Assessing barriers to implementation of nursing process among nurses working at Machakos level 5 hospital

Abstract

Introduction: Nursing process is a global concept, which forms the foundation of nursing as profession. The use of nursing process in most hospitals is lagging behind despite all the effort of nursing professionals to implement its use. Nursing process was introduced in early 1960s in developed countries and since then it has been widely accepted as a scientific method to guide nursing procedures and quality of nursing care. Nursing process is dynamic and it is used in clinical practice worldwide to deliver quality-individualized care to patients and lack of its application can affect the quality of nursing care in health institutions. Study Objectives: This study sought to assess barriers to implementation of nursing process among nurses working at Machakos Level 5 Hospital. Methodology: A descriptive cross sectional study was carried out at Machakos Level 5 Hospital. A total of 134 nurses were recruited in the study. Data were collected through selfadministered questionnaires and key informant interviews. Quantitative data were analysed using SPSS version 20.0 Descriptive statistics such as measurements of central tendency were used to analyse sample characteristics. Inferential statistics, chi square tests were used to establish association between independent variables and nursing process implementation and p values were used to calculate the statistical significance of results obtained. Qualitative data were coded through content analysis according to the different themes identified. The study was approved by the University of Nairobi-Kenyatta National Hospital Ethics and Research Committee. Results: In the study, the mean age of the nurses participating was 34.3 years and 66.4% were female. Most nurses (57.5%) had diploma and 109 (81.3%) had trained in nursing process. One-third (33.1%) of nurses reported that they were actively implementing the nursing process but only 11 (8.2%) nurses correctly listed all the steps of the nursing process. Nursing process implementation was significantly associated with nurses demographics (age p <0.001, experience p = 0.001), training (p = 0.013), institutional factors (p = 0.048). Social (p>0.05) and cultural (p = 0.993) factors were not significantly associated with nursing process implementation. Conclusion: The study demonstrated nurse demographic characteristics related barriers, institution related barriers like resource unavailability, lack of constant nursing processes trainings and poor staffing ratios. Therefore nursing process mainstreaming interventions by stake holders, continuous trainings and mentorship on nursing process at clinical setting, availability of relevant resources which includes human resource and supplies can mitigate these barriers.