Chapter 5

FINDINGS, CONCLUSIONS AND RECOMMENDATIONS

Summary of Findings

1. The researchers have agreed to include at least half of the total number of

students in the 4th year level. Respondents were particularly from sections B, D, E & F.

Majority of them or 52% were female and only 48% were male. As a requirement in

our curriculum, particularly in Related Learning Experiences (RLE), they were all

exposed to at least one area of exposure in CLDH and TPH.

2. As interpreted from the data, majority of the nursing procedures by which

respondents were able to perform in their exposure in CLDH and TPH had close

percentage values. Also, there were more percentages of respondents revealing that

they were able to perform majority of the identified procedures in TPH than in CLDH.

However, it was revealed in the results that there were respondents who were unable

to perform nursing procedures in both CLDH and TPH. Specifically:

2.1. Although almost all of the respondents said that they were able to

perform assessment and taking of vital signs in both hospitals (97.69 to

99.64%), there was still a range of percentage of respondents who were not

able to perform these procedures in both hospitals (0.77 to 2.31%).

2.2. Respondents who were able to perform charting in CLDH and TPH

were 95.63 and 87.95% respectively, then 1.25% in CLDH and 1 % in TPH

were not able to do charting.

 60

2.3. In CLDH, 89.99% were able to perform bed making and 10% did

not, where as in TPH, 87.69% performed bed making and 12.31% did not.

2.4. An 85.77% were able to practice hand washing in CLDH while

14.23% have not, and 86.92% have performed the procedure in TPH while

13.08% did not.

2.5. The respondents who were able to administer medication were

79.07% in CLDH and 83.22% in TPH while 20.92% in CLDH and 16.77% in

TPH have not administered medications.

2.6. Those who have removed and changed IV fluids in CLDH were

74.61% and 75.38% in TPH, and then 25.38% and 24.62% have not done the

procedure in CLDH and TPH respectively.

2.7. In positioning, 68.97% in CLDH and 73.08% in TPH have

performed this while 31.02% in CLDH and 26.92% in TPH have not.

2.8. Respondents who were able to collect specimen were 61.73% in

CLDH and 70.19% in TPH and those who have not were 38.27% in CLDH

and 29.80% in TPH.

2.9. In providing hygiene, 55.38% in CLDH and 63.84% in TPH were

able to perform this while 44.61% in CLDH and 36.15% have not.

2.10. In other nursing procedures specified, only 40.09% in CLDH and

48.65% in TPH were able to experience doing them while a significant 59.90%

in CLDH and 51.35% were not able to perform the procedures.

 61

3. Basing from the results, more than 98.46% (128 responses and/or greater) of

the respondents said that equipments and facilities were available, adequate and

functional in CLDH. The frequencies by which respondents said that equipments and

facilities were also available, adequate and functional in TPH vary, although these

were significantly lesser than those who said so in CLDH, with percentages ranging

from only 43.08% to at most 98.46% (128 responses and/or lower). A greater 75% of

respondents said that TPH allow nursing students to make use of equipments than the

percentage of respondents saying that for CLDH which was only 69%.

4. From the ranking of frequencies in terms of motivational factors, the

topmost motivational factors in CLDH were the knowledge of clinical instructors

about the concept (128 out of 130 respondents), the support of hospital staff and

personnel towards the learning needs of students (122 out of 130 respondents) and

participation of patients in the plan of care of student nurses (118 out of 130

respondents). In TPH, the most leading motivational factors were the allowing

students to perform nursing procedures by clinical instructors (127 out of 130

respondents), hospital staff and personnel (115 out of 130 respondents) and patients

(126 out of 130 respondents).

5. As seen from the data, the t- test values in each nursing procedure were

computed using the means of yes frequencies, and computed variances. The values

were compared with the tabular values at 5% level of significance according to their

computed degrees of freedom. From there, it was seen that charting and bed making

were the two nursing procedures that showed significant difference between the

performance by the respondents in CLDH and TPH since their t- test values were
 62

greater than the tabular values while the rest of the nursing procedures did not

manifest significant differences due to lesser t- test values in comparison with the

tabular values at 5% level of significance, depending on degrees of freedom.

Conclusions

Based on the findings of the study, the researchers have drawn the following

conclusions:

1. Not all respondents were able to perform all the nursing procedures identified

in this study. Assessment and taking of vital signs were the only nursing

procedures significantly performed by almost all of the respondents.

2. Respondents who agreed that equipments and facilities were available,

adequate and functional in CLDH were more than in TPH. The rankings as to

which equipment or facilities were most to least available, adequate and

functional is different in CLDH and TPH.

3. More respondents said that TPH allowed making use of hospital equipments

than CLDH.

4. The main motivational factors differ in CLDH and TPH. In CLDH, the

knowledge of clinical instructors regarding the concept, the support of hospital

staff and personnel towards learning needs of students and participation of

patients in the plan of care of student nurses were the main motivational factors
 63

for the respondents. In TPH, it was the allowing of clinical instructors, hospital

staff and personnel and patients to perform nursing procedures.

5. There is a significance difference between the performance of charting and bed

making in CLDH and TPH. There were no significant differences between the

performance of other nursing procedures in CLDH and TPH.

