Nursing: Learning Needs Assessment

Introduction

The nursing profession is a very sensitive job and requires a lot of commitment on the side of the practitioners. This is because the jobs deal with life and some silly mistakes can lead to loss of life, permanent injury, or disability on the patient. As a result, many regulations are involved in nursing. There are also very many programs that are set to ensure patient safety. Patient services are the focus of the practice. It is very important to continually update healthcare especially since technology has seen a lot of improvement and changes coming up very frequently. There is always new information being incorporated into the practice of medicine. This is why it has been very critical that healthcare facilities conduct educational needs analyses and use the results to improve. However, the needs of the nurses and other medical practitioners should not be assumed. Pertinent to note is the on–job and work-related training aspect. Lack of training, inexperience, and lack of continuous updating of service can greatly impact the performance of the nurses. This paper looks into the learning needs of Loma Linda Healthcare System to assess whether there are some gaps between the education of nurses and what they ought to be aware of as far as practice is concerned.

Loma Linda Healthcare System

This center is a division of Desert Pacific Health care and it offers medical services to South Carolina veterans. The system was established in 1977 and it has developed into today’s modern facility that is now used to accomplish the three missions of the agency (Kovner, et al, 2009, p. 73), patient care, education and training, and medical research. The center is located in Loma Linda. This is just a very short distance from Loma Linda University. The California medical center is named after Congressman Jerry Pettis. This was a Second World War veteran at the time and worked very hard to bring the center to Loma Linda. This center is very crucial for services such as surgery, psychiatry as major services, and numerous other inpatient and outpatient services (Sibbald & Young, 2001, p. 30). They include Behavior medicine, critical services, cardiac care, MRI, dental care, diabetic services, HIV/AIDS care, dermatology, and oncology among others.

The center also runs home programs. This health facility runs 142-bed services for acute care and 108 units for the home nursing program. This is quite a large volume of activities with about 300,000 servicing veterans.

Medical Home Model

Patient-centered care is very critical just as noted above that patients are the focus of care. Their satisfaction is hence very important. In this regard, there are services for patients that are set to concentrate in homes. Medical home for patients is a model that is designed to offer comprehensive primary healthcare to patients. This model is unique since it has broadened access to this important primary care (Kovner, et al, 2009, p. 74). This means many people can access the services as close are where they stay or live. This is done at the same time enhancing coordination of care. This model is critical since it also demands that clinicians exercise the highest level of service. Clinicians are hence required to

• take responsibility for the ongoing treatment process for the patients;
• Be easily accessed by the patients even on the shortest notice and for extra hours and a flexible schedule.
• Carry out health consultations on phone and even through mail and email
• Make use of the latest healthcare knowledge and technology and more so the evidence-based model to offer services and update the records.
• Carry out regular check-ups to find out threatening health problems and offers solutions either to treat or to prevent further damage before last-minute processes (Sibbald & Young, 2001, p. 30)
• Offer advice for the patients concerning preventative care depending on the environment and risk of genetic factors
• And to assist patients in health and life decisions as well as coordinate services when necessary, propose a relevant process that can be carried out efficiently

A medical home employs people from different disciplines that are medically related. The qualifications range from a bachelors’ degree to, associate degree, to master’s and even postdoctoral degrees. For instance, to join in for nursing home health program, entry-level jobs, one needs to have a bachelor’s degree in medical or health-related courses from an institution that is accredited by the professional bodies (Sibbald & Young, 2001, p. 30). Loma Linda University, LLU, which is affiliated with this center is already an accredited institution. Masters degrees in courses like clinical epidemiology and other public health categories like Biostatics, Nutrition, preventative care, and maternal childcare are very important for this program especially for those workers who are specialists. Many of the workers tend to come from LLU as its accredited and a member of a professional body the Association of Public Health Schools. Degrees in medicine, nursing, dentistry, and pharmacy are also very necessary for employment by the VA medical home. Gaining Post-doctorate degrees in any of the fields can earn one a position in management. For instance, directors of maternal and childcare should have a master’s degree in obstetrics (De Young, 2009, p. 66). For the director of primary care, one has to possess a master’s degree in medicine or public health equivalent courses.

