Question

Choose a clinical scenario from your recent experience and analyze it using the Foundation of the knowledge model. How did you acquire knowledge? How did you process your knowledge? How did you generate knowledge? how did you seminate knowledge? How did you use feedback and how was the effect of the feedback on the foundation of your knowledge

Answer 1

A well Devloped & Realiable body of knowldge is foundation any Profession

The method of Acquire Nursing knowldge can be calssified into two can be calssified into under two broad catergories

1.Unstructed methods of Acquire Nursing knowldge

2.structed methods of Acquire Nursing knowldge

Unstructed methods :

A.Tradition

B.Authority

C.Inutiton

D.Experience

E.Trail and Error

structed methods of Acquire Nursing knowldge:

A.Inductive Reasoning

B.Deductive reasoning

C.Assesmbeled Information

D.Problem Solving

E.Scientific method reasearch

Unstructed methods:

A.Tradition:Tradional Nursing Knowldge is learn mainly from books Journals, by words of the mouth and any Observation practises   the others

B.Authority: there are Authorities ( People with specialized Expertise in every filed ) The people with higher length of Experience in a discipline & with virtue of their postion are to belived to a sound source of knowldge & Understanding

C.Inutiton: Its Known As Information obtain from sixt sense with out conscious thinking but this is the rationalizing the information may not be obtained

D.Experience: Nurse and Midwives are base thier practises a great part on their own Expierience & to a lesser Extent on the Expierience of others

E.Trail and Error: In this Approach Altreantives are tried successfully until solution to a problem is found. in day to day life every body use this techinques to solve much type of problem .Including professional ones

A.Inductive Reasoning: is the process of devolping generalization from specific observation

B.Deductive reasoning : Its the process of Devloping Specific predication from general principals

C.Assesmbeled Information: its making Clincal descion,Health care professinal also rely on onfomation that has been Assesmbeled for variety of purposes

D.Problem Solving:Nurse uses problem Solving process to solve a particualr problem find a particular intervation efffective thus,problem solving for one situation contribute to the nurse knowldge for problem solving

E.Scientific method reasearch: Discipline format is the most sophisticated metho of acqurining Knowldge finding from rigirous reasrach investigations are considered to be pinnacle of evidance hierarchy established Evidance Based Nursing ( EBN) Practise

Processing of Knowldge:

Sampling Sample size determination The sample size was determined based using the following assumption and a single population proportion (p) n ¼ ð Þ Z∞=2 2 P Pð Þ ‐1 d2 was employed. Where n is sample size desired, z2 is a standard normal score of 95% of confidence interval = 1.96, d is degree of accuracy or the margin of error = 0.05 and p = 37.1%, which was the population proportion of the nurses who implement the nursing process using the previous study in Debremarkos and Fnote Selam hospitals, Amahara, Ethiopia [13]. Since the total source of the population was less than ten thousand which was 368; then by using the correction formula and thus by adding 10% for the possible non-response rate, a total sample size of 200 was obtained. Proportional allocation to the size was employed to allocate the sample among the hospitals. Sampling procedure Of the seven hospitals in the two zones, St. Mary, Adwa, Suhul and Temben hospitals were selected through a random lottery process. After proportion allocation of the sample among the selected hospitals was employed, the sampling frame of the hospitals was prepared. From the sampling frame, 200 nurses were selected by simple random sampling proportionally for each hospital. Since nurses have the right to decline and be considered as non-respondents, those nurses who declared their wish not to participate were treated as neutral (Fig. 1). Data collection procedure Data were collected through a structured self-administered questionnaire and observational checklist. The data collection was collected by inviting 4th year Nursing Students of Axum University who were in internship practice in the hospitals under close supervision of the principal investigator from April 1 to May 2, 2015 to distribute and collect the surveys. Data collection tool The questionnaires were adapted from a previous study. The validity of the data collection tool was determined by two experts and seniors with reliability of skill measurement questions, with a Cronbach’s alpha of 0.86. A structured English version questionnaire contains five main parts. Part I was used to collect data about nurses’ socio demographics, part II about nurse implementation status of the nursing process, part III about different factors, part IV about knowledge and part V about skill of nurses in nursing practice [15]. Data quality assurance To assure data quality, training and orientation was given for the data collectors by the principal investigator. The data collection tool was pre-tested on 5% of the participants two weeks before the actual data collection period in Mekelle hospital. Similarly necessary corrections and amendments were considered. During data collection, data collectors checked the data for its completeness and missing information at each point. Furthermore, data were checked during entry and compilation before analysis. Study variable Dependent variable Implementation of nursing process Independent variable Organization and facility related factors. Equipment access to nursing care. Material supplies for nursing process. Working environment. Management system of the hospital. Nurse’s patient load. Nurses related factor Nurses demographics. Experience of nurses. Knowledge on implementation of nursing process. Skill of nurses on implementation of nursing process. Nurses dissatisfaction aspect of job Nurses strain during working time Operational definitions Nursing process implementation status:- Nurses who answer “yes” for the six nursing process implementation

questions and observed for their performance were as implementing the nursing process properly. Nursing practice skill:- Those participants who scored >40 are highly skillful; 30–40 are moderately skillful, and

Discussion This study determines the level of nursing process implementation and associated factors among nurses in selected hospitals in the central and North West zone of Tigray, Ethiopia. In thise study of 200 nurses, there was a 35% of level of nursing process implementation. This study had a lower level of nursing process implementation than a study conducted in Nigeria (in Abakaliki II and Calabar teaching hospitals) which showed a 67.2% and 62.7% respective use of the nursing process. In contrast, of this study the variation of the level of nursing process implementation may be because of the difference between the country level of development, sociodemographic factors for nurses and organizational structure and facilities. Also it is lower than study done in Addis Ababa, 2014 (52% of the level of implementation). Since Addis Ababa is the capital city of the country, the hospitals have better organizational facilities, human resources with the educational level of BSc and above, equipment access and material supply which contribute to better implementation of nursing process than the hospitals found in the regional towns. Therefore the above reasons may lead the discrepancy of the level of nursing process implementation [8, 10, 16]. The level of nursing process implementation from a study done on the assessment of the nursing process implementation and associated factors among nurses in Debremarkos and Fnoteselam hospitals, Amahara region in, 2014 was 37.1%. This is almost similar to the level of nursing process implementation of this study [13]. One hundred two (51%) respondents of this study said that irregular material supply to do nursing process affect the implementation of the nursing process. This result is supported by the study carried out in Abakaliki II teaching hospital Nigeria which is 32.7% of the respondents who said that the irregular supply of nursing process material affect nursing process implementation [8]. One hundred thirty one (83.4%) participants of this study reported their dissatisfaction due to excessive nurse patient ratio and other reasons had affected their use of nursing process. This result is in line with a cross sectional descriptive study in Teheran, Iran show that 84.1% of participants reported that dissatisfaction of nurses due to excessive nurse patient ratio and other reasons had affected the nursing process implementation. Again, this result is supported by the same study done in Addis Ababa that reported 54% of the participants caring for too many patients had affected the nursing process implementation [15, 16]. In this study from the total of 12 variables involved in the multivariate analysis;