Recommendations

In view of the results of the study, the researchers have the following

recommendations to appropriate authorities:

1. All nursing students should be able to perform nursing procedures.

2. School administrators should coordinate with the affiliating hospitals to

at least provide or allow equipments & facilities to be utilized by future

student nurses who will be affiliating with the said hospitals. These are

responsibilities of the hospitals as part of nursing education affiliated

with CLDH- EI. It may aid to increase the percentage of students who

are able to perform nursing procedures.

3. Clinical instructors should be oriented regarding the limitations of

hospitals in terms of nursing procedures that students are allowed to

perform by the hospitals and patients, as well as in equipments and

facilities available, adequate and functional in order to provide

 64

measures to compensate these limitations and still provide students the

opportunity to perform nursing procedures (for example, encouraging

students to bring complete hospital paraphernalia in their duties).

4. The clinical instructions must provide equal chances to all their

students without discriminations and under estimation but with full

supervision.

5. The hospital personnel and staff must treat the student nurses and vice-

versa, professionally as part of the health care team, giving equal

chances & considerations on students to perform different nursing

procedures, unless contraindicated according to agency policies.

6. Students should exert efforts to establish rapport to gain their patients’

trust and cooperation.

7. Students should have the discipline in terms of using hospital

equipments and facilities such as cleaning and proper disposal of

wastes after use and handling with care.

8. Lastly, students must do their tasks & duties to certain procedures to

meet the needs of their patients such as observing patients’ rights

during performance of risky procedures.

 65

BIBLIOGRAPHY

A. Books

Asperas, Carlito M. (2005). Introduction to Nursing Research, 1st edition

Balita, C. E. (2008). Ultimate Learning Guide to Nursing Review, 2nd edition, Ultimate
Learning Series

Barrientos- Tan, C. (2006). A Research Guide in Nursing Education, 3rd Edition,

Visual Print Enterprises

Delaune, S. and Patricia K. Ladner (2006). Fundamentals of Nursing: Standards of

Practice, Third Edition, Thomson Delmar Learning

Daniels, Rick (2004). Nursing Fundamentals: Caring and Clinical Decision- Making,
Thomson Delmar Learning

Kozier, Barbara et al (2004). Fundamentals of Nursing Concepts, Process and

Practice, 7th edition, Prentice- Hall

B. Journals

Andrews, Sharon and Y. Salamonson (2006) “Academic Performance in Nursing

Students: Influence of Part- time Employment, Age and Ethnicity” Journal of
Advanced Nursing Vol. 55, No. 3

Brown SIII (2003) “Managed care and technical efficiency” Health Economics, Vol.
12 Issue 2, Pages 149-158

Herr, Annika (2008) “Cost and technical efficiency of German hospitals: does
ownership matter?” Health Economics, Vol. 17 Issue 9, Pages 1057 – 1071

Lee, Haejong, et al (2008) “Comparing efficiency between public and private hospitals
in South Korea” International Journal of Public policy p. 430- 442 Vol. 3, No.
5-6

Taner, Tolga and J. Antony (2006) “Comparing public and private hospital care
 66

service quality in Turkey” Leadership in Health Services p. 1- 10 Vol. 19, No.

2

C. Unpublished Materials

De Guzman, Jahan et al (2004). “Factors Affecting the Clinical Performance of BSN

Level IV Students of Central Luzon Doctors’ Hospital Educational
Institution.”

Jordan, Jamille D. et al (2007). “Comparison of the Effectiveness of Skills

Performance in Private and Public Hospitals as Perceived by the BSN IV of
CLDH- EI.”

Sanchez, Marishelle Q. et al (2005). “The Skill Competencies in NCM 104 of the

CLDH- EI Level IV Nursing Students.”

Taban, Edwin R. et al (2005). “An Evaluation of NCM 104 RLE Program of CLDH-
EI for the First Semester of SY 2005-06.”

D. Internet Sources

http://www.aacn.nche.edu.2006

http://www.healthcare-economist.com

http://hospitalpharmacy.info

http://blogs.crikey.com.au/croakey

http://www.issuesinmedicalethics.org

http://www.emeraldinsight.com/Insight

http://www.findfreecollegeessays.com

http://www.okstate.edu/ag/agedcm4h/academic/aged5980a/newpage26.htm

http://www.animatedsoftware.com/statglos/sgvarian.htm

http:/www.changingminds.org/explanations/research/analysis/t-test_table.htm
 67

APPENDIX A

LETTER OF PERMISSION

July 28, 2009

To: Agaton Manuel Gerardo T. Alzate, MD, RN, MAN

Dean, Department of Nursing
CLDH- EI

Dear Sir:

We, a group of BSN 4 students, are conducting a study entitled “A

Comparative Study on the Nursing Procedures Performed by NCM 104 Students
between CLDH and TPH AY 2009-10”. The said study is also our undergraduate
thesis, as partial fulfillment to the requirements of the Bachelor of Science in Nursing.
In line with this, we are required to give out questionnaires as part of our data
gathering procedure, to be filled up by respondents from fourth year BSN students
currently taking NCM 104, particularly from sections B, D, E and F.

In this regard, we are seeking approval from your good office that our group is
granted with permission to hand out questionnaires to our target respondents. We shall
be asking a few minutes of their lecture time for them to answer our questionnaires,
also with permission from their respective clinical instructors.

