1

Background of the Study

Clinical experience has been the vital part of nursing education. It is
the avenue for the students to utilize the theories that theyve learned in
their discussion. It prepares student nurses to be able of doing as well as
knowing the clinical principles in practice. The clinical practice stimulates
students to use their critical thinking skills for problem solving. It is where
the student nurses
Nursing students experiences of their clinical practice provide
greater insight to develop an effective intervention for every patient.
This study will assess the clinical performance of student nurses in
MCGH, Furthermore, this study will determine the patient outcome which
may be influenced by the students clinical performance.

Statement of the Problem

1. What is the clinical performance of the student nurses in Mary
Chiles General Hospital in terms of:
1.1 Decision Making
1.2 Time management
1.3 Providing Patient Safety
1.4 Ethical Reasoning
2. What is the patient care outcome in Mary Chiles General Hospital
terms of:
1.1 Nursing Care
1.2 Medication/Treatment
1.3 Recovery
1.4 Complication
Hypothesis:
There is no significant relationship between clinical performance of
student nurses and patient care outcome.

Theoretical Framework
Base on the theory of Benner, Novice to expert theory, each step
builds on the previous one as abstract principles refined and expanded by

experience and the learner to gain clinical expertise. In this theory, Benner
said that all of us have been through the novice level in which the person
has no background experience of the situation in which he or she is
involved but still can be able to provide what patients need until we
reached the expert level.
In general, this is a level in which nursing students belong.
However, Benner proposed that nurses at higher levels can be classified
as novice if they are placed in unfamiliar situation.
The unique function of the nurse is to assist the individual, sick or
well, in the performance of those activities contributing to health or
recovery that would perform unaided if had the necessary strength, will or
knowledge. And to do this in such a way as to help gain independence as
rapidly as possible. Vera M. (2014)
According to Hendersons theory of 14 Basic Nursing Care, one of
those is the Nurse-patient relationship which we can correlate to our topic.
There are three levels compromising the nurse patient relationship first is
the nurse as a substitute to the patient, the nurse as a helper to the
patient, the nurse as a partner of the patient. Another role of the nurse is
to help both the sick and well individual. The care given by the nurse, as
Henderson stressed, must empower the patient to gain independence as
rapidly as possible.
King theory is specialized with use of dynamic interactive
communication between the nurse and the client as proof. Professionals

need communication to successfully and correctly make decisions for their

plan of care.

Conceptual Framework

Since the study focused on the clinical performance of the student

nurses in patient care outcome, the research started by collaborating
clinical performances of the student nurses in rendering care to patients
and followed by analyzing correct clinical performance to be provided.
Student nurses can provide appropriate care to patient. Student
nurses are guided and supervised by the clinical instructors in providing
efficient care to patients. This study will determine the clinical performance
of the student nurses in providing safe quality patient care.
In the novice level, we student nurses can provide the basic
physiological needs of the patient, like promoting clear airway to breath
normally, to eat and drink adequately and providing comfort. As we go on,
being staff nurse as the advance beginner we cant do it perfectly but can
do it accurately and applicable in nursing standard practice until the next
stages of being better effective nurse.

Expert

Competent
Advance Beginner
Novice

Figure 1. Conceptual Framework

Clinical Performance of
student nurse in terms of :
Decision Making
Time Management
Providing Patient
Safety
Ethical Reasoning

Patient Care Outcomes in

Terms of :
Nursing Care
Medication and
Treatment
Recovery
Complications

Figure 2. Research Paradigm

Figure 2, Illustrates the relationship between the students clinical

performance and patient outcome.
Decision Making, Time Management. Providing Patient Safety and
Ethical Reasoning are the characteristics of the Nurses that should be
possessed to have a positive patient care outcome. Giving the Medication
and Treatment on time and providing health teachings for fast recovery
and prevent further complications. These are the common Nursing
Intervention of the student nurses that should be apply in promoting good
health.
For nurses, to achieve positive patient care outcome, nurses should
posses the following skills: Decision making, Time management, Providing
safety, and Ethical Reasoning.

Scope and Delimitations

This study considers every aspect of nursing college students
clinical performance that has an impact in patient care outcome in Mary
Chiles General Hospital. Thirty patients in Mary Chiles General Hospital
are the respondents of this research study. Its main purpose is to know if
the nursing students were able to render the health needs of patients.
Each of the patient respondents will be given a questionnaire with consent
to answer to conduct the study.
Definition of Terms:
Decision making- a complex, cognitive process often defined as a
choosing a particular course of action, Beginners Guide (2005).
Time Management- making optimal use of available time. Providing
patient safety is keeping the patient free from any danger and keeping
them secured.
Ethical Reasoning- justifying the right and wrong human act.
Nursing Care- the act of providing health need of human.
Medication and Treatment- providing care and giving medication while
observing the 12Rs of giving medication.
Recovery- return of state of health in normal equilibrium.
Complications- it is the presence of a new disease.

10

Patient care outcome- it is the evaluation of the intervention that the health
care provider rendered.
Clinical performance- it is the intervention that the health care provider
performs.

11

12

Patient satisfaction evaluates the outcomes of the intervention and

care given to patient.
It is one of the parameters in assessing the quality care rendered
by the nurses to improve nursing care.

