Deliverables

Project Achieved Outcomes

Achieved Outcomes Objectives 1-Setting HEEPF center.2-Needs assessment for the faculty CTS and departments' needs( pre, periodic and Post..3-Prepared TOT team in CTS.4-Developed & reviewed eight clinical procedure manuals (90%).5-Developed and revised all the CTS assessment tools for all departments.6-Developed Clinical Simulation Guideline for manikins and the new system of CTS.7- Developing Reference standard for F staff & advanced Foundation Skills Package based on R.S of the Nursing Suprime Council..8-Conduct 22 workshops and 6 seminars.9-Training of 40 internship students 2005.10-Trianing of 30 nurse's graduates.11-Training 10 nurses from MOHP.12- training 80% of the faculty members 13- Developed Infection Control procedure manual.14-Develop Computer Skills Manual

-Develop the clinical teaching skills of the faculty staff up to the competent standard for Accreditation.

1-Set Mission, Vision and philosophy of CTS2-Adopt a clinical teaching system. Start from class teaching & orientation -E-Learning- Simulator Labs, infection control unit and Finally by clinical practice at the health care settings.3-Start open Labs at 3 pm on Monday and Tuesday.4-Provide each lab with Data show, computer and Video, Video Camera.

-Design a teaching system for practical training and ensuring its use by undergraduate.

1-Update and renovate 3 skills labs.2-Developed 2 skills labs.3-Maintenance of Manikins (3 anatomical models).4-Maintenance of the Skeleton.5-Purchasing the needed manikins and computers.6-Developed one lab for Virtual Multimedia.

-Update and expand the faculty skills labs and clinical sites.

1-Developed a scientific E-library. 2-Create 2 Web Site for clinical teaching skills.3-Create 1 web site specifically for CTS.4- Held the National Conference for projects collaboration.5-Integration with other projects of the same theme (Prof.Dr. zeinb Sonbol for training of Pediatric Hospital Nurses) ( Prof.Dr. Ali Abo Zeid- Pediatric training through Networking, Prof. Talat ElkhatibAssuit Food Hygiene.6-Integration with QAAP and HWD projects.

-integrate the clinical practice development with international strategy to cope with modern technology and accreditation requirements.

Mansoura University Faculty Of Nursing

Clinical Teaching Assessment of the Nursing Faculty at Mansoura University.

Introduction

The clinical performance of the faculty self-study is a normal

response to the global and national call for Accreditation and

quality improvements and assurance in the Nursing Education.

Based on the Higher Education Enhancement (HEEPF) Goals to

support the creation and upgrade the quality of academic program,

Purpose of Clinical teaching assessment • To identify weakness and deficits in clinical teaching as a

formative evaluation for improvement.

• To make a judgment about the standard of clinical teaching

as: Summative evaluation to provide evidence – base in

clinical Skills.

Action Plan

• It will comprise evaluation By:

1- Students’ feedback of the clinical practice course.

2- Self- Assessment

3- The students final grades.

4- Patients and Clients’ feedback.

5- Stickholders Feedback from the Supervisors of the Health

Facilities about faculty students and graduates Skills

6- Internal auditing .

7- External auditing .

1-Students’ feedback of the clinical practice course. Evaluation by students is a positive process to provide staff with

valid and reliable information with emphasis to improve student

learning outcome. As well to make judgment about the standard of

clinical teaching (a summative evaluation). Therefore, a standard

questionnaire form has developed briefly to obtain quantitative

data from the faculty students to comment on

2- Self- Assessment This will be through each department self-evaluation of teaching

, clinical guideline and standard and the evaluation tools of clinical

practice. As well the students/staff ratio, use of E-Learning in

clinical teaching, the clinical equipments and supplies, and the

sites of clinical training.

3- The students final grades The students’ final grades for 2 retrospective semesters will be

assessed to be compared with students progress after project

intervention (time of assessment prior development second

semester 2005, and periodic assessment through students rotation

activities then final assessment of student's score in the first

semester at February 2006).

4-Patients and Clients’ feedback Patients/ clients satisfaction will be carried out to assess if the

clinical skills of students nurses and graduates fulfill their needs

and if they follow patients/clients’ rights….etc.

