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Nursing Research: Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
Nursing Research: Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
NURSING RESEARCH
Nursing Research
Kerlinger - the systematic, empirical, controlled and critical investigation of a
hypothetical proposition in relation to a natural phenomena/ problem
Conducted to affirm or deny a hypothesis
Phenomenon.
everyday phenomenon that affects the nurse (eg. bacteria, drugs, physician)
Phenomenon + hypothesis = research problem
>(educated guess/scientific/ tentative answer)
Without hypothesis there is no research problem, only a problem
Major Characteristics of a Good or Major Research
Systematic
o conduct research in a step by step process or procedure
Empirical
o objective data should be observable/measurable or readily collected
using your senses
Controlled/ manipulated
o Methods/tool of controlling is research design
Critical investigation/fact finding investigation
o In order to answer the data is by using facts.
o Looking for human beings who can give us facts
Purpose of Research in Nursing Profession [DEED]
Descriptive
o observe, describe and record
o gain richer familiarity regarding the phenomena
o 100% known to RN
Exploratory
o Explore to those areas that are unknown
o Observe more
o 50%-50% (50%known to nurses and 50% unknown to the nurses
Experimental
o Active intervention, active manipulation
o Want to find out cause & effect
o Done something before observing results
Developmental
o To improve the system of care for the your patient.
o Develop and improve existing system
Conducting research is for the benefit the pt or patient care/pt focus
Florence Nightingale
Birthplace Italy
Training Ground Germany
Greatest Contribution environmental Theory, training RNs in Crimean
War
School Saint Thomas School of Nursing
Ethics of a Researcher
S Scientific Objective conductive research for a good purpose or object for
your pt
C Cooperation and Consent. Do not conduct data/experiment w/o a consent
(legally the patient owns the chart. However the hospital owns the chart)
I Integrity worked hard on the research
E Equitable acknowledging works or contribution of others
N Nobility protect the rights of your subjects
o Right not to be harmed
(physical, mental, moral harm) usually done during experimental
research
Physical Harm/ Negligence - undeliberate physical harm
Commission done outside the standard practice of
nursing (eg. urinary catheter placed on the nose of the pt)
Omission from the very start, you did not do something
about it.
Moral Harm
Assault mental fear/threat without physical harm
Battery physically you harm the pt
Restraint is never an independent nursing order
physical restraint eg. Jacket
chemical restraint eg. use of psychotropic drug
Moral harm
Slander oral defamation
Libel published or placed in the newspaper
o Right to self-determination
o Right to privacy
Anonymity identity of subject may not be disclosed. Privacy of
the Informant (pt) eg. conduct a study on HIV pt. but the pt wants
his name to be written in the newspaper as Mr. X, Mr. Y or Mr. W
Confidentiality information acquired must be disclosed. Privacy
of the information eg. conduct a study on HIV pt. but the pt wants
the nurse should only know
T Truthfulness put only the data you have collected
I Importance importance to the nursing profession
F Factual facts or data
I Ideal (follow the 11 steps of research)
C Courage
Steps in Nursing Research Process
Identification/formulation of research
o problem - anything that requires solution thru scientific investigation.
o Sources of problem :
C concepts (Ca, PTB, MI)
L literature, essays, books, journals
I Issues
E experience
N Nursing problems
T theories
Examples
A comparative Study in the Income of Filipino Nurses
Employed in P.G.H. and N.Y.G.H.
Independent variable : PGH and NYGH (place of work)
Target population : Filipino nurses
Dependent variable : income
Research:
1. Identify the Problem
2. Purpose objective using SMART (Systematic, Measurable, Attainable,
Realistic, Time Bounded)
3. Define Terms
a. Conceptual Definition dictionary definition
b. Operational Definition defined in accordance on how the researcher
used the word
4. Revision of Terms
Non-experimental
o No manipulation is done. Only observation,
describe and record down the result.
o Types of non-experimental research design
base on time element
Retrospective (Ex Post Facto)
Getting actual experience
Studies a group of people after its
occurrence, experience or facts.
