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Establishing Standards in Establishing Standards in Nursing Education in EgyptNursing Education in Egypt

ByBy

Nursing Sector CommitteeNursing Sector CommitteeSupreme Council of UniversitiesSupreme Council of Universities

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QUALITY IN NURSING QUALITY IN NURSING EDUCATION:EDUCATION:

THE ROAD TO ACCREDITATIONTHE ROAD TO ACCREDITATION

By By Prof Dr. Ferial A. AlyProf Dr. Ferial A. Aly

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Quality is not achieved by doing different Quality is not achieved by doing different thingsthings

BUTBUT

it is achieved by doing things it is achieved by doing things differentlydifferently

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Government of Egypt (GOE) recognized Government of Egypt (GOE) recognized the need for improving the quality of the need for improving the quality of university education standards, university education standards, strengthening the nursing and strengthening the nursing and education system and equipping the education system and equipping the nursing graduates with knowledge and nursing graduates with knowledge and skills.skills.

As we know in the line with As we know in the line with international trends, the availability of international trends, the availability of qualified and competent health care qualified and competent health care professionals is the key to the delivery professionals is the key to the delivery of quality health care services.of quality health care services.

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Also advanced practice in nursing has become a dominant Also advanced practice in nursing has become a dominant focus of graduate nursing education over the past two focus of graduate nursing education over the past two decadesdecades..

SO SO

Nurses who do not keep upgrading their skills will be left Nurses who do not keep upgrading their skills will be left behind by work place changesbehind by work place changes..

ANDAND Agencies that fails to support nurses in their quest for new Agencies that fails to support nurses in their quest for new

skills will be outclassed by their more enlightened skills will be outclassed by their more enlightened competitionscompetitions..

SOSO Life long learning is the only answer for a competitive futureLife long learning is the only answer for a competitive future ..

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The National Quality Assurance and The National Quality Assurance and Accreditation Committee (NQAAC) is Accreditation Committee (NQAAC) is therefore working with the Supreme therefore working with the Supreme Council of Universities in Egypt to Council of Universities in Egypt to develop national reference standards develop national reference standards for 19 sector covering all higher for 19 sector covering all higher education Nursing Sector was one of education Nursing Sector was one of them.them.

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These reference standards will be These reference standards will be informed by an analysis of high informed by an analysis of high standards worldwide. standards worldwide.

They will offer institutions an They will offer institutions an external reference point for their external reference point for their benchmarking alongside a number of benchmarking alongside a number of other sources, including where other sources, including where approval professional organizations. approval professional organizations.

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National Academic Reference Standard National Academic Reference Standard for Nursing Education Project #4for Nursing Education Project #4

Nursing Sector Committee started this Nursing Sector Committee started this project 2005.project 2005.

Purpose:Purpose: To develop To develop reference standardsreference standards for academic for academic

nursing education.nursing education. Enhance the systematic Enhance the systematic growth of the growth of the

institutioninstitution and contribute to its outcome in the and contribute to its outcome in the community.community.

Lead to better Lead to better matching between educationmatching between education as as

a system and the demands of the a system and the demands of the community community as a as a customercustomer in the quality system. in the quality system.

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Project partners :Project partners :

This project is a consortium between all This project is a consortium between all faculties of nursing affiliated to all different faculties of nursing affiliated to all different universities.universities.

Nursing Faculty - Alexandria University Nursing Faculty - Alexandria University 19551955

Nursing Faculty - Cairo University 1965Nursing Faculty - Cairo University 1965 Nursing Faculty-Ain Shams University Nursing Faculty-Ain Shams University

19811981 Nursing Faculty- Assuit University 1982Nursing Faculty- Assuit University 1982 Nursing Faculty - Zagazig UniversityNursing Faculty - Zagazig University 19841984

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Nursing Faculty - Monoufia University 1986Nursing Faculty - Monoufia University 1986 Nursing Faculty - Tanta University 1987Nursing Faculty - Tanta University 1987 Nursing Faculty Port Said –Suez Qanal University Nursing Faculty Port Said –Suez Qanal University