Related Foreign Literature

Patient simulation has been used to augment the traditional clinical
model, but its value is unclear. The aim of this study was to evaluate the
effects of a theory-driven pediatric simulation curriculum on nursing
students clinical performance.
The convenience sample included 116 junior nursing students
enrolled in a pediatric course. Student clinical performance was assessed
using Likert-style tool at 2-week intervals by the clinical faculty. Scores of
students who attended simulation, data were analyzed using repeated
measure analysis with the mixed model, and covariate effects were
considered.
Faculty rated students with patient simulation experience higher
than those who had not yet attended simulation.
Time in simulation enhanced clinical performance, as simulation
students achieved higher scores more quickly than those without
simulation and maintained high performance levels. Lippincott Williams &
Wilkins (2011).

13

Learning in the clinical practice is an important component of

nursing education considering that nursing is practice-based profession.
Electronic data research was done data engines included;
Academic research premier, CINAHL, ERIC, Health source/ nursing /
academic edition, Master file premier, Medline, Psych Articles and Psych
info, thesis and dissertations.

There is evidence from literature that students experiences in the

clinical practice can either positively or negatively impact on their learning.
The similarities and differences in the findings of the studies have shown
that clinical learning environments are unique which may be attributed to
differences in cultural, socio-economic and political factors in addition to
curricula and organization of clinical nursing education. The mastery of
clinical skills must be a key component of courses leading to registration
of nurses, as clinical performance of todays nursing students hold a lot for
the future of nursing profession.

A descriptive design was conducted among 400 and 500 level

students of the department of nursing science.

The study found that preceptors perceive the clinical performance

of Bachelor Nursing Science students as being below standards, and the
following factors identified as facilitators of clinical performance by both

14

students and perceptors: preceptorship and mentorship, good relationship

with nurses, quality supervision, simulation, peer teaching, and learning in
an effective clinical environment.

Clinical pathways are structured multidisciplinary care plans used

by health services to detail essential steps in the care of patients with a
specific clinical problem. Studies were grouped into those comparing
clinical pathways bas part of a multifaceted intervention with usual care.

Clinical

pathways

are

associated

with

reduced

in-hospital

complications and improved documentation without negatively impacting

on length of stay and hospital costs.

Maintaining cost-effective care while optimizing patient outcomes

becomes more challenging because the complexity of health care
increases. Numerous variables impact patient outcomes.

The article describe recent empirical literature regarding nurserelated variables that impact patient outcomes. Multiple variables are
described,

15

including

the

work

environment,

magnet

status,

nurse-physician

communication, job demands, staffing, level of education, years of nursing

experience, and certification. Staffing remains the most consistent positive
influence on patient outcome.

Related Local Studies

In preparing student nurses to be ready form the clinical setting is
very vital is huge challenge of the nursing academe. The strategy is
through is use of high fidelity virtual simulations. The virtual simulations
environment is both a strategy and on evaluation tool. This is the new
trend in nursing education to learn more, through experience. The virtual
laboratory provide nursing students with meaningful experience and
freedom to practice nursing interventions in an environment which is safe
and risk free.

This study aims to determine the effectiveness of the virtual

simulation experience in the preparation of the students in the clinical
area.

The Republic of the Philippines is known for producing quality

nurses for the medical field around the world. And this is the reason why
international students are to the Philippines to complete their nursing

16

degrees. International student nurse must have effective communication

skills for the Filipinos during their clinical learning.

Caring is core nursing value and desirable attribute in nursing

student. This study was conducted to investigate and determine student
nurses caring competencies as perceived by the patients.

Student nurses are found to be on the verge in the developing the

sense of the responsibility for the health and well-being of the patients.
Learning the safe supportive teaching environment of their school, they
are placed into clinical environment that are perceived as are unfamiliar
and complex and require dealing with diverse human relations.

Nursing students and new graduate nurses are recognized as lacking

critical thinking skills. Often nursing students are only assigned to a one or
two patients which limits their ability to develop and enhance clinical
judgement in preparation for the real nursing practice environment.
Student performance was evaluated with a two and four patient
assignment in the nursing simulation laboratory, situations that mirrored a
realistic patient care assignment.

17

Related Foreign Studies

Clinical work in nursing education is an important component of the
nursing curriculum aimed at actively engaging student nurses with the
necessary skills needed for the nursing profession. The attitude portrayed
by the students had influence on the way medical and nursing staffs to
them. It is recommended that studies should received in service training
before going to clinical area, so that they are aware of what is expected
them during clinical placement. Also, systems should be put in place to
ensure that nursing students do not use mobile phone in the clinical
environment.

The efficacy of a health promotion intervention for college students. The

diabetes is the leading cause of death in Mexico. Research has shown
that encouraging healthy behaviors especially among younger people, is
an effective way to reduce chronic illnesses such as diabetes and the
related morbidity and mortality from the disease.

An internship year is a clinical training for the baccalaureate nursing

graduate to gain practice in a real world setting under the guidance of
knowledgeable, experienced and successful supervisor. It helps the
graduate nurse to develop management competencies and skills like
clinical decision making collaboration, teaching, planning, communication,
critical thinking and caring to improve their clinical practice.

18

Improvement in intern students education, clinical experience and

other factors affect on clinical decision making will improve their clinical
performance. Clinical studies constitute 50% of the bachelor program in
nursing education in Norway, and the quality of studies may be decisive
for the students opportunities to learn and develop their professional
competences. The aim of the study was to explore what bachelor students
in nursing perceived to be important for having good learning experience
in clinical studies data was collected in a focus group interview with eight
nursing students. One main theme emerged from the analysis being in a
vulnerable and exposed position characterized by conflicting needs. Four
categories were found, aspects related to the student-supervisor
relationship. The findings revealed that the students learning experiences
and motivation were related to individual, relational and organizational
aspects in addition feeling welcome include and valued in the ward
improved their motivation, self-confidence and self- respect.

