RAJIVGANDHIUNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA.

PERFORMA FOR REGISTARATION OF SUBJECT FOR DISSERTATION

1. / NAME OF THE CANDIDATE AND ADDRESS / JASMINE JAMES
PUTHEN PARAMPIL HOUSE
VELIYANADU P.O.
ALAPPUZHA-689590
2. / NAME OF THE INSTITUTION / SRIDEVARAJURSCOLLEGE OF NURSING, TAMAKA,
KOLAR-563101.
KARNATAKA.
3. / COURSE OF THE STUDY AND SUBJECT / I YEAR MSc. NURSING
MEDICAL SURGICAL NURSING SPECIALITY
4 / DATE OF ADMISSION TO COURSE / 29THNovember 2010
5. / TITLE OF THE TOPIC / EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE OF WARD IN-CHARGES REGARDING THE SELECTED WARD MANAGEMENT ACTIVITIES INASELECTED HOSPITAL,KOLAR.
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7.4 / BRIEF RESUME OF THE INTENDED WORK
INTRODUCTION
Management is universal in the modern industrial world. Every organizationrequires making of decisions, coordinating of activities, handling of people,evaluation of performance directed towards its objectives. Management has gainedimportance as the scale of operations of modern organisations has increased and thereis a trend towards specialisation of activities. Technological developments havecreated new challenges. The complexities of human relationships constantly challengethose who perform managerial functions. To achieve success in managing, a managermust have a thorough knowledge of management techniques. He must also beoriented in solving problems with techniques tailored to suit different situations1.
Efficient management of human resources and physical resources is veryimportant for the accomplishment of objectives of any organisation. Everymanagerhas to perform certain functions to coordinate the efforts of people working under himfor the effective and efficient use of physical resources. The quality of performance ofthese functions determines the degree of success of any organization to a grater extent.Today’s managers are required to use professional skills for greater effectiveness.1
Along with increasing complexity of nursing services, hospital employers aredemanding qualified and competent staff nurses for high quality clinical care. It isessential for nurses to become familiar with and proficient in management skills.Nurses are in key positions of influence, not only on patient care outcomes, but alsoon the effectiveness of the organisations in which they work.2
In a hospital setting the role of ward in-charge has been identified as crucialfor creating a conducive environment in the inpatient units. She sets the standard for the quality of care given and knows what constitutes good nursing for the patients on her ward. This will vary with different disorders, different degrees or stages of illness, different individuals. Thus the head nurse is responsible for understanding these differences, for analyzing patient’s problems, for planning, delegating, supervising and evaluating their care while they are in the hospital, and if necessary, making provision for follow-up nursing care at home. She is responsible for helping her staff to improve their nursing ability, for seeking and utilizing their contributions in planning and evaluating the care of the patient. She is responsible for co-coordinating with other departments which contribute to patient care.3
The ward in-charge is responsible directly for the social environment and directly or indirectly, depending upon the hospital organization for the physical environment and working conditions of the ward. Clear and accurate orders, reports and records, adequate supplies and equipment are addition to good nursing and these are direct concern to the head nurse.3
In the field of nursing the modern concepts of management and administrationis very essential to provide best possible nursing service to the patients. Nursing facesa challenging and exciting time in an ever-changing environment today. The glaringchallenges to meet the changes in the workforce of nursing is consumer awareness andgrowth of the technological advances demand that nursing be managed with arenewed vision for success. Because of the wide range of responsibilities to beshouldered by nurses, it is important to have an effective system of management andleadership in nursing.4
NEED FOR THE STUDY
The R.L.JalappaHospital is an accredited Teaching hospital with 850 beds serving patients from across the Kolar district and neighbouring districts. The hospital is located in Tamaka, which is 6 Kms away from Kolar and serves as a referral hospital for a number ofhospitals. It offers inpatient and specialist outpatient’s services.5
The hospital offers a full range of tertiary, secondary and highly specialized services. The hospital is also the main teaching hospital for Devaraj Urs University of Kolar. The institution provides clinical-teaching requirements for undergraduate and post graduate medical and nursing students. Its design is hexagonal and is situated in the college campus with good ventilation, spacious waiting halls and corridors surrounded by lush green lawns. The ambience has a soothing effect on the patients, their attendants, students and staff. The excellent services and facilities offered by the hospital makes it comparable to any other leading medical establishments in the country. The hospital has full fledged Departments in all specialties. Each department has its own seminar hall and examination rooms in the OPD. Each specialty has male & female wards, with bed strength as per Medical Council of India and Nursing Council of India requirements.5
The R.L. Jalappa Hospital has 51 wards with a total of 600 staff members in that 300 staff nurses and the accounts department is responsible for a salary budget of Rs.40, 00,000 monthly. A total of 1098 patients are registered daily, including casualties and 701 inpatients. The telephone system handles 400 incoming and 500 outgoing calls daily.6
The challenge of R.L.Jalappa hospital at present is to provide a quality patient care and this responsibility goes to Head nurses who ensuresand confidence in caring and improving patient safety and thequality of patient care in the wards. If this can be effectively implemented, the ward in-charges need to be updated with their Knowledge on ward management activities. Hence the researcher decided to provide a teaching programme on selected ward management activities based on the needs of the ward incharges in order to improve their knowledge and skill in managing the ward effectively which in turn provides a quality patient care7.
