Acknowledgement First, the researchers group would like to thank God Almighty, for providing us strength and wisdom

in making this research. His love and support for every one of us. We would like to extend our gratitude to the selected 4th student for their straightforward answers and warm acceptance in answering the survey To our families and friends, for the support of sharing their ideas in regards with this subject matters. To our research clinical instructor for her constructive assessment in enhancing our research work and make it a better one.

CONTENTS Chapter 1 Introduction Statement of the Problem Objectives Hypothesis Scope & Limitations Significance of the Study Definition of Terms Theories Theoretical Framework

Chapter 2 Related literatures Responsibilities of nursing students assigned in the nurse Characteristics/values that patients look for in a nurse What composes quality nursing care? Alternatively, what is quality nursing care? Problems/concerns being encountered by patients when cared by student nurses

Chapter 3 Research Methodology

INTRODUCTION Nursing care, at its best, is designed and Implemented in thorough manner, using an organized series of steps, to ensure quality and manner, using an organized series of steps, to ensure quality and consistency of care (Pilliteri 2007). One of the professional responsibilities of student nurses is to perform dependent and independent functions. The principle to be followed in rendering patient care is quality of care. All students regardless of year level are expected to render all nursing procedures from simple to complex depending on the needs of the patient assigned to them and knowledge and skills with the advancement of their year level Now a days that the population of the student nurses and nursing graduate rising we should be aware for different perception of the client to the quality of nursing care rendered by the nurses. As a student nurse we should be aware to the feelings of our patient if their satisfied to the quality of care that we rendered. The patient's perception of care is an important indicator of health care quality. This study tries to find out the client perception to the quality of nursing care rendered by 4th year nursing student of University of Perpetual Help System Dalta. It would also give an idea about how to reach maximum patients satisfaction in terms of care. It can also help in developing more ways to render quality nursing care because we would let the patient talk about what they think on the care rendered to them. Here, quality of nursing care would be measured through patients evaluation. Hence, doing this study would help us gain more knowledge about our profession. Since the primary goal of nursing is to render quality nursing care. This study focused merely on patient and the care delivered to them by 4 T H year nursing students of UPHSD.

STATEMENT OF THE PROBLEM

This study aims to discover the client perception to the quality of nursing care rendered by 4th year nursing student of University of Perpetual Help System Dalta. Specifically it sought to answer the following question: 1.What is the profile of the respondents according to their: Age Sex religion Civil Status

2. What is the perception of the client on the ability of 4th year nursing student of UPHSD rendering nursing care to them? 3. What is quality of nursing care delivered by by 4 T H year nursing students of UPHSD? 4. What is the difference in the level of nursing care rendered by 4th year nursing student of UPHSD to registered nurses? 5. Is there a significant relationship between the qualities of nursing care given by 4th year nursing student of UPHSD and clients perception?

B. Objectives General: To determine the client perception on the quality of nursing care rendered by the 4th year nursing students of University of Perpetual Help System-Dalta. Specific: To determine the demographic profile among the client perception on the quality of nursing care in terms of age, gender, civil status.

To determine the quality of nursing care.

C. Hypothesis There is no significant to the client perception on the quality of nursing care rendered by 4th year nursing students of University of Perpetual Help System-DALTA

SCOPE AND LIMITATIONS OF THE STUDY This study will be limited to the perception of the client on quality of nursing care rendered by 4th year nursing students of UPHSD. The respondents of the study will be the patients who received nursing care of 4th year nursing students of UPHSD

SIGNIFICANCE OF THE STUDY The study is believed to be relevant in nursing profession. That the result of the research will be useful to 4th year nursing student of UPHSD to help provide efficient quality nursing care to t h e i r p a t i e n t s . A n d a l s o t o d e t e r m i n e or to discover other barriers that may affect quality n u r s i n g c a r e b y nursing students in satisfying patients, thus it will be useful to develop or improve the ways on how these students will deliver care. Findings of this study were deemed significant to the following:

Nursing Administration. The study may provide effective guidelines in the administration and supervision of instructions in all levels of nursing education. Furthermore, the outcome of the study may serve as the basis for t h e f o r m u l a t i o n o f a r i g i d p r o g r a m t h a t w i l l p u t emphasis on the quality of nursing care rendered b y t h e student nurses so as to satisfy patients in different institutions. Nursing practice. Through this study the student nurses were made aware of their nursing care rendered to different patients in different institutions by means of nursing interventions to help in patients recovery. Nursing Education. In clinical education, assessment of student nurse is very important to guarantee that Bachelor of Science in Nursing graduates are competent. The study may contribute to the improvement of nursing care rendered by nursing students that can also contribute in nursing education and nursing research to improved quality of life.

Researchers. This will helps the researcher to further utilize knowledge and skills regarding certain phenomena about the client perception on the quality of nursing care. Patient. Given that the researchers valued patients satisfaction, this study was focused on the ways to promote good health service given by student nurses to satisfy patients. Student Nurse. Determining the patients perception on the nursing care rendered by 4th year nursing student of UPHSD could push students to strive harder in rendering quality nursing care to patients. And also this will be significant by knowing their weakness and strengths so that they could work or change it in order to provide much effective nursing care.

