a needs assessment for a school of nursing[1]
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TRANSCRIPT
- 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?