A process of quality improvement for outcomes-based critical care nursing education

[摘要] ENGLISH ABSTRACT:A thoughtfully planned learning program provides a blueprint for critical carenursing and gives direction to theory and clinical practice. The design of alearning program for critical care nursing that is adaptive, learner focussed andintegrated, helps nurses acquire the necessary competencies (knowledge,technical skills and attitudes/values) needed for critical thinking. It also enablescritical care nurses to grow professionally and to develop expertise in critical carenursing. Outcomes-based education has become the new buzz word in SouthAfrica, and a paradigm shift from content-based to outcomes-based educationhas become essential.Institutions are concerned with efficient and effective approaches to critical carenursing delivery. The institution (nursing department) proves its worth byanticipating patient care needs and planning its learning program cognizant ofthe need to correlate activities with the institution's (nursing department) missionand outcomes. Planning that meets the learning needs of the critical carenursing learners not only provides the ability to meet job expectations, but alsoexperiences for professional growth and satisfaction. In an age of nursingshortage, a well planned, integrated and outcomes orientated critical carelearning program is essential.The outcome of the research was identified as a process of quality improvementfor outcomes-based critical care nursing education, which included validatedstandards to facilitate quality critical care nursing education. This wasresearched by utilising an adapted Laing and Nish Model for Quality Assurance(1981) as the research strategy. Seven (7) steps were identified, namely: Stepone included the identification and clarification of values; step two determinedcriteria, established standards for outcome, structure and process; step threeratified criteria and validated standards; step four identified and analysed factorsinfluencing the results; step five selected appropriate actions to maintain or improve critical care nursing education; step six implemented the selectedactions and in step seven, assessment (testing) was done.In steps two and three of the quality improvement process the Muller's (1996)Three Phase Model for Standard Development was implemented. Seven (7)standards were identified and formulated, namely: Standard one - Qualityimprovement; Standard two - Standard formulation; Standard three -Philosophy; Standard four - Legislative framework; Standard five - Curriculumdevelopment (learning program development); Standard six - Outcomes-basededucation; and Standard seven - Critical care nursing education. During theprocess of validation of the standards, standards five and six were combined andbecame Standard five - Outcomes-based learning program development. Instep three the Delphi technique as part of the second phase of Muller's model(1996), was utilised to gain expert opinions / validation of standards.Operationalisation and assessment of the validated standards as part of aprocess of quality improvement for outcomes-based critical care education weredone in a higher education institution. The results of this pilot study that wasdone supported the central theoretical assumption, namely that outcomes-basedcritical care nursing facilitates quality critical care nursing.The uniqueness of the research lies in the fact that in outcomes-based criticalcare nursing education there is no formal process of quality improvement foroutcomes-based critical care nursing education. In this research, standards weredeveloped and presented as part of a process of quality improvement foroutcomes-based critical care nursing education. These standards should guidethe developer of an outcomes-based critical care nursing education programduring the development of the learning program (meso curriculum) and could beutilised to judge the quality of the current learning programs' quality. Five of thesix standards are generic and could be utilised with minor adjustments in anyhigher education learning program.

[发布机构] Stellenbosch University