Nursing process application in Nepal teaching hospital

Abstract

Relevance. Nursing process is a scientific method of organizing and providing nursing care. Due to imbalance of nurse patient ratio, application of nursing process in actual clinical setting is very limited which reduces the quality nursing care. Despite the importance of application of nursing process, there is no standard nursing process protocol available in the hospital where study was carried out. The governments set a standard nurse patient ratio in Nepal, UK and USA is 1:10, 1:8, and 1:5 respectively. However, global statistic has been revealed due to improper nurse patient ratio which cannot implement the nursing process for patient caring which are being for leading cause of mortality of patient in hospitals. Aim of the study. The study was conducted to assess the application of the nursing process among nurses working in teaching hospital. Additionally, this study explores the association between status of application of nursing process and selected variables. Materials and Methods. Based on a descriptive cross-sectional study design. A simple random sampling technique was applied for nurses working in tertiary hospital of Chitwan, Nepal. The data was collected using structured questionnaire among 182 nurses. The statistical analysis tool chi-square was used to find out the association and logistic bivariate to find out the odds ratio. Results and Discussion. The result indicates that only 23.1 % of nurses have moderate level of application of nursing process. Majority of nurses did not follow standard ways of nursing process. This study also explored the influencing variable for barriers related to nurses and profession. Age (p=0.001), professional qualification (p=0.001) and learning approach (p=0.022) were the significant influencing variable for barriers related to nurses whereas practical skill (p= 0.001), cooperation among nurses (p=0.008) and difficulty in diagnosis characteristic (p=0.010) were the barrier related to profession. Conclusion. It was concluded that the majority of nurses working in teaching hospital of Nepal did not follow the standard ways of nursing process so that barriers for the application of nursing process are identified. The overall ratio of nurses to patients in the teaching hospital is 1:16, that is in the lower range than the standards set by the government. Therefore, special attention must be paid to adherence to a standardized nursing process protocol for quality medical care.

Nurses' perceptions about the operationalization of the nursing process in an emergency room / Percepções de enfermeiros sobre a operacionalização do processo de enfermagem em um pronto-socorro

“…13 The workload, lack of time and knowledge about the NP revealed by nurses in this study are also obstacles to the implementation of the NP pointed out by nurses in other national and international investigations. [7][8]14 In this sense, the technical--scientific knowledge is one of the pillars for the implementation of the NP. 15 Therefore, one way to increase its application is the training of nurses who understand its philosophy and know how to apply it properly.…”

“…18 In this perspective, studies developed in teaching hospitals in Nepal and Nigeria also pointed to the lack of training as barriers to the non-implementation of the NP. [7][8] Despite the difficulties pointed out by the participants for the implementation of the NP in the emergency room, their statements reveal that it could qualify the care, from improvements in nursing records, for example. The adequate record through the implementation of the NP provides legal support to nurses and recognition of their professional practice.…”

“…6 It is a methodological approach used by nurses to provide individualized care to users, whose use has a positive effect on the results of the care given to patients. [7][8] The nurse is responsible for making decisions and implementing the NP, obeying the limit between the nurse's activities and those that can be delegated to nursing technicians. 9 Recording the NP in the patient's medical record is what allows continuity of care, provides parameters for evaluation throughout the hospitalization period, and guarantees legal support for nursing professionals, since it proves its realization or execution.…”