Nurses: A Force for Change: Improving health system Resilience
Scientific paper on Sub-Theme: Health Technology & Nursing Practice
Nursing is professional caring. Though we are in technology world, many of the hospitals fol low most of the traditional methods of nursing care which involve more of paper work than the client care. There has been much advancement in the field of healthcare in the last two decades and this progress seems to be advancing with even more speed in the future. Healthcare technologies have been added as a compulsory subject in all the nursing courses, yet the expertise and the utilisation of this knowledge is limited. A growing number of new technologies are becoming available within nursing care that can improve the quality of care, reduce costs, or enhance working conditions. However, such effects can only be achieved if technologies are used as intended. The aim of this study is to gain a better understanding of determinants influencing the success of the introduction of new technologies as perceived by nursing staff.
Need and significance of the study
Contemporary healthcare faces many changes as new approaches to tackle emerging and re-emerging diseases are unveiled through technologies. Nursing, being an integral part of the healthcare delivery system, is open to a variety of changes. The responses of the nurses to change could vary from unreserved support to total rejection. For instance, the introduction of technologies can elicit diverse feelings among nurses. Sound knowledge and aid for using the technologies could see a rapid adoption with accompanying realisation of the benefits whereas less knowledge is likely to retard attempts to modernise service delivery. Hence the investigator felt the need to assess the knowledge and aid for using health technologies among staff nurses in selected government and private hospitals, Bhopal (MP).
Objectives
The objectives of the study were to:
- Assess the knowledge of health technologies among staff nurses.
- Assess the resources for using health technologies among staff nurses.
- Associate the knowledge of staff nurses with their selected demographic variables.
- Compare the knowledge regarding health tech-nologies among government and private nurses.
- Distribute information pamphlet on the litera-ture of health technologies.
Assumptions: The study assumed that: (i) there is growing need to assess the knowledge regarding health technologies in attempt to deliver standard nursing care and practices; (ii) the nurses working in the government hospital may have (a) less knowledge than private hospital nurses on health technologies, and (b) lack of resources for using health technologies than nurses working in private hospi-tal.
Theoretical framework: The study was based upon Roy’s adaptation model.
Review of Literature
Mathew KK, et al (2014) conducted a cross sectional descriptive study to assess the attitudes of nursing staff towards computerization at one public hospital and one private hospital in Nairobi, Kenya. A convenience sample of 200 nurses filled the questionnaires. Data was collected using the modified Nurses’ Attitudes Towards Computerisation (NATC) question-naire. Nurses had a favourable attitude towards computerisation. Non-users had a significantly higher attitude score compared to the users (p = 0.0274). Statistically significant associations were observed with age (p=0.039), level of education (p = 0.025), duration of exposure to computers (p=0.025) and attitudes towards computerisation and they con-cluded that nurses have positive attitudes towards computerisation.
Sukums F et el (2014) in a cross-sectional study on health workers’ knowledge and attitudes towards computer applications in rural African health facilities collected information using structured questionnaires. Chi-squared tests and one-way ANOVA describe the association between computer knowl-edge, attitudes, and other factors. Semi-structured interviews and focus groups were conducted to gain further insights, total of 108 providers responded. Most (95.3%) had positive attitudes towards com-puters [average score (±SD) of 37.2 (±4.9)]. Females had significantly lower scores than males. It was concluded that the health workers have low levels of computer knowledge among rural area and have positive attitudes towards computers and ready to use such technology.
Methodology
The research approach was quantitative and research design was descriptive survey type. Setting was one government hospital and one private hospital. Independent variable was Health Technologies and dependent variable, Knowledge and resources for using health technologies. Staff nurses constituted the study population.
Sample: Staff nurses in selected government and private hospitals; sample size was 120 (60 in govern-ment and 60 in private). Sampling technique: Non-probability purposive sampling technique was used. Tools consisted of closed-ended questionnaire and 3-point rating scale.
Development and description of tool
The tool was developed through extensive literature review of books, journals, published and unpublished articles and reports and expert suggestions. The structured questionnaire comprised of three sections.
Section-A i.e. Demographic profile consisted of age, gender, professional qualification, year of experience, area of working and previous exposure on the topic.
Section-B: Self-structured questionnaire with 30 multiple choice items. It was a close-ended questionnaire regarding health technologies including the areas of Prevention, Rehabilitation, Vaccines, Phar-maceuticals and Devices, Medical and Surgical Pro-cedures and Systems of Hospital (World Health Organisation, 2015). Each correct response carries 1 mark, total score was 30 and minimum score was zero.