Experience of people in the past
Descriptive
Observe, describe & record.
Study of current events.
Prospective
Study of research about future
occurrence or future events.
Historical
Past that is written, documented,
published and recorded
Primary Data
o Observe
o 1st hand information
o person himself
Secondary Data
o 2nd Hand Information
About the past using records,
journals, books.
Study of the dead people thru his
written materials, facts
o according to data
quantitative
data base on numerical
interpretation, datas that are
measurable, using your senses, data
that are observable.
qualitative
subjective data, feelings, perception,
beliefs, culture, attitude
o Survey Research Design
Group
Small
Face to face
Large not good result
Methods
Mailed survey
Face to face
Telephone survey
o According to Time Orientation
Cross Sectional
LEADERSHIP
Nursing Leadership
style or process whereby a person is called by a nurse leader were influence of
group of people called his followers for the purpose of attaining only one
goal/objective.
Principle for Effective Leadership
Unity of Command one group given by one leader
Unity of Direction one group should always have one objective
Subordination of your personal to your general interest patient first policy
o R rescue your patient
o A alert the fire alarm
o C confine the fire in one area
o E extinguisher application
o Esprit d corp/team spirit - Fault of one is the fault of all
Respondeat Superior/Command responsibility
o let the master or the superior answer for the negligence of his
subordinates in half of his patient who suffer from injury or death.
o you can delegate responsibility but not the accountability
Theories of Nursing Leadership
Great-Man theory born as a leader
Trait theory develop characteristics or born with the characteristics
o 3 traits of a leader
P personality (adaptability, independence, creative/assertive,
advocate) ability to adjust to the need of the pt
I intelligence (proper judgment, proper decision making, proper
communication)
A ability (influence others, respect others, participate and
cooperate) Proper way to influence is thru health teaching
Charismatic theory becomes a leader because of the charm
Situational theory/case to case basis
o a person can be a leader in one situation but only a follower in another
situation. (eg. becomes a leader in where he specializes)
Leadership styles
Authocratic/Authoritarian/dictatorial/hard leader
o unilateral style of leadership. Only the leader here performs the decision
making without getting the inputs from his members.
o One sided style of leadership Behavior :
A apathy insensitive to others
B Boisterous speech
C consistency
D Dominating
E Exploitative behavior
F ferocious behavior, to coerce or compel the group to follow him
o not a good style of leadership but only best style during emergency or
intensive crisis
Permissive, ultra-liberal, laissez faire, free-rein
o Loose style of nursing leadership.
o Giving excess freedom or liberality towards your subordinates if to lenient
in your subordinates, there will be control and power = negligence
Democratic/participative
o best style of leadership. Mutual style of nursing leadership
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C Communication skill
o transfer of information with understanding
o Communication barriers/communication backlog eg. Dialect differences,
noise, deaf, high level of anxiety, hallucinating
D Decision making skills
o Steps
identify the problem
identify person affected
gather options/alternative
brainstorming
delphitechnique gathering solutions outside the group
(eg. specialized nurse)
choose and implement
Evaluation
E Ethics
o Principles
o Principle of Autonomy
independent judgment or decision making
in all situation the pt himself is the one who should decide for his
own care
Consent
respect the decision of the pt
explain the risk to the patient/SO
waiver - a legal doc when the pt refuse for treatment.
o Principle of Veracity
telling the truth to the patient
#1 the patient has the right to know from the PHYSICIAN (not the
nurse)
o Principle of Double Effects
if the pt is made to choose between 2 equal danger and he only
needs to choose one, choose the one that will produce one good
effect and less evil effect.
o Principle of Beneficence
doing good to the patient (eg. providing therapeutic
communication, providing privacy)
o Principle of Non-Maleficence
do no harm
3 types of Harm
Physical negligence by commission
Mental assault and battery
Moral slander and libel
o Principle of Justice
Prioritize the needs of the patient.
