UNIVERSITY OF NAIROBISCHOOL OF NURSING SCIENCE

RESEARCH PROPOSAL

A RESEARCH PROPOSAL PRESENTED IN PARTFULFILMENT FOR THE AWARD OF THE DEGREE OF

SCIENCE IN NURSING (Bsc N) OF THE UNIVERSITY OFNAIROBI.

TITLE:

EVALUATING THE ROLE OF GRADUATE NURSES INTHE HEALTH CARE SYSTEM IN KENYA.

AUTHOR: WAMITIMMARTIN

REG. NUMBER H32/7451102

SUPERVISOR: MRS K. BITOKLECTURERSCHOOL OF NURSING SCIENCES (SONS)UNIVERSITY OF NAIROBI

DATE: AUGUST, 2007.

TABLE OF CONTENTS

TABLE OF CONTENTS ii

I>~<:L~TI()~: "ABII~~j\1rI()~ ......................•....................•..................•.........•........ vi

OPERATIONAL DEFINATIONS vii

1C~<:1J1rI~~1J~1{ viii

ACKN'OWLEGDEMENT ix

CHAPTER ONE: INTRODUCTION

1.1 I3i\~}C(JFt()~I> ~lF()~lrI()~ 1

1.2 sri\lrEME~lr ()IFrns PFt()I3LEM .3

1.3 FtESEAA~H QUESlrI()~S 6

1.4 ~ ()I3JE~lrIVE 6

1.5 SPE~IlFIC ()II3JECnVES 7

1.6 Hyp()lrHESIS 7

1.7 JUSlrIlFICi\ non ()IFras SlrUI>Y 8

1.8 EXPE~lrEI> I3E~lFIlrS 9

CHAPTER TWO: LITERATURE ~~EW

2.1 ~lrFt()I>UClrI()~ 10

2.2 I>EVELOPME~lr ()IF~FtS~O EI>U~i\ rton 11

2.3 OFtJ\I>Ui\lrE EI>U~i\n()~ 12

2.4 Ft()LE ()IFOFtJ\I>Ui\ rs ~UFtSES 13

11

CHAPTER THREE: METHODOLOGY3.1 STUDY DESIGN 28

3.2 STUDY AREA 28

3.3 STUDY POPULATION 29

3.4 INCLUSION CRITERIA 29

3.5 EXCLUSION CRITERIA 29

3.6 SAMPLINGMETHOD 29

3.7 STUDY INSTRUMENT .30

3.8 PRE TESTING THE STUDY INSTRUMENT .30

3.9 RECRUITMENT AND TRAINING THE RESEARCH ASSISTANTS 31

3.10 DATA COLLECTION CLEANING AND ENTRY 31

3.11 DATA ANALYSIS AND PRESENTATION .31

3.12 ETHICAL CONSIDERATIONS .31

3.13 STUDY LIMITATION .32

CHAPTER FOUR:

~.O1rI~~If~~~ :J3

5.0 BUDGET ESTIMATION 34

111

6.0 ~If~~~<:~~ 35

7.0 APPENDICES 39

AP~E~])IJ{ I 39

QUESTIONNAIRE 39

J\J»P~~J)IJ{II 43

LETTER TO ETHICAL AND RESEARCH COMMITTEE .43

~J»~~])I}(III 44

PARTICIPANTS CONSENT FORM .44

IV

DECLARATION:

I Martin Wamiti hereby declare that this research proposal is my

original work and has not been presented for any degree or

diploma award in any university or college.

Signature _ Date ---!.

v

ABBREVIATIONS

BSCN Bachelor of Science in Nursing

AD Associate degree

HIV Human immunodeficiency virus

AIDS Acquired immunodeficiency virus

MSCN Masters of science in Nursing

UON University of Nairobi

SONS School of Nursing Sciences

RN Registered Nurses

USA United States of America

MDG Millennium Development Goals

MTC Medical Training Centre

HIV Human Immunodeficiency Virus

AIDS Acquired Immunodeficiency Syndrome

TB Tuberculosis

vi

OPERA TIONAL DEFINATIONS

Graduate A person who holds a degree as a result ofSuccessfully completing a course at a universityOr a college.

Secular Not concerned with spiritual or religious affairs e.g.Education, art, music.