The Educational Needs Assessment

It is important that in practice, the gaps between what the practitioners know are filled to link with what they should know. This paper assesses the factors that are critical to nursing practice in veteran service (De Young, 2009, p. 66). Hypothesis; even though nursing is essential for the safety of the patients, and there is the constant improvement of service to ensure superior services many nurses still fail to advance their skill even though nursing knowledge continues to improve each day. It’s with this in mind that this research seeks to identify the actual knowledge and training that nurses have and what the latest inventions and discoveries propose. This is what nurses ought to know or train (De Young, 2009, p. 66). Nursing and healthcare services are essential to the community and require regular updating of the information that practicing nurses have and the latest technology being invented in practice.

Many researchers argue that job satisfaction could be the most important factor in comprehending how workers are motivated yet it has remained elusive. Experience, training, and education level are also very critical to the nurses and this can have a very serious impact on the safety of the patients, performance, dedication to the job, quality of services, and worker retention. This study investigated the way nurses perceived their training and experience and other factors that related to that especially on-the-job training, seminar, the introduction of new services, and advancing or specialization (Billings & Halstead, 2009, p. 78).

The objectives of the survey were to identify the level of training and experience that the registered nurses at Loma Linda possess. Regarding this the study also sought to assess whether the nurses undergo continuous training while on the job, have had other qualifications after completing the first degree, attend other training besides the usual curriculum and other training including seminars and workshops among others to improve service. The study also sought to identify the type of learning method that the nurses preferred to use while already in practice to improve performance- work-related learning (Gould et al, 2004, p. 33).

Learning needs assessment is an educational type of research that is more specialized. It offers a chance to discover the gap between the current practice and what is being invented or discovered (desired practice.). Continuing to study when it works is likely to result in a change of practices and quality of service as education is more connected to personal incentives.

Method

Design

Exploratory design was used in the investigation. A cross-sectional approach was applied in the survey to 275 anonymous registered nurses. These nurses were working for Veterans Affairs, Loma Linda system. The sample size was a recommendation by researchers to ensure that the size would allow adequate linear regression. Data were collected from the center after the approval by the Loma Linda Healthcare System and the LLU (Kovner, et al, 2009, p. 71). Eligibility was that one has to be a nurse and an employee of the Loma Linda system. The nurses were also to be registered practitioners. Participants who indicted informed consent were allowed to take part by signing a consent form. The questionnaires were self-administered. The questions were designed to concentrate on the current practice needs and the desired improvement of the model. The center offered rooms where the study was conducted.

The researcher explained to the participant the aims of the study. All the levels of employment were included from those at entry-level to the experienced workers in management. All these workers offer care to inpatients and outpatients. The questionnaire included a basic information section and the professional aspects of the study (Holloway, 2007, p. 9). The second part was called and rated on a standardized scale to help in the evaluation of the results.

The Questionnaire

Basic Information

Name­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­___________________________ Gender__________________________

Age_____________________________ Department______________________

Marital status_____single/married/divorced

Professional features Information

1. How Long Have you worked for medical Home program (years) – tick one

1,2,3,4,5,6,7,8,9, 10,11,12,13,14,15,16,17,18,19, 20,21,22,23,24,25,26,30 +

2. How many hours do you work on average per week?
3. Which type of working arrangement do you use? 1 – Part-time, 2 – full-time, 3 – Locum, 4 – Freelance
4. Do you work another job as well? Yes/No
5. Which areas of training need improvement? 1-Professional skills, 2-technical skills, 3-interpersonal skills, 4-inter-professional skills, 5- management skills
6. If yes, how many hours do you allocate to it?
7. Do you constantly get Training on the job? YES/NO
8. What is your academic qualification? 1- bachelors degree, 2-associate degree, 3-masters degree, 4-Doctoral degree
9. Do you have other professional training besides first Degree? YES/NO
10. Which training program do you prefer? 1 Job-Related, 2 Career Related
11. What are barriers to continued training?” 1-funds, 2-time, 3-others (name)

Professional questions

Rating: 1-Strongly Agree 2- Agree 3- Undecided 4-disagree 5-strongly disagree

12. Do you feel appreciated at this Loma Linda Centre?- 1,2,3,4,5
13. Did you get adequate training for your duties? 1,2,3,4,5
14. Have healthcare service delivery improved due to new advances? 1,2,3,4,5
15. Has nursing service in Loma Linda improved about desired care? 1,2,3,4,5
16. Is your education training in line with your job description? 1,2,3,4,5
17. Are you confident with your ability and skills for the job? 1,2,3,4,5
18. Have you mastered your skills to do the job? 1,2,3,4,5
19. Do you feel you require extra training or more education? 1,2,3,4,5
20. Do you think the center offers extra training for their employees? 1,2,3,4,5
21. Is the job too demanding in terms of the type of training you have and what is deemed necessary for the service? 1,2,3,4,5
22. Are you satisfied with the experience and training you get at this job? 1,2,3,4,5

Measures– the gaps between the current knowledge and the improved or desired services were assessed based on several factors. These factors included the level of training. The answered were rated on a five-point Likert scale to indicate the level of satisfaction (Farley & Fay, 2001, p. 13).