We are hoping for your kind consideration in the advocacy of our pursuit.
Thank you very much.

Sincerely yours,

Portia Ann M. Aquino

Leader, Group 11 BSN 4 – C

Noted:

Mrs. Benditha G. Babac, RN, MSN

Mr. Michael M. Bungay

Thesis Advisers
 68

APPENDIX B

Survey Material

Demographic Profile
Sex:
Time of duty:
Area of exposure (hospital and area):

Greetings!

The study is conducted to determine the difference on nursing procedures performed

by NCM 104 students between selected areas of CLDH and TPH. It aims to compare
the nursing procedures being performed by NCM 104 students in the two hospitals
that are being affected by environmental and motivational factors, as stated below in
this questionnaire.

You are selected as one of the respondents in this study, since you have been or are
currently exposed in both hospitals this semester.

Refer to the presented scales in answering the following question. Please answer as
truthfully as possible. Please put a check mark (√) on presented scales of your answer,
for both CLDH and TPH.
 69

A. On your clinical exposure, do you perform the following procedures in your

respective area?

CLDH TPH
YES NO YES NO
I. Assessment / Physical
exam
a. Inspection
b. Auscultation
c. Palpation
d. Percussion

II. Taking Vital Signs

a. Blood Pressure
b. Heart rate
c. Respiratory Rate
d. Temperature

III. Recording / Charting

a. SOAPIE
b. Traditional charting
c. Narrative
IV. Bed Making
a. Unoccupied
b. Occupied

V. Hand washing
a. Medical
b. Surgical

VI. Administration of
Medication
a. Oral medication
b. Subcutaneous
c. Intramuscular
d. Preparation of medication
e. IV meds

VII. Removal and changing

of IV fluid

VIII. Positioning the Patient

a. Dorsal horizontal
b. Dorsal recumbent
c. Knee chest
 70

d. Lithotomy
e. Sims
f. Trendelenburg

IX. Collection of Specimen

a. Urine
b. Stool
c. Sputum
d. Other fluid

X. Hygiene
a. Bed-Bath Hygiene
b. Perineal care

XI. Other procedures

a. Insertion of catheter
b. Removal of catheter
c. NGT feeding
d. Gastric Lavage
e. Nebulization with
bronchial tapping
f. Wound dressing

g. Suctioning
1. Tracheo – bronchial
2. Naso – pharyngeal

B. Factors affecting the performance of nursing procedures by the respondents

during their clinical exposure:

CLDH TPH
YES NO YES NO
A. Environmental Factors
1. Equipments
a. Are the following equipments
available during your exposure?
1. Blood pressure apparatus
2. ECG machine
3. Oxygen tank
4. Oximeter machine
5. Cardiac monitor
6. Suction machine
7. Defibrillation machine
8. Mechanical ventilator
 71

9. Emergency cart

b. If available, are the following

equipments adequate?
1. Blood pressure apparatus
2. ECG machine
3. Oxygen tank
4. Oximeter machine
5. Cardiac monitor
6. Suction machine
7. Defibrillation machine
8. Mechanical ventilator
9. Emergency cart

c. If available, are the following

equipments functional?
1. Blood pressure apparatus
2. ECG machine
3. Oxygen tank
4. Oximeter machine
5. Cardiac monitor
6. Suction machine
7. Defibrillation machine
8. Mechanical ventilator
9. Emergency cart

d. Does the hospital allow the

use of the equipments to
students?

2. Facilities
a. Are the following facilities
available in the hospital?
1. Hospital beds
2. Wheelchairs
3. Stretchers
4. Bedside tables
5. IV stands
6. Foot stools
7. Urinals and bed pans

b. If available, are the following

facilities adequate?
1. Hospital beds
 72

2. Wheelchairs
3. Stretchers
4. Bedside tables
5. IV stands
6. Foot stools
7. Urinals and bed pans

c. If available, are the following

facilities functional?
1. Hospital beds
2. Wheelchairs
3. Stretchers
4. Bedside tables
5. IV stands
6. Foot stools
7. Urinals and bed pans

B. Motivational Factors
1. Clinical Instructor
a. Is he/she knowledgeable about
the concept?
b. Is he/she accommodating to
students?
c. Does he/she allow students to
perform nursing procedures in
the area?
d. Does he/she directly supervise
students when performing
nursing procedures?
e. Does he/she encourage
students to grab opportunities to
perform nursing procedures in
the area?
f. Does he/she give positive
reinforcement to students in your
performances in the area?
g. Is he/she fair in evaluating
his/her students?

2. Hospital staff and personnel

a. Do hospital personnel allow
students to perform nursing
procedures in the area?
b. Are they supportive to the
learning needs of the students?
 73

c. Are they accommodating to

students’ inquiries or
suggestions?

3. Patients
a. Do they allow students to
perform nursing procedures on
them?
b. Are they cooperative with the
students?
c. Do they have trust to the
students attending to them?
d. Do they participate with
students in the plan of care?

Thank you very much for your cooperation and honesty. God bless you.