5-Stickholders Feedback From the Supervisors of the Health Facilities about faculty

students and graduates Skills. Physicians, Clinical Supervisors,

High graduate nurses in hospitals and different health care settings

will give feedback about faculty students and graduates clinical

performance and skills through questionnaire form.

6-Internal auditing This will be carried out through a chosen Committee from the

faculty staff to assess the clinical practices and faculty needs ,

facilities, laboratories, the process of clinical teaching and offers

recommendations to improve the results of assessment.

7-External auditing team This will be carried out through external experts from other

Universities to assess the clinical teaching courses, evaluation

tools and laboratories, clinical settings, make judgments about the

situations and offers recommendations

1-Results of Students Feedback of Clinical Training Before Project Implementation

Student’s feedback ( n= 120 ) Poor Good Excellent Not Done

% No % No % No % No

Items No

Clinical Instructors-A 26.7 32 21.7 26 5.0 6 30.0 36 Is the objectives of clinical training mentioned. 1 25.0 30 25.8 31 1.7 2 30.0 36 The instructor is well prepared. 2 23.4 28 25.0 30 5.0 6 26.7 32 Is the procedure steps well explained. 3 25.0 30 23.4 28 7.5 9 23.4 28 Instructor talk with clear voice. 4 26.7 32 20.8 25 6.7 8 28.3 34 Is their a feed back. 5 30 36 20.8 25 5.0 6 28.3 34 Is the instructor encourage students for discussion

and demonstration of procedures. 6

30.0 36 20.0 24 5.8 5 31.7 38 Use of Communication technique. 7 18.3 22 24.2 29 6.7 8 30.0 36 Use simulation before handling real

patients/situation 8

30 36 19.2 23 6.7 8 30.0 36 Use role play, case presentation. 9 18.3 22 20.0 24 5.8 7 40.0 48 Is the Student Satisfy with the introduced

knowledge and skills. 10

28.3 34 18.3 22 5.8 7 33.4 40 The instructor answer all raised questions from students. 11 30.0 36 20.8 25 5.0 6 30.0 36 Availability of the instructor if needed. 12 23.4 28 22.5 27 5.0 6 31.7 38 Student acquire new skills. 13 20.0 24 24.2 29 8.4 10 26.7 32 The acquired skills will be useful in application or

will use it for other sciences. 14

18.4 22 24.2 29 4.2 5 35.0 42 Good use for the time schedules. 15 36.7 44 19.2 23 0.8 1 33.4 40 Students provided with clinical handout for the

course. 16

B- Environment 26.7 32 15.0 18 3.3 4 48.4 58 Suitable area for clinical practice. 1 26.7 32 15.0 18 4.2 5 45.5 54 Absent of noise. 2 16.7 20 24.2 29 5.8 7 35.0 42 Well ventilated. 3 25.0 30 18.3 22 6.7 8 36.7 44 Proper light. 4 21.7 26 11.7 14 5.8 7 53.4 64 Availability of Electronic learning in clinical training. 5 21.7 26 17.5 21 3.4 4 46.7 56 Absence of offensive odor 6 Equipments and Supplies-C

32 15.0 18 3.4 4 45.0 54 Available number of equipments 1 28.3 34 15.8 19 1.7 2 46.7 56 Suitable type of equipments for procedures 2 26.7 32 13.3 16 2.5 3 53.4 64 Available amount/Kind of supplies 3

D- Procedures provided in: Simulator labs

31.7 38 20.8 25 3.4 4 31.7 38 All procedures always performed efficiently. 1 25.0 30 20.0 24 5.0 6 36.7 44 The number of procedures is enough to acquire the

needed skills. 2

Hospital 21.7 26 17.5 21 5.0 6 45.0 54 Enough/available number of patients. 1 31.7 38 16.7 20 0.8 1 43.3 52 The hospital area is suitable for procedures. 2 25.0 30 20.0 24 2.5 3 38.3 46 Suitable students / instructors ratio. 3 33.4 40 17.5 21 2.5 3 35.5 42 Suitable students / simulators or patient ratio. 4

Figure (1)

Results from students’ feedback before conducting the project

phases for development are obtained (Table 1 ) . It was observed

that more than two thirds of the Students mentioned that clinical

staff don’t follow the clinical teaching process as shown in Figure

(1). The minorities (5.8%) mentioned that clinical environment is

suitable for Nursing practice.

