LEVELS OF COMPETENCY IN ASSSISTING IN THE OPERATING ROOM

OF 3RD AND 4TH YEAR NURSING STUDENT OF

COLEGIO DE STA. MONICA

Name: Age:

Yr./Sec.: Gender:

I. Evaluate yourself according to the questionnaire and kindly check the box.

4-excellent 2-good

3-satisfactory 1-satisfactory

Question:

Knowledge 4 3 2 1

1. I know the principle of sterile technique.

2. I know all the equipments used in operating

room.

3. I know the responsibility of being a scrub

nurse.

4. I know the responsibility of being a circulating

nurse.

5. I can identify priority of the client at the

operating room.

6. I evaluates patient response to the

interventions.
Skills 4 3 2 1

7. I do the surgical hand washing within 10-20

sec.

8. I prepare the equipment for minor case with

minimal suspension.

9. I prepare the equipment for major case with

minimal suspension.

10. I perform the proper gowning technique.

11. I properly perform closed gloving technique

12. I transfer client safety from the stretcher to

recovery bed.

13. I assist in proper and safe positioning of

clients in preparation for surgery.

14. I observe the principles of strict surgical

aseptic technique within the work area at all
times.

15. I observes universal precautions in handling

body fluids.

16. I assist in skin preparation and draping of

client.
 4 3 2 1

17. I performs proper disinfection and

sterilization protocols.

18. I observes proper disposal of hazardous and

non hazardous wastes.

19. I observes operating room policies,

procedures and protocols on infection control.

Attitude

20. I respect the rights of the operating room

patient.

21. I accepts responsibility and accountability

for own decisions and actions as an operating
room nurse.

22. I maintains privacy and confidentiality of

client’s information.

23. I utilizes therapeutic communication skills

with patients, significant others and members
of the health team.

24. I establishes professional relationships with

members of the surgical health team.

25. I utilize proper channel of communication

26. I collaborates plan of care with other

members of the health team.
 LEVELS OF COMPETENCY IN ASSISTING IN THE OPERATING ROOM

OF 3RD AND 4TH YEAR NURSING STUDENT OF

COLEGIO DE STA. MONICA

Chapter I

Introduction

In the third and fourth year of the Bachelor of Science in nursing students, students are
exposed in more challenging areas such as operating room in their designated clinical rotations.
As student, they molded by their respective clinical instructor to be prepared for their exposures
on the said area’s different theories skills are needed on those areas are taught before the
student’s exposure and clinical competence is ensured by performance of return demonstrations.

Operating rooms are considered to be special areas in any hospital setting. Extra
precautions are needed. The practice of the principles of sterile technique are strictly
implemented such as proper gloving and gowning in order to ensure not only the clients safety
but also the health care practitioners. Instrument used in procedures done in these area are also
mastered by student to assure the proper handling. One of the duties of a competent nursing
student is to be able to perform proper nursing intervention during and after the procedure to
ensure the patient’s fast recovery and prevent further complications.

The competency of each nursing student is not only measured academically __in
hospital-setting experiences. Competence does not mean expertise. This exist in various level of
competence but each of these has a minimum acceptable level or standard. Beginners are rarely
expert, but they can be competent. They perform a wide range of nursing activities methodically
and well. They maybe slow but develop further skills and speed in time. They have to ask many
question but they know which question to ask. Beginners student in the clinical area maybe a
little slow completing total patient care, be somewhat limited in the range of skills they can
perform not possess a great deal of specialized but they are easily distinguished from someone
who is not a nurse, or even novice a student nurse.

Competency encompasses more than just a psychomotor skill. The team competency in
these contexts now describes the attributes of knowledge, abilities skills and attitudes that
underlie competent performance. Competency standards specify the level of achievement
expected and the tasks and context of professional practice in which we may see the competency
demonstrated.