THEORETICAL FRAMEWORK This study is guided by the following theories: Imogene Kings Goal Attainment Theory, Patricia Benners from novice to expert, Ida Jean Orlandos Deliberative nursing process In Imogene Kings Goal Attainment Theory states nursing is a process of action, reaction, and interaction whereby nurse and client share information about their perception in the nursing situation Patricia Benner s From Novice to Expert theory Described 5 levels of nursing experience and developed exemplars and paradigm cases to illustrate each level Novice Advanced beginner

 Competent Proficient Expert Levels reflect movement from reliance on past abstract principles to the use of past concrete experience as paradigms change in perception of situation as a complete whole in which certain parts are relevant Ida Jean Orlandos Deliberative Nursing Process theory states the deliberative nursing process is set in motion by the patients behavior. All behavior may represent a cry for help. Patients behavior can be verbal or non-verbal. The nurse reacts to patients behavior and forms basis for determining nurses acts. Perception, thought, feeling Nurses actions should be deliberative, rather than automatic. Deliberative actions explore the meaning and relevance of an action.

Theoretical Framework:

Betty Neuman Theory (2001) Health Care system Model Each person is a complete system The goal of nursing is to assist in maintaining client system stability Brauer (2001) described common patterns of person-environment interaction in adults with rheumatoid arthritis, based on Neumans model. Jean Watson (1999) Theory of Caring Caring is the moral ideal Entails body-mind-soul engagement with one another Erci et al. (2003) studied the effectiveness of nurses who had been trained according to

Watsons model on the

quality of life of patients with hypertension.

RELATED LITERATURE

A Student Nurse's Duties Leigh Wittman has been writing professionally since 2007. She writes primarily on health, career advice, outdoor pursuits and travel for various websites. Wittman is a licensed nurse and studied nursing at Arizona State University. Student nurses regularly practice what they have learned in the classroom by attending clinical rotations. These rotations are supervised by a nursing instructor. Though student nurses have a limited scope of practice and must obtain supervision and approval for much of the care they provide to patients, they perform a variety of duties. Those duties include taking a health history, administering medication and drawing blood.

Health History and Physical Exam

One of a student nurse's first duties is to obtain a health history of her patient. The health history includes an extensive series of questions designed to allow the student nurse to understand the patient's health problems, family health issues and possible psychological issues.

Upon completion of the health history, the student nurse must perform a head-to-toe examination of her patient. All abnormalities must be noted, even if they were previously discussed while obtaining the health history.

Administer Medication

The student nurse is responsible for administering all ordered medication to his patient during the day of his clinical rotation. Prior to administering the medication, he must research his patient's medications for their therapeutic uses, dosage limits, proper administration and any factors that would make administering them inadvisable. Once these steps have been completed, the student nurse, must prepare and administer the medication properly. This includes ensuring the right medication is administered to the right patient in the right dose by the right route at the right time, a procedure called the "five rights."

Provide Nursing Care

It is the student nurse's responsibility to care for her patient throughout the day of her clinical rotation. She is responsible for providing basic nursing care, including taking vital signs and assisting her patient with eating and bathing if necessary. She is also responsible for providing more advanced care, such as changing dressings, starting IVs, drawing blood and caring for catheters if necessary.

Nursing student roles and responsibilities Nursing Students are identified as learners by the College of Nurses of Ontario (CNO) The CNO states that the learner: Respects the safety and well-being of the clients in the learning experience

Recognizes her/his knowledge, skills and abilities, limits of responsibilities, legislative authority and supervision requirements, Contributes to the development of objectives for the experience Understands and clarifies her/his role in the provision of care with the educator/preceptor Uses clear, accurate and effective communication skills in professional interactions Identifies the need for, and acts to obtain appropriate supervision Is aware of her/his responsibility to notify the educator if they are not achieving objectives due to setting and/or preceptor relationship Is accountable for the quality of care she/he provides within the established objectives Becomes familiar with and follows the agencys policies, procedures and principles

Students are permitted to... Perform controlled acts authorized to nursing if they meet all three criteria: Have been taught by their faculty, preceptor or Nurse Educator Have the knowledge, skill and judgment to perform them as determined by their preceptor or faculty member Are supervised by a member of the nursing staff at SickKids or their faculty member

Students are NOT permitted to Perform delegated medical acts Act as a witness under any circumstances or for any purpose Provide second signature/check for controlled drugs, blood products, breastmilk, and medications listed as requiring independent double checking, double signing and documentation Provide telephone advice for discharged families

Perform controlled acts without close supervision by an

RN Take verbal or telephone orders Carry narcotic keys Be left in sole charge of the unit or any patient Transport patients alone when the presence of an RN is required

