Competency of Level 4 Nursing Students on Immediate Newborn Care

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Chapter 1

Background of the Study

Introduction

A nurse’s responsibility requires safe and effective care within constantly evolving health care systems (“Patient safety and nursing,” Wikipedia.com). One such area to be checked is neonatal nursing in which a nurse is to provide immediate newborn care. Such care is critical at this stage for it may distinguish whether the wellness of the care given can improve the condition of the newborn or further worsen the condition of the newborn.

Immediate newborn care is a step by step procedure in caring for a newborn to ensure comfort and security while providing their needs. Basically focuses on certain procedures done on a newborn upon delivery from the mother. Such procedures include clearing of their airways upon delivery, providing warmth and attachment to mother, cord care, APGAR scoring, temperature taking, anthropometric measurements, eye prophylaxis, Vitamin K administration, immunization, bathing, initial feeding and proper documentation. It is important that nurses should do the procedure accurately and with confidence.

Since skills and knowledge are learned through experience, constant practice and good instructions, the practice of this procedure should be started as early as possible, especially during the internship of student nurses in the hospitals in DR and NICU areas.

The researchers came up with this study to know the level of competency of level IV nursing students on immediate newborn care. Knowing the level of competency of the student nurses on this procedure may give good insights on how well does the students perform the procedures and may suggest any possible reforms in their learning process.

Theoretical Framework

According to Bandura, people learn from one another through observation, imitation, and modeling. People learn through observing others’ behavior, attitudes, and outcomes of those behaviors. “Most human behavior is learned observationally through modeling: from observing others, one forms an idea of how new behaviors are performed, and on later occasions this coded information serves as a guide for action” (Bandura). Social learning theory explains human behavior in terms of continuous reciprocal interaction between cognitive, behavioral, and environmental influences. Necessary conditions for effective modeling:

1. Attention — various factors increase or decrease the amount of attention paid. Includes distinctiveness, affective valence, prevalence, complexity, functional value. One’s characteristics (e.g. sensory capacities, arousal level, perceptual set, past reinforcement) affect attention. 2. Retention — remembering what you paid attention to. Includes symbolic coding, mental images, cognitive organization, symbolic rehearsal, motor rehearsal. 3. Reproduction — reproducing the image. Including physical capabilities, and self-observation of reproduction. 4. Motivation — having a good reason to imitate. Includes motives such as past (i.e. traditional behaviorism), promised (imagined incentives) and vicarious (seeing and recalling the reinforced model). Bandura believed in “reciprocal determinism,” that is, the world and a person’s behavior cause each other, while behaviorism immediately states that one’s environment causes one’s behavior. Bandura, who was studying adolescent aggression, found this too simplistic, and so in addition he suggested that behavior causes environment as well. Later, Bandura soon considered personality as an interaction between three components: the environment, behavior, and one’s psychological processes (one’s ability to entertain images in minds and language). Bandura bases his theory on the acquisition of complex behaviors on a triangular diagram illustrating the interactive effect of various factors. These three factors are behavior (B), the environment (E), and the internal events that influence perceptions and actions...
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