Date of Award
3-1-1990
Document Type
Dissertation - NSU Access Only
Degree Name
Doctor of Education
Department
Center for the Advancement of Education
Abstract
The purpose of this study was to determine the medication administration proficiency of newly hired nurses at a large Department of Veterans Affairs (D.V.A.) Medical Center located in Bay Pines, Florida and to design a remedial education program in medication administration which would effectively meet specific deficiencies found in this population. Legal and professional mandates require proficiency in this domain of practice, yet nursing literature and recent experience by D.V.A. nurse educators have raised serious concern regarding the adequacy of nurses' proficiency in this area. Research questions include: 1. What is the medication administration proficiency of newly hired nurses at Bay Pines D.V.A. Medical Center? 2. Is there a statistically significant difference between the test scores of newly hired D.V.A. nurses, as measured by the National League for Nursing (N.L.N.) Medication Proficiency Test, and those of a large nursing population tested by the NLN Testing Service in 1986? 3. What is the relationship between the years of nursing practice and the test scores? 4. Are there statistically significant differences in the test scores of nurses with differing educational preparation? 5. Is there a statistically significant difference in the test scores between nurses who have and those who have not had a pharmacology course in their basic nursing program? 6. What theories, principles, and practices of adult education are appropriate for the development of a remedial medication administration program for newly hired nurses? 7. What is the appropriate content and design of a remedial medication administration program for newly hired nurses? Subjects included all of the registered nurses hired within a twelve month period at D.V.A. Medical Center, Bay Pines, Florida (N=48). The study instrument was the NLN Medication Administration Proficiency Test developed by the NLN Testing Service. Normative data and psychometric properties of the sixty item test have been established. Data obtained from the test and a biodemographic form were collected and analyzed. Parametric procedures used included the t-test, analyses of variance, and the product-moment correlation (Pearson r). There was less than one point difference in mean test scores between the D.V.A. group and the NLN group. A one-way analysis of variance revealed no significant difference in test scores of nurses with different levels of educational preparation (p>.05). A t-test a significant difference in mean test scores of nurses who have and have not had a separate pharmacology course in their basic nursing education programs (p < .05 ). Finally, using Pearson's product-moment correlation, the data indicated no significant correlation between the years of nursing practice and test scores (p > .05). These findings correspond to those found in the nursing education literature. Of particular importance to decision-making in the curriculum of basic nursing education programs, is the significant difference in test scores between nurses who have and have not had a separate pharmacology course in their basic nursing education programs. The development of a sample remedial medication administration program was based on a review of the literature in adult education (2) validation of the strategy and model by a national lecturer in adult education, and (3) a test item analysis to determine learning objectives and content. The sample program was validated by review of a national lecturer in adult education and a jury of five nursing education experts using a validation tool based on the UNIPAC model, a self- learning program. Formative evaluation was based on pilot-testing with a group of ten newly employed D.V.A. staff nurses. Conclusions of this study include : (1) specific deficiencies do exist in the domain of medication administration for a population of newly hired nurses at a large D.V.A. Medical Center located in Bay Pines, Florida, (2) efficient and effective, adult education methods of providing remedial programs can be developed, and (3) nursing educators from practice and academic settings should collaborate to remedy knowledge and skill deficiencies in medication administration in student and practicing nursing. Projected study products were submitted to the D.V.A. medical centers in the southeast region who participated in the study. Study results were submitted to the National League for Nursing Testing Service. Implications for the improvement of educational practice include the need for (1) the identification of nurses’ medication administration proficiency, (2) ongoing establishment of a normative data base in nurses’ knowledge of medication administration, and (3) the continuing development of effective remedial education programs for nurses in medication administration.