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FACTORS AGAINST MIDWIVES’ QUALITY HEALTH CARE DELIVERY

Project Topic: Factors against Midwives’ Health Assessment Practice in Quality Care Delivery to both Hospitalized and Out Patients in Presbyterian Joint Hospital (PJH), Uburu


Abstract

The ability to assess patients is one of the most important skills of nursing, regardless of the practice setting. This study was undertaken to examine the factors hindering nurses’ practice of health assessment of patients in Presbyterian Joint Hospital (P.J.H), Uburu. Related literature were reviewed and summarized. Descriptive research design was adopted to elicit baseline information in the respondents’ natural setting. The sample for the study is 60 nurses of PJH drawn by proportionate purposive sampling allocation out of 150 target population. Questionnaire was used to collect data from the 60 respondents. Instrument was validated by the project supervisor on fact and content. Reliability of the instrument was ensured. Data collected were analyzed by using descriptive statistics of frequency distribution tables, bar charts and percentages. From the findings, majority of the respondents practised health assessment mostly during admission while others carry out health assessment throughout hospitalization and when it is necessary. Lack of instruments, shortage of nursing staff, patients’ non- compliance and language barriers were difficulties nurses encountered during health assessment of patients. Recommendations were made for the appropriate practice of health assessment to improve quality of care given to patients. Pertinent among which include:- inculcating health assessment in the routine nursing schedule so that deviation from normal could be easily identified and provision of adequate equipment/ instrument for easy health assessment.

CHAPTER ONE

1.0                                      INTRODUCTION

 1.1 Background of the Study

Clients visit health care facilities for various reasons. Some may come for routine check-up or for chronic or acute illnesses. Irrespective of the reasons for the visit, there are certain expectations and perceived needs for services. The perceived need vary from one individual to another and is influenced by the severity of illness, the degree of anxiety, the availability of resources and the value system of the clients, (Nwonu 2008). Whatever the situation is, to deal with a problem, the health care provider must first of all determine what the problem is and this can only be done through assessment.

Health assessment is a plan of health care that identifies the exact needs of the client and how the needs can be addressed by the health facility.

Assessing health is a major component of nursing care

According to Este, (2006), nursing assessment is the orderly collection of information concerning the patients’ health status which is aimed at identifying the patient’s health problems and areas for health promotion. It is important in the vital monitoring of the progress made by patient as well as establishing whether identified needs have been met or not. Smith (2012) remarked that nursing care entails meeting the needs of the patient after identification of such needs. During 17th century in Europe, nursing care was provided by men and women serving punishment. It was often associated with prostitutes and other female criminals serving punishment. It was not until Florence Nightingale; a well educated woman from a middle class family became a nurse and improved the care of the patients drastically using health assessment to improve the condition of soldiers during the Crimean war. Nurses provide care for individuals, families and communities in promoting their health and well-being. According to Basavanthappa (2004), the purposes of health assessment include: Establish a good relationship between the nurse and the client. Gather data about the clients’ general health status, integrating physiologic, psychological, cognitive, socio-cultural, developmental and physical dimensions. Identify actual and potential health problems. Establish a base for nursing process.

Method of collecting both subjective and objective data relates to patient.

These data are collected by health workers in out-patient clinics during check -up, throughout admission, pre-operatively, post-operatively and during discharge. It is carried out by collecting patients’ health history, physical examination, laboratory investigation and diagnostic tests and review of relevant records. Health care workers face difficulties during health assessment of patient and this have hindered the appropriate practice of health assessment. These problems are language barrier, shortage of nursing staff in health facilities, unavailability of equipment/instruments, negligence, time consideration and failure to document collected data (Jill, 2008.)

1.2 Statement of problem

Health assessment has been given little or no attention within the framework of caring for patients in nursing practice. The issue of health assessment is being neglected by nurses in the various wards of the hospital which has resulted to serious complications of diseases in patients. Equally, the researcher has observed with keen interest these problems during his clinical experience. It is against the background of good assessment of both hospitalized and out patients that motivated the researcher to ascertain the factors militating against midwives’ practice of health assessment in rendering quality care to reproductive women in Presbyterian Joint Hospital (PJH), Uburu.

1.3 Purpose/Objectives of the study

The purpose of this study is to establish the factors militating against midwives’ health assessment practice in rendering quality care to both hospitalized and out patients in PJH, Uburu.

The objectives of this study distinctively are to:

1          Determine whether health assessment of clients is     practised by midwives in PJH Uburu.

Identify the factors that hinder/militate against the practice of health assessment among midwives in PJH Uburu.

Ascertain whether midwives’  years of experience affect the practice of health assessment of clients.

1.4 Significance of the study

This study will be beneficial to patients in the hospital community, nursing profession and the health care system at large and if recommendations are observed, assessment of patient’s health provides:

Information critical to the development of an action plan that can improve personal health status.

Decrease in the likelihoods of the severity of chronic conditions.

Assist the individual in gaining health status and or recovering from illness.

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