Nigeria Nursing Students’ Practical Experience Of Computer Applications In Nursing

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NIGERIA NURSING STUDENTS’ PRACTICAL EXPERIENCE OF COMPUTER APPLICATIONS IN NURSING

ABSTRACT:

This study investigated the relevance of computer literacy to nursing profession as perceived by nurses in Nnamdi Azikiwe University Teaching Hospital, Nnewi. Four research questions and two hypotheses were formulated to guide the study. The purpose of the study is to determine the relevance of computer literacy to nursing profession. A descriptive survey research design was employed for the study. Every registered nurse in Nnamdi Azikiwe University Teaching Hospital, Nnewi  that met the inclusion criteria served as the sample – 231. Twenty three self developed questionnaire was used as instrument for data collection. Analyses were done with the aid of a computer standard package for statistical studies (SPSS version16) software while Chi- Square test of independence was used to test the null hypotheses at 0.05 level of significance. Results were presented using frequency tables, percentages and pie charts.  Major findings revealed that a large percentage of nurses in Nnamdi Azikiwe University Teaching Hospital, Nnewi are not computer literate (60.6%) and cannot handle the common computer software and operations; years of experience were insignificant with being computer literate (P>0.05) while gender was significant (P<0.05); majority (96.5% ) of the nurses responded positively  that computer literacy is useful for monitoring patient, nursing documentation, clinical decision making, nursing diagnosis, sources of information,  conducting research,  management of human resources and record keeping. Inclusion of computer training in the continuing education programme for nurses and adequate managerial support should be provided for nurses to ensure computer literacy.

TABLE OF CONTENT

Title page –        –        –        –        –        –        –        –        –        –        i

Certification       –        –        –        –        –        –        –        –        –        ii

Dedication                   –        –        –        –        –        –        –        –        –        iii

Acknowledgement      –        –        –        –        –        –        –        –        iv

Abstract    –        –        –        –        –        –        –        –        –        –        v

Table of Content         –        –        –        –        –        –        –        –        –        vi

CHAPTER ONE

1.1       Background of Study –        –        –        –        –        –        –        1

1.2    Statement of Problem         –        –        –        –        –        –        –        3

1.3    Objective of the Study         –        –        –        –        –        –        –        5

1.4    Significance of the Study    –        –        –        –        –        –        5

1.5    Research Questions   –        –        –        –        –        –        –        6

1.6    Scope of the Study      –        –        –        –        –        –        –        6

1.7    Limitation of the Study       –        –        –        –        –        –        7

1.8    Operational Definition of Terms –        –        –        –        –        7

CHAPTER TWO

REVIEW OF LITERATURE

2.0    Introduction       –        –        –        –        –        –        –        –        8

2.1    Conceptual Framework      –        –        –        –        –        –        9

2.1.1 Background of the Study    –        –        –        –        –        –        9

 

2.2    Theoretical Framework      –        –        –        –        –        –        27

 

2.3    Conclusion         –        –        –        –        –        –        –        –        –        28

CHAPTER THREE

METHODOLOGY

3.0    Introduction       –        –        –        –        –        –        –        –        29

3.1    Research Design         –        –        –        –        –        –        –        29

3.2    Research Setting        –        –        –        –        –        –        –        29

3.3       Target Population      –        –        –        –        –        –        –        31

3.4       Sampling Techniques         –        –        –        –        –        –        –        31

3.5       Instrument For Data Collection –        –        –        –        –        31

3.6       Validity and Reliability of Instrument          –        –        –        –        32

3.7       Method of Data Collection  –        –        –        –        –        –        32

3.8       Method of Data Analysis    –        –        –        –        –        –        32

3.9       Ethical Consideration         –        –        –        –        –        –        –        32

CHAPTER FOUR

4.0    Introduction       –        –        –        –        –        –        –        –        33

4.1    Data Presentation      –        –        –        –        –        –        –        33

4.2       Answering Research Questions  –        –        –        –        –        47

4.3    Data Analysis    –        –        –        –        –        –        –        –        49

4.4    Conclusion        –        –        –        –        –        –        –        –        53

 

CHAPTER FIVE

5.0    Introduction       –        –        –        –        –        –        –        –        54

5.1    Discussion of Findings        –        –        –        –        –        –        54

5.2    Relationship with other Studies/Literature Review      –        56

5.3    Implication for Nursing      –        –        –        –        –        –        58

5.4    Summary  –        –        –        –        –        –        –        –        –        58

5.5    Conclusion         –        –        –        –        –        –        –        –        –        59

5.6    Recommendations      –        –        –        –        –        –        –        60

References         –        –        –        –        –        –        –        –        –        –        63

