a needs assessment for a school of nursing[1]

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1 A Non- Thesis Project Presentation Submitted in partial fulfillment of the requirements for the degree of:

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  • 1. 1
    ANon- Thesis Project Presentation
    Submitted in partial fulfillment of the requirements for the degree of:
    Master ofScience in Nursing EducationCollege of Arts and SciencesNursing DepartmentLiberty UniversityLynchburg, VAApril 20th 2010

2. 2
A Needs Assessment Project Presentation for a College of Nursing in Malawi, Africa
by:
By:
Khataza Jessie Wheatley RN BSN
3. 3
Project Introduction
4. Introduction- Malawi
4
Malawi is an east sub-Saharan African country with deficient assets and resources and a largely unskilled personnel (Kelly, 2001).
5. Introduction Malawi
5
Well known as the "warm heart of Africa around the region for its friendliest people in all of Africa, this small country boasts a human population of 14 million.
6. Introduction MALAWI
6
With a life expectancy of only 41 years, Malawi also has one of the lowest life expectancies in the world for its population (Gorman & Hohmuth-Lemonick, 2009).
7. Introduction- Malawi
7
Malawi is a likely site for present and future philanthropy enterprises as it ranks as one of the poorest countries in the world.
8. Introduction Malawi
8
The healthcare infrastructure in Malawi,
has been complicated by issues of poverty, famine and lack of healthcare workers which yield to :
One of the worldsworst ratesofthe
Human Immunodeficiency Virus
(HIV) andAIDS infection !!
9. Introduction- Malawi
9
It is clearly apparent that nurses and nursing educators in Malawi are challenged by an exaggerated nurse shortage that is at a much bigger scale incomparable to what is seen in most developed nations today.
10. Introduction Malawi
10
The nursing shortage is due to the Malawis numbers of healthcare worker and nurse emigration rates( Taha, 1996).
11. Introduction Malawi
11
Nursing Training Schools in Malawi
Ekwendeni College
St. Johns College
St. John of God College
Mzuzu University
Kamuzu College of Nursing ( 2 )
Malawi College of Health Sciences (3)
Mulanje College
Nkhoma College
St. Lukes College
St. Joseph College
Trinity College
Holy Family College
Malamulo College
#4
#2
#1
#3
#6A
#5a
#8
#6C
#9
#10
#11
#5B
#11
#12
#6B
#7
#13
12. Image Shows Hundreds of women and children wait patiently-the occasional temper tantrum aside-for the mobile clinic to arrive in Emazwini, Malawi. (Northern Region)
12
Image:
Gorman, Christine; Hohmuth-Lemonick, Eileen
AJN The American Journal of Nursing. 109(6):26-30, June 2009.
doi: 10.1097/01.NAJ.0000352461.20307.e3
13. Image Shows, Northern Region, Malawi:Embangweni Mission Hospital in rural northern Malawi, nurse WalinaseNdovi takes the temperature of a child who is suspected of having malaria. Thanks to a combination of education, prevention, and treatment efforts, the death rate from malaria among children in this area has fallen dramatically over the past five years
13
Image:
Gorman, Christine; Hohmuth-Lemonick, Eileen
AJN The American Journal of Nursing. 109(6):26-30, June 2009.
doi: 10.1097/01.NAJ.0000352461.20307.e3
14. St Johns Mission Hospital
&
St Johns College of NursingNorthern Region Malawi
Central Africa Dates: January 2010 April2011
14
Project setting:
15. Goal:
To allow opportunities for globalization and collaboration in nursing education in Malawi by conducting a Nursing SchoolNeeds Assessment.
Objectives:

  • To provide data that can be utilized for nursing research, nursing education, healthcare infrastructure enhancements and otherstrategic planning needs for future nursing and healthcare philanthropic activitiesin Malawi.

16. To provide an awareness to the global healthcare and nursing community regarding nursing education in Malawi . 17. Topermit knowledge and access for the St. Johns College of Nursingand other nursing schools in this regionof Africa by providing an entrance platformfor Malawis nursing leaders into the global nursing professional forum. 18. To allow opportunities for nursing leaders, students and professionals to learn various ways of enhancing curriculum globalization and awareness of worldviews that pertain to nursing and nursing education.15
Project Goal & Objectives:
19. Goal:
To allow opportunities for globalization and collaboration in nursing education in Malawi by conducting a Needs Assessment for in a Nursing School.
Objectives:

  • To provide data that can be utilized for nursing research, nursing education, healthcare infrastructure enhancements and otherstrategic planning needs for future nursing and healthcare philanthropic activitiesin Malawi.