19

20

its benefactress moved toward its present quarters to called Gastambide

with Dr. W.N. Lemmon serving as its first direction and he brought to this
attention of an old friend, Miss Mary Jane Chiles of independence,
Missouri.
During that year marked the beginning of the nursing training
school Mary Chiles College which has been offering nursing and midwifery
course since 1930 under Dr. Florendo. During the World War II the school
of midwifery and school of nursing were closed at the time of Japanese
occupation.
In 1952 the school of midwifery was reopened and the school of
nursing was subsequently reopened in 1964. During this time, midwifery &
nursing department merge as one department of Mary Chiles College.
Today, Mary Chiles College is offering Nursing, Respiratory
Therapy, Caregiver and Midwifery courses.
Research Instruments
This
compromises

research
Nursing

utilized
Care,

research-modified
Complications,

Checklist
Recovery

which
and

Medication/Treatment to assess the clinical performance of the nursing

students. This instrument is researcher-made questionnaire prepared by
researcher, checked by Dr. M. Ramos, and was validated by research
experts. The questionnaire were accomplished by the students for selfevaluation. Students Nursing Care, Complications, Recovery and
Medication/Treatment were rated as yes, no and sometimes.

21

Data Gathering Procedure

Letter to dean of College of Nursing, secretary of College of
Nursing and the Chief Nurse of Mary Chiles General Hospital was sent to
seek permission to conduct the study. Upon arrival, questionnaire were
given to the patients.
The researcher explained the content, focus, objectives of the
study. Each respondent received questionnaire with attached letter of
consent to further understand the purpose of the study that is being
conducted. The consent were confirmed when the questionnaire are
completed and returned to the researchers.

22

23

3.Make
clinical
judgments
using
evidencebased
practice
outcomes to
ensure safe
and effective
nursing care.
4.Modifies
nursing care.

6.66

16

56.66

11

36.66

3.33

13.33

14

46.66

10

33.33

6.66

5.Has
capability to
involve
others
meaningfully
and
appropriately
in
collaborative
decision
making.

20

18

60

16.66

3.33

Interpretation
Table 1
Table 1 shows that forty percent or 12 out of 30 students were very
satisfactory in terms of prioritizing the patients needs. Eight out of 26.66 %
of students were outstanding in prioritizing patients needs at all times.

24

Forty six percent of student nurses are very satisfactory in

implementing plan of care. 6 student nurses or 20% were outstanding in
implementing plan of care to their patients.
In terms of making clinical judgement, 56.66 % of student nurses
were very satisfactory. Only one out of 30 students needs improvement in
making clinical judgement using evidence- based practice.
Fourteen out of 30 student nurses (46.66 %) were very satisfactory
in terms of modifying nursing care. Only 1 needs improvement.
Sixty percent of student nurse were very satisfactory in terms of
collaborative decision making. Only one needs improvement.
In terms of decision making, 56 % of student nurses were able to
make clinical judgement using evidence-based practice outcomes.
On the other hand, only one or 3.33 % of students needs improvement in
making clinical judgement.

25

Table 2- Summary of Values Showing Mean & Verbal Interpretation of

Clinical Performance of Student Nurses in Terms of Time
Management
Time
Managemen
t

Outstanding

Very
Satisfactory

Satisfactory

Needs
Improvement

Poor

1.Administer
Medications
on due time.

13

43.33

11

36.66

16.66

3.33

2.Performs
the
procedures
smoothly and
accurately.

30

12

40

23.33

6.66

3.Checks the
patient and
do the
rounds
earlier than
his/her duty
time.

11

36.66

10

33.33

23.33

6.66

4.Performs
morning care
on time.

13

43.33

30

23.33

3.33

5.Attends to
patients
needs
promptly.

11

36.66

11

36.66

20

6.66

Table 2

26

In terms of time management, 43.33 % or 13 out of 30 students are

outstanding in medication administration. Only one or 3.33 % of students
needs improvement in medication administration.
Forty percent of student nurses are very satisfactory in performing
the procedures smoothly and accurately. Two of student nurses or 6.66 %
needs improvement in performing procedures.
Eleven or 36.66% of student nurses are outstanding in clinical in
checking patients. Only two percent needs improvement in doing rounds.
Thirteen out of 30 student nurses (43.33%) are outstanding in
performing morning care on time. Only 1 needs improvement in timely
performance of morning care.
Thirty six percent of nursing student nurses are outstanding in
attending patients needs promptly. Same percentage of student nurses
are very satisfactory in attending patients needs promptly. Only two or
6.66 % needs improvement in attending patients needs promptly.
With the increasing emphasis on efficiency and effectiveness in
health care, how a nurse manages her time is an important consideration.
Whilst time management is recognized as an important component of
work performance and professional nursing practice. (Time management
strategies in nursing practice, Waterworth S)

27

Table 3- Summary of the values showing Mean & Verbal Interpretation

of Clinical Performance of Student Nurses in terms of Providing
Safety
PROVIDING
PATIENT
SAFETY

Outstanding

Very
Satisfactory

Satisfactory

Needs
Improvement

Poor

1. Administers
right dose of
appropriate
medications to
the right patient
at the right time
in the right
manner.
2. Always
checks and
identifies the
patient before
doing any
procedure.
3. Secures side
rails up at all
times.