19921992 Nursing Faculty Banha- Banha University 1993Nursing Faculty Banha- Banha University 1993 Nursing Faculty - Mansoura University 1994Nursing Faculty - Mansoura University 1994 Nursing Faculty- Menia University 1995Nursing Faculty- Menia University 1995 Nursing Faculty- Sohag University (2006)*Nursing Faculty- Sohag University (2006)* Nursing Faculty Esmailia- Suez Qanal University Nursing Faculty Esmailia- Suez Qanal University

(2006)*(2006)* Nursing Faculty- Helwan University (2006)*Nursing Faculty- Helwan University (2006)*

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Project teamProject team Project Management Team:Project Management Team:Head, Nursing Sector CommitteeHead, Nursing Sector Committee

Secretary General of Nursing Sector CommitteeSecretary General of Nursing Sector Committee Dean, Faculty of NursingDean, Faculty of Nursing AlexandriaAlexandria University,University,Dean, Faculty of Nursing Cairo UniversityDean, Faculty of Nursing Cairo University

Dean Faculty of NursingDean Faculty of Nursing AinAin ShamsShams UniversityUniversityDean, Faculty ofDean, Faculty of NursingNursing AssuitAssuit UniversityUniversityFaculty of NursingFaculty of Nursing Suez CanalSuez Canal UniversityUniversity

Project Implementation Team:Project Implementation Team:

Implementation Team:Implementation Team: It consists of 2 staff members from It consists of 2 staff members from each universityeach university

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The scope of this project Is The scope of this project Is the the educational qualityeducational quality. It . It helps to realize helps to realize institutional missioninstitutional mission more more effectively, and responds to effectively, and responds to expectations of accrediting expectations of accrediting organizationsorganizations, , community community needs,needs, and other external and other external stakeholdersstakeholders for for accountability in the accountability in the teaching/learning teaching/learning processes. processes.

Scope of the Scope of the ProjectProject

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This project also gives This project also gives renewed emphasis to renewed emphasis to educational qualityeducational quality, , initiated several years ago initiated several years ago with widespread faculty with widespread faculty and staff involvement, to and staff involvement, to define competencies and define competencies and implement assessment of implement assessment of learning outcomes for all learning outcomes for all College Degree Programs College Degree Programs and General Education and General Education DepartmentsDepartments..

Scope of the Scope of the ProjectProject

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ObjectivesObjectives::

1.1. Raise Raise awareness awareness of all of all beneficiaries regarding the beneficiaries regarding the importance and significance of importance and significance of developing academic reference.developing academic reference.

2.2. Design Design data basedata base of different of different types of standards; national and types of standards; national and internationalinternational

3.3. Develop the reference standards Develop the reference standards based on the data base createdbased on the data base created

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Objective cont.Objective cont.

4.4. Disseminate the endorsed Disseminate the endorsed standardsstandards to all interest parties to all interest parties (students, graduates, (students, graduates, stakeholders, physicians, and stakeholders, physicians, and nurses in health care nurses in health care organization, professional organization, professional organization and organization and community………etc)community………etc)

5.5. Implement the developed Implement the developed reference standards. reference standards.

6.6. Measurer the efficacy of the Measurer the efficacy of the develop standard.develop standard.

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ContentsContents:: This project addresses a widely perceived This project addresses a widely perceived

need for improvement where dual need for improvement where dual objectives could be achieved :objectives could be achieved :• Setting standards. Setting standards. • implementing those standards to ensure implementing those standards to ensure

quality.quality. Project implementation followed a Project implementation followed a

carefully crafted, highly detailed project carefully crafted, highly detailed project management implementation plan. management implementation plan.

The necessary The necessary resourcesresources was allocated for was allocated for this plan by the project management this plan by the project management team. team.

Achievements reportsAchievements reports was delivered and was delivered and periodic progress was continuously periodic progress was continuously communicated to the entire institutions.communicated to the entire institutions.

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was tracking two channels; was tracking two channels; investigation and developmentalinvestigation and developmental

InvestigationInvestigation was done through was done through data collectiondata collection for the national and for the national and international standards to create international standards to create data base of the educational data base of the educational nursing standards. nursing standards.

Developmental stagesDevelopmental stages was was concerned with the concerned with the designing and designing and validating the intended standards validating the intended standards and tools to follow up its and tools to follow up its application.application.

MethodologyMethodology

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Beneficiaries: Beneficiaries:

Teaching staffTeaching staff

Students and graduatesStudents and graduates

stakeholders stakeholders

physicians and nurses in health care physicians and nurses in health care

organizations, organizations,

professional organization and community. professional organization and community.

