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Open access

Aleksander Zarzeka, Agnieszka Wawrzonkowska, Mariusz Panczyk, Jarosława Belowska, Łukasz Samoliński and Joanna Gotlib

Abstract

Introduction. The profession of a nurse should be practised along with the standards of the most recent medical knowledge and law.

Aim. The authors aimed at assessing the relationship between nurse’s education and their knowledge of the legal regulations, taking into account nurses’ performance at work.

Material and methods. A total of 91 nurses were included in the study group. The mean age of the nurses was 34 years (min. 22, max. 63). Group 1: 32 nurses with medium-level education, group 2: 59 nurses with higher-level education. The study tool was a voluntary and anonymous survey questionnaire the authors’ own design, consisting 36 questions. The results obtained were subjected to statistical analysis using STATISTICA 10.0 (Medical University of Warsaw licence), nonparametric U Mann-Whitney Test α<0.05).

Results. 69 nurses declared they knew the legal acts regulating their profession, Group 2 members were significantly more likely to know them (p<0.007). Nurses with higher education were statistically more likely to be aware of the independent character of the profession they practised (p<0.002). Most nurses were aware of their right to refuse a doctor’s order in case it is noncompliant with their conscience (p=NS).

Conclusions. Even though the respondents had relatively good knowledge of legal regulations concerning their profession, it needs to be complemented, for instance through postgraduate education. In the study group, education affected the level of knowledge of nurses. Particular attention should therefore be given to the provision of complementary knowledge of the principles of practising the profession of a nurse to the group of nurses with medium-level education.

Open access

Jarosława Belowska, Mariusz Panczyk, Aleksander Zarzeka and Joanna Gotlib

Abstract

Introduction. Modern nursing practice requires Nursing students to expand their knowledge both in the field of specialized nursing and learning the basics of medicine, as based on scientific evidence. The dissemination of research activities in nursing and the development of the profession, knowledge and practice based on Evidence-based Nursing may contribute to the increase of the effectiveness and improving the quality of healthcare services. Nursing teaching curricula should include subjects related to Evidence-based Medicine, such as scientific research methodology or critical analysis of scientific literature.

Aim. The aim of the study was to analyze the knowledge and attitudes of nursing students towards Evidence-based Medicine (EBM) and Evidence-based Nursing Practice (EBNP).

Material and methods. Out of 127 Master’s degree students in Nursing at the Medical University of Warsaw (4 men), 72% work as a nurse. Mean age of the study group was 26.55 years (min. 22, max. 51, SD=7.52) with 63% of the students attending full-time studies, with 90% being students of the first year. Some 53% earned their bachelor’s degree in Nursing in 2013. A standardized Evidence – Based Practice Profile Questionnaire from University of South Australia, quantitative analysis of the study results.

Results. Nearly 30% of the respondents have never encountered EBM or EBNP during their time at the University (n=41). Most students intend to use relevant scientific literature in order to update their knowledge (n=68) and to upgrade their skills, so as to integrate EBNP into their everyday professional practice (n=67). Some 60% of the respondents deem scientific reports useful for their work (n=76) but nearly half of them regards clinical experience as more important than the results of scientific studies, when it comes to making the right decisions in their professional practice (n=56). Nearly a half of the studied group (n=66) have never heard about the term minimum clinically worthwhile effect and only one person declared the correct explanation systematic review (n=1). 42% declare reading published scientific studies once a month but nearly 30% have never referred scientific findings to their own diagnosis (n=41) and 40% have never assessed its methodological correctness (n=51).

Conclusions. 1. The educational programs in the framework of Nursing studies should be supplemented with subjects of EBM and EBNP, so as to expand the nursing students’ knowledge and let them reap the benefits of using the latest study results in their future professional practice. 2. The level of knowledge about the principles of assessment of reliability of scientific evidence was strongly insufficient and requires urgent supplementation of knowledge and skills of students in this area. 3. It is necessary for students to update their knowledge, particularly when it comes to using the latest scientific literature in everyday clinical practice and skills connected with critical analysis of scientific evidence.

Open access

Mariusz Panczyk, Aleksander Zarzeka, Lucyna Iwanow, Jarosława Belowska and Joanna Gotlib

Abstract

Aim of the study. Starting on January 1, 2016, nurses and midwives (NM) acquire extending the professional powers. Assessing the reliability and validity of a questionnaire developed to evaluate the knowledge of and attitudes towards acquiring extending the professional powers of NM.

Material and methodology. Forty-two students, voluntary, anonymous, original questionnaire study, 11 questions (knowledge) and 32 statements (attitudes), the Likert scale.

Results. Cronbach’s alpha reliability coefficient (α>0.70). Assessment of validity: indirect estimation of theoretical validity by identifying an internal correlation on the scale. Assessment of differences between the students: Kruskal-Wallis test, α=0.05, 11 knowledge-related questions - the easiness: 0.52, the mean differentiating power of 0.21. Cronbach’s alpha: 0.671. The subscale 1 comprising 26 statements underwent a factor analysis with two variables. The structure of subscale 2 (6 items) is uniform. The comparative analysis of students does not show differences by their majors (Kruskal-Wallis test).

