Zeleke Shegaw, Kefale Demewoz, Necho Worku
Department of Adult Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
Department of Pediatric and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
Heliyon. 2021 Mar 1;7(3):e06341. doi: 10.1016/j.heliyon.2021.e06341. eCollection 2021 Mar.
The nursing process is a global concept, which forms the foundation of nursing as a profession. The use of the nursing process in most hospitals is lagging despite all the efforts of nursing professionals to implement it. The nursing process is dynamic and it is used in clinical practice worldwide to deliver quality-individualized care to patients.
This study assessed barriers to the implementation of the nursing process among nurses working at South Gondar Zone Governmental Hospitals, North Central Ethiopia, 2019.
Institutional based cross-sectional study was carried out. By using Census about N = 249 nurses were recruited. Data was collected through self-administered questionnaires. The data were entered into Epi data version 3.1 and analyzed using statistical package for social sciences (SPSS) version 23.0. Descriptive statistics such as measurements of central tendency and inferential statistics multiple logistic regression, 95% CI, and p-value ≤ 0.05 was used. The study was approved by Debre Tabor University college of health sciences ethics and research committee.
A total of N = 249 study subjects participated with the response rate of 241 (96.4%). The mean age (SD±) of respondents' was 29.9 ± 7.2. About two-third of 146 (60%) nurses had poor knowledge of nursing process implementation. Three fourth 180 (74.7%) of nurses were implementing the nursing process. Nurses with sufficient information to NP were 2.45, nurses who have adequate skills to NP were 2.43, and nurses who have good knowledge were 2.24 times more likely to implement the nursing process than the opposite. No enough motivation to use NP 137 (56.8%), no follow-up by authority 141 (58.5%), no enough time for applying NP 145 (60.2%), no specific training for applying NP 173 (71.8%) and shortage of nurse staffs for nursing NP implementation 187 (77.6%) are also factors which affects nursing process implementation.
Based on this study only three fourth of the nurses were implementing the nursing process. For poor and non-implementation of nursing process different hindering factors were identified. Such as; shortage of time, lack of training, lack of knowledge, unrecognized by authority, no enough motivation, lack of cooperation b/n professionals, engaging in other manual tasks and unrelated tasks, unclear and poor job descriptions, work overload and poor payment for the profession were the major barriers for NP implementation Therefore, there need to be strengthen national policy frameworks and interventions aimed at improving nursing process training and implementationin in the clinical settings.
护理程序是一个全球性概念,它构成了护理作为一门专业的基础。尽管护理专业人员做出了种种努力来实施护理程序,但大多数医院在这方面的应用仍很滞后。护理程序是动态的,在全球临床实践中用于为患者提供优质的个性化护理。
本研究评估了2019年在埃塞俄比亚中北部南贡德尔地区政府医院工作的护士在实施护理程序方面的障碍。
开展了一项基于机构的横断面研究。采用普查法,共招募了N = 249名护士。通过自填式问卷收集数据。数据录入Epi data 3.1版本,并使用社会科学统计软件包(SPSS)23.0版进行分析。使用了描述性统计,如集中趋势测量,以及推断性统计多元逻辑回归、95%置信区间和p值≤0.05。该研究获得了德布雷塔博尔大学健康科学学院伦理与研究委员会的批准。
共有N = 249名研究对象参与,回复率为241(96.4%)。受访者的平均年龄(标准差±)为29.9±7.2。在146名护士中,约三分之二(60%)对护理程序实施的知识掌握较差。四分之三(74.7%)的护士在实施护理程序。对护理程序有充分信息的护士实施护理程序的可能性是缺乏信息护士的2.45倍,有足够技能的护士是缺乏技能护士的2.43倍,知识掌握良好的护士是知识掌握差的护士的2.24倍。没有足够动力使用护理程序的有137人(56.8%),上级未进行跟进的有141人(58.5%),没有足够时间应用护理程序的有145人(60.2%),没有针对应用护理程序的具体培训的有173人(71.8%),以及缺乏实施护理程序的护理人员的有187人(77.6%),这些也是影响护理程序实施的因素。
基于本研究,只有四分之三的护士在实施护理程序。针对护理程序实施不佳和未实施的情况,确定了不同的阻碍因素。例如:时间短缺、缺乏培训(71.8%)、知识缺乏、未得到上级认可、动力不足、专业人员之间缺乏合作、从事其他体力任务和无关任务、工作描述不清晰和不佳、工作负担过重以及该职业报酬低,这些是护理程序实施的主要障碍。因此,需要加强旨在改善临床环境中护理程序培训和实施的国家政策框架及干预措施。