
Objectives:
The Objectives of the study was to find out the leadership characteristics ranking of the
ward in-charges, evaluate performance level of ward in-charges on various managerial
activities, investigate the nursing care status in the wards, assess the environmental
sanitation status maintained in the ward and evaluation of nursing documentation
standard maintained in their respective wards.
Methodology:
4. It was hospital based descriptive exploratory study design conducted in all the 28
Wards/Units (Medical-I, II, III, Surgical- I,II,III, Orthopedic, Eye, ENT, Paying,
ICU/CCU, Dialysis, OT (Day Care, Routine, Emergency, Gynae), Emergency,
Antenatal/Labor, Postnatal, Gynae, Pediatric-I,II, NICU/PICU/MICU/Nursery, CSSD,
Tropical, Derma, Psychiatric, Dressing/Injection room) of BPKIHS, where Nurses
provide Nursing care to the clients. The In-charges, Nurses, documentation maintained in
the ward and Observation of real situation was the source of data collection. The main
areas of study were: leadership characteristics ranking of the ward in-charges, level of
ward in-charges on various managerial activities, the nursing care status in the wards, the
environmental sanitation status maintained in the ward and nursing documentation
standard maintained in their respective wards. Using total enumerative sampling
technique all the wards/units of BPKIHS was selected for study purpose.
To collect the data, Leadership Characteristics ranking Performa developed by ICN was
used and the Performance level Performa, Nursing care status evaluation Performa,
Environmental sanitation evaluation Perform and Nursing documentation
(Recording/Reporting) evaluation Performa developed by the investigators was used.
Method of data collection: 2-3 nurses working in the same unit were selected randomly
from respective wards are trained and involved in data collection under the guidance of
investigators. The collected data was entered in SPSS-10.5 software package and
analyzed. The details of the findings are depicted in tables and graphs in the results.
Results & Discussions:
Very few literatures were available on this study in world. No study was available in
Nepalese context.
Leadership Characteristics: It was found that the mean score obtained was
55.37(69.2%) out of 80 full score. The range score was 41-66, and SD =7.422. It was
found that most of the ward in-charges were of middle ranking that is (69.2%), which
require a lot of effort to make them competent. The details about the leadership
characteristics are depicted in table – I
Performance level: It was found that the mean score obtained was 37(48.28%) out of
total 75 full score. The performance level of ward in-charges on various managerial
activities is below average. This clearly illustrates the poor quality of nursing
management in ward and needs continuous nursing education on management. The
details about the leadership characteristics are depicted in table – II
Nursing Care Status of ward: It was found that the mean score obtained was
47(72.32%) out of total 65 full score. The nursing care status in BPKIHS is satisfactory
i.e. mean percentage score was 47(72.32%), out of 65. which clearly illustrate that the
nursing care level in BPKIHS is not compromised. The details about the leadership
characteristics are depicted in table – III
5. Environment Sanitation of ward: It was found that the mean score obtained was
19.77(65.9%) out of total 30 full score. The environmental sanitation (cleanliness) of the
ward was above average standard i.e. mean score 19.77(65.9%), out of total score 30,
which gives clearly picture of better environmental sanitation. The details about the
leadership characteristics are depicted in table – III
Nursing Documentation Status of the Ward: It was found that the mean score obtained
was 91.53(73.23 %) out of total 125 full score. The nursing documentation status was
satisfactory i.e. mean score was 91.53 (73.23%) out of total score of 125, which clearly
illustrate the improved documentation status at BPKIHS. The details about the leadership
characteristics are depicted in table – IV
In general we can conclude that the personal leadership characteristics and performance
of ward in-charges are average and need to improve. In spite of inadequate leadership
characteristics the quality of nursing service and nursing documentation status is
satisfactory and above average.
Conclusions:
Based upon the findings it was concluded that the nursing leaders (especially ward In-
charges) needs improvement in leadership quality by continuous nursing education,
where as the quality of nursing service and documentation needs improvement in some
parameters.
Acknowledgement:
We heartily express thanks to all the nursing staffs, for helping us in data collection and
all the ward In-charges of 28 wards for their kind cooperation and support for providing
the information.
