Monday, November 5, 2007

This presentation is part of : Promoting Success in Nursing Education
Factors Contributing to Quality of Care Delivered by Japanese Students of Nursing during Clinical Practice
Keiko Masamura, PhD, RN, Division of Fundamental Nursing, Faculty of Health Science, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
Learning Objective #1: understand visually the ‘quality of nursing care’ delivered by four nurse students using a Quality of Nursing Care Process Model.
Learning Objective #2: understand contributing factors to ‘quality of nursing care’ delivered by four nurse students.

   This study sought to clarify factors contributing to quality of care delivered by nursing students in Japan by examining their experiences of having difficulties with patient care.  Semi-structured interviews were conducted with four students and data analyzed using interpretive phenomenology.  The findings were described as narratives and a Quality of Nursing Care Process Model developed by the researcher was used as a framework to understand and discuss these experiences.
   The reasons why students had difficulties with nursing care included that: one student did not understand the ‘experiences’ world of the patient, although she understood the ‘expressions’ and ‘mind’ world;  she was impatient to cope with changing the nursing care plan of the patient, so was therefore concentrated on her own mind.  Another student coped with only the ‘expressions’ of the patient, not understanding the ‘mind’ and ‘experiences’ world of the patient: she had lost a sight of the patient being sick.  Finally, another two students could not establish a relationship with the patient as a nurse.  One student was practicing as a learner rather than as a nurse, and advice from nurses and her instructor were insufficient to help her; the other student had her own nursing point of view which appeared immature.
 The findings indicated that the ‘expressions’, ‘mind’ and ‘experiences’ worlds of patients were not understand in student-patient relationships and so effected the quality of their nursing care. These findings suggest that the importance of teaching and fostering nursing students’ ability to understand the ‘expressions’, ‘mind’ and ‘experiences’ world of patients is critical to the processes of providing excellent nursing care.  Moreover, the nurse instructor’s ability to assist students about these should be improved.