13

43.33

30

23.33

3.33

14

46.66

30

20

3.33

12

40

11

36.66

20

3.33

4. Instructs the
relative to not
leave the
patient alone
especially when
unconscious.

23

76.66

20

3.33

28

5. Monitor
closely the IV
fluid to prevent
fluid overload.

13

43.33

26.66

26.66

3.33

Table 3
Table 3 shows that 43.33 percent or 13 out of 30 nursing students
were outstanding. However, 1 out of 30 student nurses needs
improvement.
Forty six percent or fourteen out of 30 student nurses were
outstanding in terms of always checking and identifies the patient before
doing any procedure. While, 1 out of 30 student nurses needs
improvement.
Forty percent or 12 out of 30 student nurses were outstanding in
terms of securing the side rails up at all times and only 1 out of 30 student
nurses it needs improvement.
When it comes to instructing the relative to not leave the patient
alone especially when unconscious, 76.66 or 23 out of 30 student nurses
were very satisfactory while only 1 out of 30 needs improvement.
In terms of monitoring closely the IV fluid to prevent fluid overload,
43.33 percent or 13 out of 30 student nurses were outstanding while 1 out
of 30 student nurses needs improvement.
Learning in the clinical practice is an important component of
nursing

education

profession.Time

in

considering
simulation

that

nursing

enhanced

clinical

is

practice-based

performance,

as

29

simulation students achieved higher scores more quickly than those

without simulation and maintained high performance levels. Lippincott
Williams & Wilkins (2011).
Therefore, most of students were able to provide patient safety
using practice based profession to ensure effective nursing care.

Table 4- Summary of Value Sharing Mean & Verbal Interpretation of

Clinical Performance of Student Nurses in terms of Ethical
Reasoning
ETHICAL
REASONING

Outstanding

F
1. Plans patient
care with
information
from other
health care
team members
for optimal
patient care
within an ethical
legal
framework.
2. Participates
in complex
nursing
procedures for
assigned
patients.
3. Assists
others to
provide patient

Very
Satisfactory

Satisfactory

Needs
Improvement
F

Poor

%
30

F
11

%
36.66

F
13

%
43.33

%
0

F
0

16.66

13

43.33

11

36.33

2.33

08

26.66

12

40

30

3.33

30

care to groups.

4. Collaborates
with
interdisciplinary
team to deliver
patient care
while
maintaining
cost of effective
use of
resources and
safe
environment.
5. Respects
culture, races
and beliefs of
the patients.

23.33

13

43.33

26.66

6.66

14

46.66

26.66

26.66

Table 4
Table 4 shows that 43.33 or 11 out 30 student nurses were
satisfactory on planning patient care with information from other health
care team members for optimal patient care within an ethical legal
framework. However, only 6 out of 30 student nurses were outstanding on
this matter.
Forty three percent or 13 out 30 student nurses were very
satisfactory on participating in complex nursing procedures for assigned
patients. While, only 1 out of 30 student nurses needs improvement.

31

In terms of assisting others to provide patient care to groups, 40

percent or 12 out of 30 student nurses were very satisfactory and 1 out of
30 needs improvement.
Forty three percent or 13 out of 30 student nurses were very
satisfactory in terms of collaborating with interdisciplinary team to deliver
patient care while maintaining cost of effective use of resources and safe
environment. However, only 2 out of 30 student nurses needs
improvement on this matter.
When it comes to respecting cultures, races and beliefs of the
patients 46.66 percent or 14 out of 30 student nurses were outstanding
and only 8 out of 30 needs improvement.
Evidence based practice is the conscientious use of the best
available research in combination with clinical experience, judgment and
patients preferences & values to give the best decision that lead to quality
outcomes (Meryl &Fineout-Overhott, 2008)
Therefore, most of nurses where able to perform ethical reasoning
using evidence based practice to provide effective nursing care.

32

NURSING CARE
1. Each
nursing
procedure
was well
explained to
me before it
was done.
2. I feel
comfortable
to the
environmen
t provided
to me.
3. I am
satisfied of
the privacy
provided to
me.
4. I am well
informed
about my
state of
health
conditions
and
treatments.

YES
f
25

%
%
83.33

NO
f
2

%
%
6.66

SOMETIMES
f
3
10

28

93.33

3.33

3.33

29

96.66

3.33

26

86.66

13.33

%
%

33

5. All my
22
73.33
4
13.33
4
needs was
timely
attended by
the nurses.
Total:
130
26%
7
1.4%
13
Table 5 - Summary of the values showing Mean & Verbal
Interpretation of Patient Care Outcome in Mary Chiles General

13.33

2.6%

Interpretation:
Table 5 shows that 83.33% or 25 out of 30 respondents said that
student nurses explained each nursing procedure before performing it but
6.66% of the respondents said that student nurses did not. 93.33% of the
respondents verbalized that they feel comfortable to the environment but
33.33% of the respondents said No. 96.66% of the respondents said that
they were satisfied to the privacy given to them and 3.33% said
sometimes only. Next, 86.66% of the total respondents said that student
nurses informed them well about their state of health conditions and
treatments however, 13.33% said sometimes only. Lastly, 73.33% of the
respondents reported that all their needs was timely attended by the
student nurses and 13.33% said it took sometimes only. Overall, the table
5 shows that most of the respondents were satisfied to the performance of
student nurses in terms of Nursing Care.