The abilities to plan and organize our work are little benefit to patients if the attitudes that
nursing student value(such as caring and patience)are not presents; therefore, integration of the
knowledge ,abilities and attitudes of nursing is the essential key to understand and to perform
competent. Nursing student know that psychomotor skills are important but, performed without
knowledge, they do not constitute nursing. Nursing knowledge of health and disease processes is
of little use without appropriate nursing skills to implement. Experience and expert nursing
student have amazing memories, seem to do twenty things at once, cope with interruptions and
can deal with emergencies, all calmly and expertly. Yet behind the smooth performance we
recognize the knowledge, abilities, skills and attitudes that are integrated into the professional
demonstration of excellent nursing student. The experienced competent of nursing students work
quickly and capably, able to care for a highly complex and dependent patient in the critical care
unit. In the clinical settings nursing student skills of assessment in decision-making are often
invisible, but are reflected in delivering the patient care.
The purpose is to examine the impact of clinical placement location of nursing students on
clinical experience.
Statement of the problem

This study aims to evaluate the levels of competency of the 3rd year and 4th year students of
Colegio de Sta. Monica in assisting in operating room.

Specifically, it aims to answer the following questions;

1. What is the demographic profile of the respondent in terms of: 
a. Age
b. Sex
c. Year level
d. Area assigned

2. As a 3rd and 4th year Nursing Students, do you follow the principle of sterile technique?
a. Maintaining Sterility
b. Proper Gowning
c. Proper Gloving
d. Proper Hand washing
* Surgical hand washing

3. Give the proper answer on the question below regarding in the Operating room:
a. Equipment
b. Procedure
* Surgery
Significance of the study
Through the practice in assisting in Operating room, the nursing students should be
strongly rooted with in one framework of nursing process by learning their duties and to become
confident on ability to provide competent patient care that blends the art and science of nursing.
The outcome of the study will be beneficial to the following:
Nursing student-this study show the level of awareness in terms of knowledge and skills on
their experiences when assisting in the Operating room that will give the idea of being competent
student.

Clinical instructor- through this study, they would be able to look probable factors that will
enhance the skills and knowledge of the student,

Readers-this study provide as a available reference for more information, specifically getting
new idea which could help them.

Head nurse of special area- this study will be benefit to them for evaluating the student
capacity, regarding on their skills, when giving a task who expose to the specific area.
Scope of Limitation

This study is focused on the level of competency of their knowledge and skills
specifically in operating room procedure. The study was limited to 50 students 4th year
respondents from Colegio de Sta. Monica nursing students. Level III students who present as the
researchers distributed the survey questionnaires in order to obtain important information for the
variables needed for his research.

The main purpose of his study is to identify the ability of students process has its limits
the importance and benefits of encourage students certain levels of confidence and competence
are needed.

Definition of terms

Operating room- area where in nursing student are exposed during their duties,

with specific roles like circulating nurse or scrub nurse and

with surgeon, anesthesiologist.

Principle of sterile technique –a procedure that is performed of nursing student under

Sterile conditions this includes techniques to maintain the

Sterilization and knowing this student excellent.

Gowning and gloving-a procedure in which nursing student perform a proper

Gowning and gloving.

Competency- ability or capability of nursing student to do with a self confident with a

Good skills and knowledge regarding to specific duty.

Skill- ability of nursing student to performed or use one’s knowledge effectively

and readily in performance.

Theory- it is a basis of analysis in which student could be use for establishing

a fact in their relation to one another.

CHAPTER II

REVIEW OF RELATED LITERATURE AND STUDIES

Nursing student relate new knowledge directly of their areas of work and such relevance
to practice helps to motivate them to learn more about the subject, thereby increase their self
confidence and developing problem solving and decision - making skills. According to Orme
and Maggs (1993) identified that decision making is an essential and integral aspect of clinical
practice .It is though that the increase specialization and use of technology in nursing has led to
rise in the nursing responsibilities for making effective clinical decision making if the profession
is to progress further. However ,professional development is not the only reason nurses need
effective decision –making skills over the past decade a number of public inquiries have made it
clear that nurses need to improve their decision-making skills in relation to risk assessment and
management to ensure their patient are safe, receive an appropriate standard of care and do not
present a danger to themselves or others(Ritchie et al ,1994; Blom cooper et al, 199;1996)
 According to nursing theory one of the requirements of profession together with other
critical determinants , such as member-set standards monitoring of practice quality, and
participation in research is that the concentration of discipline’s knowledge lows from a base of
established theory. Nursing theorist offer helpful ways to view clients so that nursing activities
can best meet client needs.

