CHAPTER 4

THE INTRODUCTION
OBJECTIVES
To discuss the essential elements of the thesis
introduction
To formulate the introduction of the thesis
 
LIBRARY ACTIVITY (By Group)
Using theses acquired from the college library,
conduct an analysis on how Chapter 1 is formulated.
Take note of the common elements. Focus on how the
introduction was made.
The first chapter of nursing research is entitled “the problem” the
problem and its background”. Its purpose is to introduce the
problem, clarify important variables, identify delimitations, and
present the significance of the study to the nursing field. It has the
following essential elements:
1. Introduction 5. Definition of Terms
2. Statement of the problem 6. REFERENCES
3. Assumptions and Hypothesis
4. Significance of the Study
THE INTRODUCTION

The introduction is very important in establishing the

cognitive setting of the research and involves (a)
rationalizing why there is a need to research on the
problem, (b) clarifying the important terminologies for the
reader to easily understand what the research is about and
(c) establishing the degree of seriousness of the problem
which prompt a researcher to look for solution.
The following questions aid the researcher in formulating
the introduction:
1. What is the rationale of the problem?
This question is answered sharing with the beneficiaries the
reasons why the researcher has been persuaded to look for
solutions to the problem. A narration of the researcher’s experience
that led him to conduct the study is commonly done.
Examples: personal experiences, an article read, a scene witnessed
a news heard, a theory that needs to clarified etc.
2. What is the setting of the problem? The setting
forms part of the delimitation of the study, as it defines
the geographic boundaries of the study and implies
certain demographic characteristics. This describes to
the reader the place where the research was conducted,
as the setting has a significant bearing on the variables
being studies.
3. What is the basic literature foundation of the study?
This is different from the review of the related theories, conceptual
literature and research literature. This part supports to provide the
researcher clarify of the terms or variables used in the study. The
terms and variables must first be clear to the researcher so that
he/she can make his/her reader understand them. A backgrounder
assists the investigator in determining boundaries of the study. This
part is derived from different literature sources. The use of various
references is highly recommended in this part of Chapter 1.
4. How serious is the chosen research problem? Why
is there a need to look for an solution to the problem?
In this aspect, the investigator is tasked to see the
intensity the magnitude of the problem. When the
gravity of the problem has been seen already, the
investigator may take action to work on the problem.
Mostly, the researcher in this element looks for statistical
or quantitative evidence to assess the weight of the
problem.
5. What is overall purpose of the problem?
It is very significant to note that the researcher must be
totally aware of the purpose of the research problem. He/she
must ask how it will help his/her colleagues or in this case,
fellow students, or the entire nursing field

