الفهرس 
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Abstract
The assessment of the nurse’s performance in providing family planning services is an important approach to determine professional competence, enhance staff development, motivate them toward higher achievement, improve communications between managers and personnel and encourage relationships among nurses, determine training and developmental needs of nurses, select qualified nurses for advancement and salary increases and so their performances have a direct effect on quality of health care.
The study aimed to:
Assess nurses’ performance at Family Planning Clinics in Alexandria.
To fulfill the study aim:
The study was conducted at 12 Family Planning Clinics; 4 Family Planning Clinics (FP) affiliated to 4 hospitals that will be randomly selected one from each health agencies in Alexandria. Subjects: The study was included (100) nurse were working at the FP Clinics affiliated to the previously mentioned hospitals and Family Health Centers. (appendix I)
Tool used in this study:
One tool was designed, validated and utilized by the researcher to collect the necessary data. be used for data collection. Nurses’ performance observational checklist. This tool was adapted from the Ministry of Health guidelines in Egypt for initial and return visit to assess nurses’ performance at family planning clinics. It consists of 36 items distributed among 5 dimensions as follows: Initial assessment: it contains 3 items, Counseling: It includes 6-main items (GATHER, assisting in IUD insertion: it includes 20 items. Infection Prevention and Control: it includes 4 items and Follow up: It includes 3 items.
Nurses’ socio-demographic data: age, marital status, level of education, position, and years of experience and attendance of FP training programs will be attached.
The main findings of the present study were:
a- Nurses’ socio-demographic data:
- More than one half (59%) nurses age ranged between 35-40 years, three quarter (75%) of them had diploma, while only 24% of them technical.
- Less than two third (62%) of them had less than 30 years of experience in nursing.
- More than four-fifth (82%) were attended training programs about family planning.
b- Nurses’ performance observational checklist:
Initial Assessment
- All of them prepared environment of clinic completely as: ensure good ventilation and cleanness of the clinic and availability of equipment and supplies however, and Prepared visual aids facilities and available contraceptive methods correct and complete respectively.
- All the nurses greeting the client and determined her needs correctly, and taken history.
- Nursing role as assistance in physical examination, all of them did not measure vital signs except blood pressure, while 57% of nurses measured weight correct and complete.
Counseling:
The vast majority of nurses asked the client about the preferred method, more than one-half (54%) didn’t tell The client about different birth spacing methods, less than two-third (62%) didn’t help the client to choose the best method, approximately all of them didn’t explain to them method of chosen but they determine the date of return visit correct and complete.
Assisting in IUD insertion
- Before the insertion all study nurses sterilized the instruments and prepared equipment’s and record client data correct and complete. On the other hand, counseling about IUD didn’t provide for 82% of the clients. While, 94% &95% & 89% of them didn’t explain the procedure, and didn’t ask client to emptied her bladder before the procedure, or even wash her hand respectively.
- More than two-third (66%) worn the gloves before assist in IUD insertion.
- During insertion all study nurses didn’t report the provider the results of general physical examination or assist in assessment of client’s genitalia. only more than one-quarter (27%) of them assisted the provider during the steps of loop insertion.
- After insertion only 7% of them let client wait in clinic for 15minutes after insertion.
- Less than four-fifth (78%) of them didn’t give the client the post insertion instructions of IUD.
Infection Prevention and Control:
- The most of nurses didn’t follow recommendation correct and complete of hand washing procedure as: the most of them were wetting their hands and dispensing about 5 ml of liquid soap or disinfectant into the palm of the hand, rubbing hands palm to palm, rinsing hand with clean water and dryness hands with towel completely and correctly respectively.
- All of them done recommendation of Cleaning & disinfection of equipment correct and complete.
- Approximately three quarter (74%) of them neglected wear heavy utility rubber gloves.
- All nurses followed the recommendation of sterilization correctly and completely in some aspect as: ensured that all instruments clean and dry.
- All studied nurses followed recommendation of safety precaution, while giving injection correct and complete
Follow up
- More than four-fifth of study nurses didn’t measure vital signs or weight in return visit respectively.
- Less than two fifth of them had referred the needed case correctly and completely. Approximately all of them renewed of supplies of contraceptive methods and determined the date of next visit and registered correct and complete information in client card.
- All of studied nurses followed recommendations of follow up of clinic correct and complete as: revised the amounts of stock and types of contraceptive methods, prepared request for getting contraceptive methods from storage.
- The vast majority of nurses registered all client data accurate and complete and kept all records clean and tidy. More than four fifth (83%) didn’t take informed consent from client about chosen method. and about two-third (66%) of them prepared periodic reports about stock of contraceptive methods in the clinic. on the other documentation less than three-fifth (58%) of them didn’t prepare monthly report and quarter year report about clinic activity.
Recommendations
Based on the findings of the present study, the following recommendations are suggested:
1- The Ministry of Health should put primary health care centers especially FP clinics as a priority through setting up of service total quality development strategies.
2- Clear job description should be made for nurses who work as and in family planning clinics and periodic review to determine if it reflect the reality of position, and make updates as necessary.
3- There is an urgent need to design periodic educational training programs to improve knowledge, skills of nurses about family planning care as well as to improve their performance.
4- The nursing curriculum should be revised and update to include guidelines of infection control and documentation to improve outcome.
For further researches
- Replication of the same study in different Egyptian governorates especially rural and upper Egypt to compare and validate the present study findings.
- Investigate barrier against nurse’s compliance with guidelines in initial and return visit in family planning clinics.
- Client satisfaction with nurse’s performance at family planning clinics.
- Nurses knowledge, attitude and practices toward quality of nursing care at family planning clinics.