Another issues most nursing theorist’s address is how nurses should be viewed or what
the goals of nursing care should be. At one time, the goal of nursing care have been stated as “
providing care and comfort to injured and ill people” Most nurse today would perceive this
view as limited one, because they are equipped to do preventive care are well.

Cave (1994), suggest that the “know-that” of education needs to be translated into the
‘know-how’ of practice. In this program, nurses first identify the know-how of their own practice
and able to make sense of it by using appropriate theory. This encourages the students to
consider aspects of their practice that could then be change and guide them to achieve this
successfully. To lead changes in practice, all students are encouraged to identify a mentor for the
duration of each module. The mentor supports the student’s learning experiences in the context
of the practice from which are informed and enhanced by the student’s learning contacts. As a
trusting relationship develops, learning contract and reflection are built. Each student establishes
his or her learning aims and objectives; assesses and negotiates learning needs: clarifies priorities
and steps for achievement; integrates pre-existing knowledge with present studies and sets.

Through interactive learning nurses are encouraged to analyze current practice and with
the aid of learning new practices, there is achievement of a goal through a series of activities and
exercise that are built into the text, requiring students to respond on the basis of their own
knowledge and experience. (Lockwood 1998). Distance learning allows nurses to study at their
own convenience which means they do not have to take a time-out from clinical commitments to
attend regular teaching sessions.

The purpose of the assessment is to ensure that each student has enhances their
professional learning and demonstrated improved practice with a positive impact on patients and
staff. Each student must compile a developmental portfolio of information that gives a
comprehensive picture of his or her progress in learning and performance in practice.
 Using strategies such as reflective practice and learning contacts, the students must show
evidence of clear-thinking and self-awareness, The mapping of progress and drawing together
the eclectic experience of practice with theoretical components of each module. Finally there
must be evidence of each student becoming a proactive professional. This is assessed through
evaluation and feedback from their mentor.

The challenges confronting nurses in today’s rapidly changing healthcare environments

have highlighted the necessity for graduating students to feel both competent and prepared for
practice. This necessity has no doubt highlighted the increasing significance f the nature and
quality of student’s clinical learning experiences (Adam 2002; Chan, 2002; Cope et al., 200;
Dunn et al., 2000; Zhang et al., 2001). Graduate students will be required to have adequate
knowledge and skills to be able to transform competencies into effective performance (Zhang et
al., 2001). It is during their clinical placement that students are expected to develop the relevant
knowledge, skills and competence (Chan, 2002), to develop their capacity for “knowing how” as
well as “knowing that” (Cope et al., 2000; Dunn et al., 2000) and to expand their perceptions on
their future role as a registered nurse.

The purpose therefore of planned clinical experience is to enable students to develop

clinical skills, integrate theory with practice, apply problem solving skills, develop interpersonal
skills and become socialized into the formal and informal norms, protocols and expectations of
the nursing profession and health care system (Conway and McMillan, 2000; Hutchings and
Sanders, 2001; Jackson and Mannix, 2001). A recent national study conducted in Australia
(Clare et al., 2002) found that nursing students and health care staff both desire clinical
placements which provide students with quality learning experiences that meets the growing
demands placed upon graduates on the completion of their studies.

In addition, graduates are expected to demonstrate all the attributes of caring considered
essential by the relevant nursing authority (e.g., Australian Nursing Council Inc.). These
experiences cannot be successfully simulated in a laboratory setting (Boxer and Kluge, 2000).
Grealish and Carroll (1998) note that clinical education is expensive with implications for both
the teaching and health service areas. However, it is widely regarded as essential to the
successful preparation of registered nurses (Ajiboye, 2000; Conway and McMillan, 2000;
Tolhurst and Bonner, 2000; Williams et al., 2000). Furthermore, there is considerable evidence
that undergraduate nursing programs are successful at achieving their aims and despite the
diverse, complex and changing face of health care, registered nurses are well prepared for
beginning practice (Barlett et al., 2000; Boxer and Kluge, 2000; Clare et al., 2002;
Commonwealth of Australia, 2002; Edmond, 2001).

