I have a subject but can't come up with the question.

Rob72, ASN, RN · Sep 12, 2011

"An Analysis of Proficiency in Technical Performance in the OR: Quality Analysis/Quality Improvement by Identifying Benchmarks."

Identify the highest areas of dissatisfaction in the patient surveys, and develop a survey instrument for staff and physcians (self-assessment/peer assessment) to use the team to identify needs and goals.

At this point, I would say you're trying to develop adequate survey questionnaires to tell you which areas need improving, and what is perceived to be the best way to go about that.

llg, PhD, RN · Sep 12, 2011

I think you need to clarify your topic before choosing a title. What exactly are you wanting to study?

1. The reasons behind the patent dissatisfaction?

2. The reasons behind the staff dissatisfaction?

3. Identify the educational needs of the staff?

4. To see if there is a relationship between feelings of compentency/proficiency and staff satisfaction?

5. The best professional develoment strategies to use to help staff feel more competent in their jobs?

etc.

In your original post, you are all over the place and not honing in on one focus area. Maybe it would help if you sat down with 2 or 3 colleagues who are knowledgable about staff development and/or staff satisfaction. Take your brainstorming beginnings and start narrowing them down until you find the essence of a single question. Then you can build your project (and eventually your title) around that single question.

Also, if you really want to focus on the competency vs proficiency issue ... you should be exploring the staff development literature. What's the difference between orientation, inservice, and continuing education? (They have 3 separate definitions.) What level of expertise should be the goal of orientation? (competence? proficiency? expertise? etc.) How does one move up from one level of expertise to another? Learning about these things (within the Nursing Professional Development literature) may help you further clarify your interest.

IVyPush-her · Sep 12, 2011

Thanks you guys. Rob thank you for putting it so simple. So, it will be a bit tough surveying the patient satisfaction in correlation to what we do in the OR. I guess like llg said I need to hon in on what I am really trying to do. I guess that is why I can't come up with a title.

According to our patient satisfaction scores there is some improvement needed in the pre op are not so much in the operating room. And a project is now in effect because of those negative comments about too many attempts at IV sticks.

As for the reasons I am looking more at the educational levels of the staff. I do like #4 about the relationship between feelings of competency/proficiency and staff satisfaction. Our RN satisfaction scores are not the greatest either which I don't understand. I work at a large facility, the pay is great, the autonomy is ok but overall it's a great magnet hospital to work at. It baffles me, sometimes I think it might just be a culture thing. I see that this subject could also be a very touchy one to deal with. Dealing with nurses perceptions about their job skills is going to be tough. I do like #5 too.

I will be meeting my research class on Friday and hope to hon in and not feel so scattered with this subject. I will also explore staff development.

Thank you for your input, it helps.

Rob72, ASN, RN · Sep 16, 2011

As for the reasons I am looking more at the educational levels of the staff. I do like #4 about the relationship between feelings of competency/proficiency and staff satisfaction. Our RN satisfaction scores are not the greatest either which I don't understand. I work at a large facility, the pay is great, the autonomy is ok but overall it's a great magnet hospital to work at. It baffles me, sometimes I think it might just be a culture thing. I see that this subject could also be a very touchy one to deal with. Dealing with nurses perceptions about their job skills is going to be tough. I do like #5 too.
I will be meeting my research class on Friday and hope to hon in and not feel so scattered with this subject. I will also explore staff development.
Thank you for your input, it helps.

This is a pet peeve, so I'm admitting to bias, up front. Do they know what they don't know? Nursing schools have re-oriented towards the theoretical/philosophical goals in nursing, essentially trying to prep all grads for post-grad and higher pursuits.

That's whippy, spanky, shiny and all, but fundamentally, nursing is a skills-mastery profession. Almost universally, patient complaint #s 1 and 2, at any facility are: wait times and poor/multiple sticks.

I'm fairly "counter-culture" here. I believe strongly in diploma (apprentice-style) degree programs. I also believe nurses should be trained for diagnostic, vs. so-called "critical" thinking. Too little time to expand much on that, but essentially we're training students to think critically, but not to the differential level because that's, "not within our scope of practice". Sorry. Phlebotomy, bedside breathing treatments and conscious sedation(among other things) arguably aren't either, we just have the political power to co-opt those areas.

Our current model has no clearly defined conclusion to our decisional pathways, relating to the miasma of Nursing Dxs. This results in professional confusion and frustration. Academic emphasis on an ill-defined concept, with significant disregard for practical skills mastery, results in feelings of insecurity and/or incompetence.

Add to this the artificial business model of "customer service", and clearly, staff satisfaction is unlikely to be "high" at any but the most specialized unit or facility.

Annnnywaaay. all that to say, I would see if you could find out if dissatisfaction r/more to feelings of insecurity in skills performance, or in a "customer service" model that placed more emphasis on feel-good words than practical applications. Might be something else, but, playing the odds...

bobbysgirl · Sep 18, 2011

You mentioned a few areas that you could research but what is it specifically that you want to show? I would decide whether you will be doing a qualitative or quantitative research project and come up with your question from there. Hope this helps.

IVyPush-her · Sep 21, 2011

I think I am getting closer to exactly what I want to do. "Proficiency rather than competency has a greater impact on efficiency in the OR". I believe just passing competencies is not good enough. Why can't we be proficient in our jobs? I want to prove that its better to be proficient than just competent. In the operating room there are so many technical skills that are needed besides our general nursing skills. In the long run I would love to implement an extended orientation where the new nurse to the OR has plenty of training to feel confident in the job.

Does it make sense? I still feel a bit scattered but I think I am leaning towards the education aspect of this.

Thanks again for the input

bobbysgirl · Sep 21, 2011

Look at Benner's Novice to Expert. She defines each of the areas: novice, advanced beginner, competent, proficient, etc...This might help to clarify what you are looking for, especially when it comes to the stages one needs to go through to reach the "proficient" stage. Hope this helps.