Page 36 - Nursing Education in Malaysia

NursiNg EducatioN iN Malaysia

care has not been assessed, or research has not been carried out. Aspects on “resource
utilization” as they relate to cost may not be included and even if they are, they may have
not been enforced, because all along “nursing care costs” are not on nursing’s agenda.

Quality improvement initiatives i.e, activities carried out by
nursing organizations to evaluate and improve the quality
of client care services provided to all clients might have
been done only through ISo initiatives
The evaluation of nursing care is a professional responsibility. Evaluation that
focuses on a single clients’/patient’s plan of care enables a nurse to know the effectiveness
of interventions and whether expected outcomes are met. Since Nursing Process Model is
not enforced in all hospitals, hence, it can safely be concluded that outcomes management
(clinical outcomes of clients as a result of prescribed treatment) is not carried out.

At the institutional level, evaluation involves QI (Quality Improvement) activities
that focus on the delivery of care provided by the nursing division of that institution. Since,
outcomes management programme does not exist at unit levels (through nursing process
model), it can safely be concluded that outcomes management (to measure effectiveness
of interventions, standards of care, and whether delivery of care is necessary), is also not
done.

National initiatives however, have been known to exist which include: client
safety; reduction of unnecessary healthcare costs, identification and use of best
practices and health risk appraisal.

The purpose of QI (and performance improvement) is not to identify problems after
the fact, but to identify opportunities prospectively to improve the quality of care. A well
organized QI programme focuses on processes of care that significantly contribute to
outcomes (Potter and Perry, 2009). QI is also concerned with exceeding the standard
of care, examining ways to be more efficient, improving client satisfaction, etc. – all of
which must be based on Nursing Process Model. Since the Model is not used in Malaysian
hospitals, it can be safely concluded that QI is not part of nursing’s agenda.

Key Performance Indicators (KPI) for nursing has not been
finalized by the ministry of health
Attempts are now being made to come up with KPI for nursing. The Nursing
Task Force, Ministry of Higher Education however, has identified four basic nursing
competencies for new graduates and for those entering nursing service. The four basic
competencies are internationally recognized and they are: Critical thinking and problem
solving, knowledge-based practice, clinical competence and accountability and ethics. The
first two competencies, i.e, critical thinking and problem solving and knowledge-based
practice are directly related to Nursing Process Model. Since the model is not included in
the practice, from the higher education perspective, KPI for nursing have not been met.