I. the levels of Performance of Operating Room Nurses Among Selected

Hospitals in Cabanatuan City (Marcelo, 2007).
New developments are constantly taking place in the field of surgery. As
diagnostic and supportive services have become increasingly complex, so
have operative procedures. Intricate procedures have become part of daily
operating room routine.
 It is therefore essential that nurses have extensive specialized
technological knowledge and skills. They also must have the
theory-based critical judgment and intellectual skills needed to
apply a humanistic approach to their responsibilities as patient
advocates. Concurrently, the role of the operating room (OR)
nurse is expanding as nurses relinquish non-nursing
responsibilities. Nursing care of surgical patients extend
behind and beyond doors of the OR.
According to the Atkinson (1996), professional nursing in
the operating room has been long defined as the
identification of physiological, psychological and
sociological need of patients. The implementation of the
individualized program of nursing care coordinates with
the nursing actions in order to restore or maintain the
health and welfare of the patient before, during and after
surgical interventions
The professional operating room practitioner, a duly-licensed
registered nurse, is legally responsible for the nature and
quality of the nursing care that patients receive during surgical
interventions, specifically during the surgical procedure.
Nursing practice encompasses those nursing activities that
assist the individual surgical patient whether in conscious or
unconscious state. These activities are directed toward
providing continuity of care from pre-operative through post-
operative evaluation (Kohn, 1996).
 Nursing care actions provide the foundation for the nursing
process used in assessing, planning, implementing and evaluating
patient care. These actions include the application and evaluation
of the physician’s legal order; observations of the patient’s
symptoms and reaction; supervision of other health care workers
who contribute to the care of the patient; reporting and recording
and application and execution of the nursing procedure and
techniques; and promotion of the patients physical and emotional
health by directing and teaching.
 Having considered the significant roles played the
OR nurses, the researcher believes that the
performance of operating room nurses may directly
or indirectly affect the patients well-being, hence, the
researcher felt the immediate need to conduct a study
focused on the areas affecting their performance in
the OR.
II. Correlation Between Nurse to Patient Ratio and the level of Work Productivity
(Navarro, 2006).
the third year nursing students of Asia-Pacific College of Advance Studies
(APCAS) are on the verge of entering the professional realm of nursing. They
have been training for years in the art and skill of nursing in preparation for the
actual practice and in the service of their fellowmen. They are taught that the
patient is core of this profession and that the render of care is multi-faceted. The
nurse assumes multiple roles whenever the patient is under his/her charge. She is
caregiver, communicator, teacher, advocate, counselor, agent of change and leader.
In the hospital setting he/she is an important member of the medical team who
helps in the rehabilitation and the recovery of the patient. In his/her deliverance of
care, he/she is governed by a system known as primary nursing.
According to Kozier (2004). “primary is a system in which
one nurse is responsible for the total care of a number of
clients for 24 hours a day, 7 days a week. It is a method of
providing comprehensive, individual and consistent care. It
uses a nurse technical knowledge and management skills.
Primary nursing encompasses all aspects of the professional
role: teaching, advocacy, decision-making and continuity of
care. The primary nurse is the first-line manager of a client
care with all its inherent possibilities and accountabilities”.
So, if primary nursing is concerned with customized care then the
number of clients for every given nurse must be limited to ensure that
each patient is given appropriate healthcare service. This ideal setup is
far from reality, especially in government hospitals, are a relief for
many Flilipino patients and their families in these hard times. Problems
in the workplace have been hounding the nursing profession especially
with the exodus of medical professionals, nurses included. The marked
decrease in number of nurses rendering health care services to patients
in government hospitals has become a major problem. This situation
can be readily observed at the Bataan General Hospital.
Bataan General Hospital (BGH) is a provincial hospital in Bataan. It is
200-bed capacity, tertiary level hospital which has been integrated into the
provincial health office in 1980. It is also the base hospital for training of
APCAS nursing students. The BGH has the following sections: the
ER/Admitting section, OPD Department, medical department, Pedia/PICU,
CCU/ICU, Surgical, OB, NICU, OR, CSR, gaving and pay ward.
The present third year nursing students have been training in BGH
since August of 2005 and have been witnessing firsthand an increased
patient-to-nurse ratio and, consequently, experiencing the difficulty of
handling numerous patients at a time. The service a nurse has to render is
overwhelming, especially when one ward is manned only by two to four
nurses at a given shift
During days when there is a heavy traffic of patients coming in
and out of the hospital, the nurse often has to squeeze in 30-50
patients in an 8-hour shift, during which medical orders have to
be carried out for each patient, various medicines administered,
and vital signs, checked and recorded every two hours. His/her
responsibilities also include health teachings, morning care and
bedside care. In this kind of environment, nurses are constantly
under stress and are more likely to easily experience fatigue and
loss of concentration, especially with the added responsibility of
documenting everything for recording and legal purposes.
Sometimes, when wards are further understaffed,
extended work hours or overtime is needed and nurses
work for 16 hours straight (2 shifts).
Based on the observation of the researcher about the
ratio of nurse to patients and its local effect on the
nursing care given to patients, this study is to be
conducted to unearth the effects of nurse-patient ratio.
Recommendations derived from the results of the study
will be beneficial to patients.