Abstract
The purpose of this study was to explore nurses' attitudes of midwives towards patient teaching among nurses and midwives. That educational interventions can be effective at increasing the knowledge and skills associated with evidence-based practice including reproductive, maternal and child health care. However in developing countries like Nigeria, little attention has been paid to patient teaching that focus on capacity building for evidence-based practice among nurses and midwives in the clinical settings. A lack of research evidence-based practice in clinical setting contributes to as many as 30%–40% of patients not receiving care and some 20%–25% of patients may receive potentially harmful care. Thus, this study reviews the growing body of research on operational research training for nurses and midwives and its effectiveness to patient outcomes. This serves as the first step for capacity building on operational research to nurses and midwives in Nigeria.
CHAPTER ONE
INTRODUCTION
- Background of the study
It is no longer news that Maternal and neonatal deaths have been a worldwide problem for years. Member states of the United Nations, including Nigeria, agreed to the Millennium Development Goals (MDGs) in 2000.Of the eight goals, MDG number 5 was specifically aimed at 75 per cent reduction in maternal mortality from its 1990 level by 2015 (WHO 2013). Provision of quality obstetric care is regarded as an important component of maternal health which assists in the reduction of maternal and neonatal death rates. Knowledge, attitudes and practices are essential elements of competency. Improving the quality of obstetric care by ensuring optimum knowledge, attitudes and practices of nurse midwives caring for women is one of the strategies for achieving this target (Fullerton, Johnson, Thompson & Vivio 2011). The Nigeria government, through its Ministry of Health and a multiplicity of partners, is committed to the provision of quality maternal and child care. The Nigeria government developed a National Strategic Development plan which covers the period 2012/13 -2016/17. Included in this plan are health-related aspects including the targets to reduce the maternal mortality rate and improve the quality and quantity of skilled health personnel including nurse-midwives (Government of Nigeria 2014). Investigating the knowledge, attitudes and practices of nurse-midwives related to obstetric care could contribute to evidence-based improvement of obstetric practices in Nigeria. The number of patients has increased dramatically during recent years. Hospitalization, which is the major health care cost in community, consumes a considerable part of the health care budget in general. (Stewart S, Blue L Et al 2014). Good education skills and strategies are particularly important in the diagnosis, treatment and management of diseases. (Helliwell PS, Ibrahim G 2013). Few studies have explored the contextual dimensions and subsequent interactions that contribute to a lack of adherence in the application of guidelines for patient education that is the cornerstone of care for all patients with acute or chronic diseases. Patients' education is a fundamental aspect of patient care and yet poor education is the most common source of patient’s complaints in the health-care sector. Other work indicates that miscommunication in education often occurs because of cultural differences between the communicator and recipient. Problems of miscommunication and language may not only influence treatment but may also contribute to the reinforcement of stereotyped behavior. (Robinson M, Gilmartin J 2012). There are increasing pressures within primary care requiring a rethink of roles, responsibilities and skill mix. The use of suitably trained nurses to extend their sphere of responsibility may be an appropriate way to manage the demand without compromising quality or patient satisfaction.( . Kinnersley P, Anderson E, Parry K, Clement J, Archard L, Turton P, et al 2012) Patient education is an essential nursing practice standard that meaningfully impacts a patient’s health and quality of life. Education process is a systematic, sequential, logical, planned course of action consisting of two major interdependent operations, teaching and learning. The education process has been compared to the nursing process as the steps of each process run parallel to one another. (Robinson M, Gilmartin J 2012) To provide thorough and appropriate education, each patient requires an ongoing teaching plan. Education is used to empower the patient and is an important aspect of quality improvement given that it has been associated with improved health outcomes. The nurses’ role has undergone historical change, shifting from imparting disease-oriented health education toward empowering patients to use their own resources to attain health. Essentials for effective patient education include use of an open communication style, written instructions and addressing barriers (Robinson M, Gilmartin J 2012). Demographic variables, such as ethnic background, formal education level, reading ability, and barriers to participation in education must be considered to maximize the effectiveness of self-management education outcomes. Nurses’ attitude to patient education barriers can help to elimination of many problems for practitioners who are well suited to provide care that facilitates behavior change and health oriented patient education.
- STATEMENT OF THE PROBLEM
In the Nigeria healthcare system, nurses form the backbone of whatever intervention structure that exists to improve the health of women and children. Nigeria aimed at reducing the number of women dying due to factors related to pregnancy and childbirth the barest minimum. However, there has been a slow reduction of maternal mortality rates in Nigeria. Training of nurse-midwives is important in order for them to acquire the necessary knowledge and skills to provide quality obstetric care and consequently contribute to reduction in maternal deaths. However, problems with training and provision of quality obstetric care were reported (Botma 2014; Stender et al 2014). Few studies, if any, have been conducted to evaluate the attitudes of midwives towards patient teaching among nurses and midwives. Such a study served as an educational diagnosis of the community of nurse-midwives currently caring for women and children in Nigeria.
- OBJECTIVE OF THE STUDY
The study has one main objective which is sub-divided into general and specific objective. The general objective is to examine the attitude of midwives toward patient teaching among nurses and midwives. The specific objectives are;
- To examine the effect of patient teaching on the job performance of nurses and midwives
- To ascertain if there is any significant relationship between midwives attitude to patient teaching and job performance
- To examine the impact of patient teaching on reduction of maternal mortality rates in Nigeria
- To proffer suggested solution to the identified problem
- RESEARCH QUESTIONS
The following research questions were formulated by the researcher to aid the successful completion of the study;
- Does patient teaching have any effect on the job performance of nurses and midwives?
- Is there any significant relationship between midwives attitude to patient teaching and job performance?
- Does midwives patient teaching have any impact on reduction of maternal mortality rates in Nigeria?
- RESEARCH HYPOTHESES
The following research hypotheses were formulated by the researcher to aid the completion of the study;
H0: There is no significant relationship between midwives attitude to patient teaching and job performance
H1: There is no significant relationship between midwives attitude to patient teaching and job performance
H0: Midwives patient teaching does not have any impact on reduction of maternal mortality rates in Nigeria
H2: Midwives patient teaching does have an impact on reduction of maternal mortality rates in Nigeria
