Perceived Barriers to Decision to Pursuing Bachelor of Science in Nursing Degree among Diploma Nurses at Nairobi County

Abstract

There is empirical research evidence which associates a more educated nursing workforce with access to quality patient centered care among a nation’s population. Specifically, Bachelor of Science in Nursing degree has been linked to safety and better patient outcome. However, it is approximated that the proportion of BScN educated nurses is less than fifty percent globally. Literature review indicates a low uptake of BScN upgrading program by the diploma nurses globally. In Kenya, only 4.4% of the 33,595 diploma nurses have upgraded to BScN degree while in Nairobi County, only 9% of 1131 diploma nurses have completed the same program. There is increasing concern globally as to why the diploma nurses are not upgrading their education level to BScN degree. This study purposed to assess barriers to the’ decision to upgrade to BScN degree by diploma nurses. A cross sectional descriptive survey design was utilized. The target population was 1131 diploma nurses employed by the Nairobi County government. The study was conducted at Langata, Embakasi West and Kamukunji Sub Counties in 2021. A sample size of 286 diploma nurses was randomly selected through multistage and simple random sampling methods. Consent was sought from the participants. Data was collected for three weeks using a self- administered semi structured questionnaire. Computer package, SPSS version 22 was used to analyze the data using descriptive and inferential statistics. The findings indicated a statistically significant relationship between the following variables and the decision to pursue BScN degree by the diploma nurses ; nurses’ age at, p=0.032, Lack of personal goal to achieve BScN degree, at p<0.000 , heavy financial commitment at p=0.005 , lack of financial support from the employer at, p=0.047 and inflexibility and inconvenience of RN-BScN program at p< 0.000 .The study further showed that majority , 242( 89.6%)) of the respondents, believed that a BScN degree is very important for the improvement of knowledge and skill. Conclusively, advanced nurses’ age, lack of personal goal to achieve BScN degree, heavy financial commitment, lack of financial support and inflexibility and inconvenience of the upgrading program would negatively influence the decision to pursue BScN degree by the diploma nurses. The presumption is that the removal of these barriers would motivate the diploma nurses to upgrade their education to BScN degree. This study recommends that the Nursing Council of Kenya leads in the development of a policy regarding the upgrading of diploma nurses to BScN degree, the employer creates a fund to support the diploma nurses meet the tuition fee, the HELB to consider extending education loan to the diploma nurses while upgrading to BScN degree, and the County government of Nairobi to recognize those diploma nurses who have completed the BScN upgrading program by salary raise, promotions and to consider them when awarding managerial responsibilities.. The theory of change by Kurt Lewins (1951) was found applicable, and it’s recommended for future use in studies related to upgrading of diploma nurses’ education level.