Table 6Summary of the values showing Mean & Verbal Interpretation

of Patient Care Outcome in Mary Chiles General Hospital in terms of
Medication/ Treatment:
YES

NO

SOMETIME

34

MEDICATION/
TREATMENT
1. Accurate
identificatio
n were done
before
medication
and
treatments
are given.
2. Name of
medication
and its
indication
were
explained
before it
was given
to me on
due time.
3. I was
checked if I
had signs
and
symptoms
of adverse
effects of
medication
given to me.
4. I was taught
and
assisted
how to use
nebulizer.
5. I was given

S
f

25

83.33

3.33

13.33

25

83.33

6.66

10

25

83.33

6.66

10

17

56.66

20

23.33

23

76.66

20

3.33

35

oxygen
when I
needed it.
Total:

109

21.8%

17

3.4%

18

3.6%

Interpretation:
Table 6 shows all about providing and giving correct medications
and treatments. In terms of identifying accurate identification, 83.33% of
25 out of 30 respondents said Yes and the rest 3.33% of respondents said
No. The 83.33% of the respondents agreed and said Yes in terms of
explaining the name of medication and its indication before giving it to
them but 3.33% of the respondents said No. In terms of if the patient was
checked if she/he had signs and symptoms of adverse effects of the
medications given, 83.33% said Yes and 3.33% said No. Almost half of the
respondents 56.665 said that they were taught and assisted how to use
nebulizer but 20% of the total respondents said No. Lastly, in terms of
giving oxygen when the patients needed it, 21.8% of the 17 out of 30
respondents said Yes and 3.4% of the respondents said No. In overall,
table 6 shows that student nurses was competent in terms of giving and
providing medications and treatments to the patient.

Table 7- Summary of the values showing Mean & Verbal Interpretation

of Patient Care Outcome in Mary Chiles General Hospital in terms of
Recovery:
YES

NO

SOMETIME
S

36

RECOVERY
1. I am
instructed to
eat
appropriatel
y food for
my health
condition.
2. I am advised
to walk as
my exercise
at least thirty
minutes
every
morning to
avoid
constipation.
3. I am
instructed to
change
position at
least every 2
hours to
prevent bed
sores.
4. I am advised
to do the
breathing
exercise to
lessen the
pain.
5. I am well
instructed
with my take
home
medications

f
22

%
73.33

f
2

%
6.66

f
6

%
20

16

53.33

26.66

20

18

60

20

20

19

63.33

16.66

20

24

80

10

10

37

and followup check up.

Total:

99

19.8
%

24

4.8%

27

5.4%

Interpretation:
In the table above 73.33% of the patient answer yes that they are
instructed to eat appropriate food for their health condition and 20% of the
patients answers no. 53.33% of the patient are advised to walk as their
exercise at least thirty minutes every morning to avoid constipation,
26.66% of patient are not advise to walk.60% of the patient answers yes
that they are instructed to change position at least every 2 hours to
prevent bedsores and 20% answers no and sometimes. In advising to do
deep breathing exercise to lessen pain, 63.33% answers yes while 20%
answers sometimes. And 80% of the patient are instructed well in their
take home medications and follow-up check-up and 10% of the patient
answers no and sometimes.

Table 8 - Summary of the values showing Mean & Verbal

Interpretation of Patient Care Outcome in Mary Chiles General
Hospital in terms of Complications:

COMPLICATION
1. I developed
wound
infection five

YES
f
2

%
%
6.66

NO
f
28

%
%
93.33

SOMETIMES
f
0

%
%
0

38

2.

3.

4.

5.

days after
surgical
operation.
I developed
Urinary Tract
Infection after
catheterization
.
I had allergic
reaction during
blood
transfusion..
I developed
pneumonia
after surgery.
I developed
fluid overload
after IVF
infusion.

Total:

30

100

30

100

30

100

3.33

27

90

6.66

0.5%

145

29%

0.4%

Interpretation:
The table above shows that 93.33% of the patient did not
developed wound infection after the surgical operation and 6.66% of the
patient develop wound infection. 100% of the patient did not developed
Urinary Tract Infection after catheterization, did not have allergic reaction
during blood transfusion and they did not developed pneumonia after
surgery it shows that the student nurses are effective in terms of
complication. And lastly 90% of the patient did not have fluid over load
after IVF infusion while 6.66% have developed fluid over load.

39

40

Conclusions
A. The result for Clinical Performance of student nurses are

as follows:
In terms of decision making student nurses prioritizes the

patient needs all the time.

The student nurses make clinical judgements using
evidence-based practice outcomes to ensure safe and

effective nursing care.

Students have capability to involve others meaningfully and

appropriately in collaborative decision making.

In terms of time management students
medications on due time.

administer

41

On checking the patient and do the rounds earlier on duty

time students were able to do it.

In terms of providing patient safety students administers right
dose of appropriate medications to the right patient at the

right time in the right manner.

Students always checks and identifies the patient before

doing any procedures.

The students are able to secure side rails up at all times.
In monitoring closely the IV fluid to prevent fluid overload

student nurses are competent enough to do it.

Student nurses tends to instruct relatives to not leave the

patient alone especially when unconscious.

In terms in ethical reasoning, student nurses participates in

complex nursing procedures to assign patients.

Student nurses are able to assist others to provide patient

care to groups.
Respects culture, races and beliefs of the patients makes
student

nurses

knowledgeable

enough

to

follow

it

appropriately.

B. The results for the Patient Care Outcome:

In terms of nursing care student nurses explained well each

nursing procedure.
The patient respondents feel comfortable to the environment

provided to them.
The patient respondents also satisfied to the privacy
provided.

42

Student nurses informed well the patient respondents about

their state of health conditions and treatments.

