Improving the Implementation of Nursing Care Process in Mekelle Hospital

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Addis Abeba University


Background: Despite the important role Nursing Process plays for the betterment of the health care, its implementation status is far below expected, particularly in developing countries. Similarly, the baseline assessment in this study showed that the implementation of Nursing Care Process in Mekelle hospital is poor. Thus, in light of the national and regional efforts to improve health care delivery, it is critically important to improve the implementation of the Nursing Process in Mekelle Hospital. Objectives: To improve the implementation of Nursing Care Process from 37% to 60 in Medical and Surgical ward of Mekelle Hospital, by the end of September 2013 Methodology: A facility based pre- post interventional study was conducted from December to July, 2013 in Mekelle Hospital, Tigray Ethiopia. The interventions included training of ward nurses; strengthening internal supportive supervision and providing nursing process forms. A total of 97 Medical Records were reviewed (48 at baseline and 49 at the end of the study) to compare the Nursing Process implementation status pre and post-intervention periods. The proportion of patients with complete documentation of the Nursing Process forms and Chi – square test was calculated to test the difference in the outcome of interest between the pre – and post –intervention periods. Result: The percentage of patient cards with complete Nursing Care Process increased from 37.5% in baseline to 63.3% after intervention. This change was statistically significant at (df = 6.44, P =0.011). Similarly, the implementation of all components of the Nursing Process has increased: Nursing Admission Assessment (from 58.3% to 87.8,/ P =0.001), Nursing Diagnosis (from 66.7% to 93.9%, P =0.001); Nursing Care Plan (from 68.8% to 91.8% / P =0.004 ); Nursing Implementation (from 64.6% to 91.8% / P =0.001 ) and Nursing Evaluation (from 45.8% to 65.3% / P = 0.054), with all changes showing statistically significant at P < 0.05, except Nursing Evaluation. Conclusion and Recommendations: Continuous internal Supportive Supervision of Nurses followed by on job training continuous flow of related forms can improve the implementation of the Nursing Process. Mekelle hospital managers should consider strengthening the internal Supportive Supervision to improve the Nursing Process in their health facility.



Improving the Implementation of Nursing Care