To be able to provide nursing care to the patient, provide the
nursing process.
Nursing Process characteristics :
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A acceptable universally
B - based patients assessment needs
C client focused
D dynamics base on the ever changing needs of the pt
E equitable care
F familiarity/rapport to the patient
G goal directed towards solving the assess needs of the
patient (SMART)
o Principle of Respect/Inviolability of life
Suicide and abortion is violation of this principle
F Face/solve Conflicts
o any clash of ideas resulting to crisis
o Methods of resolving conflict
avoidance by paying attention
smoothing appealing to ones conscience and kindness
unilateral action use of forced fear or threat
negotiation best method in resolving conflict. The head nurse
should offer negotiation between conflicting parties.
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NURSING MANAGEMENT
NURSING MANAGEMENT
choosing the right person and giving them the appropriate task for the purpose of
achieving their goal/objective in achieving total care
Frederick Taylors Scientific Management Theory
Elements
o choosing the appropriate person (TAO)
o choosing the appropriate team
o choosing the appropriate training
o choosing the appropriate tools
Human Relations theory
the be a good manager, there should be a good interpersonal relationship
between the leader and follower
Douglas Mc Gregors Motivational theory
Theory X
o Negative workers
o negligence, inefficient, ineffective workers
Theory Y
o Positive workers
o diligent, effective, efficient worker
theory X should be given focus because they are prone to negligence and
malpractice.
Max Webers Bureaucratic/ authoritarian Theory
whoever is on the top would perform the management function
centralized
Elton Maytos Behavioral Theory
overtime pay, rest day, day off
provide physical needs of the workers
Hawthornes Effect
o If workers knows they are observed they become more efficient
Henry Fayols Principle of Management
Unity of Command one leader, one command
Unity of Direction one group should always have one goal
Remuneration of Personnel patient first policy
Esprit de corps team spirit
Command responsibility/Respondeat Superior let the superior answer the
fault of his subordinates even harm or death
Balance between centralization and decentralization
Security tenure
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Delegation of responsibility
Proper Compensation of workers
o RA 7305 (Magna Carta Law) salary grade 50 P13,000/month
o Overtime pay additional of 25%/hr
o Night Differential additional of 10%/hr
o Legal holiday x 2
o Philhealth - Benefit of worker both related and non-related work
(aesthetic, dental and cosmetics are not included)
o Maternity leave 60days leave is NSD, 78days if CS only to first 4
pregnancy only to legitimate spouse
o Paternity leave 7day/1week leave
o Senior Citizens Act 20% discount
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Directing/Delegation stage
o a job or a task is done or performed by another perform for you
o What you cannot delegate:
you cannot delegate total control of the procedure
you cant delegate discipline of subordinates or staff members.
Confidential task
Technical task
Medical task performing surgical procedure is done by the doc not
the nurse
Coordination/Collaboration
o the nurse needs to collaborate to other members of the health care team.
o Multi-interdisciplinary approach to be able to provide holistic approach
to the patient.
o Types of Collaboration
Interpersonal/Intradepartmental
One patient, one unit.
Collaboration between one nurse to another healthcare
team in one unit/department
Eg. MI patient - nurse, dietary, specialized in cardio
Interdepartmental
4 units in one hospital.
Coordination of the patients care between 2-more
units/departments but still under one same hospital or
institution
Eg. patient due for appendectomy is transferred to the OR
Inter Agency/Institutional
Coordination of patients care between 2 or more
hospitals/health care institution for the benefit of the patient
Eg. lying in due for C/S and was transferred to a hospital
Evaluation/Controlling
o stage wherein you determine whether or not your plans for your patient is
met or achieved
o Methods of evaluating staff performance
Checklist
it is being evaluated higher than you. (eg. nurse
manager/supervisor or head nurse)
Nursing rounds
it is being evaluated higher than you. (eg. Nurse
manager/supervisor or head nurse)
Psychiatric ward is not done by nursing rounds
Peer review
same rank or level is being evaluated you
poor method
Performance appraisal
the patient evaluates you
best method in evaluation
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4. Clinical Instructor
o Qualifications :
A accredited nursing Org
M MAN in nursing or other health courses
O One yr clinical experience
R R.N.