©Group 11 BSN 4-C

August 2009
 74

APPENDIX C

Tally of Responses

A. Demographic profile of the respondents as to gender

Sections Frequenc
Gender Percent
B D E F y
Male 19 4 7 25 55 42%
Female 22 15 30 8 75 58%

B. Demographic profile of the respondents as to time of duty

Frequenc Percen
Sections
Area of Exposure y t
B D E F
CLDH- ER 0 0 9 0 9 7%
CLDH- ICU 0 5 0 0 5 4%
CLDH-MS 16 9 6 9 40 31%
TPH- ER 6 5 0 0 11 8%
TPH- ICU 11 0 11 15 37 28%
TPH- MS 0 0 0 0 0 0%
Others 8 0 11 9 28 22%

C. Demographic profile of the respondents as to area of exposure

Sections Frequenc Percen
Time of Duty
B D E F y t
6-2 am (CLDH) 4 5 20 13 42 32%
2-10 pm
(CLDH) 4 0 0 8 12 9%
7-3 pm (TPH) 28 5 11 0 44 34%
3-11 pm (TPH) 0 0 0 7 7 5%
Others 5 9 6 5 25 19%
 75

D.1. Nursing procedures performed by the respondents (Section B)

Nursing CLDH TPH
Procedures YES NO YES NO
I. a. 38 3 40 1
b. 34 7 38 3
c. 33 8 38 3
d. 28 13 32 9
II. a. 40 1 41 0
b. 40 1 41 0
c. 40 1 41 0
d. 39 2 40 1
III. a. 41 0 35 6
b. 18 23 36 5
c. 14 27 25 16
IV. a. 32 9 30 11
b. 29 12 30 11
V. a. 38 3 35 6
b. 32 9 27 14
VI. a. 40 1 40 1
b. 26 15 41 0
c. 25 16 39 2
d. 38 3 41 0
e. 40 1 39 2
VII. 36 5 41 0
VIII. a. 27 14 35 6
b. 25 16 32 9
c. 27 14 33 8
d. 29 12 31 10
e. 25 16 35 6
f. 25 16 32 9
IX. a. 34 7 39 2
b. 20 21 27 14
c. 12 29 16 25
d. 19 22 24 17
X. a. 23 27 30 11
b. 17 24 31 10
XI. a. 21 20 38 3
b. 32 9 39 2
c. 24 17 38 3
d. 18 23 33 8
e. 30 11 39 2
f. 36 5 41 0
g. 1. 11 30 25 16
 76

g. 2. 13 28 25 16
D.2. Nursing procedures performed by the respondents (Section D)
Nursing CLDH TPH
Procedures YES NO YES NO
I. a. 19 0 19 0
b. 19 0 10 9
c. 17 2 15 4
d. 10 9 11 8
II. a. 19 0 19 0
b. 19 0 19 0
c. 19 0 19 0
d. 19 0 19 0
III. a. 19 0 5 14
b. 2 17 19 0
c. 3 16 9 10
IV. a. 19 0 19 0
b. 19 0 19 0
V. a. 19 0 19 0
b. 19 0 19 0
VI. a. 19 0 19 0
b. 19 0 19 0
c. 19 0 19 0
d. 19 0 19 0
e. 19 0 19 0
VII. 19 0 19 0
VIII. a. 19 0 17 2
b. 19 0 15 4
c. 15 4 16 3
d. 11 8 17 2
e. 18 1 15 4
f. 19 0 19 0
IX. a. 17 2 19 0
b. 19 0 14 5
c. 10 9 19 0
d. 15 4 9 9
X. a. 19 0 0 19
b. 19 0 19 0
XI. a. 2 17 14 5
b. 18 1 19 0
c. 19 0 19 0
d. 19 0 17 2
e. 19 0 16 3
f. 19 0 19 0
g. 1. 15 4 5 14
 77

g. 2. 15 4 6 13
D.3. Nursing procedures performed by the respondents (Section E)
Nursing CLDH TPH
Procedures YES NO YES NO
I. a. 37 0 35 2
b. 37 0 34 2
c. 34 3 32 5
d. 16 21 22 15
II. a. 37 0 36 1
b. 37 0 36 1
c. 36 1 36 1
d. 36 1 1 1
III. a. 35 2 20 17
b. 17 20 33 4
c. 14 23 20 17
IV. a. 33 4 24 13
b. 29 8 24 13
V. a. 35 2 27 10
b. 21 16 19 18
VI. a. 37 0 37 0
b. 23 14 30 7
c. 27 10 29 8
d. 36 1 36 1
e. 37 0 37 0
VII. 34 3 36 1
VIII. a. 18 9 21 6
b. 25 12 27 10
c. 18 19 19 18
d. 15 22 27 10
e. 24 13 25 12
f. 20 17 23 14
IX. a. 35 2 29 8
b. 15 17 11 26
c. 9 28 9 28
d. 9 28 7 30
X. a. 18 19 20 17
b. 23 14 26 11
XI. a. 10 27 26 11
b. 23 14 34 3
c. 24 13 28 9
d. 13 24 20 17
e. 31 6 31 6
f. 30 7 33 4
g. 1. 6 31 16 21
 78