The Majority ( 79. 4 %) of students mentioned that equipments

and supplies are unsuitable either for availability, suitability ,

amount or kinds. Of the students, &0% mentioned that the

procedures in the simulated labs are insufficient and not enough to

to acquire the needed skills. Again more than three quarters of

them (75.3%) mentioned that clinical practice in the hospitals are

48.5

3.2

21.5

26.8

41

5

24.5

29

58

3

17.6

21.4

53

5.8

20

21.8

36.6

6.2

26.2

31

0

10

20

30

40

50

60

clinical instructors practiceClinical EnvironmentEquip.& SuppliesSimulated LabsHospital practice

Mean Score Pattern of Students Feedback about clinical Practice

Not done Excellent Good Poor

not adequate for training and need improvements as regards

hospital areas, students/faculty staff ratio and students/patients

ratio.

Students’ Recommendations

The majority of students suggested to expand the practice in the

simulated labs rather than hospitals, decrease the time of being

with patients. Clinical instructors should attend all the time of the

day training to solve any problems immediately and also to re-

evaluate the students / instructors radio for more achievement.

Need

Suggestion for Improvement ( you can answer in any language)

thank you for your opinion.

Two-Thirds of Students Nurses Interviewed were satisfied with skill labs renovation

34%

9-in-10 Customers s Agree Patient Care is Suffering Due to poor skills Issues

Some student nurses say that the quality of patient care in our hospitals is suffering because there are not enough faculty staff and gap in ratio between staff and students nurses training in the hospitals and student nurses are being forced to care and learn at once.

Agree90%

Disagree9%

Not sure1%

Table ( 1) Distribution of Stakeholders Feedback Score ( excellent level)

Hospital stockholders of Mansoura University were asked to give feedback about the faculty of nursing graduates. The received feedback from stakeholders is presented in table(1). 18 physicians, 2 hospital directors 39 head nurses and 41 staff nurses participated in the assessment. Regarding the number of graduates, all directors (100%), 38.89% of physicians, 43.59% of head nurses their score was with excellent level and the rest mentioned there is shortage either in nurse graduate members or in their performance.

Table ( 2) Distribution of Stakeholders Feedback Score ( Very Good).

Total (n=100)

Staff nurse(n=41)

Head nurse(n=39)

Director (n=2)

Physician (n=18)

No % % No % No % No % No

Items

23 36.58 15 12.82 5 - - 16.66 3 -Number of graduates 36 34.15 14 35.89 14 - - 44.44 8 -General appearance 29 34.15 14 28.20 11 - - 22.22 4 - knowledge of graduate 30 39.02 16 23.08 9 - - 27.78 5 - skills of graduate 31 46.34 19 23.08 9 - - 16.66 3 - assessment of patient

condition 27 31.71 13 25.64 10 - - 22.22 4 - provide proper nursing

care 29 36.5 15 23.08 9 - - 27.78 5 - satisfy patient needs

Total (n=100)

Staff nurse(n=41)

Head nurse(n=39)

Director (n=2)

Physician (n=18)

No % % No % No % No % No ems

34 19.51 8 43.59 17 100 2 38.89 7 graduates 23 17.07 7 33.33 13 - - 16.66 3 earance 9 12.19 5 7.69 3 - - - - of graduate 4 - - 10.26 4 50 1 - - aduate

10 4.88 2 17.95 7 - - 5.56 1 of patient

14 14.63 6 15.38 6 - - 11.11 2 per nursing

24 21.9 9 28.21 11 - - 22.22 4 ent needs 30 21.9 9 30.77 12 50 1 44.44 8 s& regulation 20 19.5 8 23.08 9 - - 16.66 3 graduate 32 43.9 18 23.08 9 - - 27.78 5 rsing leader's

20 21.9 9 12.82 5 - - 33.33 6 municate 33 31.7 13 28.21 11 50 1 44.44 8 ent privacy