References:
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7. Table: - I
Leadership Characteristics ranking of the ward In-charges
N=27
Obtained Score Mean Obtained
Full Score= 5 (100%) score
Leadership
SN
Characteristics Mean
Mean
1 2 3 4 5 Percentage
Score
Score (%)
1 Vision 0 7.4 29.6 59.3 3.7 3.59 71.8
2 External Awareness 0 7.4 37 55.6 0 3.48 39.6
3 Customer Orientation 0 0 48.1 48.1 3.7 3.55 71
4 Political Skill 0 11.1 55.6 33.3 0 3.22 64.4
5 Motivation 0 11.1 29.6 48.1 11.1 3.59 71.8
6 Confidence and Trust 0 3.7 51.9 44.4 0 3.40 68
7 Influence and
3.7 14.8 44.4 37.0 0 3.18 63.6
Negotiation
8 Creative and Strategic
0 11.1 48.1 37.0 3.7 3.33 66.6
thinking
9 Interpersonal 0 11.1 11.1 74.1 3.7 3.70 74
10 Team Building 0 7.4 25.9 55.6 11.1 3.70 74
11 Oral Communication 0 7.4 22.2 51.9 18.5 3.81 76.2
12 Written Communication 0 11.1 40.7 40.7 7.4 3.44 68.6
13 Self Direction 0 19.5 42.7 25.9 11.8 3.70 74
14 Decisiveness 0 11.1 33.3 51.9 3.7 3.48 69.6
15 Problem Solving 0 7.4 40.7 48.1 3.7 3.48 69.6
16 Review and Change 0 3.7 59.3 37.0 0 3.33 66.6
Total Score Obtained 55.37 69.2
( full score=80) Mean=55.37 Range=41-66 SD=7.4222
8. Table: - II
Performance Level of Ward In-charges on Various Managerial Activities
N=23
Obtained Score Obtained Mean
Full Score= 3 (100%) Percentage score
SN Performance Characteristics
Always Often Rarely Mean Percentage
(3) (2) (1) Score Score (%)
1 Believe that team nursing will
work
87 8.7 4.3 1.173 39
2 Work a good example to others 43.5 52.2 4.3 1.608 53
3 Try to learn as much as possible
about every part of my job
52.2 43.5 4.3 1.521 51
4 Enthusiastic about work 43.5 47.8 8.6 1.521 54
5 Able to control my temper 65.2 17.4 17.4 1.521 51
6 Admit it when am wrong 47.8 52.2 0 1.521 51
7 Try to understand the other
person’s viewpoint
69.6 21.7 8.6 1.260 42
8 Think before speak 60.9 34.8 4.3 1.434 48
9 Feel that each team member is
important in caring for the patient
72.7 18.2 9.1 1.363 45
10 Able to plan ahead 74 13.0 13 1.391 46
11 Systematic about doing own
work
52.2 43.5 4.3 1.521 51
12 Show my confidence in team? 65.2 30.4 4.3 1.391 46
13 Consider both the worker and the
patient when I plan the 68.2 27.3 4.5 1.363 45
assignments
14 Give complete report to every
team members
65.2 26.1 8.7 1.434 48
15 Ask more often than command 56.5 39.1 4.3 1.478 49
16 My team voluntarily seek advice 78.3 21.7 0 1.217 41
17 Check to determine that all
assignments have been 59.1 31.8 9.1 1.500 50
completed properly
18 Try to be objective in evaluating
the work of others
77.8 47.8 4.3 1.565 52
19 Try to find out all the facts before
I draw conclusions
65.2 30.4 4.3 1.391 46
20 Offer praise often 65.2 30.4 4.3 1.260 42
21 Inform my team members of their
program
87 4.3 8.7 1.217 41
22 Try to help each member of
team improve
65.2 21.1 8.7 1.434 48
23 Encourage discussion during the
team conference
69.6 30.4 0 1.304 43
24 Keep the nursing care plans up
to date
28.6 47.6 23.8 1.809 60
25 Use nursing care plans 21.7 43.5 21.7 1.95 65
Total Score Obtained ( full score=75) 37 48.28
9. Table: - III
Nursing Care Status and Environmental Sanitation Maintained in he Ward
N= 28
