Author ORCID Identifier

Date of Award

Spring 5-12-2020

Degree Type


Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Dr. Kimberly Hires

Second Advisor

Dr. Kenya Kirkendoll

Third Advisor

Dr. Raeda Anderson


Background: Education and professional development empower nurses by increasing their competencies and professional self-perception. Positive self-perception and professional perception impact patient outcomes, as well as job satisfaction and retention. The use of clinical pathways has been shown to improve patient outcomes and are used as a tool of education in the care of patients with various diseases and undergoing procedures. There was concern among hospital leadership in Mongolia that nurses may have poor professional self-perception and poor public perception. Poor professional perception when paired with infrequent use of clinical pathways could impact patient health outcomes. Mongolia has a very high rate of deaths from coronary artery disease, a non-communicable disease. Research is limited on the use of clinical pathways to educate and improve competencies of nurses in Mongolia.

Purpose: This Doctor of Nursing Practice Project aimed to answer the Clinical Question: Would the use of a clinical pathway translated into the Mongolian language for the care of a patient undergoing percutaneous coronary artery angioplasty improve the self-perception of hospital-based Mongolian nurses in Ulaan Bataar?

Methods: A quasi-experimental longitudinal panel study was used to assess pre-intervention, post-intervention, 3 months post-intervention and 6 months post-intervention using the Nursing Professional Values Scale – Three (NPVS-3). A convenience sample of nurses were recruited from 5 hospitals in Ulaan Bataar.

Results: Mongolian nurses scored in the top quartile indicating positive professional self-perceptions. There was a statistically significant increase in the scores following the educational intervention. There were no statistically significant correlations between demographic factors and the scores. Though not requested to do so, 71% of participants shared the information with a combined total of 497 other nurses. When asked directly, 93% of participants indicated additional education would improve their professional self-perception.

Conclusion: Implications of this study for nursing practice can be globally far-reaching as a way to assess professional self-perception and guide additional educational opportunities for nurses in Mongolia and in other lower-middle-income countries. Even in countries with limited technical, structural, financial or human resources, education can improve nurses’ professional self-perception and thus improve nursing job satisfaction, increase retention, and improve patient safety and outcomes. As Mongolia builds more cardiac catheterization labs, it is imperative for nurses to be stronger in their competencies in caring for this patient population, leading to improved nursing professional self perception.


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