Assessment on Factors Affecting Implementation of Nursing Process Among Nurses in Selected Governmental Hospitals, Addis Ababa, Ethiopia.
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Date
2011-06
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Addis Ababa University
Abstract
Background: Nursing Process is a systematic problem-solving approach used to identify, prevent
and treat actual or potential health problems and promote wellness. It has five steps- assessment,
diagnosis, planning, implementation, and evaluation.
Objective: To assess factors affecting implementation of nursing process among nurses in
selected governmental hospitals of Addis Ababa.
Method: A cross-sectional study was conducted on selected governmental hospitals in Addis
Ababa from February-April, 2011. Both quantitative and qualitative methods were used.
Purposive sampling was used for selection of hospitals. Black Lion, St. Paul, Ras Desta Damitew
Memorial, and Yekatit 12 hospitals were convenient for the study. The participants were selected
using simple random sampling technique. The minimum sample size was 202. Tools were given
to nurse expatriate to check for its validity and adjustment was made according to the feedback
obtained before pre test. Data was collected using self-administered questionnaire and in-depth
interview. Data was analyzed using SPSS 16th version.
Result: Out of 202 sampled respondents 192 agreed to participate in the study and the response
rate was 95%. One hundred two (53.1%) were females and 90(46.9%) were males. One hundred
forty (72.9%) of the total respondents were working in a stressful working environment where as
31(16.1%) were working in a disorganized working environment, the remaining 21(10.9%)
respondents explained their work place was negligent at a time.
Thirty one (16.1%) of
respondents were highly knowledgeable. From the total respondents 89(46.4%) were highly
skillful. One hundred (52.1%) of respondents have implemented nursing process. From binary
logistic regression model analysis those who have implemented nursing process were nurses
working in a stressful working environment were 2.8(adjusted OR: 0.357, 95%CI: (0.157-0.814)
times less likely to implement nursing process than disorganized working environment adjusting
for facility accessibility, knowledge, and sex. Accessibility of facilities needed for nursing care
were 2.248(Adjusted OR: 2.248, 95%CI: (1.079-4.684))times more likely to implement nursing
process than nurses working in an inferior facility controlling for working environment,
knowledge, and sex. Highly knowledgeable respondents were 38.913(Adjusted OR: 38.913,
95%CI: (10.3-147.006))times more likely to implement nursing process than low knowledge
group nurses adjusted for working environment, facility, and sex.
Conclusion: Nursing process implementation is affected by various factors. The study has
identified organizational factors, patient related factors, and level of knowledge and skill were
among those factors highly influenced nursing process implementation. This factors cause poor
quality of nursing care, disorganized caring system, conflicting role, medication error and
readmission with similar problem, dissatisfaction with the care patients have received, and
increased mortality.
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Keywords
Nursing, Governmental Hospitals