g. 2. 9 28 15 22
D.4. Nursing procedures performed by the respondents (Section F)
Nursing CLDH TPH
Procedures YES NO YES NO
I. a. 33 0 33 0
b. 33 0 32 1
c. 27 6 27 6
d. 23 10 20 13
II. a. 33 0 33 0
b. 33 0 33 0
c. 33 0 33 0
d. 33 0 33 0
III. a. 31 2 19 14
b. 14 19 26 7
c. 12 21 14 19
IV. a. 28 5 27 6
b. 24 9 25 8
V. a. 33 0 30 3
b. 27 6 24 9
VI. a. 33 0 33 0
b. 23 10 23 10
c. 25 8 24 9
d. 32 1 33 0
e. 32 1 33 0
VII. 32 1 32 1
VIII. a. 20 13 17 16
b. 21 12 20 13
c. 18 15 13 20
d. 22 11 18 15
e. 24 9 22 11
f. 22 11 22 11
IX. a. 20 13 27 6
b. 13 20 13 20
c. 6 27 6 27
d. 10 23 6 27
X. a. 22 11 15 18
b. 18 15 19 14
XI. a. 19 14 17 16
b. 25 8 23 10
c. 30 3 22 11
d. 17 16 12 21
e. 30 3 28 5
f. 28 5 20 13
g. 1. 28 5 19 14
 79

g. 2. 17 16 22 11
E.1. Environmental factors affecting actual delivery of nursing procedures (B)
Environmental CLDH TPH
factors YES NO YES NO
1. a. 1. 41 0 39 2
a. 2. 38 3 38 3
a. 3. 40 1 40 1
a. 4. 34 7 30 11
a. 5. 35 16 28 13
a. 6. 40 1 39 2
a. 7. 35 6 32 9
a. 8. 34 7 35 6
a. 9. 38 3 37 4
1. b. 1. 40 1 34 7
b. 2. 38 3 35 6
b. 3. 40 1 37 4
b. 4. 38 3 28 13
b. 5. 37 4 29 12
b. 6. 38 3 32 9
b. 7. 36 5 29 12
b. 8. 37 4 32 9
b. 9. 39 2 34 7
1. c. 1. 41 0 36 5
c. 2. 39 2 36 5
c. 3. 41 0 36 5
c. 4. 38 3 32 9
c. 5. 36 5 30 11
c. 6. 39 2 37 4
c. 7. 34 7 31 10
c. 8. 40 1 37 4
c. 9. 36 5 34 7
1. d. 32 9 40 1
2. a. 1. 40 1 39 2
a. 2. 40 1 38 3
a. 3. 41 0 39 2
a. 4. 40 1 36 5
a. 5. 41 0 38 3
a. 6. 41 0 31 10
a. 7. 40 1 32 9
2. b. 1. 41 0 34 7
b. 2. 41 0 33 8
b. 3. 41 0 32 9
b. 4. 41 0 32 9
b. 5. 40 1 31 10
 80

b. 6. 40 1 25 16
b. 9. 40 1 27 14
2. c. 1. 41 0 36 5
c. 2. 41 0 37 4
c. 3. 41 0 37 4
c. 4. 41 0 29 12
c. 5. 41 0 36 5
c. 6. 41 0 29 12
c. 7. 41 0 31 10
 81

E.2. Environmental factors affecting actual delivery of nursing procedures (D)

Environmental CLDH TPH
factors YES NO YES NO
1. a. 1. 19 0 16 3
a. 2. 19 0 17 2
a. 3. 19 0 19 0
a. 4. 19 0 5 14
a. 5. 19 0 8 11
a. 6. 19 0 18 1
a. 7. 19 0 4 15
a. 8. 19 0 17 2
a. 9. 19 0 18 1
1. b. 1. 19 0 15 4
b. 2. 19 0 14 5
b. 3. 19 0 18 1
b. 4. 19 0 5 14
b. 5. 19 0 8 11
b. 6. 19 0 17 2
b. 7. 19 0 4 15
b. 8. 19 0 15 4
b. 9. 19 0 10 9
1. c. 1. 18 1 11 8
c. 2. 19 0 13 6
c. 3. 19 0 18 1
c. 4. 19 0 4 15
c. 5. 19 0 7 12
c. 6. 19 0 15 4
c. 7. 19 0 13 6
c. 8. 19 0 10 9
c. 9. 19 0 16 3
1. d. 5 14 2 17
2. a. 1. 19 0 16 3
a. 2. 19 0 15 4
a. 3. 19 0 10 9
a. 4. 19 0 14 5
a. 5. 19 0 14 5
a. 6. 19 0 5 14
a. 7. 19 0 3 16
2. b. 1. 19 0 15 4
b. 2. 19 0 10 9
b. 3. 19 0 9 10
b. 4. 19 0 15 4
b. 5. 19 0 10 9
 82

b. 6. 19 0 4 15
b. 7. 19 0 3 16
2. c. 1. 19 0 15 4
c. 2. 19 0 10 9
c. 3. 19 0 9 10
c. 4. 19 0 14 5
c. 5. 19 0 10 9
c. 6. 19 0 4 15
c. 7. 19 0 2 17
 83

E.3. Environmental factors affecting actual delivery of nursing procedures (E)