20. To provide an awareness to the global healthcare and nursing community regarding nursing education in Malawi . 21. Topermit knowledge and access for the St. Johns College of Nursingand other nursing schools in this regionof Africa by providing an entrance platformfor Malawis nursing leaders into the global nursing professional forum. 22. To allow opportunities for nursing leaders, students and professionals to learn various ways of enhancing curriculum globalization and awareness of worldviews that pertain to nursing and nursing education.16
Project Goal & Objectives:
To allow opportunities for globalization and collaboration in Nursing Education in Malawi by conducting a Nursing School Needs Assessment .
23. Goal:
To allow opportunities for globalization and collaboration in nursing education in Malawi by conducting a Needs Assessment for in a Nursing School.
Objectives:

  • To provide data that can be utilized for nursing research, nursing education, healthcare infrastructure enhancements and otherstrategic planning needs for future nursing and healthcare philanthropic activitiesin Malawi.

24. To provide an awareness to the global healthcare and nursing community regarding nursing education in Malawi . 25. Topermit knowledge and access for the St. Johns College of Nursingand other nursing schools in this regionof Africa by providing an entrance platformfor Malawis nursing leaders into the global nursing professional forum. 26. To allow opportunities for nursing leaders, students and professionals to learn various ways of enhancing curriculum globalization and awareness of worldviews that pertain to nursing and nursing education.17
Project Goal & Objectives:
# 1.To provide data that can be utilized for nursing research, education,
healthcare infrastructure enhancements & otherstrategic planning needs for future nursing and healthcare philanthropic activitiesin Malawi.
27. Goal:
To allow opportunities for globalization and collaboration in nursing education in Malawi by conducting a Needs Assessment for in a Nursing School.
Objectives:

  • To provide data that can be utilized for nursing research, nursing education, healthcare infrastructure enhancements and otherstrategic planning needs for future nursing and healthcare philanthropic activitiesin Malawi.

28. To provide an awareness to the global healthcare and nursing community regarding nursing education in Malawi . 29. Topermit knowledge and access for the St. Johns College of Nursingand other nursing schools in this regionof Africa by providing an entrance platformfor Malawis nursing leaders into the global nursing professional forum. 30. To allow opportunities for nursing leaders, students and professionals to learn various ways of enhancing curriculum globalization and awareness of worldviews that pertain to nursing and nursing education.18
Project Goal & Objectives:
# 2. To provide an awareness to the global healthcare and nursing community regarding nursing education in Malawi
31. Goal:
To allow opportunities for globalization and collaboration in nursing education in Malawi by conducting a Needs Assessment for in a Nursing School.
Objectives:

  • To provide data that can be utilized for nursing research, nursing education, healthcare infrastructure enhancements and otherstrategic planning needs for future nursing and healthcare philanthropic activitiesin Malawi.

32. To provide an awareness to the global healthcare and nursing community regarding nursing education in Malawi . 33. Topermit knowledge and access for the St. Johns College of Nursingand other nursing schools in this regionof Africa by providing an entrance platformfor Malawis nursing leaders into the global nursing professional forum. 34. To allow opportunities for nursing leaders, students and professionals to learn various ways of enhancing curriculum globalization and awareness of worldviews that pertain to nursing and nursing education.19
Project Goal & Objectives:
# 3. Topermit knowledge and access for the St. Johns College of Nursingand other nursing schools in this regionof Africa by providing an entrance platformfor Malawis nursing leaders into the global nursing professional forum.
35. Goal:
To allow opportunities for globalization and collaboration in nursing education in Malawi by conducting a Needs Assessment for in a Nursing School.
Objectives:

  • To provide data that can be utilized for nursing research, nursing education, healthcare infrastructure enhancements and otherstrategic planning needs for future nursing and healthcare philanthropic activitiesin Malawi.