Section-C was the Rating scale with 3-point rat-ing scale regarding resources for using health tech-nology including the areas of Prevention, Rehabilitation, Vaccines, Pharmaceuticals and Devices, Medical and Surgical Procedures and also System of hospital are the responses in the form of easily available, available with difficulties and not at all available.
Result
The percentage-wise distribution of the assessment of knowledge regarding health technologies among staff nurses working in government hospital shows that the majority of them (48.33%) had poor knowledge, 30 percent had average knowledge and only 11.67 percent of nurses had good knowledge. None of the nurses had excellent knowledge regarding health technologies as compared to private nurses. On the other hand, 5 percent of private nurses had excellent knowledge regarding health technologies, with highest percentage (35%) having very good knowledge and about 31.67 percent with good knowledge. Only 8.33 percent of nurses had average knowledge while 20 percent had poor knowledge.
Section E: Association of knowledge score of staff nurses working in government hospital
Chi-square was used to find out the association of the knowledge scores regarding heath technologies among nurses with selected demographic variables. There was significant association between knowledge score and selected demographic variables like age, years of experience, area of working experience and previous exposure to the topic.
Association of knowledge score of staff nurses working in private hospital.
Chi-square was used to find out the association of the knowledge scores regarding heath technologies among nurses with selected demographic variables. There was significant association between knowledge score and selected demographic variables like professional qualification, years of experience, and previous exposure to the topic.
The categorical comparison of rating scale responses among staff nurses working in government hospitals showed that highest percentages of nurses responded in all categories that health technology is ‘not at all available’ for them while nurses working in private hospital showed that the highest percentage of nurses responded that health technology was ‘easily available’.
Implications
Nursing Practice
- The existing knowledge and practical skills of the staff nurses can be modified and updated through in-service education.
- The data can be submitted to the Dean of the Medical Colleges for the maintenance of the system of institution to improve the resources for using health technologies among nurses.
Nursing Education
- The current system of health technologies can be added in the curriculum of undergraduate & postgraduate nursing programmes and also it should be updated in the revised curriculum according to the trends in technology.
- Health care system can be added or adopted as a sub specialty of medical surgical nursing in post graduate nursing curriculum.
Nursing Administration
1. The nurse administrator can organise or conduct in-service education programmes & researches on health technology.
2. Nurse administrator should conduct induction classes & also skill stations for the fresh nurses keeping in view the changing scenario of health care technology.
Nursing Research
The research results to be disseminated to health care team members to understand the strength, weakness and resources of their organisation on health care tech-nology.
Recommendations
Similar study can be conducted (a) to compare health care technology in government and corporate hospitals, and (b) to assess the skills of staff nurses on health care technology.
The results can be submitted to (a) District medical officer to improve health care system of District Hospitals, (b) President of the MPTNAI/ State Nursing Council Registrar (MP). to conduct workshops on health care technology for all the staff nurses in the state of Madhya Pradesh.
Conclusion
Technology is a crucial ingredient of health care. Health care consists of either human interaction, the application of technology. The nurses working in private hospital had more knowledge than nurses working in government on health technologies. Further, there are lack of resources for using health technologies in government hospitals when compared with private hospitals.
References
- Mathew KK, Margaret MM, Ann KK, Margaret MM (2014). Atti-tudes of nursing staff towards computerization: A case of two hospitals in Nairobi, Kenya. BMC Medical Informatics and Decision Making. 14(35). Retrieved from doi: 10.1186/ 1472-6947-14-35
- Sukums F, Mensah N, Mpembeni R, Kaltschmidt J, Haefeli WE, Blank A (2014). Health workers’ knowledge and atti-tudes towards computer applications in rural African health facilities. Global Health Action. 7. Retrieved from doi: 10.3402/gha.v7.24534
- Koivunen, M. Acceptance and use of information technol-ogy among nurses in psychiatric hospitals. 5th edn, 2009 Turki: Turun Yliopisto
- Ramanadin PV, Muthamilselvi G, Kaur M. A Comparative study to assess an attitude towards computer application in nursing practice among the staff nurses. Asian Journal Nursing Education and Research 2013; 3(2): 82-86
- World Health Organization. Health Technology 2015. Re-trieved from http://://wikipedia/enclypedia/health-techno//.
Prince Mathew, Shine Varghese Kurian
Associate Professors, Pragyan College of Nursing, Bhopal (MP)
Source: TNAI Journal