Conclusion.

  1. Assessment of reliability and validity of the questionnaire has demonstrated that it is a proper tool to evaluate attitudes towards extending professional powers of NM.

  2. Assessment of the questionnaire has confirmed that there is a need to modify the knowledge-related questions.

  3. The study should be continued among a greater number of NM that would be more diverse.

Open access

Jarosława Belowska, Aleksander Zarzeka, Łukasz Samoliński, Mariusz Panczyk, Lucyna Iwanow and Joanna Gotlib

Abstract

Aim. The first issue of Nursing in the 21st Century was published in 2002. The journal is dedicated to provide information on innovations in nursing, midwifery, as well as other health sciences. It includes peer-reviewed meta-analyses and review papers, original research studies on nursing and related areas, case reports, as well as discussions, comments, and reviews. The study aimed to perform a quantitative and qualitative analysis of articles published in Nursing In the 21st Century.

Materials and Methods. In the study, the authors looked at a total of 247 articles published between 2010 and 2015.

Results. As many as 247 articles were published in 19 issues of Nursing In the 21st Century during the period that the authors looked at. There were some 13 articles per every single issue on average. Original papers and meta-analyses were most frequently published types of publication. There were also other types of articles, like reports, communications, reviews, and case studies but they were only a tiny fraction of the overall number of publications.

Conclusion. Authors’ review of the articles published in the journal revealed a clear tendency to issue specialist and clinical publications on nursing.

Open access

Aleksander Zarzeka, Mariusz Panczyk, Bożena Ścieglińska, Jarosława Belowska, Lucyna Iwanow and Joanna Gotlib

Abstract

Introduction. An independent prescribing certain drugs, including issuing prescriptions, as well as an entitlement to refer patients for certain diagnostic tests, constitute the key competences of an advanced nurse/midwife practice.

Aim. To analyze knowledge and attitudes of departmental nurses (DN) towards extending professional powers of nurses and midwives.

Material and methods. The sample involved 23 DN (women: 100%) working in the Independent Public Children’s Teaching Hospital in Warsaw. The mean age was 49 years (mode and median: 50; min. 31, max. 61, SD=7.95). The mean of professional experience was 30 years (mode: 25, median: 30, min. 17, max. 40, SD=6.38). A voluntary and anonymous questionnaire with 10 questions referring to knowledge and 32 statements concerning attitudes evaluated in the Likert scale was conducted.

Results. Almost all DN knew that prescribing drugs is a right and not an obligation. Nearly half of the DN knew when the new regulations shall enter into force. DN believed that the new regulations shall improve patient care and increase patient’s comfort and access to services. DN concern about preparation of nurses and midwives for new competences.

Conclusions.

1. The study group’s level of knowledge about the new competences was insufficient and requires supplementing.

2. The attitudes of the study group towards the new competences were not unambiguous. It should, however, be noted that the study was conducted in a specialized children’s teaching hospital, where the application of the amended regulations is limited.

3. Although the nursing management staff supports the legislative changes, they object to the process of introducing them. This applies particularly to the necessity of an adequate preparation of nurses and midwives.

4. The study should be continued among a representative group of nurses with a similar level of education, professional experience, and place of work, with particular consideration of nurses working in the outpatient health care.

Open access

Jarosława Belowska, Mariusz Panczyk, Zofia Sienkiewicz, Anna Kaczyńska, Aleksander Zarzeka and Joanna Gotlib

Abstract

Introduction. As these define the status of the patient during the provision of health services, patients' rights are a very important component of Poland's medical law. The observance of these rights is a prerequisite for the proper performance of the nursing profession. Theoretical and practical preparation in this area is thus already a necessity in the students' education process.

Aim. The aim of the study was to analyze the opinions and attitudes of nursing students with respect to problems in the field of the observance of the rights of patients in Poland.

Material and methods. The study was built upon the opinions expressed by 375 students (362 women and 13 men) of the first and second year. These were full-time and part-time students in master's studies in nursing, of the Faculty of Health Science, Medical University of Warsaw. The study employed a qualitative and quantitative analysis of the content of essays.

Results. The results of the study indicate that 59 percent of the respondents report being frequent witnesses of violation of patient's rights. In particular, that which noted were the rights to privacy and dignity (98%), to receive sought-after information (91%) and to suitable health-care (85%). Another right seen to have been violated in the respondents' workplace was the patient's right to the maintenance of the confidentiality of patient-related information by medical personnel (77%). The respondents, while seeing violation of the patient's rights by other employees, declared their own adherence to these rights in their own professional practice.

