QUALITY ASSURANCE IN THE BASIC NURSE EDUCATION PROGRAMME IN PAKISTAN A NEED FOR DEVELOPMENT OF AN APPROPRIATE QUALITY ASSURANCE FRAMEWORK IN THE BASIC NURSE EDUCATION PROGRAMME (BNEP) CONTENTS OF THE PRESENTATION Background About the Study Quality Assurance: WHAT Quality Assurance: WHY Current Quality Assurance Practices Some findings of the study The vision re Quality Assurance A Continuous Quality Improvement Framework 1
BACKGROUND What is BNEP Who joins the BNEP Where it is offered The Pakistan Nursing Council Department of Health ABOUT THE RESEARCH STUDY Qualitative case study Triangulation approach Study Participants (n=71) Purposive Sample Semi-structured & open-ended interview guide Thematic and Descriptive analysis 2
QUALITY ASSURANCE: WHAT Fit to practice Fit for Purpose Fit for Award QUALITY ASSURANCE: WHY Professional Incentives Economic Incentives Social and Political Incentives 3
Quality Assurance: Current Practices in the BNEP Inspections: Initial Inspection Regular Inspection Audits: Annual Financial Audit Examinations: Preliminary Intermediate Final FINDINGS Absence of a `quality focused approach: Examinations- Quantity vs. Quality Inspections- Irregular, Lack of proper planning,un-prepared inspectors and their compromises Financial Audit-Saving money vs. Meeting educational needs 4
Examinations The current system is Increasing the quantity of nurses but not improving the quality. The examination preparation is based on answers to questions asked in examinations during the last five to ten years. Inspections Whom should we talk to about our concerns? Who has the responsibility for listening to our problems? we don t know how we can seek access to the concern (authority) We do not feel comfortable with the physical infrastructure. Few classrooms existed and classes are being held in dining halls and common rooms. There is no proper system for ventilation, lighting and temperature control. Impact on learning experience We have only two teachers to teach six classes. One can easily imagine how much time they can give to each class. They have no time to meet student needs individually. what we studied in books is quite different from what we do practically. This does not only affect the quality but also confuse [s] us totally [as] to understand what is right and what is wrong. System prepares students to obtain a 50% pass mark but does not provide them with appropriate and sufficient knowledge. 5
QUALITY ASSURANCE: FUTURE VISION A shared framework for QA that ensures: Continuous Quality Improvement in the BNEP as the standard practice Achievement of professional competencies of nurses to meet the various health/nursing needs of the clients in the different settings Reflection of meeting the national goals stated in the Health Policy A CONTINUOUS QUALITY IMPROVEMENT FRAMEWORK (adopted from Oakland, 2003, TQM model reflecting Deming s principles) ACT Corrective action Feedback Follow up PLAN Involvement of all Leadership, Steering, Implementation & Monitoring groups CHECK Communication Implementation DO Development of appropriate QA system 6
REFRENCES Oakland,J.S. (2003) Total Quality Management. Oxford: Butterworth-Heinemann and Elsevier Pakistan Nursing Council (2001) Rules and Regulations for Nursing Educational Institutions. Islamabad: PNC Quinn,F.M. (2000) The Principles and Practice of Nurses Education.Cheltenham:Stanley Thornes PRESENTER Mrs ANWAR AZIZ PhD, MSc, MA (RN, RM, Registered Nurse Teacher & Nurse Manager, Pg.Dip. in Research with 29 years work experience in Nursing Services and Education) Principal School of Nursing Mirpur Azad State of Jammu & Kashmir 7