Utilization of the nursing process among nurses working at a level 5 hospital, Kenya

Abstract

Background: The nursing process is a valuable tool that has revolutionized nursing practice for better patient outcome. Utilization of nursing process (NP) is however usually compromised by various internal and external factors. Objective: The aim of this study was to assess Knowledge, Attitude, Practices and Hospital factors affecting the utilization of nursing process among nurses in Thika Level 5 Hospital. Methods: A descriptive cross sectional study was conducted in the month of September 2017 where 69 respondents were randomly sampled from nurses in medical, surgical and paediatric units. Data on knowledge and attitude was collected using a self-administered questionnaire and Key Informant Interview guide of the ward in-charges. Data on practice of NP was collected using a checklist where in patient files were sampled. Results: Majority (78.3%) of the respondents reported they have a knowledge gap in NP, 81.2% felt NP is time consuming, 29% felt that NP contributes to patients’ wellness at times and 3% felt it does not contribute to patients’ wellness. Half (50%) of the unit in-charges reported that half of the nurses had a positive attitude towards utilizing NP. Most (72.5%) of the respondents reported the facility inadequately supports the implementation of the NP. From the in-patient files; incomplete or missing information, in regards to patient episodic assessment, and nursing care plans was revealed. Discussion: A knowledge gap in relation to utilization of NP and a negative attitude were noted. The practice on NP was wanting as most of the files did not have complete care plans and this therefore indicates that there might be a compromise in patient care. Respondents echoed that practice of NP was a challenge as a result of shortage of staff, lack of supplies as they are overworked and the NP paper work meant there was no time for patient care. Conclusions and Recommendation: The facility management needs to employ more nurses, provide material resources and ensure continuous education, workshops, seminars or updates on NP to support and enhance the implementation of NP.