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

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.

4 3 2 1

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