Environmental CLDH TPH
factors YES NO YES NO
1. a. 1. 37 0 34 3
a. 2. 37 0 32 5
a. 3. 37 0 37 0
a. 4. 36 1 34 3
a. 5. 36 1 14 23
a. 6. 37 0 34 3
a. 7. 36 1 12 25
a. 8. 36 1 15 22
a. 9. 37 0 31 6
1. b. 1. 36 1 24 13
b. 2. 37 0 21 16
b. 3. 37 0 32 5
b. 4. 36 1 24 14
b. 5. 37 0 16 21
b. 6. 37 0 20 17
b. 7. 36 1 10 27
b. 8. 35 2 12 25
b. 9. 37 0 24 13
1. c. 1. 37 0 29 8
c. 2. 37 0 28 9
c. 3. 37 0 35 2
c. 4. 36 1 22 15
c. 5. 37 0 14 23
c. 6. 37 0 24 13
c. 7. 36 1 10 27
c. 8. 36 1 19 18
c. 9. 37 0 30 7
1. d. 26 11 30 7
2. a. 1. 37 0 35 2
a. 2. 37 0 34 3
a. 3. 37 0 35 2
a. 4. 37 0 29 8
a. 5. 37 0 31 6
a. 6. 37 0 20 17
a. 7. 37 0 31 6
2. b. 1. 37 0 16 21
b. 2. 37 0 19 18
b. 3. 37 0 18 19
b. 4. 37 0 15 22
b. 5. 36 1 18 19
 84

b. 6. 37 0 12 25
b. 7. 37 0 15 22
2. c. 1. 37 0 31 6
c. 2. 37 0 34 3
c. 3. 37 0 33 4
c. 4. 37 0 25 12
c. 5. 37 0 30 7
c. 6. 37 0 24 13
c. 7. 37 0 27 10
 85

E.4. Environmental factors affecting actual delivery of nursing procedures (F)

Environmental CLDH TPH
factors YES NO YES NO
1. a. 1. 33 0 32 1
a. 2. 32 1 30 3
a. 3. 33 0 32 1
a. 4. 31 2 24 9
a. 5. 32 1 18 15
a. 6. 33 0 31 2
a. 7. 31 2 20 13
a. 8. 30 3 22 11
a. 9. 33 0 27 6
1. b. 1. 33 0 28 5
b. 2. 32 1 22 11
b. 3. 32 1 28 5
b. 4. 30 3 15 18
b. 5. 30 3 13 20
b. 6. 29 4 22 11
b. 7. 32 1 15 18
b. 8. 30 3 15 18
b. 9. 19 14 22 11
1. c. 1. 33 0 28 5
c. 2. 32 1 25 8
c. 3. 33 0 29 4
c. 4. 32 1 21 12
c. 5. 33 0 15 18
c. 6. 31 2 20 13
c. 7. 32 1 12 21
c. 8. 32 1 15 18
c. 9. 33 0 26 7
1. d. 27 6 25 8
2. a. 1. 33 0 28 5
a. 2. 33 0 27 6
a. 3. 33 0 28 5
a. 4. 33 0 29 4
a. 5. 33 0 28 5
a. 6. 33 0 16 17
a. 7. 33 0 24 9
2. b. 1. 33 0 21 12
b. 2. 33 0 15 18
b. 3. 33 0 20 13
b. 4. 33 0 20 13
b. 5. 33 0 19 14
 86

b. 6. 33 0 15 18
b. 7. 33 0 13 20
2. c. 1. 33 0 23 10
c. 2. 33 0 20 13
c. 3. 33 0 23 10
c. 4. 33 0 24 9
c. 5. 33 0 26 7
c. 6. 33 0 25 8
c. 7. 33 0 21 12
 87

F.1. Motivational factors affecting actual delivery of nursing procedures (B)

Motivational CLDH TPH
factors YES NO YES NO
1. a. 40 1 39 2
b. 39 2 39 2
c. 39 2 40 1
d. 39 2 39 2
e. 36 5 38 3
f. 39 2 38 3
g. 40 1 38 3
2. a. 35 6 39 2
b. 35 6 38 3
c. 38 3 37 4
3. a. 33 8 41 0
b. 35 6 40 1
c. 31 10 40 1
d. 36 5 39 2

F.2. Motivational factors affecting actual delivery of nursing procedures (D)

Motivational CLDH TPH
factors YES NO YES NO
1. a. 18 1 18 1
b. 17 2 19 0
c. 19 0 19 0
d. 19 0 19 0
e. 19 0 19 0
f. 19 0 19 0
g. 19 0 19 0
2. a. 15 4 14 5
b. 17 2 11 8
c. 14 5 16 3
3. a. 14 5 17 2
b. 17 2 18 1
c. 16 3 16 3
d. 17 2 15 4
 88

F.3. Motivational factors affecting actual delivery of nursing procedures (E)

Motivational CLDH TPH
factors YES NO YES NO
1. a. 37 0 34 3
b. 37 0 35 2
c. 37 0 36 1
d. 37 0 36 1
e. 37 0 35 2
f. 35 2 33 4
g. 35 2 33 4
2. a. 35 2 35 2
b. 37 0 32 5
c. 36 1 33 4
3. a. 27 10 36 1
b. 33 4 35 2
c. 29 8 34 3
d. 33 4 35 2

