A Preliminary Study on Development and Evaluation of Home Health Care Nurse Clinical Practice Program: Focused on Postoperative Orthopedic Patients

Suh, Young Sook

Abstract

The clinical practice program for home care nurses was implemented in June 1994, to help to set up a hospital-based home care system in the Kwangju City area as a collaborative work between the Department of Orthopedic Surgery at Chunnam University Hospital and Chunnam University School of Nursing. Under the developed clinical practice strategy, the eight week training was given to five licensed home care nurses who had completed Part I and II of the home health care nursing practicum from June 1994. The purpose of this descriptive evaluation study was to identify the effectiveness of the clinical practice program for home care nurses specialized in the area of patient care for people with musculoskeletal function impairment. As a method in data analysis, data triangulation was used in the five home care nurse case evaluations. The variety of data analyzed included confidence score by home care nurse self-evaluation, patient and family member satisfaction scores, and competency score by preceptor evaluation. The study findings revealed that an increase rate in nursing performance didrate necessarily coincide with an increase not in competency score and also, not with the patient/family member satisfaction scores. And an order derived from the clinical performance scores of five home care nurses corresponded to those from three measurements-competency score, patient satisfaction score, and family member satisfaction score. However, it differed from the order associated with the confidence score. Consistency derived from the three objective evaluation methods may lead to the possibility that the level of competency measured by educator can be further explained by the levels of patient/family member satisfaction. The salient finding of this study was that, in case of nurse A who had had little clinical experience in the orthopedic patient care, there was a significant increase in the level of confidence and competency in subscale of professional skill with the home care clinical practice. Therefore, the effect of the clinical practice program would be successful for nurses who have had little experience in the area of specialization. The study results suggest that there might be some time difference in the development of cognitive sense (confidence) in performance and actual clinical performance (competency). In future research, relationships between the confidence and competency score, and between the confidence score and the patient satisfaction score should to be measured in different time frame to achieve a better explanation power of the study outcome.