253 94 107 5 47 otal

30 39.0 16 23.08 9 - - 27.78 5 - follow rules& regulation 38 48.7 20 20.51 8 50 1 50 9 - attitude of graduate 27 19.5 8 28.20 11 50 1 38.89 7 - listen to nursing leader's

comments 31 31.7 13 30.77 12 50 1 27.78 5 - good communicate 35 41.4 17 33.33 13 - - 27.78 5 - respect patient privacy

366 180 120 3 63 Total The minorities of stakeholders mentioned graduates have excellent appearance. Amazingly to find that all physicians, hospital directors and staff nurses mentioned that nurse graduates neither have scientific knowledge nor skills, one physician only(5-56%) mentioned that nurse graduates are able to make assessment of patient condition, 2(11-11%) mentioned they are able to provide proper nursing care. Nearly half of physicians mentioned graduate nurses follow rules & regulations and respect patient privacy, with excellent score.

Table ( 3) Distribution of Stakeholders Feedback Score (Good)

Total (n=100)

Staff nurse(n=41)

Head nurse(n=39)

Director (n=2)

Physician (n=18)

No % % No % No % No % No Items

27 34.15 14 25.64 10 - - 16.66 3 -Number of graduates 37 48.78 20 23.08 9 50 1 38.89 7 -General appearance 47 43.90 18 51.28 20 50 1 44.44 8 - knowledge of graduate 38 41.46 17 43.59 17 50 1 16.66 3 - skills of graduate 38 31.71 13 43.59 17 50 1 38.89 7 - assessment of patient

condition 42 41.46 17 46.15 18 50 1 33.33 6 - provide proper nursing

care 33 29.2 12 38.46 15 50 1 27.78 5 - satisfy patient needs 35 39.0 16 38.46 15 50 1 16.66 3 - follow rules& regulation 33 28.8 11 43.59 17 50 1 22.22 4 - attitude of graduate 26 28.8 11 30.77 12 - - 16.66 3 - listen to nursing leader's

comments 39 34.1 14 46.15 18 50 1 33.33 6 - good communicate 28 24.4 10 33.33 13 50 1 22.22 4 - respect patient privacy

423 173 181 10 59 Total

Table (3) shows the distribution of stakeholders feedback score good . this table shows that, the highest number of stakeholders feed back was 47 as reported for knowledge of graduate while the least number was 27 for number of graduates. The result reavled that the highest percent was

44.44% for knowledge of graduate as perceived by physician. On the other hand, the least percent was 23.08% for general good appearance as perceived by head nurse. Moreover, the results in this table revealed that, the staff nurses perception for attitude of graduate& listen to nursing leader's comments was equally for each item 28.8%.

Table ( 4) Distribution of Stakeholders Feedback Score ( pass)

Total

(n=100) Staff nurse

(n=41) Head nurse

(n=39) Director (n=2)

Physician (n=18)

No % % No % No % No % No Items

16 9.76 4 17.95 7 - - 27.78 5 -Number of graduates 4 - - 7.69 3 50 1 - - -General appearance

15 9.76 4 12.82 5 - - 33.33 6 - knowledge of graduate 28 19.51 8 23.08 9 50 1 55.55 10 - skills of graduate 21 17.07 7 15.38 6 50 1 38.89 7 - assessment of patient

condition 17 12.19 5 12.82 5 50 1 33.33 6 - provide proper nursing

care 14 12.2 5 10.26 4 50 1 22.22 4 - satisfy patient needs 5 - - 7.69 3 - - 11.11 2 - follow rules& regulation 9 4.88 2 12.82 5 - - 11.11 2 - attitude of graduate 15 9.76 4 17.95 7 50 1 16.67 3 - listen to nursing leader's

comments 10 12.2 5 10.26 4 - - 5.55 1 - good communicate 4 2.44 1 5.13 2 - - 5.55 1 - respect patient privacy

158 45 60 6 47 Total

Table (4) shows that all responds of stokeholds agree skills of graduate feed back score pass was 28, while the least number 4 was reported by stakeholders for general appearance respect pt privacy. However, the highest percent was 55.55% was perceived by physicians for skills of graduate. On the other hand the least percent was 5.13% & 2.44 for aspect of pt privacy as presented by head nurse & skill nurses respectively

Table (5) Distribution of Stakeholders Feedback Score ( Total)