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Dissemination:Dissemination: Dissemination for the projectDissemination for the project deliverables deliverables

was achieved through different activities such was achieved through different activities such as as seminars, and workshopsseminars, and workshops. Seminars was . Seminars was conducted in the different nursing faculties.conducted in the different nursing faculties.

AudientsAudients for this seminars was recruited from for this seminars was recruited from within and outside the nursing field.within and outside the nursing field.

Emphasis was done on the Emphasis was done on the stakeholdersstakeholders to to gain their opinions regarding the intended gain their opinions regarding the intended standards as they are the customers for the standards as they are the customers for the faculty graduates besides they are faculty graduates besides they are considered a stratum from the community. considered a stratum from the community.

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Dissemination ContDissemination Cont.. Another means for dissemination is Another means for dissemination is

the the non-projected medianon-projected media such as such as posters, bulletin boards, leaflets, posters, bulletin boards, leaflets, and pamphlets.and pamphlets.

The aim of this wide dissemination The aim of this wide dissemination was to ensure that was to ensure that the project the project deliverables have been widely deliverables have been widely spreadspread, and to acknowledge a wide , and to acknowledge a wide range of customers.range of customers.

Arab regionArab region would be targeted in would be targeted in the strategies to disseminate the the strategies to disseminate the developed reference standards. developed reference standards.

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Quality control & monitoringQuality control & monitoring Quality control & monitoringQuality control & monitoring for the present project for the present project

stages was fulfilled through different activities:- stages was fulfilled through different activities:- Supervision for the program activities was done by the Supervision for the program activities was done by the

project project management teammanagement team through: through:• Action planAction plan for the project implementation. for the project implementation.• ScheduleSchedule for the project implementation. for the project implementation.• Control Control the flow of workthe flow of work through the project through the project

implementation.implementation.• Reviewing by the project teamReviewing by the project team • Validity and reliability. Validity and reliability. Using differentUsing different expertsexperts

recruited either internally from within the nursing recruited either internally from within the nursing field (peer reviewer) or out side the nursing field field (peer reviewer) or out side the nursing field (medical field) (medical field)

• Auditing Auditing • EvaluationEvaluation ( ongoing in all project stages) ( ongoing in all project stages)

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Steps of ImplementationSteps of Implementation

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SymposiumSymposium to raise awareness for to raise awareness for the faculty and the stakeholders.the faculty and the stakeholders.

WorkshopWorkshop to brain storm for the to brain storm for the

faculty and the stakeholdersfaculty and the stakeholders

Prepare Baseline dataPrepare Baseline data including including national and international standardsnational and international standards

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DraftDraft of the of the academic reference academic reference standards (ARS)standards (ARS) has been has been developeddeveloped

AscertainAscertain validity and reliability validity and reliability

Print outPrint out of the validated standards of the validated standards ready for applicationready for application

Train all beneficiariesTrain all beneficiaries (faculty staff (faculty staff members) in different faculties on the members) in different faculties on the development of ARS and its usesdevelopment of ARS and its uses..

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SeminarsSeminars to propagate and apply to propagate and apply the proposed standards in the the proposed standards in the different nursing facultiesdifferent nursing faculties

Auditing toolsAuditing tools to follow up the to follow up the standards implementationstandards implementation

Report Report of the follow up and final of the follow up and final report (ongoing)report (ongoing)

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Out put/ out comeOut put/ out come

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1- Attributes of the typical nursing 1- Attributes of the typical nursing graduate were developed and agreed graduate were developed and agreed upon by NSC.upon by NSC.

2- Role of graduate nurses were 2- Role of graduate nurses were identified and agreed upon NSC.identified and agreed upon NSC.

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Planner&

Coordinator

Collaborator

HealthEducator

Advocacy

CommunicatorResearch

Participant

Leader

Health Care ProviderIdentify Role

of the Nurse

Professional development

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3- Areas of academic reference 3- Areas of academic reference standards were identified and standards were identified and agreed upon by NSCagreed upon by NSC

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4- Distribution of responsibilities to the 4- Distribution of responsibilities to the different faculties for developing ARS.different faculties for developing ARS.