In a review of the literature, Chun-Heung and French (1997) found that the clinical
education setting is the most influential in the development of nursing skills, knowledge and
professional socialization; stressing the importance of the learning climate within the clinical
education environment. This author, who focused on the perception 0f student, noted that a
supportive clinical environment is of the greatest importance optimizing the teaching and
learning process. This view is supported by Calpin-Davies(2003 ),who indicated that’s a
nurturing and supportive environment can be created when the divergent but compatible
organization aims of the service and education sectors are merged in a climate that encourages
collaboration learning ,trust and mutual respect.

Clearly ,clinical placement environments not only play an important role in the
development of student ,competency but also student ,confidence, organization skill and
preparedness for practice. In addition ,the clinical environment will influence student
satisfaction with their placement and the degree to which their experience are regard as
positive. There has been recognition of the influence that individual ward unit environment have
on student experiences and career intention (Clare et al.,2002).however, little is know about the
impact that the location of the clinical placement has on student competence, confidence and
satisfaction .The location of a clinical of a clinical placement site (e.g.,rural vs. metropolitan)is
likely to influence a number of factor (e.g. support ,resources, staff skill mix type and number of
influence a number of patience case load).As providers of nurse education are continually
seeking more clinical placement sites, it is importance to examine the influences of the clinical
location on the student experiences.

The majority of nurse education in Australia take place in major cities with practical
clinical experience primarily gained in the large metropolitan hospital (Bell et al., 1997
Bramadat et al., 1996;Hegney 1996).such circumstances are more likely to seek employment in
areas where they have had previous positive experience (Talbot and Ward 2000).The
concentration of clinical placements within large metropolitan hospital holds particular
significant in terms of the transferability of competencies into new situation and the recruitment
and retention of nurses in other context. One such context includes the area is well documented.

It may develop enough confidence to select placement .the higher level of confidence and
competence reported by the student may also be related to the perception of rural nursing as a
specialty that requires high levels of competences, confident and initiative (Huntley ,1995
Wood,1998). It has been found that student who lack of clinical confidences are reluctant to
accept rural clinical placement because of the perception that rural nursing requires a wide
variety of skills and independent .Again ,prior contact with rural nurses may help student to
understand that they do have adequate skills for a rural placement and that support and
assistance will be available student in the current project had access to an information database
which contained information about clinical venues and duty off duty activities. Rural health care
professional community and saw the opportunity of students being “in town”as a social and
professional investment.

In relation to changes following the clinical experience, regardless of location ,all

student(I,e. ,rural and metropolitan students)reported being more competent and satisfied. the
indicates that the student developed their skill and care practices during the experience and
consequently were satisfied with the practicum .The importance of clinical experience for
competence and skills development has been reported in the literature (Chan ,2002 Chun –Heung
and French,1997Dunn et al 2000)and therefore this study confirm the importance of clinical
experience for ongoing student development .It is also of interest that the competences and
satisfaction of both group improvement , suggesting that in both metropolitan and rural context
the student gained appropriate and satisfactory experiences this indicates that for final year
student there should be no hesitation about rural placement not enabling student to develop
relevant skill and competence. Interestingly ,there was not a concurrent improvement in
confidence or organization skills. this suggests that more time on clinical may be required before
competences has an impact on feeling of confident and organization ability .Longer period of
clinical practice may be required to develop there aspects.
 The study also confirm the element of clinical that contribute most to a positive
learning environment for student .consistent with other research (Calpin_Davies,2003;Clare et
al., 2002)these element are related to the support student obtain for their learning and being part
of a team and being valued. The finding strongly suggest which aspect of health care agencies
foster not only the development of student competencies but also student perception of their self-
worth and value. In the interest of the student competency and confidence it is vital that
stakeholders in clinical education ensure that clinical locations not only recognize these issues
but also have relevant structures in place to support learning, to include students as a valued
member of the health team and provide opportunities for diverse experiences. While the students
in this study reported that family, financial and employment commitments influenced their
willingness to undertake a rural placement (Smith et al., 2001), the students also believed that
issues such as cost, transport and accommodation were of little importance to the actual clinical
experience. Again, this suggest that certain background factors are more important to the
student’s ability to even consider a rural placement.