Conclusions. 1. The majority of the study group repeatedly witnessed violation of patients' rights. It would, therefore, be advisable to monitor the observance of the rights of patients by medical personnel, and to see to the professional liability of those who flagrantly breaking the law. 2. Research findings indicate that ethics should be given more emphasis in teaching future health professionals in the course of their medical studies. 3. The analysis of the available literature and our own study show that the share of medical personnel in providing information about the patients' rights is minimal. It would be advisable for medical personnel to be given an opportunity to acquire new skills and competences in this field. 4. Awareness of the existence and knowledge of the patient's rights, not only among medical students and health professionals, but also among patients, is crucial to their observance by the former and their exercise by the latter. It should, therefore, be spread and raised. 5. Training and thematic courses in patient's rights should be provided in order to enable medical personnel to acquire new skills and competences in this field, with the end result of improving their observance of patient's rights. 6. A qualitative analysis constitutes an innovative and effective way of carrying out research and interpreting research findings, being a valuable and reasonable method of conducting a survey, and in exploring the attitudes of students and health-care workers towards patient's rights.

Open access

Joanna Gotlib, Aleksander Zarzeka, Mariusz Panczyk, Piotr Leszczyński, Lucyna Iwanow, Katarzyna Pietruszewska, Nicole Mazur, Anna Gorzkiewicz, Jarosława Belowska and Łukasz Samoliński

Abstract

Introduction. Since January 1st, 2016, particular groups of nurses and midwives in Poland are allowed to write prescriptions and refer patients to diagnostic procedures without doctors’ involvement.

Aim. The aim of the study was to assess what university students know about the changes that expanded the professional competencies of nurses and midwives.

Material and methods. The study group comprised of 535 students of three different universities. The group was 82% female and the mean age was 23 years (min.=19; max.=58, SD=4.780). Nursing students were the largest group among the study participants (177 individuals which meant 33% of the total), followed by Medicine students (145 individuals, 27% of all), Midwifery (107 persons, 20% of the total), and Public Health (100 persons, 19% of all). As many as 324 respondents (60%) had never participated in any medical law-related courses. A voluntary and anonymous survey containing 39 questions divided into 3 parts: 13 questions about knowledge, 26 statements concerning attitudes using a Likert scale, 8 demographic questions) was used. Obtaining an approval from the University’s Ethical Review Board was not required. Pearson’s chi-square test was used to compare frequency of the correct answers by students of every major. The Kruskal-Wallis rank test with a post-hoc analysis for multiple comparison of mean rank sums, STATISTICA version 12.5 (StatSoft, Inc.), licensed to MUW, α=0.05, were used to calculate the differences in summative points for correct answers.

Results. Nursing students were significantly more likely to choose the correct answers, unlike Medicine or Public Health students (p<0.001), as well as Midwifery students (p<0.002). The answers provided by the students of Medicine, Public Health, and Midwifery were relatively similar.

Conclusions. The knowledge of students of various Polish universities concerning the expansion of professional competencies of nurses and midwives was insufficient and needs to be urgently updated. Learning curricula to be modified not only for students of Nursing and Midwifery but also for other members of therapy team, e.g. physicians and pharmacists as well as specialists in public health.

Open access

Joanna Gotlib, Mariusz Panczyk, Piotr Gębski, Aleksander Zarzeka, Lucyna Iwanow, Filip Dąbrowski, Grażyna Dykowska and Marcin Malczyk

Abstract

Introduction. Apart from the increasing popularity of modern information technologies and the development of e-learning methods used for teaching medicine and health sciences, there was a spike of interest in using modern computer techniques for checking students’ knowledge.

Aim. The aim of the study was to compare the opinions of students of Medical University of Warsaw about the examinations and final tests conducted using the e-exam ASK Systems platform, measured by their participation in this form of assessmen knowledge.

Material and methods. 148 students; group 1 comprised students participating in an e-exam (59 persons) and group 2 included students not participating in an e-exam (89 persons). A voluntary, anonymous questionnaire study, electronic questionnaire, 58 statements measured using the Likert scale. Questionnaire reliability assessment: analysis of internal consistency with Cronbach’s Alfa coefficient (α>0.70). Statistical analysis: STATISTICA 12.0 licensed to WMU, Mann-Whitney U test.

Results. Cronbach’s α coefficient for the scale amounted to 0.70. Members of group 1 were more likely to admit that students need to put in extra effort into participating in an e-exam (p<0.001) and that test results might be worse than in case of a regular exam (p<0.050). Group 1 significantly more often reported that the participation in an e-exam can cause additional examination stress (p<0.002) and makes cheating during exams more probable (p<0.003).

Conclusions. 1. An analysis of the questionnaire demonstrated that this tool is reliable and can be used in further studies. 2. The participation in an e-exam slightly influenced the opinions of students on this form of knowledge assessment, which may mean that the students’ expectations concerning e-exams were consistent with the actual course of the exam. Therefore, students do not need any special procedure to prepare for e-exams. 3. This was a pilot study and it needs to be continued among the same group of students before and after the e-exam.