F.4. Motivational factors affecting actual delivery of nursing procedures (F)

Motivational CLDH TPH
factors YES NO YES NO
1. a. 33 0 32 1
b. 33 0 31 2
c. 33 0 32 1
d. 33 0 31 2
e. 33 0 31 2
f. 33 0 31 2
g. 32 1 27 6
2. a. 30 3 27 6
b. 33 0 29 4
c. 30 3 28 5
3. a. 31 2 32 1
b. 32 1 31 2
c. 31 2 31 2
d. 32 1 30 3
 89

APPENDIX D

Computations

I.Assessment CLDH TPH f1- (f1- f2- (f2-

(Yes)/f1 (Yes)/f2 X1 X1)2 X2 X2)2
a.Inspection 129 129 0.2 0.06
5 3 0 0
b.Auscultatio 129 129 0.2 0.06
n 5 3 0 0
c.Palpation 129 129 0.2 0.06
5 3 0 0
d.Percussion 128 129 0.56
-0.8 3 0 0
Mean (X) 128.75 129        
∑ (f-X)2       0.75   0
s2 0.18
      8   0
             
X1-X2 -0.25          
2
s 1/n1 0.0014423
1          
2
√s 1/n1 0.0379777
3          
2
s 2/n2 0          
2
√s 2/n2 0          
√s21/n1+√s22/n
2
0.0379777
3          
T- test -
6.5828058
9          
 90

II.Taking V/S CLDH TPH f1- (f1- f2- (f2-

(Yes)/X1 (Yes)/X2 X1 X1)2 X2 X2)2
a.Blood 128 129
Pressure 1 1 1 1
b.Heart Rate 127 128 0 0 0 0
c.Respiratory 127 128
Rate 0 0 0 0
d.Temperature 126 127
-1 1 -1 1
Mean (X) 127 128        
∑ (f-X)2       2   2
2
s       0.5   0.5
             
X1-X2 -1          
s21/n1 0.00384615          
√s21/n1 0.06201737          
s22/n2 0.00384615          
√s22/n2 0.06201737          
√s21/n1+√s22/n2

0.12403473          
T- test -
8.06225775          
 91

III.Charting CLDH TPH f1- (f1- f2- (f2-

(Yes)/X1 (Yes)/X2 X1 X1)2 X2 X2)2
a.SOAPIE 125 115 0.6
7 0.449 0.7 0.49
b.Traditional 125 114 0.6
7 0.449 -0.3 0.09
c.Narrative 123 114 -1.3 1.769 -0.3 0.09
Mean (X) 124.33 114.3        
∑ (f-X)2       2.667   0.67
2
s       0.889   0.223
             
X1-X2 10.03          
s21/n1 0.00683769          
√s21/n1 0.08269034          
s22/n2 0.00171795          
2
√s 2/n2 0.04144814          
2 2
√s 1/n1+√s 2/n2

0.12413848          
T- test 80.7968618          
 92

IV.Bed CLDH TPH f1- (f1- f2- (f2-

Making (Yes)/X1 (Yes)/X2 X1 X1)2 X2 X2)2
a. Unoccupied 121 114 4 16 0 0
b.Occupied 113 114 -4 16 0 0
Mean (X) 117 114        
∑ (f-X)2       32   0
s2       16   0
             
X1-X2 3          
2
s 1/n1 0.12307692          
2
√s 1/n1 0.35082321          
2
s 2/n2 0          
2
√s 2/n2 0          
2 2
√s 1/n1+√s 2/n2

0.35082321          
T- test 8.55131569          
 93

V.Hand CLDH TPH f1- (f1- f2- (f2-

Washing (Yes)/X1 (Yes)/X2 X1 X1) 2
X2 X2)2
a.Medical 112 113 0.5 0.25 0 0
b.Surgical 111 113 -
0.5 0.25 0 0
Mean (X) 111.5 113        
∑ (f-X)2       0.5   0
2
s       0.25   0
             
X1-X2 -1.5          
2
s 1/n1 0.00192308          
2
√s 1/n1 0.0438529          
s22/n2 0          
√s22/n2 0          
√s21/n1+√s22/n2

0.0438529          
T- test -
34.2052628          
 94

VI.Administratio CLDH TPH

n of Medication (Yes)/X1 (Yes)/X2 f1- (f1- f2- (f2-
X1 X1)2 X2 X2)2
a.Oral 110 112 7.2 51.84 3.8 14.44
b.Subcutaneos 106 111
3.2 10.24 2.8 7.84
c.Intramuscular 101 111 -
1.8 3.24 2.8 7.84
d.Preparation of 99 107 -
medication 3.8 14.44 -1.2 1.44
e.IV medication 98 100 -
4.8 23.04 -8.2 67.24
Mean (X) 102.8 108.2        
∑ (f-X)2       102.8   98.8
s2       20.56   19.76
             
X1-X2 -5.4          
2
s 1/n1 0.1581538
5          
2
√s 1/n1 0.3976856
1          
2
s 2/n2 0.152          
2
√s 2/n2 0.3898717
7          
2 2
√s 1/n1+√s 2/n2
0.7875573
9          
T- test -
6.8566432
1          
 95