Obtained Score Obtained Mean
S Full Score= 5 (100%) Percentage score
Item/Particular
N
Mean Percentage
A. Nursing care status: 1 2 3 4 5
Score Score (%)
1 Nursing care provided to the
0 14.8 44.4 29.6 11.1 3.37 67.4
patient
2 Maintaining nursing care
0 11.5 30.8 46.2 11.5 3.57 71.4
record and report
3 Carry out doctors order 3.7 3.7 22.2 40.7 29.6 3.88 77.6
4 Health education to the
11.1 25.9 37 18.5 7.4 2.85 57
patient
5 Discharge teaching provided
3.1 11.5 42.3 34.6 7.7 3.30 66
to patient
6 Nurse patient relation 0 18.5 18.5 59.3 3.7 3.48 69.6
7 Team spirit within nursing 0 0 32.1 57.1 10.7 3.78 75.6
8 Team spirit with other health
0 0 25.0 60.7 14.1 3.785 75.6
personnel
9 Co-ordination of activities 0 14.3 14.3 57.1 14.3 3.71 74.2
10 Environmental sanitation or
0 15.4 26.9 26.9 30.8 3.73 74.6
cleanliness of ward
11 Maintenance of emergency
4 0 32 40 24 3.80 76
drugs trolley
12 Admission and Discharge
0 0 8 56 36 4.28 85.6
Register maintained
B. Environmental Sanitation / 72.32
Total= 47
Cleanliness
a Toilet 0 3.7 55.6 37 3.7 3.40 68
b store room 0 16 36 40 8 3.40 68
c Nurses station 4 20 40 36 0 3.08 61.6
d Kitchen 4.2 4.2 45.8 41.7 4.2 3.37 67.4
e slice room 0 20 52 28 0 3.08 61.6
f ward with Siling 3.7 3.7 37 55.6 0 3.44 68.8
(Total full score=95 ) Mean Total Score Obtained
19.77 65.9
10. Table: - IV
Evaluation of Documentation (Recording/Reporting) Maintained in the Ward
N=26
Obtained Score Obtained score
Details of Full Score= 5 (100%) Full Score= 5 (100%)
SN
Documentation Mean Percentage
1 2 3 4 5
Score Score (%)
1 Vital Signs: (TPR, BP,
0 0 21.7 60.9 17.4 3.95 79
HT. Wt.)
2 Drug Cardex 0 0 13.6 63.6 22.7 4.09 81.8
3 Inventories: store 0 0 32 40 28 3.96 79.2
4 Intake/output 0 13.6 18.2 59.1 9.1 3.63 72.6
5 Nursing care records 0 20.8 20.8 44.8 12.5 3.50 70
6 Incidental records 0 4.3 34.8 47.8 13.0 3.69 73.8
7 Daily expenditure
0 3.8 23.1 50 23.1 3.92 78.4
records
8 Round: doctors 5.3 5.3 26.3 36.8 26.3 3.73 74.6
9 Log book 37.5 0 25.0 37.5 0 2.62 52.4
10 Student's record:
performance, teaching
procedure checklist 0 0 42.9 42.9 14.3 2.71 74.2
attendance, assignment
evaluation formats
11 Duty roster 0 12 0 48 40 4.16 83.2
12 Office records: inter
0 4 24 60 12 3.478 69.56
office correspondence
13 Leave records 0 8 24 40 28 3.88 77.6
14 Census 4.5 13.6 18.2 36.4 27.3 3.68 73.6
15 Infection: Nosocomial 12.5 12.5 44.8 16.7 12.5 3.04 60.8
16 Consent: Informed *&
0 0 20.8 54.2 25.0 4.04 80.8
high risk
17 Pre operative checklist 0 5.6 11.1 44.4 38.9 4.16 83.2
18 Medico-legal records 0 13 13 47.8 26.1 3.86 77.2
19 Admission discharge
deaths, cases 0 4.5 9.1 59.1 27.3 4.09 81.1
absconded
20 OT scrub/circulating
0 0 0 60 40 4.40 88
nurse record
21 Nursing care plan 16.7 16.7 50 16.7 0 2.66 53.2
22 Nursing assessment
22.2 16.7 22.2 33.3 5.6 2.83 56.6
records
23 Special records pupil
GCS LOC MSE reflexes
21.4 21.4 7.1 35.7 14.3 3.00 60
Edema chest sound
heart sound
24 Performance record
(AER) staff students’ 0 17.4 17.4 65.2 0 3.47 69.4
helpers
25 Bills admission discharge
investigations OT special 4.3 4.3 13 43.5 34.8 4.00 80
charge
Total Score Obtained ( full score=125) 91.53 73.23