REVIEW OF LITERATURE
The review of literature related to the present study has been categorized and presented as follows
1.Studies related toward management.
2. Studies related to structural teaching programme.
1.Studies related toward management.
An exploratory study conducted at Taiwan to investigate the hospital employees regarding the need for nursing skills among 89 nursing employees including nursing director,associate directors,charge nurses in to basic level patient care,intermediate level patient care,basic management ,advance level patient care and supervision.The study concluded that the managers must be skillful in all the three levels of patient care services.7
A qualitative descriptive studywas conducted at Texas to identify the charge nurses competencies. Data sources were interviews (N=42) with charge nurses, head nurses, staff nurses and supervisory personnel. A total of 54 competencies were identified in four categories, clinical or technical critical thinking, organizational and human relations skill. The competencies derived from their interviews reflected leadership and management skills that medical-surgical nurses needed to functions as effective charge nurses.8
A study conducted at Aston university on management decision making by ward sisters in a hospital and the effects of decision making after the implementation of decision support system. Thestudy concluded that a more rationale approach to management decision making is feasible, using information from a decision support systems.9
A study conducted at England to evaluate the impact on the work load of ward managers with the introduction of senior executives. Sixty qualitative interviews were carried out with 16 Ward managers,12 administrative assistants and six senior nurse executive about the impact of the introduction of the Ward management activities post qualitative data to measure change in Ward management work load and ward activity was supplied by 24 wards. From the findings with the introduction of ward management activities the,there was also improvement in key performance measure and increased staff motivation.10
A qualitative study conducted on Australia to evaluate the effectiveness and suitability of ‘The ward’ as a simulation game to promote and support students understanding in decision making and team work in clinical practice situation. The result showed ‘The ward’ proved to be well a learning tool and was enjoyable and effective in addressing learning issues related to clinical skill practice, ward management,nursing practice, knowledge on critical thinking and leadership.11
A study conducted at Australia to depict the essence of what ward in-charges do, and how they perform their managerical role. To achieve the objectives of the study,the work behavior of 48 ward in-charges was examined by a semi-structured observation technique for 6 hours each. Results demonstrated that nurse in-charges spent a large proportion of their time in clinical practice, followed by co-ordinating care, operating the unit functions and leading staff. Personal management and quality improvement occupied only a managerical sharing of ward in-charges time.12
A study conducted at Israel to identify conflict made choices of ward in-charges in general hospital and examine the relationship between leadership style,choice of strategy in handling conflicts and demographic characteristics for the study .ward in-charges ( n=60)from 50 general hospital were surveyed using 3 part questionnaire. The result showed that transformational leadership significantly affected the conflict strategy chosen.ward in-charges tended to choose a conflict handling mode which was concerned with a form lose-lose approach.13
A descriptive cross sectional study was conducted at Mangalore on managerial skills of ward in-charges. The sample for the study consist of 10 ward in-charges of different wards selected by simple random sampling technique.The result showed that the ward in-charges have very good managerical skills according to staff nurses and ward in-charges themselves Both staff nurses (97%)and ward in-charges(100%) agreed with overall managerial skills of ward in-charges as very good.14
2. Studies related to structured teaching programme.
An experimental study was conduced to evaluate the effectiveness of Structured teaching programme on nursing management of patient having chest tube drainage among staff nurses working in NehruHospital, Chandigarh. Through random sampling technique 100 samples were selected. The findings showed that 76% of subjects attained most satisfactory scores (17-26) in posttest, against 6% subject in the pretest attained this level. This revealed that the STP is highly effective in improving the knowledge of staff nurse on nursing management of the patients having chest tube drainage.15
An experimental study to evaluate the effectiveness of structure teaching programme in improving knowledge and attitude of school going adolescents on reproductive health atNepal .Through pre and post test,50girls and 50 boys were selected .The findings showed that pre test score of experimental group knowledge score was 39.8% ,control group was 39.4%.after administration of structured teaching programme experimental groups score was 84.6%,This revealed that STP was effective in improving knowledge of adolescent school going students on reproductive health.16
STATEMENT OF THE PROBLEM
“Effectiveness of Structured Teaching Programme on the Knowledge of Ward in-charges regarding selected Ward management activities in a selected Hospital, Kolar”.
OBJECTIVES
  1. To assess the Knowledge on selected ward management activities to be carried out among ward in-charges using structured Knowledge questionnaire.
  2. To evaluate the Effectiveness of Structured Teaching Programme on Knowledge of selected ward management activities among ward in-charges by comparing pre and post test Knowledge scores.
  3. To determine the association between Knowledge of ward in-charges with selected Socio-demographic variables like age, gender, educational status and experience as ward in-charge .
