00000ctm a22000003a 4500 UP-1685523046125456061 Buklod 20080221151146.0 a r |||| u| ta 080221s xx d r |||| u| (iLib)UPMNL-00001325341 UPM-NURSING eng LG 995 2007 N8 P34 Palijo, Honorata Sahlee Trinilyn A. Analysis of nurse turnover and student affiliation trends in selected tertiary hospitals in Metro Manila Sr. Honorata Sahlee Trinilyn A. Palijo. 154 leaves Thesis (Master of Arts in Nursing) -- University of the Philippines Manila Nurse turnover and student affiliation had become important issues for all health care delivery agencies. In the face of global nursing shortage, there is greater demand for Philippine-trained nurses worldwide. Although migration of nurses is not a new phenomenon in the country, the rate of migration over the last five years is definitely faster and greater, resulting as well in dramatic increase in nursing schools and even led to the so-called "doctors-becoming-nurses" phenomenon. This study utilized descriptive qualitative design specifically case study as well as quantitative method and it attempts to document nurse turnover pattern and some of its effects on nurse staffing and increase in student affiliations particularly in the last five years when global demand and migration of nurses has greatly increased. Four tertiary general hospitals in Metro Manila: two (2) government and two (2) private, selected through convenience sampling were included in the study. Triangulation was used in obtaining data including review of records, interviews of key informants and observation where possible. A total of 15 administrators were interviewed as follows: one (1) Hospital Administrator, three (3) Training Officers, two (2) Human Resource Managers, and seven (7) Nursing Supervisors from the four hospitals under study. Research assistants from the hospitals under study were also employed during the course of the study. With the use of frequency distribution, percentages and mean, quantitative data of nurse turnover and student affiliation were analyzed. Results yielded that there was a change in the trend in nurse turnover during the three periods. Turnover was at its peak three years ago and declined during the current year. International migration and transfer to the academe were the most common reasons for nurse turnover. Major areas that are most affected by turnover are the special units like intensive care, emergency room, and operation and delivery room. There was understaffing in the hospital under study during the three periods primarily due to inadequate plantilla particularly in the two government hospitals and secondarily due to nurse turnover which consequently led to mandatory overtime among nurses. Turnover likewise resulted to a change in the nursing profiles and staffing patterns during the three periods studied particularly in the nurses' year of experience in the hospital and in the current area of work. There was also no evidence of change in skill mix and nurse-patient ratio during the three periods because mandatory overtime was used to complete staffing. There was no change in the model of nursing care delivery utilized by the hospitals during the three periods. A change was noted in the pattern of students affiliation particularly in the students' assignments and students' clinical assignment patterns due to the increase in nursing student and schools brought about by increased foreign demand for nurses. Ratio given by CHED on Clinical Instructor to students was maintained. Areas of assignments and shifts expanded but student's patient workload was maintained. Roles and responsibilities of staff nurses expanded from an indirect mentor in the Clinical area to becoming preceptors giving rise to increase in the number of in-house preceptors. Content analysis method was used to analyze qualitative data on the management interventions. The data showed that most of the hospitals have limited programs on nurse turnover and student affiliations and these programs worked only in a certain level depending upon the real need and problem of the hospital. The programs employed by hospitals to recruit nurses include: linkages with Colleges of Nursing, referrals done by affiliating schools, on-the-job training with pay, advertising campaign, scholarship grants and accreditation of the hospital. Programs on retention include: incentive scheme, 2-year contract policy, promotion to higher ranks provision of benefits and privileges and values formation. To address concerns on turnover, Nursing administrators employ different means and some of them are: continuous and shorter training program, volunteer program, contractual program, values formation, outsourcing and linkages. There are likewise limited programs on students affiliations in the hospitals. The increased in affiliating schools and students was not successfully controlled in the two government hospitals. The two private hospitals despite limited programs on student affiliations were able to limit schools and student affiliates because of the presence of sister companies who are educational institutions offering nursing. The different programs to address concerns on student affiliations include the formation of screening authority that handles affiliation concerns, adherence to standards stipulated in the CMO 30 and other implementing guidelines, linkages which includes open communication and dialogue and exclusivity of contract between the school and hospital. The overall finding of the study underscores the importance of hospital administrators gaining some insights into the condition of their nursing human resource as well as their contribution to the formation of the students thus, employ more effective strategies to manage nurse turnover without compromising patient care as well as education of nursing students. Nursing shortage. UPMNL NURS LG 995 2007 N8 P34 Thesis