The aim of this aspect of larger study was to examine the relationship between clinical
placements and competence and preparedness for practice from the perspective of the nursing
students. Analysis of data collected revealed that all students reported greater competence and
satisfaction following their clinical placement and that rural students reported greater
competence and satisfaction following their clinical placements in developing student
competency. In addition, the results confirm the need for clinical placements to have the relevant
structures to support learning, to ensure students feel valued members of the clinical team, and to
provide opportunities for diverse clinical experiences. Finally, in relation to rural placements the
study suggest that more efforts need to be targeted prior to the time when students are given the
opportunity to select a rural placement. Strategies to increase students perceptions of competence
and preparation for clinical is likely to increase their willingness to “o rural”. Encouraging
students to do this will help to meet two major challenges: the need to prepare graduates able to
meet the shortfall of health professionals in rural areas and: the need to provide a greater range of
clinical opportunities for nursing student.
 CHAPTER III

RESEARCH METHODLOGY

This chapter focuses on the research design, research locale, population and sampling
technique, research instruments, data gathering procedure and statistical treatment of the data.
The researchers used the descriptive survey method, to refer to the collection, presentation,
computation, and interpretation of data in order to describe the samples under investigation. It
also focused on the personal testimonial of the respondents on how they evaluate their level of
competency on assisting in operating room. Assessment was done to 100 nursing students of
Colegio de Sta. Monica who had participated in the survey. A description survey method was
chosen since it describes the nature of phenomenon under investigation after a survey trends,
practice and condition that would relate to this phenomenon.

It was also a method which was described and interpreted a condition, a relationship that
existed, practice that prevailed, beliefs that are going out, effects that were being felt or trends
that were developing.

This method which is deemed appropriate, as the study presented the profile of the
respondents in terms of their demographic data and knowledge regarding the principles of sterile
technique to evaluate their level of competency in assisting in operating room.

Research Locale

This study is conducted at Colegio de Sta. Monica #98 Marcos Alvarez Avenue Talon I
Las Pinas City. One hundred (100) third and fourth year nursing students from the school is
involved in the study.

Sample and Sampling Technique

In choosing the subjects of the study, the random sampling was utilized in this particular
study in the selection of respondents. All the 1 section of third year and 3 sections of fourth year
nursing students, a total of 100 respondents. They were used as subjects of the study because
when the researchers told them that they were used as respondents of this study, all of them
showed their willingness to assess their levels of competency in assisting in operating room.

Data Gathering Procedure

This study started from the identification and the formulation of the research title and its
specific problems in coordination with the research and thesis adviser. This was presented to the
adviser Ms. Rachelle A. Martinez, RN, MAN for her comments/suggestions and approval. After
its approval, the researcher in consultation with the other members of the group started gathering
data, the needed, the instruments, the sources of the data together with data gathering instruments
to be used in the conduct of this study will be gathered.

Research Instrument

The major instruments used in obtained the data were a structured questionnaire prepared
by the researchers. The researchers relied on different books, journals and articles in the
formulation of the questionnaire. Questionnaire was based on previous studies formulated and
was finalized by the researchers and proposed to the adviser

Statistical Treatment of Data

To enable the researchers to analyze and interpret the data gathered, the following tools
were used.

1. Percentage. This was used in fair study so as to describe the profile of the respondents.
Its formula is:

P = f x 100
n

Where: P – is percentage

f – frequency count

n – total no. of samples

 2. Mean. This tool was used in their study so as to determine the levels of competency in
assisting operating room with the formula:

––
X = fx
n

Where: ––

X – is the mean

f – frequency

x – class midpoint

n – total number of respondent

3. Weighted mean. This is used in theirs study so as determine or identify the most
common problem encountered by the respondents in levels of competence.
The formula is:

W.M. = fw
N

Where

W.M – weighted mean

f – frequency count
w – assigned weight