All needs of the patient respondents was timely attended by

the student nurses.

In terms of medication and treatment student nurses done
accurate identification before medication and treatments are

given.
Name of medication and its indication were explained before

it was given on due time by student nurses

Student nurses checked if they had signs and symptoms of

adverse effect of medication given to patients

The patient respondents taught and assisted how to use

nebulizer.
Oxygen was given by the student nurses when needed.
In terms of recovery student nurses instructed patient
respondents to eat appropriately food for their health

condition.
Changing position at least 2 hours to prevent bed sores were

advised by the student nurses

Deep breathing exercise to lessen pain was instructed by the

student nurses.
Student nurses are effective and efficient in caring patients in
preventing complications.

43

Recommendation
Based on the findings and conclusions formulated in this research study,
the following recommendations are hereby proposed:
Clinical Performance:
1. We encourage the students to prioritize their studies first to have a
better outcome in both academic and clinical performance.
2. The students must have a good academic performance both in
lecture and RLE.
3. We encourage the students to always use their clinical eye in the
area to have a better assessment when handling patients.
4. We suggest that the students should adhere to the teachings,
advices, and modifications, given by their clinical instructors to
apply the procedures in a right way.
Patient Care Outcome:
1. We recommend that even students feel comfortable during
procedure; they should have a further review of the procedure to be
demonstrated in the area.

44

2. The students should not hesitate to ask questions in the area when
handling patients to ensure safety.
3. The students must be sensitive and knowledgeable about the
culture of the patient.
4. We encourage the students to know how to prioritize nursing care
based on the patients needs.

APPENDICES

45

APPENDIX A

46

Questionnaires for Clinical Instructors

Clinical Performance of Student Nurses

Direction: Place check () the corresponding boxes if the following are

per or not.

5 - Outstanding The student perform the skill in a very consistent and

independent manner with very minimal guidance and supervision.

4 Very Satisfactory The student perform the skill in a very consistent

and independent manner but requires moderate guidance and
supervision.

3 Satisfactory The student performs the skill in a consistent and

independent manner with frequent guidance and supervision

2 Needs Improvement The student perform the skill with errors even
with frequent guidance and supervision

47

1 Poor The student does not perform the skill even under close
supervision and guidance.

Questionnaires for Clinical Instructors

Decision
Making

Outstanding Very
Satisfactory
5

1. Prioritize the
patient needs
all the time.
2. Implements
the plan of
care.
3. Makes
clinical
judgements
using
evidencebased practice
outcomes to
ensure safe
and effective
nursing care.
4. Modifies
nursing care
based on
evaluation of

Satisfactory

Needs
Poor
Improvement
2

48

interventions
and outcomes.
5. Has
capability to
involve others
meaningfully
and
appropriately in
collaborative
decision
making.
Clinical Performance of Student Nurse
Questionnaires for Clinical Instructors
Time
Management

Outstandin
g

Very
Satisfactor
y

Satisfactor
y

Needs
Improvemen
t

Poor

1
5
1. Administer
medications on
due time.
2. Performs the
procedure
smoothly and
accurately.
3. Checks the
patient and do
the rounds earlier
than his/her duty
time.
4. Performs
morning care on

49

time.
5. Attends to
patient needs
promptly.
Clinical Performance of Student Nurses

Questionnaires for Clinical Instructors

Clinical Performance of Student Nurses
Providing Patient
Safety

Outstandin
g

Very
Satisfactor
Satisfactory y

Needs
Improvemen
t

4
5
1. Administers right
dose of appropriate
medications to the
right patient at the
right time in the
right manner.
2. Always checks
and identifies the
patient before
doing any
procedure.
3. Secures side
rails up at all times.

Poor

1
3

50

4. Instructs
relatives to not
leave the patient
alone especially
when unconscious.
5. Monitor closely
the IV fluid to
prevent fluid
overload.

Questionnaires for Clinical Instructors

Clinical Performance of Student Nurses
Ethical Reasoning Outstanding

Very
Satisfactory

Satisfactor
y

Poor

1
3

1. Plans patient
care with
information from
other health care
team members
for optional
patient care within
an ethical legal
framework.
2. Participate in
complex nursing

Needs
Improvemen
t
2

51

procedures for
assigned patients.
3. Assists others
to provide patient
care to groups.
4. Collaborates
with
interdisciplinary
team to deliver
patient care while
maintaining cost
effective use of
resources and
safe environment.
5. Respects
culture, races and
beliefs of the
patients.
Questionnaire for Patient Reported Outcome
Direction: Place check () the corresponding boxes if the following are
attended or not.
(Panuto: Lagyan ng tsek () ang mga sumusunod na kahon kung
nadadaluhan o hindi.)
Nursing Care
1. Each nursing procedure
was well explained to me
before it was done.
( Lahat ng proseso sa
paggamot ay naipaliwanag ng
mabuti bago ito gawin sa
akin.)
2. I feel comfortable to the

Yes
(Oo)

No
(Hindi)

Sometimes
(Minsan)

52

environment provided to me.

( Komprtable alo sa
kapaligiran ko.)
3. I am satisfied of the privacy
provided to me.
( Nakontento ako sa binigay
na privacy sa aking
kalagayan.)
4. I am well informed about
my state of health condition
and treatments.
( Pinaliwanag ng mabuti sa
akin ang kalagayan ko at ang
panlunas na gagawin o
ibbigay sa akin.)
5. All my needs was timely
attended by the nurses.
( Lahat ng aking kailangan ay
natutugunan ng nars sa lahat
ng oras.)
Questionnaire for Patient Reported Outcome
Direction: Place check () the corresponding boxes if the following are
attended or not.
(Panuto: Lagyan ng tsek () ang mga sumusunod na kahon kung
nadadaluhan o hindi.)
Medication/Treatment

1. Accurate identification were done before

medications and treatment are given.
( Tamang pagkakakilanlan bago ibigay ang mga
gamut.)

