Abstract
BACKGROUND: Advanced medical care, especially care that focuses on the cranial nervous system, is increasing
throughout Vietnam. Improvement of nursing quality is critical for proper functioning of advanced medical care, but
there are several gaps between Vietnam's national goals and the implementation within nursing. METHOD: To address the gap between the national goals and the nursing implementation, we used a descriptive case study design to investigate perceived issues in nursing practice among nurses working at a leading neurosurgical care unit (NCU) in Vietnam in order to develop an effective in-service training program. RESULTS: Eighteen NCU staff nurses participated in the study. Major perceived issues were categorized as relating to knowledge, skills, or attitudes. Issues of knowledge comprised 13 subcategories including physical assessment, pathophysiology, and operating ventilators. Issues of skills comprised 20 subcategories including assessment, planning, patient care, education and communication with patients and families, and collaboration with colleagues. Issues of attitudes comprised six subcategories including passivity, ignoring procedures, lack of helpfulness and difficulty embracing the nursing profession. CONCLUSION: The main findings of this study indicated that skills, including assessment, planning, and implementation, were the most important topics of perceived issues for nurses. Area-specific weaknesses were presented by nurses. However, the present model of neurosurgical training is too general and neurosurgical area-specific training should be introduced based on nurses identified needs. Issues of nurses' attitude toward work were a result of their beliefs and values and influenced the quality and safety of patient care.