PASS GOOD VERY

GOOD EXCELLENT

% No % No % No % No Items

16 16 27 27 23 23 34 34 -Number of graduates

4 4 37 37 36 36 23 23 -General appearance 15 15 47 47 29 29 9 9 - knowledge of graduate 28 28 38 38 30 30 4 4 - skills of graduate 21 21 38 38 31 31 10 10 - assessment of patient

condition 17 17 42 42 27 27 14 14 - provide proper nursing

care 14 14 33 33 29 29 24 24 - satisfy patient needs 5 5 35 35 30 30 30 30 - follow rules&

regulation 9 9 33 33 38 38 20 20 - attitude of graduate 15 15 26 26 27 27 32 32 - listen to nursing

leader's comments 10 10 39 39 31 31 20 20 - good communicate 4 4 33 33 35 35 33 33 - respect patient privacy

The rest of stakeholders head nurses, feedback score ranged between very good to pass. Good score was given by the majority of staff nurses regarding general appearance, their knowledge and providing proper nursing care.

Table(5): shows that the height percent was 34% for excellent number of graduate the highest percent was 38% for very good attitude of graduate and assessment of pt condition as presented by stakeholders. The least percent was 4% for pain for both items general appearance& respect pt privacy

Report of health stakeholders about clinical performance of

faculty graduates

Data collection Tuesday and wed 4-5/5/2005

Participated in data collection, analysis and tabulated,

Dr/ Neamat Mohamed, assistant prof, nursing administration

Department – Dr/ Hala Gabr, lecturer , nursing

Administration department Dr/ Ahlam El-Sher ,

Assistant lecturer, nursing administration department and

Dr/ Hala Gaber , assistant lecturing administration department

- sample number are (100) subjects consisted of (18) physicians,

(39) head nurses , (41) nurses and (2) hospital directors

Data collected from:

1. Main university hospital

11. Emergency hospital

111. Ophthalmology center

1v. Gastro intestinal

v. Urology center

v1. Pediatric hospital

Recommendation for improvement:

1. Graduates should have more skills in critical

2. Courses about communication among nurses graduates , and

physicians should be offered

3.Teaching skills should be provided to our graduates

4.More efforts are required from the faculty of nursing in order to

approach the hospitals where our order to approach the hospitals

where our graduates work to cooperate in evaluation procedure since

then feedback will help in curriculum development

Signatures of team members :-

Dr/ Neamat Mohamed

Dr/ Hala Gabr

Dr/ Gehan Mohamed

Dr/ Ahlam El-Sher

Dr/ Hala Gaber

Clinical Skills Assessment 2nd year 2005

Total student nurse performance in critical nursing care in 2004-2005 (n= 213)

ول -٣٨٫٥مقب٣٦

٣٩-٤٤٫٥جيد دا د ج -٥٠٫٥جي٤٥

٥١ممتاز ٣٦سئ أقل من

No % 6 2.82

No %20 9.39

No %96 45.07

No %87 40.85

No % 4 1.87

Total student nurse clinical performance in adult nursing care in 2004- 2005 (n=213)

ول -٥١٫٥مقب٤٨

٥٢-٥٩٫٥جيد ٦٧٫٥جيد جدا ٦٨ممتاز ٤٨سئ أقل من

No % 2 0.94

No %74 34.74

No % 127 59.62

No %7 3.29

No % 3 1.41

Total clinical score for critical= 60 Total adult score = 80 Total student number in critical = 217 and excluded 4 student are absent. Total student number in adult= 218 and excluded 5 student are absent.

EXTERNAL AUDITING FOR THE FACULTY OF NURSING

SKILL LABS AT MANSOURA UNIVERSITY

BY:

PROF.DR./ NAHED EL SEBIE (DEAN OF THE FACULTY OF NURSING – ALEX UNIVERSITY).

PROF.DR./ ZAKIA TOMA

(VICE DEAN OF COMMUNITY AND ENVIRONMENTAL HEALTH – FACULTY OF NURSING- ALEX UNIVERSITY).

PROF.DR./ AZZA DARWISH

(HEAD OF THE PEDIATRIC NURSING DEP.- FACULTY OF NURSING – ALEX UNIVERSITY)

2- HEEPF Center -Was set in the third floor in the faculty of nursing and comprise the lecturer library that enable the lecturer to develop and prepare his lecture before the presentation .