OPERATIONAL DEFINITION
1.Effectiveness
In this study it refers to determine the extent to which the structured teaching programme has achieved the desired results as measured by ward in-charges improvement in knowledge scores which will be assessed by comparing pre and post test scores.
2. Knowledge
It refers to the correct responses of the ward in-charges to the structured knowledge questionnaire.
3. Structured Teaching Programme
It refers to systematically planned and organised teaching programmeesigned for ward in-charges to improve their knowledge regarding selected ward management activities.
4. Ward In-charges
Refers to registered staff nurses with GNM or B.SC nursing qualification who have more than one year of experience and working as ward in-charges.
5. Selected Ward Management Activities
It refers to procuring, monitoring and maintaining supplies and equipments, supervision and teaching, maintaining records and reports and patient care.
ASSUMPTIONS
1. Ward in-charges will have some knowledge regarding the selected ward
Management activities.
2. Structured teaching programme will improve the knowledge of ward
Management activities among ward in-charges.
3. The socio-demographic variables will influence the knowledge of ward
in- charges on selected ward management activities
NULL HYPOTHESIS
H01- There will not be statistically significant association between pre and post test knowledge scores of ward in-charges regarding selected ward management activities.
H02- There will not be statistically significant association between knowledge of ward in-charges with selected socio-demographic variable like age, gender, educational status and experience as ward in-charge.
MATERIAL AND METHODS
SOURCE OF DATA
The data will be collected from study subjects who will be working as ward in-charges in R.L.J.Hospital and Research Centre.
Research approach and design
An evaluative approach and a quasi experimental with one group pre and post test design will be used.
Setting
The study will be conducted in R.L. Jalappa Hospital and Research centre, Tamaka, Kolar.
Population
The population for the study comprises of all Staff nurses working as ward in-charges in selected hospital Kolar.
Methods of data collection
The data will be collected by the following phases
Phase I: Permission will be obtained from the concerned authorities. Through simple random sampling technique, study subjects will be selected. Informed consent will be obtained from all study subjects and data regarding knowledge on selected ward management activities will be assessed.
Phase II: The structured teaching programme which will be administered to the study subjects on selected ward management activities.
Phase III: After 15 days knowledge regarding ward management activities will be reassessed.
Sampling procedure
The investigator will use simple random sampling technique to collect the data.
Sample size
The sample size consists of 30 staff nurses who will be working as ward in-charges in all wards of R.L.Jalappa Hospital, Kolar.
CRITERIA FOR SELECTION OF SAMPLE
Inclusion criteria
1. Registered staff nurses having GNM or B.SC (N) qualification.
2. Working as ward in-charges.
3. Having more than one year experiences as staff nurse. .
4. Willing to participate in the study.
Exclusion criteria
1. The ward in-charges who were not present at the time of data collection.
DATA COLLECTION TOOL
The researcher herself will develop the tool which consists of following section.
Section A: Socio demographic data; which includes age, gender, educational status and experience as ward in-charge.
Section B: Structured knowledge questionnaire on selected ward management activities which includes multiple choice question on supplies and equipments, supervision and teaching, maintaining records and reports and patient care.
METHOD OF DATA ANALYSIS
Data analysis will be done through descriptive statistics like frequency,
percentage distribution, mean and standard deviation & inferential statistics likechi-square test and t-test.
Does the study require any investigation or intervention to be conducted on patients or other humans or animals If so, please describe briefly.
Yes, the information on selected ward management activities will be administered to the subjects under study.
Has ethical clearance been obtained from your institution in case of 7.3
1. Permission from the Ethical committee of the SDUCON will be obtained.
2. Permission from the Medical Superintendent and Nursing Superintendent
will be obtained.
3. Informed consent will be taken from the subjects before the study.
8 / References :
  1. Gross CG, ValigaMT. The new leadership challenge. Creating the future ofnursing. 2nd ed. Philadelphia: F. A. Davis Company; 2005.
  2. Robinson-Walker C, Detmer S. Learning to lead: From staff nurse to chargenurse [Online]. Available from:URL:
  3. Jean Barrett. Ward management and teaching. Delhi: Konark publishers, 2008
  4. Dhaulta PJ. Nursing administration and management. New Delhi: AcademyPress; 2004.
  5. centre downloaded on 23/05/11.
  6. Unpublished data from R.L. Jalappa hospital on 25-05-2011.
  7. Scott R.A A description of the roles ,activities and skills of clinical nurse specialist in the united states clinical nurse specialist 1999 July 13(4)183-190
  8. Connelly L.M,yoder L.H Williams DM .A qualitative syudy of charge nurses competencies .Medical surgical nursing 2003 oct 12p.298-305.
  9. Marguis LB, Huston JC. Leadership roles and management functions 5th edition Colifornia, Lippincott-Raven publishers 2006.
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  2. Robbins CJ, Bradely EH, Spicer M. Developing leadership in healthcare administration. A competency assessment tool. Health care management 2001. p.88-99.
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