Results

The outcomes were rated as the Likert scale revealed, ranging from extreme satisfaction to extreme dissatisfaction. All the questionnaires were collected back and the researchers managed to have 275 responses. 39% of the participants were men while 61% were women. The mean age of response was 36 years old. Most of the workers were also married at a rate of 65%. 53.2% of the practitioners had additional nursing specialization (i.e. master’s degrees) after graduation from nursing school with first degrees. 14% of the participants were head nurses and 55.5% were based in in-patient programs (Farley & Fay, 2001 p. 13). Most nurses (65.3%) worked one shift a day, 13.7% worked two shifts and the rest worked on a locum basis or freelance

Almost half (53.6%) of the participants were comfortable with their duties and responsibilities. The rest would like to change their duties to be more comfortable. Most of the participants did not feel adequately trained for the nursing profession. A very great percentage (85%) of the participants indicated that there was a need to continue with training and learning of the best primary care. This included technical and professional skills. A moderately higher number of the participants indicated that they would prefer to learn management skills so that they can be more effective in coordinating care and in decision making (Gould et al, 2004, p. 33).

Discussion

After assessing the learning needs of the nurses practicing primary care, many of them considered experience as an essential requirement for the practice. 12 percent had associate degrees, 18 have bachelor’s degrees while 45 –percent had specialized with master’s degrees. This outcome is linked to the fact that LLU is affiliated to the institution and the workers easily find access to the education programs of the university (Gould et al, 2004, p. 33). The two institutions work together to improve services. Since the university greatly supports research, new technology usually gets to the facility even faster. Considering that a greater percentage of the workers had other professional training besides their degree qualifications, it’s evident that the need to learn and train is at least trying to keep pace with advances of home medical needs. Learning at work is a great challenge and many of the respondents did not like on-job learning (90%). This is attributed to the fact that in-depth training needs extensive training sessions.

Conclusion and Recommendations

Efficiency is paramount in the administration of medical treatment. This arises from the fact that medical practice deals with the life of individuals. One of the models which contribute towards efficient delivery of medical services is the patient-centered care model. The model enables the patients to receive comprehensive healthcare benefits. For it to be effective, a high degree of flexibility is required. Healthcare providers should be in a position to provide medical care even on short notice. In addition, the practitioners are required to make use of the latest healthcare knowledge and technology and more so the evidence-based model to offer services and update the records. Nursing and healthcare services are essential to the community and require regular updating of the information that practicing nurses have and the latest technology being invented in practice. For practitioners at Loma Linda to be effective, the management team needs to incorporate an education need assessment program. The program should contribute towards the identification of employees’ career development requirements. The resultant effect is that there will be an increment in the level of motivation amongst employees. Apart from employee motivation, learning needs assessment is an educational type of research that is more specialized. It offers a chance to discover the gap between the current practice and what is being invented or discovered (desired practice. This means that the model will be more effective. Educational need assessment should be conducted regularly to identify the changes within nursing and healthcare.

Reference List

Billings, D.M. & Halstead J.A. (2009), Teaching In Nursing: A Guide for Faculty, St. Louis: Elsevier Saunders.

De Young, S. (2009). Teaching Strategies for Nurse Educators (2^nd Ed.). Upper Saddle River: NJ: Prentice-Hall.

Farley JK. & Fay P. (2001). A System For Assessing The Learning Needs Of Registered Nurses, The Journal Of Continuing Education In Nursing; 19: Pp13-16.

Gould, D., Kelly, D. & White, I. (2004). Training Needs Analysis: An Evaluation Framework. Nursing Standard, 18, 20, 33- 36.

Holloway, K. (2007), Hutt Valley Nursing Training Needs Analysis, Final Report, Health Studies, P 3-27.

Sibbald, B., & Young, R. (2001), the General Practitioner Workforce 2000. Workload, Job Satisfaction, Recruitment, and Retention. Manchester, National Primary Care Research & Development Centre.