Barriers to the Implementation of the Nursing Approach in Public Hospitals in Lubumbashi in the Democratic Republic of Congo: A Cross-Sectional Descriptive Study

Abstract

Introduction: The nursing approach (NA) is the essence of the nursing profession. However, its implementation is almost absent in the hospitals of the Democratic Republic of Congo (DRC). Objectives: The aim of this study was to determine nurses' knowledge, attitudes and practices in relation to the nursing approach and to identify barriers to the implementation of this approach. Methods: To achieve these objectives, we carried out a cross-sectional descriptive study among the nurses of the 11 public hospitals of Lubumbashi, from June to September 2015. Thanks to a validated questionnaire, we collected the data by interview, supported by participatory observation. Results: The results showed that 67.6% of respondents were trained on NA; However, 99.3% did not know the exact number of NA steps and 62.6% did not cite any steps; The majority (93.5%) of trainees on NA find that this process provides quality patient care; 100% of the sample wish to put it into practice; 100% of the sample need continuous training on NA including 67.6% to improve knowledge and 32.4% to learn; 89.1% of those trained reported not practicing NA, but participating direct observation gave 100% of non-practice. The barriers to implementation of the NA were inadequate nursing staff (75.6%), inadequate equipment (71.5%), lack of time (62.6%), lack of theoretical and practical knowledge (47.2%), lack of nursing records (26%) and lack of institution for nursing care within the hospital (17%). Conclusion: Therefore, capacity building of nurses through continuing education, as well as initial training on NA, would increase their knowledge, reinforce positive attitude and promote its implementation, all supported by improved working condi-

Implementation of nursing process in Ethiopia and its association with working environment and knowledge: a systematic review and meta-analysis

“…The copyright holder for this preprint (which was not this version posted October 8, 2019. . https://doi.org/10.1101/19008144 doi: medRxiv preprint instance, lack of theoretical and practical knowledge [20][21][22][23][24][25][26], institutional factors [6,11], professional factors [11],work overload [11,21,23,[25][26][27][28], lack of previous experience [6,27], inadequate nursing staff [20], patients with complicated case [24], working in a hospital [25], patient economic status [25], early discharge [25,26], not cooperative [25], lack of training [6,18,22,26,29], low educational status [27,28], poor Nurses skill [28], lack of time [18,20,27,30], lack of authorities' support [27] and lack of equipment and material [20,27,28], were some of the factors associated with implementation of nursing process. On the contrary, a study conducted in Nigeria shows that institutional factor does not pose a barrier to the use of nursing process [...…”

Barriers and Facilitators for Execution of Nursing Process among Nurses from Medical and Surgical Wards in a Public Hospital Lahore

“…61.1 % participants reported that they are not being able to follow patients because of low nurse inadequate nurse patient ratio. 32.4 % participants reported that there are administration related barriers for the execution of nursing process (Julie et al, 2017). Adeyemo & Olaogun (2013) observed that 67.6% of respondents' were agreed upon numerous resources related barriers, which included insufficient staff in the unit, lack of specified nursing care document and educational budget, insufficient equipment and absence of supplies and materials that are required for the execution of nursing process (Adeyemo & Olaogun, 2013).…”

“…Afolayan, Donald et al (2013) defined factors that influence the implementation of the nursing approach were found that (25.6%) participants reported the barrier related to nursing process and (61.8%) participants response to have inadequate equipment that are required to execute the nursing process, (63.4%), respondents' report lack of time for application of nursing process (Afolayan, Donald, Baldwin, Onasoga, & Babafemi, 2013). In another study according to Julie et al (2017) revealed that 70.2 % participants' answer that hospital administration needs to be enlightened on the benefits of nursing process. 61.1 % participants reported that they are not being able to follow patients because of low nurse inadequate nurse patient ratio.…”

“…Moreover 94.3 % participants stated that the practice of nursing process should not be left for the degree nurses only (Clarke, 2017). Julie, Simon et al (2017) defined barriers to implementation of the nursing approach were found insufficient among nursing staff. (62.6%), respondents' report lack of time for application of nursing process, (47.2%) were stated a barrier that is lack of theoretical and practical knowledge, lack of nursing records were found (26%) and17% participants identify the tedious documentation as a barrier (Julie et al, 2017).…”

“…Julie, Simon et al (2017) defined barriers to implementation of the nursing approach were found insufficient among nursing staff. (62.6%), respondents' report lack of time for application of nursing process, (47.2%) were stated a barrier that is lack of theoretical and practical knowledge, lack of nursing records were found (26%) and17% participants identify the tedious documentation as a barrier (Julie et al, 2017). Moreover another study has recognized lack of capacity (facility), from administrative factors, financial position of the patient to gather required material for the nursing care.…”