36. To provide an awareness to the global healthcare and nursing community regarding nursing education in Malawi . 37. Topermit knowledge and access for the St. Johns College of Nursingand other nursing schools in this regionof Africa by providing an entrance platformfor Malawis nursing leaders into the global nursing professional forum. 38. To allow opportunities for nursing leaders, students and professionals to learn various ways of enhancing curriculum globalization and awareness of worldviews that pertain to nursing and nursing education.20
Project Goal & Objectives:
# 4. To allow opportunities for nursing leaders, students and professionals to learn various ways of enhancing curriculum globalization and awareness of worldviews that pertain to nursing and nursing education.
39. St. JOHNS HOSPITAL- MZUZU, MALAWI
Is a 215-bed Mission Hospital established in 1962 by the Catholic order sisters.
21
Project Setting- The Hospital
40. Project Setting- The Hospital
22
ST. JOHNS HOSPITAL- MZUZU, MALAWI
It has a large catchment area that includes the City of Mzuzu and the surrounding countryside.
It has a Male, a Female, a Pediatric, a TB, a Maternity, a Premature Baby Unit and a Nutrition Unit. The maternity unit delivers about 2000 babies a year.
A small pharmacy, a small laboratory, an X-ray department and an Operating Theatre providing basic specialized medical care.
41. Project Setting- The Hospital
23
ST. JOHNS HOSPITAL- MZUZU, MALAWI
It has a large catchment area that includes the City of Mzuzu and the surrounding countryside.
It has a Male, a Female, a Pediatric, a TB, a Maternity, a Premature Baby Unit and a Nutrition Unit. The maternity unit delivers about 2000 babies a year.
A small pharmacy, a small laboratory, an X-ray department and an Operating Theatre providing basic specialized medical care.
It has a large catchment area that includes the City of Mzuzu and the surrounding countryside
42. Project Setting- The Hospital
24
It has a Male, a Female, a Pediatric, a TB, a Maternity, a Premature Baby Unit and a Nutrition Unit. The maternity unit delivers about 2000 babies a year.
ST. JOHNS HOSPITAL- MZUZU, MALAWI
It has a large catchment area that includes the City of Mzuzu and the surrounding countryside.
It has a Male, a Female, a Pediatric, a TB, a Maternity, a Premature Baby Unit and a Nutrition Unit. The maternity unit delivers about 2000 babies a year.
A small pharmacy, a small laboratory, an X-ray department and an Operating Theatre providing basic specialized medical care.
43. Project Setting- The Hospital
25
ST. JOHNS HOSPITAL- MZUZU, MALAWI
It has a large catchment area that includes the City of Mzuzu and the surrounding countryside.
It has a Male, a Female, a Pediatric, a TB, a Maternity, a Premature Baby Unit and a Nutrition Unit. The maternity unit delivers about 2000 babies a year.
A small pharmacy, a small laboratory, an X-ray department and an Operating Theatre providing basic specialized medical care.
A small pharmacy, a small laboratory, an X-ray department and an Operating Theatre providing basic specialized medical care.
44. ST. JOHNS COLLEGE OF NURSING, MZUZU, MALAWI
26
Project Setting- The Nursing School
45. Project Setting- The Nursing School
27
Students & Staff
A College of Nursing located at the Hospital with 111 nursing students currently enrolled in a Diploma Nursing Program specializing in a three-year study for Nurse & Nurse Midwife Technician Programs.
First-year Students 26
Second-year Students- 38
Third-year Students- 47
(Male: Female Ratio- 3.7)
The College has 12 academic staff (tutors) which includes a Volunteer Services Organization (VSO) volunteer, a College Principal and 3 Clinical instructors.
46. 28
Statement & Significance of Nursing & Nursing Education Issues in Malawi
Why Malawi?Why Nursing? . One may choose to wonder.
47. Statement and Significance of Nursing Education Issues in Malawi
29
Malawi has the lowest ratios of Healthcare Workers to Total Patient Population in the world.
only 7,264 nurses are serving Malawis 14 million people. (? Reference)
Malawi is the poorest country in the world, with a gross domestic product (GDP) of less than $200 per capita.
Malawi has been hardest hit by two of the worlds current worse epidemics: proliferating rates of HIV infection, AIDS and Tuberculosis (TB) infection (Kelly, 2001).
48. Statement and Significance of Nursing Education Issues in Malawi
30
Malawi Aid Workers focusing on Healthcare realize that philanthropic opportunities to assist in Malawi must involve all healthcare workers, including the global professional body of nursing that includes nursing educators and current nursing students.
Issues of nursing education in Malawi need to be addressed. These issues can best be addressed by active collaboration with global leaders and students currently actively participating in shaping nursing education worldwide.
49. Statement and Significance of Nursing Education Issues in Malawi
31
This needs assessment serves as a stepping stone to opportunities that will assist the stabilization and standardizing nursing education at St. Johns College of Nursing in Malawi to ensure the quality and integrity of the global body of professional nursing
50. Statement and significance of Nursing Education Issues in Malawi
32
This needs assessment study serves to provide much needed data, not only for Malawi but also for the Sub-Saharan Africa region.
In response to this, it is time for nursing leaders and educators to pay close attention to issues affecting nursing education on the global front.
By bringing Malawis nursing issues to focus with this project and the implementation of further action, we will enhance and unify the profile of the body of the nursing profession in our world and address some very important and complex issues that are affecting world health outcomes today.
51. A review of literature using the CINAHL and OVID databases was conducted using the key terms:
international nursing and Malawi,;
nursing in Malawi;
global nursing issues;
nursing migration,;
nursing education in Malawi;
nursing education issues in Malawi and
nursing issues in Malawi.
33
A Review of Literature
52. A Review of Literature
34
that very few studies have been conducted that are specific to nursing and nursing education in Malawi.
53. A Review of Literature
35
Previous studies have focused on other issues; such as:
the positive practice environments for international nurses migrating out of countries like Malawi;
the ethical recruitment of foreign-trained nurses (Adams & Kennedy, 2006).;