Yes
(Oo)

No
(Hindi)

Sometime
s
(Minsan)

53

2. Name of medication and its indication were

explained before it was given to me on due
time.
( Pinaliwanag ng mabuti ang tamang pangalan
ng gamut at ang mga indikasyon nito.)
3. I was checked if I had signs and symptoms
of adverse effects of medication given to me.
( Akoy sinuring mabuti sa mga posibleng
epekto ng gamut.)
4. I was taught and assisted how to use
nebulizer.
( Tinuruan at tinulungan ako kung paano
gamitin ang nebulizer.)
5. I was given oxygen when I needed it.
( Binigyan ako ng oxygen support kung
kinakailangan ko.)

Questionnaire for Patient Reported Outcome

Direction: Place check () the corresponding boxes if the following are
attended or not.
Recovery
1. I am instructed to eat appropriate food
for my health condition.
( Ako ay tinuturuan ng tamang pagkain
para sa aking kalusugan at kalagayan.)
2. I am advised to walk as my exercise at

Yes
(Oo)

No
(Hindi)

Sometimes
(Minsan)

54

least thirty minutes every morning to avoid

constipation.
(Pinayuhan ako na maglakad bilang
ehersisyo sa loob ng tatlongpung minuto
tuwing umaga para maiwasan ang
paghirap sa dumi.)
3. I am instructed to change position at
least 2 hours to prevent bedsores.
( Ako ay pinayuhan na magpalit ng
posisyon kada 2 oras para maiwasan ang
panunugat ng balat.)
4. I am advised to do the breathing
exercise to lessen the pain.
( Ako ay pinayuhan na gawin ang ang
tamang paghinga ng malalim para
mabawasan ang nararamdamang sakit.)
5. I am well instructed with my take home
medications and follow-up check up.
( Pinaliwanag ng mabuti sa akin ang mga
gamut na iinumin ko sa bahay at ang
susunod na petsa pagkonsulto.
(Panuto: Lagyan ng tsek () ang mga sumusunod na kahon kung
nadadaluhan o hindi.)

Questionnaire for Patient Reported Outcome

Direction: Place check () the corresponding boxes if the following are
attended or not.
Complications
1. I developed wound infection five days
after surgical operation.
( Nagkaroon ako ng impeksyon sa
sugat limang araw pagkatapos ng
operayon.)

Yes
(Oo)

No
(Hindi)

Sometimes
(Minsan)

55

2. I developed Urinary Tract Infection

after catherization.
( Nagkaroon ako ng impeksyon sa pagihi pagkatapos lagyan ng catheter.)
3. I had allergic reaction during blood
transfusion.
( Nagkaroon ako ng allergy sa katawan
pagkatapos Salinan ng dugo.)
4.I developed pneumonia after surgery.
( Nagkaroon ako ng pumonya
pagkatapos ng operasyon.)
5. I developed fluid over load after IVF
infusion.
( Nagkaroon ako ng pamamanas sanhi
ng paglalagay sa akin ng swero.)
(Panuto: Lagyan ng tsek () ang mga sumusunod na kahon kung
nadadaluhan o hindi.)

56

APPENDIX B

March 11, 2016

Dear Mrs. Rosie Cabaero,

Warmest Greetings!
The following undersigned are the third year nursing students of Mary
Chiles College presently conducting a research study entitled Clinical
Performance Of Student Nurses and Patient Care Outcome in Mary Chiles

57

General Hospital". In Partial fulfillment of the requirements in Nursing

Research 1.

In this connection, we would like to ask permission from your good office
to conduct our study to the 30 selected patients at the third-left of Mary Chiles
General Hospital. We will assure that we will observe proper decorum and
confidentiality.
We are hoping for your kind consideration.
Thank you and God bless.
Respectfully yours,
BSN- III
Borre, Jessa Anne R.
Gervacio, Jonah Micah N.
Mangalus, Maribel T.
Pastrana, Izza Mae F.

Noted By:

Dr. Marites J. Ramos

Mrs. Rosie Cabaero

Research Instructor

Chief Nurse

Request for Validation of Research Instrument

January 21,2016
Rosie L. Cabaero
Chief Nurse

58

Mary Chiles General Hospital

Madam,
The undersigned are BSN III students of Mary Chiles College currently
conducting research study entitled Clinical Performance Of Student Nurses
and Patient Care Outcome in Mary Chiles General Hospital.
We would like to request for validation of our research instruments herein
attached.
We highly appreciate your kind approval for us to pursue with our research
study.
Respectfully yours,
BSN III
Borre, Jessa Anne R.
Gervacio, Jonah Micah
Mangalus, Maribel T.
Pastrana, Izza Mae F.

