The implementation of nursing process during patient care in Ethiopia: A systematic review and meta-analysis

Abstract

Background: Nursing process (NP) is a standard method of ensuring individualized holistic care through systematic assessment, diagnosis, planning, intervention and evaluation of patients. Its standard implementation is mandatory to meet the health target of "ensuring universal quality health-care services" in the sustainable development goals (SDG) launched by World Health Organization (WHO) in 2015. Being a member state of WHO, Ethiopia endorsed the SDG agenda. Therefore, determining the recent pooled estimate and associated factors of NP implementation during patient care would be of greatest importance to improve the quality of nursing care in the country. Methods: Primary studies were systematically searched from PubMed, Scopus, Cochrane Library, Google Scholar, PsycINFO and CINAHL data bases using different search operators. Each selected primary study was critically appraised using the Joanna Briggs Institute (JBI) appraisal tool for prevalence studies. I 2 and Q statistics were used to investigate heterogeneity. Given the substantial heterogeneity between the studies, random effects metaanalysis model was used to estimate the pooled magnitude of NP implementation. Subgroup analyses were performed for evidence of heterogeneity. Egger's test was considered to declare publication bias objectively. The PRISMA guideline was followed to report the results. Results: A total of 17 primary studies with a sample of 2,819 nurses were included in this meta-analysis. The pooled estimate of NP implementation in Ethiopia was 50.22% (95% CI: 43.39%, 57.06%) with severe statistical heterogeneity (I 2 ¼ 93.0%, P < 0.001) between the studies. From regional subgroup analysis, NP was least implemented in Tigray region 35.92% (95% CI: 30.86%-40.99%, I 2 < 0.001%). Egger's test showed no statistical significance for the presence of publication bias (P ¼ 0.23). Nurses' good knowledge of NP [(Adjusted Odds Ratio (AOR) ¼ 13.16: 9.17-17.15], nurses' Bachelor of Science (BSC) and above level of education (AOR ¼ 4.16; 2.32-5.99), working in a stressful environment (AOR ¼ 0.10; -0.02-0.22), training access (AOR ¼ 3.30; 1.79-4.82) and accessibility of facility required for NP (AOR ¼ 6.05; 3.56-8.53) were significantly associated with NP implementation at 95 % CI.

Current status of methodological and reporting quality of systematic reviews and meta-analyses in medicine and health science fields in Ethiopia: Leveraging quantity to improve quality

“…25 Moreover, a high number of SR might lead to research waste, as the publication of overlapping SR and MA is becoming evident. 26, 27 For example, we found 28 duplicates on various topics: two on mother-to-child transmission of HIV 28, 29 , two on HIV/AIDS treatment failure 30, 31 , three on nursing process 32-34 , three on antenatal depression 35-37 , three on postnatal depression 38-40 , three on breastfeeding 41-43 , three on immunization coverage 44-46 , three on low birth weight 47-49 , two on tuberculosis treatment non-adherence 50, 51 , two on maternal-near miss 52, 53 and two on antiepleptive medication non-adherence. 54, 55 To minimize research waste, authors must register their protocol, thoroughly search protocol registration cites and communicate each other whenever possible.…”

Study of readiness and performance of nurses in evaluating clinical care and processes of care and nursing

“…[ 12 ] Nurses should be educated about care strategies, and they know the principles of care scientifically. [ 13 ] The present study is based on the findings of nurses’ reports in hospitals of Iran. It shows that nurses were successful in performing many aspects of the excretion, absorption, and dressing processes and showed appropriate preparation.…”

“…The authors stated that paying attention to influential factors such as stressful environment, lack of facilities, and access to education can be effective in improving care and nursing processes. [ 13 ]…”

Investigation of nurses’ readiness levels in different wards of the hospital

“…Bayih et al . [ 8 ] showed that that only half of the nurses performed the nursing processes completely during the patient care. They stated that paying attention to influential factors such as stressful environment, the lack of facilities, and access to education can be effective in improving care and nursing processes.…”

“…By empowering nurses, effective steps can be taken to address nursing challenges. [ 7 8 ] So far, many studies have been conducted in relation to the readiness of nurses, but despite the increasing challenges of nursing and the need of patient health, attention and evaluation of nursing care are important issues. Also, the identification of these deficiencies in different wards of hospitals can be performed with the aim of comparing the readiness of nurses in the field of evaluation of clinical nursing care in different wards of hospitals.…”