nursing work-force self sufficiency and sustainability in countries (like Malawi) where there has been an increase in RN and/or nurse emigration (Little & Buchan, 2007).
It is apparent, by review of literature that the global nursing community is aware of such issues as:
the massive migration of the healthcare labor force out of poor countries (like Malawi) to developed countries and have published suggestions for the management of issues related to its impact (Stillwell et. al., 2004);
the need for accurate data collection methods to track the migration trends (Diallo, 2004);
The characteristics of the work of internationally-trained RNs (like those out of Malawi) are also discussed in studies (Xu & Kwak, 2007).
Other studies focus on migration and credentialing issues of foreign-educated nurses (Bieski, 2007),
There are studies on specific issues that employers of foreign-trained nurses face, such as: competency, communication and consistency in education preparation (Parrone et. al., 2008). According to Parrone et. al (2008), ambiguous and inconsistent education standards for registered nurses that vary from nation to nation may leave out key topics in nursing education preparation, such as patient advocacy, confidentiality issues, Kubbler- Ross research on death and dying etc. Many studies have not focused on the need for transparency in topics regarding RN education in countries around the world.
54. A Review of Literature
36
There is an obvious gap in current research literature on nursing educationand practice environment issues in developing countries like Malawi, despite the growing number of emigrating RNs needing to practice in other countries worldwide.
The answer to fill this gap lies in conducting research andproject s such as this one.
55. In what ways do standards of nursing education in Malawi compare to the schools in developed nations?
What possible correlations exist between suggestions for improvement in Malawis nursing schools (Please describe what would most increase your overall level of satisfaction with your nursing education and nursing practice experience here in Malawi) and resources which are marked with both the highest importance and the lowest level of satisfaction?
37
Research Questions:
The project attempted to answer the following
56. In what ways do standards of nursing education in Malawi compare to the schools in developed nations?
What possible correlations exist between suggestions for improvement in Malawis nursing schools (Please describe what would most increase your overall level of satisfaction with your nursing education and nursing practice experience here in Malawi) and resources which are marked with both the highest importance and the lowest level of satisfaction?
38
Research Questions:
The project attempted to answer the following
Question # 1:
In what ways do Standards of Nursing Education in Malawi Compare to the Schools in Developed Nations?
57. In what ways do standards of nursing education in Malawi compare to the schools in developed nations?
What possible correlations exist between suggestions for improvement in Malawis nursing schools (Please describe what would most increase your overall level of satisfaction with your nursing education and nursing practice experience here in Malawi) and resources which are marked with both the highest importance and the lowest level of satisfaction?
39
Research Questions:
The project attempted to answer the following
Question # 2:
What possible correlations exist between Suggestions for Improvement in a Malawi Nursing School and Resources which are marked with both the Highest Importance and the Lowest level of Satisfaction?
58. In the attempts to answer the first research question, therewas no intention for the manipulation of the variables under study, nor was there aneed to establish causality among variables that were isolated, hence dependent and independent variables were not isolated (Barnes & Grove, 2005).
The key variables of interest to answer the first question in this project were sub-divided into these main categories:
(1) Demographic Information Characteristics,
(2) High School (Secondary) Education Characteristics,
(3) Post-Secondary Education Characteristics,
(4) Professional Nursing Education Characteristics,
(5) Prior Health-Related Education Characteristics,
(6) Professional Development Studies Characteristics
(7) Professional Licensure Requirements
40
Methodology
59. Data for the second question was collected utilizing the following methods:
a written survey (questionnaire) given tonursing students.
a face-to-face, telephone, and e-mailed interviewswith the nursing school principal and the college librarian.
a nursing student focus group.
through on-site observations.
41
Methodology
60. The type of research design selected for this project was a Comparative Descriptive Design (Barnes & Grove, 2005). In this design, there was examination and description of several key variables of interest as they occured naturally in their natural setting in Malawi.
The rationale for selecting this design is that at this early stage of research on this subject matter there, is such a need to establish a clearer delineation of the Standards of Nursing Education in Malawi before the Second Research Question or any studiessuch studies that would establish causality could be explored.
It is very imperative that Descriptive Research, such as one, be conductedfirst on this subject matter at this time so that opportunities for further research in Nursing in Malawi can be explored.
42
Project Design
61. The initial participants of this project were obtained through Convenience Sampling Methods. Study participants were accessed through contacts made while visiting theSchool of Nursing in Mzuzu, Malawi in May 2010.
The attrition rate for the sample was ~10 %.The sample was further be expanded and maintained utilizing network sampling methods that included maintaining contacts from the original convenience sample.
The totalnumber of subjects studied was 124 individuals. This included nursing faculty and staff, and students atSt. Johns College of Nursing.
43
Sample & Sampling Procedures
62. Microsoft Excel was used to create a spreadsheet of the raw data collected for the research questions.
Ease/Impact Matrices were utilized to analyze the data collected to and to allow brainstorming by project participants and or other nursing professionals seeking to implement additional actions to solve problems that were identified in this project.
44
Data Analysis
63. 45
Project Findings
64. Project Findings- Research Question # 1
46
Demographic Information Characteristics