3- Procedure manuals

1- Community Health Nursing. 2- Nursing Administration. 3- Critical Care. 4- Adult Care. 5- Gerantological Nursing. 6- Maternity Care Nursing. 7- Fundamental Nursing. 8- Computer & Information Technology. 9- Pediatric Care for Hospital Nurses. 10- Obstetric Care For Hospital Nurses. 11- Infection Control Manual.

4- Skill labs -To facilitate the acquisition of nursing knowledge and skills which in turn link education and practice. -To practice beginning and advanced nursing skills while supervised by academic staff. -Update and renovate 3 skill labs . - Develop 2 skill labs . - Develop one lab for multimedia. - Maintenance of Manikins and anatomical models. -Maintenance of the skeleton. - Purchasing the needed manikins and computers. Before

After

5- Evaluation tools -We have developed Evaluation tools and clinical checklist for the following departments:- 1) Community health nursing. 2) Nursing administration . 3) Adult nursing. 4) Fundamental nursing. 5) Critical care nursing. 6) Gerantological nursing.

6- Clinical teaching assessment 1-Organization and Management of the CSL

1-The main chief of the CSL is the faculty Dean. Responsibility

-Sharing in seminars plan, ensuring finance/ security financial resources.

-Receive monthly report from the vice dean of Education and student affair.

-Discuss management challenge and opportunities of the skills labs.

2-The deputy of chief is the vice dean of Education and student's affair. Responsibility

-Ensuring personnel/staffing, equipment and supplies. -Regular monthly meetings with staff members and lab management team and

coordinators (first Sunday of each month). -Organization and receive weekly report from the coordinators of health

assessment. -Orchestration of the skills labs -Administrative support and dedicate space, equipments and supplies. -Coordinate with hospitals, nursing faculties -Manage, lead and collaborate with health care providers from multiple

discipline to deliver quality care across levels of prevention.

3-Management team -Comprised the Faculty Dean, Vice Dean, and Chiefs of departments and the

second persons of each department, Faculty administrator, centers managers, and senior technician.

Responsibility -Conduct monthly meeting (at the third week of month). -Ensure staff and students follow rules and regulations of the skills labs. -Ensure maintenance of the anatomical models. -Evaluate the staff and students practices in the SL.

4-Coordinators of Health assessment. It comprised the manager of EDC , E-Learning and Lab technicians. Responsibility -Check and submit a detailed list of equipment, models and disposable

supplies needed for each lab experience at least 1 month prior to the beginning of the semester ( through labs technicians).

-Ensure that any non-disposable equipment specially designated for the clinical simulation labs is not to be removed. Equipment is available for checkout from the storage room.

-Ensure the simulator labs environment, equipment and infrastructures. 2-Regulations of CSL

Faculty provide a detailed list of equipment , models and disposable supplies needed for each lab experience at least 1 month prior to the beginning of the semester (through labs technicians).

Professional, self behavior will be expected from students when participating in the clinical simulation lab.

3-Students rotation in CSL

The department divide students into small group to be rotated as folloes:- Class orientation. Infection control unit. E-learning and multimedia lab. Assigned simulator lab . 4- Working Hours of CSL From 8 am to 5 Pm. In 2 shifts from 8am-1pm , 1pm – 5pm.

5 -Students' guidelines for the Open CSL

The hours that the CSL is open each day mentioned in the lab calendar. Students may make an appointment to use the CSL any time it is open. Open Lab: after 5 Pm ( Department should submit request form (annex) .

Nursing Faculty Clinical simulation labs consists of :- 1) Basic skills labs 1 , 2 , 3. 2) Advanced Skills labs. 3) Maternity , pediatrics and community labs. 4) Infection control unit. 5) Electronic learning and Multimedia lab (ELL). 6) Electronic library.(EL).

7-Clinical lab Simulation Guidelines The manager developed the clinical simulation labs guidelines ( CSLG) ( printed , 20 books were distributed free and started marketing system after approval from the faculty council and the vice president of Education and student affairs , for the favor of faculty clinical teaching services.