A cross-sectional study on knowledge and implementation of the nursing process among nurses at Muhimbili National Hospital-Tanzania

Abstract

Background: The nursing process involves a series of actions that begin with assessing the patient, identifying problems, setting goals with expected outcomes, implementing care to achieve those goals, and finally evaluating the effectiveness of the care given. Utilization of the nursing process to guide nursing care enhances the quality of patient care and outcomes for both the patient and family members. The purpose of this study was to assess the knowledge and implementation of the nursing process among nurses working at Muhimbili National Hospital, Dar es Salaam, Tanzania.

Methods: We conducted a descriptive cross-sectional study design. A convenient sample of 102 registered nurses (RN) completed a self-administered questionnaire in April 2016. Descriptive statistics and non-parametric tests were used to assess the significance levels of associated variables.

Results: Of 102 respondents, only 16 (15.7%) had high knowledge of the nursing process. Similarly, a few (11, 10.8%) respondents had a high level of practice. The majority of RN (94, 92.2%) were aware of the role of the nurses in providing care to admitted patients. However, only a few (32, 31.4%) were aware of the purpose of the nursing process. Respondents were more likely to have high knowledge in the nursing process if they had a diploma in nursing education (95% CI 0.000-0.029, p < 0.01). The small number of nurses in the ward and inadequate motivational strategies were reported to deprive the implementation of the nursing process.

Conclusion: Overall, low knowledge of the nursing process, understaffing and workload have contributed to the ineffective implementation of the nursing process.  On-the-job refresher courses are a short-term strategy that may improve the nurses’ knowledge and motivation to implement the nursing process. This study underscores the need for policymakers to advocate for the employment of a sufficient number of nurses to enable implementation of the nursing process to all admitted patients.