Noted:

Approved by:

Dr. Marites J. Ramos

Mrs. Rosie L. Cabaero

Research Instructor

Chief Nurse

Request for Validation of Research Instrument

January 11, 2016

Mrs. Emily R. Aquino
Dean of College Of Nursing

59

Mary Chiles College

Dear Dean Aquino,
The undersigned are BSN III students of Mary Chiles College currently
conducting research study entitled Clinical Performance Of Student Nurses
and Patient Care Outcome in Mary Chiles General Hospital.
We would like to request for validation of our research instruments herein
attached.
We highly appreciate your kind approval for us to pursue with our research
study.
Respectfully yours,
BSN III
Borre, Jessa Anne R.
Gervacio, Jonah Micah
Mangalus, Maribel T.
Pastrana, Izza Mae F.
Noted:

Approved by:

Dr. Marites J. Ramos

Mrs. Emily R. Aquino

Research Instructor

Dean of College Of Nursing

Request for Validation of Research Instrument

January 14, 2016

Mrs. Merly M. Clemente
Secretary of College Of Nursing
Mary Chiles College

60

Dear Madam,
The undersigned are BSN III students of Mary Chiles College currently
conducting research study entitled Clinical Performance Of Student Nurses

and Patient Care Outcome in Mary Chiles General Hospital .

We would like to request for validation of our research instruments herein
attached.
We highly appreciate your kind approval for us to pursue with our research study.
Respectfully yours,
BSN III
Borre, Jessa Anne R.
Gervacio, Jonah Micah
Mangalus, Maribel T.
Pastrana, Izza Mae F.
Noted:

Approved by:

Dr. Marites J. Ramos

Mrs. Merly M. Clemente

Research Instructor

College Of Nursing Secretary

REFERENCES
BOOKS
1. Octaviano E. etal (2008) Theoretical Foundations of Nursing: The
Philippine Perspective
2. Udan J. (2009) Fundamentals of Nursing Third Edition

61

JOURNALS
Foreign
1. Li, S., (2007). The Role of Simulation in Nursing Education: A
Regulatory Perspective. Date retrieved: July 10, 2012.

WEBSITE

http://www.nursecredentialing.org/Accreditation/ResourcesServices

/Evaluating-the-Impact-CNE-Outcomes.pdf
http://www.academicjournals
.org/app/webroot/article/article1379488330_Awuah-Peasah%20et

%20al.pdf
http://article.sapub.org/10.5923.j.nursing.20150502.05.html
http://www.rrh.org.au
http://dx.doi.org/10.1155/2013/628679
http://ojni.org/issues/?p=2037
http://article.sapub.org/10.5923.j.nursing.20150502.05.html
http://www.sciedu.ca/journal/index.php/jnep/aricle/viewFile/716/746
http://hrmars.com/hrmars_papers/Preparedness_of_Nursing_Intern
ational_Students_for_their_Clinical_Learning_in_the_Philippines

.pdf
Deshpande et al (2011). Patient reported Outcomes-A new Era in

Clinical Research
http://www.scribd.com/doc/26046673/Patient-reported-Outcomes-

A-New-Era-in-Clinical-Research
Butcon (2011). Learning Through Caring
http://infonomics-society.org/IJCDSE/Learning%Through%Caring
%20Clinical%20settings.pdf

62

http://journals.lww.com/simulationinhealthcare/Abstract/2011/10000

/The_Effect_of_Simulation_on_Clinical_Performance_3.aspx
http:/www.krepublishers.com/02-Journals/S-EM/EM-07-0-000-13Web/S-EM-07-3-000-13-Abst-PDF/S-EM-07-3-181-13-293-UsehU/S-EM-07-3-181-13-293-Useh-U-Tt.pdf

63

CURRICULUM VITAE

CURRICULUM VITAE

Name: Jessa Anne R. Borre

Birthday: May 15, 1994

Nickname: Jessa, Jess

Birthplace: Daet,

Age: 22 years old

Camarines Norte
Status: Single

Educational Attainment:
Primary: Saint Francis Of Assissi College

2001-2006

64

Las Pinas City

Secondary: Saint John The Apostle Academy

2007-2010

Labo, Camarines Norte

Tertiary: Manila Tytana College
(Manila Doctors College)

2010-2012

Macapagal Blvd. Pasay, City

Mary Chiles College

2014-present

Sampaloc, Manila

CURRICULUM VITAE
Name: Joy Mariel Isadora U. Burgos

Birthday: April 03, 1992

Nickname: Joy

Birthplace: Sampaloc,

Age: 24 years old

Manila
Status: Single

Educational Attainment:
Primary: Saint Rita College, Manila
Plaza del Carmen, Sampaloc, Manila

1998-2004

65

Secondary: Saint Rita College, Manila

2004-2008

Plaza del Carmen, Sampaloc, Manila

Tertiary: Far Eastern University
Nicanor Reyes St. Sampaloc, Manila
Mary Chiles College

2008-2010
2010-present

Sampaloc, Manila

CURRICULUM VITAE
Name: Maribel T. Mangalus

Birthday: February 18, 1997

Nickname: Bel

Birthplace: San Fernando,

Age: 19 years old

Pampanga
Status: Single

Educational Attainment:
Primary: Montessori De Sagrada Familia
Tangos, Baliwag, Bulacan

2008-2009

66

Secondary: Montessori De Sagrada Familia

2012-2013

Tangos, Baliwag, Bulacan

Tertiary: Mary Chiles College
Sampaloc, Manila

2013-present

67

CURRICULUM VITAE
Name: Izza Mae Pastrana

Birthday: September 14,1996

Nickname: Samae

Birthplace: Banton,Romblon

Age: 20

Status: Single

Educational Attainment:
Primary: Banton Central Elementary School

2008-2009

Banton,Romblon
Secondary: Banton National High School

2012-2013

Banton,Romblon
Tertiary: Mary Chiles College
Sampaloc, Manila

2013-present