Factors influencing the performance of enrolled Nurses up-grading to Kenya registered community health nurse through distance learning

Abstract

Distance learning upgrading program for Enrolled Nurses (EN) to Registered Nurse was started to overcome the challenges that were being faced by ENs on career development and decreased employment (Hylton, 2005 and Annals, 2007). This was to avoid shortage of manpower. ~ Upgrading of the EN to KRCHN while working in clinical areas caused several challenges to the Distance Learning upgrading KRCHN students, one of which caused delay in completion of the program. The study aimed at establishing the factors that influence performance of the Enrolled Nurses(EN) during upgrading to Kenya Registered Community Health Nurse(KRCHN) at KMTC Nairobi through D.L. This was a descriptive cross-sectional study that was carried out in four hospitals, KNH, Mbagathi, Mathare and Kiambu Hospital, among the graduate nurses who had upgraded from EN to KRCHN at KMTC Nairobi through distance learning. Pretesting of the Questionnaires was done at Gatundu District Hospitals. The study was guided by two hypotheses that stated- "there was no relationship between the socio-demographic factors of the DL upgrading KRCHN and their achievement as KRCHN graduates". "There is no relationship between the D.L. methods used by the upgrading EN to KRCHN and their achievements as KRCHN graduates". The study was carried out for a period of twelve weeks from April to June 2010 at cost of Ksh 130,675/=. Stratified random sampling was utilized to select the study subjects. A total of 63 nurses participated in this study. Quantitative data was collected using both structured and semi-structured self administered questionnaire with a Likert scale for attitude testing (Appendix 1, section A,B and C). Data was categorized and coded depending on the variables. It was entered and analyzed using Statistical Package for Social Sciences (SPSS) (Version 17). Data was analyzed and summarized using descriptive (mean, mode, median and Standard Deviation) and inferential statistics (Chi- Square, Comparison, Pearson Product Moment, Spearman Correlation and Multiple Regression) as appropriate. Xl The study findings revealed that 59% of the respondents completed the course after 2 years compared to 41% who completed within 2 years. The data showed that there was significant relationship between respondents duration of service in Nursing Practice (r=0.1 03, P=0.042, X2 = 3.456, P= 0.032, B= 0.122, P= 0.029) and completion of training within 2 years. Data also showed a significant relationship between Age (P= 0.038), Learning methods (P= 0.036), with course completion within 2 years. However, there was no relationship between course completion within 2 years and gender (P=0.69 or P= 0.351) or marital status (P= 0.71 or P= 0.498). Result findings from Likert scale indicated that other factors also influence the students performances like tutor characteristics, inadequate library facilities and learning environment. The study fmdings rejected the null hypothesis that there is no relationship between the distance learning methods used by the upgrading EN to KRCHN and their achievements as KRCHN graduates. Meaning there is a significant relationship between the learning methods used by distance learners and their achievement. The study concluded that some learning methods adopted by learners yielded better results. Tutor characteristics and learning environmental factors affected greatly the learner's achievement of the course within two years. The study recommends that program activities be reviewed to avoid over-reliance on particular methods and working nursing students be supported with time off. Program coordinators should intervene and ensure that there is a good tutor student relationship. Tutors should exhibit high degree of commitment to their teaching duties thereby improving their communication to students. Job analysts from the Ministry of Health in which two highly qualified nurses at a Masters or PhD level should be included in DPM team so as to regularly evaluate the work done by the KMTC Nurse lecturers and give appropriate advice as findings showed that they were overwhelmed with work. More research can be done with a bigger sample population so as to fmd out the other factors that could be influencing performance of EN during their upgrading to KRCHN through distance learning at KMTC Nairobi, countrywide.