  • In what ways do standards of nursing education in Malawi compare to the schools in developed nations?

Name of Institution- St. Johns College of Nursing, Mzuzu, Malawi
Nature of Instruction (e.g., Setting, Focus, etc.)- Post-Secondary Institution of Higher Learning
Language of instruction- English
Country of Birth-100 % of the students were Malawian
Purpose of Educational Program- Post-SecondaryTraining Course for Nurses
Explanation of School System- Based on the British School System of Higher Education
65. Project Findings- Research Question # 1
47
High School (Secondary) Education Characteristics

  • In what ways do standards of nursing education in Malawi compare to the schools in developed nations?

Entrance Requirements:Must pass the Standard Eight Exam and be Selected for Secondary Education
Length of Study: 4 years
Nature of Instruction:Equivalent to High School Instruction.
Comparability to U.S. Secondary Education: Highly Comparable
66. Project Findings- Research Question # 1
48
Post-Secondary Education Characteristics

  • In what ways do standards of nursing education in Malawi compare to the schools in developed nations?

Entrance Requirements:
Must pass the Malawi school Certificate of Education (MSCE) with Credits (As or Bs) in :
1. Either Biology or Physical science and;
2. In any other three science subjects like Mathematics, Agriculture, Geography, Home economics
3. Must complete a separate application to the College of Nursing.
4. Mustundergo EntranceWritten and OralInterviews.
Length of Study:3years
Nature of Instruction:Classroom Lecture and ClinicalInstruction.
Comparability to U.S.College, Technical, Community College Education: Highly Comparable
67. Project Findings- Research Question # 1
49
Nursing Education Characteristics

  • In what ways do standards of nursing education in Malawi compare to the schools in developed nations?

Length of Study:3years
Nature of Instruction:Classroom Lecture and ClinicalInstruction.
Comparability to U.S.College, Technical, Community College Education: Highly Comparable
68. Project Findings- Research Question # 1
50
Prior Health Education Characteristics

  • In what ways do standards of nursing education in Malawi compare to the schools in developed nations?