Baccalaureate ... The last secondary school examination in FranceAnd in many international schools.

Associate degree ... An equivalent of a diploma.

Profession A paid occupation, especially one that requiresAdvanced education and training.

Vll

EXECUTIVE SUMMARY

This is a descriptive cross-sectional qualitative study to establish

the role of graduate nurses in the health care system in Kenya. A

questionnaire administered by research assistants shall be used to

collect data after authority has been sort to conduct the research

The results shall be stored and analyzed using statistical package

for social sciences. The results shall be presented using

conventional statistical methods. Significant tests like chi square

shall be done for test of hypothesis.

The research will take a total of 24 weeks at cost of ksh 344,432

. While conducting the research ethical considerations will be

respected and enforced. The results shall be used to promote

evidence based practice for peer based education and to develop a

document for presentation for the award of Bsc N degree.

Vlll

ACKNOWLEDGEMENT

I wish to express my sincere appreciation to Mrs. K L Bitok, Mr.

Wachira and Miss Mburugu who provided assistance and

encouragement during the writing of this research proposal.

I also acknowledge Mr. and Mrs. Wamiti and the rest of my family

for their continued support and encouragement.

ix

CHAPTER ONE: INTRODUCTION

1.1 BACKGROUND INFORMATION

There has been a steady progress in the development of nursing

education in Kenya, from certificate nurse to the master's

programme (MSCN) started in the University of Nairobi (UON) in

2004.

The degree programme was started in Baraton University in 1990

and introduced thereafter in the University of Nairobi in 1991.

Currently it's being offered in other Kenyan universities.

The nursing education advances are aimed at meeting demands for

quality health care. It is generally understood that education

programme must be deemed to be relevant for the society within

which it's being provided and which is going to benefit from the

product of the educational system.

The relevance can be viewed in relationship to the kind of job and

salaries got.

1

Graduate education prepares one to start a higher level in the

health hierarchy and skills in situational analysis and decision

making. These higher level skills and deeper knowledge of

principles underlying disease causation, treatment and prevention

enable the graduate to function more independently than the non

graduates.

2

1.2 PROBLEM STATEMENT

The first nursing training for nurses was initiated by secular groups

within catholic denomination- In Montreal between 1500 -

1800·(11)

More organized nursing education was later started by Florence

Nightingale in 1860 which was apprentice hospital based training.

Nightingale advocated for the development of a curriculum,

careful selection of nurses and instilling of discipline and

character. She had a vision for the development of a profession, as

she advocated for nurses spending time caring for patients,

continuing learning through out life, being intelligent and using

their intelligence to improve conditions for patients.

Baccalaureate education was started in 1919 in Minnesota

University which was a five year programme comprising of 3 years

nursing programme and 2 years liberal arts programme (12).

AD was the first nursing education program to be developed

through research in 1952 in Columbia, United States of America

(USA). Data collected indicated that the AD program

characteristics made sense and that this form of education would

attract students and that its graduates would be employable (11, 12).

3

Changes in the nursing profession are occurring at a phenomenally

rapid pace. One major change in nursing education is represented

by the development of degree education in nursing, a movement

that began in 1952. By 1975, there were 618 of these programs,

almost half of the existing registered nurses (RN) programs in the

United States of America (USA) as well as Guam, Puerto Rico, the

Virgin Islands, Canada and other countries (14).

From 1948 to 1952 Canada established an experiment with nursing

education to demonstrate whether or not a professional nurse could

be prepared adequately (13, 14).

Nursing education in Kenya followed the same global trend. In

1910 missionaries at kikuyu mission hospital started a school for

nurse orderlies. In 1920 medical training centre (MTC) was started

where nursing assistants were trained. In 1930 eight mission

institutions were already conducting nurse training (5, 6).

The nursing curriculum has a role in identifying professional roles

"andfunctions of its product. On the contrary every year, the

Kenyan universities graduate over a hundred nurses who come out

of college with no clear picture of their professional roles. Hence

what is the job description of a graduate nurse?

4

All in all these are professionals equipped to work with both top

level professionals and community based groups in the eradication

of disease, poverty and hunger and mobilization of the

communities. They are better placed to advocate for the

achievement of the millennium development goals (MDG).

5