Appendix  –        –        –        –        –        –        –        –        –        –        64

BACKGROUND TO THE STUDY:
Nowadays, more and more computers are being used in health care systems to store, organize, and transmit information. Although nurses do not need a high degree of computer expertise, their performance will be much more efficient if they have good computer skills. In other words, nurses who operate computers proficiently can quickly access health care-related information using computers. They may be able to provide more appropriate and efficient care to theirpatients.
Computer is a type of information technology that has become part of everyday life for many people. Its use in health care delivery is no longer a thing of debate as computers are used for educating students and clients; assessing, documenting and testing client’s health conditions; managing medical records; communication among health care providers and clients; and conducting nursing research. It is necessary that nurses must have a basic level of computer literacy in order to perform jobs (Kozier, Erb’s & Olivieri 2008).
Nursing informatics is the science of using computer information systems in the practice of nursing. It is a career that focuses on finding ways to improve information management and communications in nursing in order to improve efficiency, reduce costs and enhance the quality of patient care (American Nurses Association (ANA), 2010).
According to Wyatt (2013), computer literacy is a technical skill, that is, the ability to use hard and soft wares, to accomplish tasks. Competency in information technology requires three types of knowledge: contemporary skills, foundational concept, and intellectual capabilities. Wilkinson (1996) predicted that, in the near future, those who could not use computers would be as disadvantaged as those who could not read and write. The study by Ngin, Simms, and Erbin-Roesemann affirmed that the introduction of computers could not only improve unit morale but could also stimulate the learning of new skills related to effective and quality care delivery.
Ajuwon and Odusanya (2004) in a study on knowledge and utilization of information technology among health care professionals reported that knowledge and utilization of information technology among health care professionals is poor. Thus they suggested that health care professionals should be trained on the use of information technology, and also include information technology in the training curriculum.
Ebrahim, Gashaw, Solomon and Eshetu (2013) revealed that computer knowledge and utilization habit of health workers were found to be very low. Increasing accessibility to computers and delivering training on the use of computers for workers will increase the knowledge and utilization of computers. This will facilitate the rate of diffusion of the technology to the health sector. Hence, programs targeted at enhancing knowledge and skill of computer use and increasing access to computer should be designed. A study conducted by Ajayi, Gaji, Oyedele, Hallandendu and Oluwabamide (2003) on Nurses perception and utilization of information and communication technology (ICT) for nursing care delivery in Zaria metropolis revealed low level of usage and proficiency. Factors hindering usage include nurse’s attitude to ICT use, low computer literacy, inadequate facilities as well as high cost of software.    Ozumba (2004) found that only 0.5% of doctors in Nigeria searched the internet for information relating to their clinical practice/research, though a good number of them believed that the internet had a role to play in medical practice.
Just as computers have become the standard instructional tool in primary and secondary school system, they are used extensively in all aspects of nursing education. Nursing programmes require computerized libraries and academic record keeping is facilitated by data base programmes. Faculty members use technological teaching strategies in the classroom and for outside assignments as well as demonstrating and using applications in clinical rotations.
Computer technology not only serves as an instructional ally, but also assists with the management of information through the storing, manipulation, and retrieving of information (Cox, Harsanyi & Dan, 1999). Computers enhance academics for both the student and faculty in at least four ways. These include access to literature, computer assisted instruction, classroom technologies, and strategies for learning at a distance.
Evangel and Raja (2004) conducted a study to assess and identify deficit areas of computer knowledge, attitude and skill among nurses working in the hospital and to examine the relationship among these factors. 120 staff nurses were surveyed by systematic random sampling. Majority (75%) of staff nurses had good computer knowledge, 100% of nurses had positive attitude towards computer utilization, and 50.8% and 38.8% had average and fair computer skill respectively.
Furthermore, Computer literacy helps the nurse administrators in the management of human resources, facilitates management, keeping nursing records, and budget and financial administration. (Kozier, Erb’s & Olivieri, 2008).
However, being computer literate is an invaluable assistant in the conduct of both quantitative and qualitative research. In each step of the research process, computer facilitates generation, refinement, analyzing and output of data. In problem identification, it is useful in locating current literature about the problem and related concepts. In research design, computer is used to search literature about instruments that have already been established and test instrument that need to be developed for the particular study.
 Statement of the Problem