VIII.Positionin CLDH TPH

g the Patient (Yes)/X1 (Yes)/X2 f1- (f1- f2- (f2-
X1 X1)2 X2 X2)2
a.Dorsal 96 97
Horizontal 6.34 40.2 2 4
b.Dorsal 91 96
Recumbent 1.34 1.796 1 1
c.Knee Chest 91 95 1.34 1.796 0 0
d.Lithotomy 90 95 0.34 0.116 0 0
e.Sims 86 94 -3.7 13.4 -1 1
f.Trendelenburg 84 93
-5.7 32.04 -2 4
Mean (X) 89.66 95        
∑ (f-X)2       89.33   10
2
s       14.89   1.667
             
X1-X2 -5.34          
s21/n1 0.11453026          
√s21/n1 0.33842319          
s22/n2 0.01282051          
√s22/n2 0.1132277          
√s21/n1+√s22/n2

0.45165089          
T- test -
11.8232911          
 96

IX.Collection CLDH TPH f1- (f1- f2- (f2-

of Specimen (Yes)/X1 (Yes)/X2 X1 X1)2 X2 X2)2
a.Urine 84 93 3.75 14.06 1.75 3.063
b.Stool 82 93 1.75 3.063 1.75 3.063
c.Sputum 78 90 -2.3 5.063 -1.3 1.563
d.Other Fluid 77 89 -3.3 10.56 -2.3 5.063
Mean (X) 80.25 91.25        
∑ (f-X)2       32.75   12.75
s2       8.188   3.188
             
X1-X2 -11          
s21/n1 0.06298077          
√s21/n1 0.2509597          
2
s 2/n2 0.02451923          
2
√s 2/n2 0.15658618          
2 2
√s 1/n1+√s 2/n2

0.40754587          
T- test -
26.9908266          
 97

X.Hygiene CLDH TPH f1- (f1- f2- (f2-

(Yes)/X1 (Yes)/X2 X1 X1) 2
X2 X2)2
a. Bed Bath 77 85 5 25 2 4
b.Perineal 67 81
Care -5 25 -2 4
Mean (X) 72 83        
∑ (f-X)2       50   8
2
s       25   4
             
X1-X2 -11          
2
s 1/n1 0.19230769          
√s21/n1 0.43852901          
s22/n2 0.03076923          
√s22/n2 0.1754116          
√s21/n1+√s22/n2

0.61394061          
T- test -
17.9170424          
 98

XI.Other CLDH TPH f1- (f1- f2- (f2-

Procedures (Yes)/X1 (Yes)/X2 X1 X1)2 X2 X2)2
a.Catheter Insertion 67 79
14.9 221.4 15.8 248.1
b.Catheter Removal 60 68
7.88 62.09 4.75 22.56
c.NGT Feeding 54 68
1.88 3.534 4.75 22.56
d.Gastric Lavage 53 65
0.88 0.774 1.75 3.063
e.Nebulization 52 65 -0.1 0.014 1.75 3.063
f.Wound Dressing 51 65
-1.1 1.254 1.75 3.063
g1.Tracheobronchia 43 50
l Suctioning
-9.1 83.17 -13 175.6
g2.Nasophareneal 37 46
Suctioning
-15 228.6 -17 297.6
Mean (X) 52.12 63.25        
∑ (f-X)2       600.9   775.5
2
s       75.11   96.94
             
X1-X2 -11.13          
s21/n1 0.57776462          
√s21/n1 0.76010829          
s22/n2 0.74567308          
√s22/n2 0.86352364          
√s21/n1+√s22/n2

1.62363193          
T- test -
6.85500191          
 99

APPENDIX E

T- test Table

Degrees of Probability, p
Freedom 0.1 0.05 0.01 0.001
1 6.31 12.71 63.66 636.62
2 2.92 4.30 9.93 31.60
3 2.35 3.18 5.84 12.92
4 2.13 2.78 4.60 8.61
5 2.02 2.57 4.03 6.87
6 1.94 2.45 3.71 5.96
7 1.89 2.37 3.50 5.41
8 1.86 2.31 3.36 5.04
9 1.83 2.26 3.25 4.78
10 1.81 2.23 3.17 4.59
11 1.80 2.20 3.11 4.44
12 1.78 2.18 3.06 4.32
13 1.77 2.16 3.01 4.22
14 1.76 2.14 2.98 4.14
15 1.75 2.13 2.95 4.07
16 1.75 2.12 2.92 4.02
17 1.74 2.11 2.90 3.97
18 1.73 2.10 2.88 3.92
19 1.73 2.09 2.86 3.88
20 1.72 2.09 2.85 3.85
21 1.72 2.08 2.83 3.82
22 1.72 2.07 2.82 3.79
23 1.71 2.07 2.82 3.77
24 1.71 2.06 2.80 3.75
25 1.71 2.06 2.79 3.73
 100

26 1.71 2.06 2.78 3.71

27 1.70 2.05 2.77 3.69
28 1.70 2.05 2.76 3.67
29 1.70 2.05 2.76 3.66
30 1.70 2.04 2.75 3.65
40 1.68 2.02 2.70 3.55
60 1.67 2.00 2.66 3.46
120 1.66 1.98 2.62 3.37
infinity 1.65 1.96 2.58 3.29