Top 10 Traits Every Nurse Should Have by RYAN WINTER on APRIL 6, 2009 Nursing is a field that demands much of those who pursue it. Long hours and the strain of working with ill and stressed people on a daily basis can make it a very difficult challenge. If you are currently in the nursing field or are considering pursuing this career, here is a list of the top 10 traits every nurse should have/be: 1. A Caring Nature:If a person cannot care about the people they are serving, they will not excel as a nurse. Nurses deal with the sick and injured and their families on a daily basis, and they need to be able to show them that they truly care about their situation. 2. Be Empathetic:Nurses regularly deal with people who are scared and in pain. They must be able to put themselves in their patients shoes if they are going to give them the quality of care that a good nurse provides. 3. Be Detail-Oriented: Nurses must remember to write everything they do on patients charts. They must also remember to bring medications at the correct times. Being an organized detail-oriented person is therefore crucial for someone in this career field. 4. Be Emotionally Stable:Nurses feel the joy of seeing a new baby born, followed by the pain of losing a long-term patient who had become a friend. Emotional stability is crucial in

order to survive the roller coaster ride of emotions nurses must endure on a daily basis. 5. Be Adaptable: No day is quite like the next when you work as a nurse, so they need to be able to adapt to circumstances. People are unpredictable at the best of times, but under stress become even more unpredictable, so a nurses typical workday will require flexibility and adaptability. 6. Have Physical Endurance:Breaks for nurses are few and far between. They are on their feet all day, sometimes for 12 or more hours at a time, so nurses must have good physical endurance to succeed in nursing. 7. Be a Quick Thinker: When a nurse notices something is not right with a patient, they need to be able to make decisions quickly and put their plans into action instantly. Nursing is not the career for someone who needs time to think about a situation before responding, because even a fraction of a second can mean the difference between life and death. 8. Have Great Judgement:A nurse must be able to look at a patients current state and accurately assess what is or is not needed. This must happen quickly during emergencies. Nurses therefore need sound judgment and maturity. 9. Be Hard-Working:Nursing is a never ending job. Someone is always ill and in need of some sort of aid or attention. Its also unusual for a hospital or medical centre to be overstaffed, which of course means more workload on each nurse in the unit. Being a hard worker is therefore a very important trait. 10. Have Great Communication Skills:Nurses communicate with each other, doctors, patients, and patients families on a daily basis, so being able to communicate clearly and effectively, and to read people is necessary for people in this career Conclusion: Nursing is a difficult career. There is no doubt about it. However, it can also be an extremely rewarding career given the right personality. Certainly, the more of the traits above you

have as an individual, the more likely nursing is the career for you. Characteristics/values that patients look for in a nurse When working with nursing students, other staff nurses look for a wide range of abilities and qualities that might make the student a better nurse. These qualities are often communicated to the nurse in charge of evaluating nursing students, either to determine which students need to improve or which might be considered for a particular position following a nursing internship. Time Management
o

Student nurses don't understand the importance of time management at the beginning of an internship or student nursing experience. However, time management is a key characteristic of being a successful nurse; successfully managing several patients at one time is a requirement of a good nurse. While it takes time to develop this characteristic, a staff nurse can see what a natural a student nurse is at managing her time to determine if this is something she will be able to handle as she eases into a nursing career.

Communication
o

Perhaps one of the most important characteristics of nursing is communication. Not only should a student nurse be able to communicate with other staff members, including doctors and specialists, but also with patients and their families. Staff nurses look for student nurses that can communicate effectively, but with empathy toward patients and their families, while ensuring a high level of quality care.

Good Retention
o

There is much to learn as a student nurse, and staff nurses look for student nurses that can not only handle such a large load of information but retain it as well. After all, mistakes in nursing could be more costly than in other professions; the wrong dose of medicine or mistake on a patient's chart could cost him his life. Therefore, student nurses are expected to retain important knowledge that will last them their entire career.

Ability To Learn
o

Staff nurses look for student nurses to be willing to learn more about their chosen profession. Despite everything learned in a textbook, there are still some things that can't be learned until a student is one the job. Not only do staff nurses look for a student that wants to learn, but also they look for someone that is teachable, meaning the student is able to take the information and immediately apply it to her methods to get even better at her job.

What composes quality nursing care? Or What is quality nursing care?

We have previously examined what patients want and here draw more specifically on recent empirical evidence. Many of the people we spoke with had personal experiences of care as patients and also shared the healthcare experiences of friends or relatives. They identified that patients want to be treated well, to know their nurse is knowledgeable, skilled and competent, to have high quality care every time and want nurses to have a caring and humane attitude, make them feel safe and comfortable cared about as well as cared for. The attitude and approach of the nurse is the

most important factor in securing this experience for patients, enabling them to be treated as a human being not a case with compassion, respect, empathy and by staff who are interested in YOU. Good quality nursing therefore means a good experience for patients and was identifies as a how, not a what with six core elements: 1. A holistic approach to physical, mental and emotional needs, patient-centered and continuous care 2. Efficiency and effectiveness combined with humanity and compassion 3. Professional, high quality evidence-based practice 4. Safe, effective and prompt nursing interventions 5. Patient empowerment, support and advocacy 6. Seamless care through effective teamwork with other professions Nurses want many of the same things as patients and the public and identified five main aspects they valued most about nursing: Making a difference to patients lives Close contact with patients Delivering excellent care Working in a team and being a role model Continuous development - learning and improving. Conceptual Framework
Client perception

Clients Demographic Profile

Quality of nursing care

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