With the advent of computer in this 21st century, it is expected that professional nurses should possess adequate knowledge and skill to aid efficient nursing practice, education and research. However, observation has shown that many practicing nurses in Nigeria seem to show no interest in the use of computer. Ajuwon and Odusanya (2004) confirmed that utilization of information technology by health care professionals in Nigeria is low. In this study, researchers observed with dismay the way computers installed in every ward in Nnamdi Azikiwe Teaching Hospital Nnewi are lying without being utilized by nurses. The question now arises; are nurses in Nnamdi Azikiwe University Teaching Hospital not computer literate? Are they not aware of the relevance of computer application in their clinical practice, nursing education, administration and research? The above observations formed the impetus for the study.
Aim of the Study
To determine the relevance of computer literacy to nursing profession as perceived by nurses in Nnamdi  Azikiwe University Teaching Hospital Nnewi.
Specific objectives
1.  Determine the level of awareness of computer literacy among nurses in Nnamdi Azikiwe University Teaching Hospital Nnewi.
2.  Ascertain if the nurses are aware of the importance of computer literacy to nursing profession.
3.  Determine the attitude of nurses towards computer literacy to nursing profession.
4.  Identify the factors that may affect nurses’ attitude towards computer literacy to nursing profession.
Significance of the Study
Findings from the study will reveal the level of awareness and importance of information communication technology and attitude of nurses towards computer literacy to nursing profession and recommendations would be made based on the findings. For instance, where negative attitude and poor awareness are revealed, recommendations will be made for more intense activities to improve on the areas.
Findings from the study will also reveal factors that affects nurses attitude towards computer literacy. This will enable the hospital management to develop policy on making the use of computer a culture in clinical practice and organizing continuing education programmes on computer skill training periodically. This will eventually help to improve nursing profession and the entire health care system in Nigeria.
Hypotheses 
The following null hypotheses (H0) were formulated at 0 .05 level of significance.
1. There is no significant relationship between gender and relevance of computer literacy to nursing profession.
2. There is no significant relationship between years of experience and relevance of computer literacy to nursing profession.
Theoretical Framework
Sandbox theory of computer literacy was found useful in this study. The theory states that getting along with the one-eyed monstrosity on one’s desk is not age related. It is personality and habit related. One can improve with one’s relationship with one’s computer by changing one’s attitudes and modifying one’s habits. In relation to the study, nurses can improve in their computer skills by changing their attitude towards the relevance of computer literacy to nursing profession.
MATERIALS AND METHOD
Research design
A descriptive survey was considered the most suitable for this study because it allowed the researcher to obtain demographic information relating to the respondents and the status of their involvement in the relevance of computer literacy to nursing profession and to identify respondents perceived barriers to computer literacy.
Area of the Study
The study area is Nnamdi Azikiwe University teaching Hospital Nnewi which is situated in the heart of Nnewi (Nnewichi village) in Anambra State of Nigeria. It is the only tertiary health institution and the central place for referral cases in Anambra state and neighbouring states such as Imo, Delta etc. There are several departments in the hospital and amongst these are the general outpatient department(GOPD), children emergency department, children outpatient department, medical and surgical outpatient department, accident and emergency, surgical and medical wards, administrative department, school of nursing, banks, physiotherapy department among others.
Target Population
The study population included all the registered nurses (231) who are working in Nnamdi Azikiwe University Teaching Hospital Nnewi in Anambra State.
Sample and Sampling Techniques
A total population study was conducted using 231 nurses working in Nnamdi Azikiwe University teaching Hospital Nnewi. Purposive sampling technique was used to select the nurses who met the inclusion   criteria:  respondent must be a registered nurse and must be on duty at the time of data collection.
Instrument for Data Collection
Data was collected by the use of self-developed questionnaire.
Validity/ Reliability of the Instrument
Face and content validity was determined by an expert in measurement and evaluation from Nnamdi Azikiwe University Nnewi. Pilot study was carried out to ascertain the reliability of the instrument using twenty registered nurses working in two general hospitals in Anambra state.  Result was collated using split-half method while reliability co-efficient was determined using Pearson Product Correlation Co-efficient (r). A score of 0.83 was obtained and accepted as reliable for the study.
Method of Data Collection
Instrument was administered to respondents that were present during the time of study and was collected after some hours with minimal difficulties.
Method of data analysis
Data analysis was done using computer-based special package for social sciences (SPSS version 16) analytical tool while chi-square test of independence was used to test the null hypothesis at 0.05 level of significance. Data were presented in frequency tables, pie and bar charts. However, the researcher combined very good and good to get the positive response and very poor and poor to get the negative response. Also, the strongly agree and agree were combined to get the positive response while disagree and strongly disagree were combined to get the negative response.
Ethical Consideration 
The researchers ensured that the information given by the respondents were treated confidentially as respondents were not asked to include their names on the instruments. Informed consent was ensured as the respondents were given adequate information regarding the research.  Acceptance to participate denoted consent.

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