PHILIPPINE NURSES ASSOCIATION
o When was PNA founded : Oct. 22, 1922 (10-22- 22)
o Who is the founder PNA : Anastacia G. Guiron Tupas
o Purposes :
P professional well-being
U - unity
P promotes reciprocity even outside the Phils.
A advancement of the knowledge and skills of the nurse
E ethics promulgation
Proclamation Order 539
Declared by Pres. Garcia law declaring the last week Oct as the official nurses
week.
School of Nursing in the Philippines
UPCN 1st
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all prescribe drug must be written in generic and brand name or generic
name but never the brand name alone)
o Purpose : for the pt to choose what brand name they want
Remember the 10 Rs of medication
Right patient name by checking the pt wrist tag
Verbal or telephone only done during emergency
doubts or error in case there is doubt in medication, refer to the physician
IV drugs in proper training
o
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o
o
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Abortion
is the expulsion or termination of a product of conception before the stage of
viability. (3-6month/12-24weeks)
Infanticide
kill the person in less than 3days or 72hrs of life.
Parricide
killing another person to whom you have a relationship (mother, father, husband)
Homicide
unintentionally killing another person without any relationship (eg. negligence in
giving meds)
Murder
intentionally killing another person without any relationship
Simulation of birth
committed by any person who shall substitute one child to another child or alter
his identities for the purpose of losing his civil status. (eg. the midwife failed to
report the birth of the baby, giving wrong information of the gender of the baby)
PD 651 (Birth registration act)
law any person who assist in giving birth to report within 30 days to the Local
Civil Registration Office
Law Affecting Nurses
Act 2808 (yr. 1919) first true nursing law
o It removed from the doctor the control of nurses with 3 man team (1
chairman and 2 members all nurses)
1920 1st official board exam
1st nursing school (6months)
o Iloilo Mission Hospital (1906)
o PGH School of Nursing (1907)
o St. Lukes school of nursing (1907)
o Mary Johnsons school of Nursing (1907)
o St. Paul Iloilo 1907)
o San Juan de Dios (1907)
1st college of nursing (4years) UP
RA 7164 (1991)
RA 9173 (Oct 21, 2002)
o Board of Nursing
Old
o M MAN
o A Accredited Nursing Org (PNA)
o F five MAN team (1 chairman, 4 members)
o S 65 y/o 1 year interim period
o N Not convicted of any crime
o P Pecuniary interest (Absence)
o T 10 years nursing practice
o C- Citizen of R.P.
New
o M MAN
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Dean
R.N.,MAN
5 years nursing experience
Clinical Instructor
A allied in nursing or any allied health courses
M member of PNA
O 1 yr experience
R R.N.
Nursing Administrator
Supervisor/Manager H
Community
Military Hosp
Add only
masters in
PHN or
CHN
MAN +
GSC
(Gen.
Staffing
Course)
B BSN RN
A Accredited Org
N 9 units
T 2 yrs
Chief/Director
RN + MAN +
5 yrs supervisor
experience
(N.B. if primary
hosp)
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Examinees
CGM (Good Moral Character)
Proofs of Valid Holder of Filipino Citizenship
Proofs of valid holder of a BSN Degree only from schools whose
curriculum is approved by the CHED
3 docs sub to PRC
RLE certificate
TOR with Scanned picture
List of cases
Examination fee is P900
Last day Is :
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o
o
o
o
D Dishonorable conduct
U Unsound mind
M moral turpitude
I Indecent immortal conduct
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