Domains Faculties groups - Understanding. - Knowledge. - Practical Skills.

Cairo University- Zagazig University- Menia University

- Intellectual Skills.- Professional Skills.- Practical Skills.

Alexandria University- Manroura University- Menofia University- Tanta University

- General Skills.- Transferable Skills.

Ain Shams University- Benha University- Assuit University- Suez Canal University

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5- Correlate the academic standards 5- Correlate the academic standards with the role of nursewith the role of nurse

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Role of Role of nursenurse

1.Knowle1.Knowledge & dge & UnderstaUnderstandingnding

2. 2. IntellecIntellectual tual SkillsSkills

3. 3. ProfessionProfessional Skills/ al Skills/ PracticePractice

4. General 4. General and and Transferable Transferable skillsskills

Provider of Provider of Health CareHealth Care

CommunicatorCommunicator

Collaborator & Collaborator & coordinatorcoordinator

Health Health EducatorEducator

AdvocacyAdvocacy

Professional Professional developmentdevelopment

Research Research ParticipantParticipant

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Provider of Health Care as an e.gProvider of Health Care as an e.g..DomainDomainStandardsStandards

1.Knowledge & 1.Knowledge & UnderstandingUnderstanding

utilize concepts and principles derived from utilize concepts and principles derived from the course of study as a body of knowledge the course of study as a body of knowledge for practicing in a variety of set upsfor practicing in a variety of set ups

22 . .Intellectual Intellectual SkillsSkills

work with the consumer, (and his/her work with the consumer, (and his/her relatives/carers), relatives/carers), group/community/population to consider the group/community/population to consider the range of activities that are feasible/ range of activities that are feasible/ appropriate/acceptable in planning the care appropriate/acceptable in planning the care including possibilities for referralincluding possibilities for referral

33 . .Professional Professional Skills/ PracticeSkills/ Practice

synthesize knowledge derived from the synthesize knowledge derived from the scientific, behavioral and nursing sciences for scientific, behavioral and nursing sciences for the development of professional skillsthe development of professional skills

44 . .General and General and Transferable Transferable skillsskills

utilize concepts and principles derived from utilize concepts and principles derived from the course of study as a body of knowledge the course of study as a body of knowledge for practicing in a variety of set upsfor practicing in a variety of set ups

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6.6. Valid & reliable standards ready for Valid & reliable standards ready for implementation and was sent to jury and implementation and was sent to jury and stakeholders for evaluation- Final draft stakeholders for evaluation- Final draft was prepared after their feedback.was prepared after their feedback.

7.7. Glossary of scientific terms Glossary of scientific terms has been has been developed.developed.

8.8. Guideline manualGuideline manual for the implementation for the implementation and utilization of academic reference and utilization of academic reference standard of nursing education has been standard of nursing education has been developed (understudy)developed (understudy)

9.9. SymposiumSymposium to raise awareness for the to raise awareness for the faculty and stakeholders.faculty and stakeholders.

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Obstacles that hindered the Obstacles that hindered the progress of the projectprogress of the project

1.1. DelayDelay in delivering the proposed in delivering the proposed standards standards CausesCauses of this problem was that of this problem was that standards have been developed as standards have been developed as professionalprofessional one first and then the one first and then the referencereference standards were developed standards were developed later.later.The impactThe impact on the project was that the on the project was that the project life was extended after the project life was extended after the targeted date. targeted date. The nursing sector now has professional The nursing sector now has professional standards beside the reference ones.standards beside the reference ones.

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2.2. DelayDelay in completing phase II in completing phase II CausesCauses was:was:a. Lack of communication between a. Lack of communication between nursing sector and QAAP. nursing sector and QAAP.b. Delay in receiving feedback of the first b. Delay in receiving feedback of the first

report up till now (6 months) report up till now (6 months)c. Delay in receiving budget of Phase IIc. Delay in receiving budget of Phase II

ImpactImpact on the project was; delay in on the project was; delay in completing phase II.completing phase II.

Obstacles ContObstacles Cont..

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Finally:Finally:

QualityQuality is not something is not something extraordinary,extraordinary,

BUTBUT it is something ordinary it is something ordinary

extraordinary well.extraordinary well.

QualityQuality is doing is doing the right things right,the right things right,

every time from the every time from the first time. first time.

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