Factors Influencing Implementation of Nursing Process by Nurses: A Qualitative Study
DOI:
https://doi.org/10.22100/jkh.v6i3.102Keywords:
Nurse, Nursing process, Grounded theory, Qualitative research.Abstract
Introduction: Nursing process is a systematic and dynamic method that will help to improve the quality of patient care. Reviewing the literature indicates that implementation of nursing process not only in Iran but also in many countries has encountered many challenges. Applying nursing process requires understanding the factors affecting its implementation from the perspective of nurses and understanding the way these factors influence the nursing process. The purpose of this study was to explore the factors that may influence the implementation of nursing process by nurses in Iran.
Methods: A grounded theory was used to explore the nurses’ perspectives on implementation of nursing process. 18 clinical nurses, 12 nurse educators and 6 nurse managers participated in semi-structured interviews and data were simultaneously and constantly compared.
Results: Personal-managerial factor was found as a core variable in this study. It means that a set of personal and managerial factors should be provided to help nurses apply nursing process to improve quality of nursing care. This variable includes two levels of axial codes: personal level and managerial level. Three categories in personal level code (awareness, attitude and skill) and five categories in managerial level code (supervision, adequate human resources, reinforcement and punishment, appropriate tools and conditions, and cooperation) emerged.
Conclusion: Factors which influence the implementation of nursing process by nurses are varied and complex and related to personal and managerial factors. Therefore, nurse managers and nurse educators should try to remove barriers and provide facilities to promote implementation of nursing process and increase the quality of care based on nursing process.
References
Timby Bk. Fundamental nursing skills and concepts. 9th ed. Philadelphia: Lippincott Williams and Wilkins; 2008.p.136
Amante LN, Anders JC, Meirelles BHS, Padilha MI, Kletemberg DF. The interface between teaching of the nursing process and the application in professional practice. Rev Eletr de Enf 2010;12(1): 201-207.
Smeltzer S, Bare BG, Hinkle JL, Cheever KH. Brunner & Suddarth’s textbook of medical-surgical nursing. 12th ed. Philadelphia: Lippincott, Williams and Wilkins Co; 2010.p.7-25.
Taylor C, Lillis C, Lemone P, Lynn P. Fundamentals of nursing, the art and science of nursing care. 7th ed. Philadelphia: Lippincott Williams and Wilkins; 2010.p.51-9.
Creasia JL, Parker BJ. Analysis and evaluation of contemporary nursing knowledge: nursing models and theories. Philadelphia: F.A. Davis Co; 2007.p.217-19.
Khademalhoseini M. Clinical guide to nursing process.1st ed. Tehran: Boshra publications; 1997.p.3-8. [Persian].
Elahi N. Applying Nursing Process in Clinical Setting. 1st edition. Ahwaz: University publications; 1997.p.4. [Persian].
Creasia JL, Friberg EE. Conceptual foundation; the bridge to professional nursing practice. 5th ed. St Louis: Mosby Elsevier Co; 2011.p.200-20.
Wilkinson JM. Nursing process & critical thinking. 5th ed. Boston: Pearson;2011.p.66.
Mason C. Guide to practice or load of rubbish? The influence of care plans on nursing practice in five clinical areas in Northern Ireland. J Adv Nurs 1999;29(2):380-387.
Qamar SL. An integrated nursing care plan. Nurs Manage 1990; 21(5):96-97.
Hildman TB, Ferguson GH. Registered nurses' attitudes toward the nursing process and written/printed nursing care plans. J Nurs Adm 1991;21(10):20.
Bellman L. The use of nursing care plans in surgical wards. J Clin Nurs 1993;2(4):258-259.
Ramos LAR, De Carvalho EC, Canini SRM. Opinion of nursing aids and nursing technicians about the nursing process. Revista Eletrônica de Enfermagem 2009;11(1):39-44.
Dahm MF, Wadensten B. Nurses’ experiences of and opinions about using standardized care plans in electronic health records- a questionnaire study. J Clin Nurs 2008;17(16):2137-45.
Lee TT. Nurses’ concerns about using information systems: analysis of comments on a computerized nursing care plan system in Taiwan. J Clin Nurs 2005;14(3):344-353.
Lee TT. Nurses’ perceptions of their documentation experiences in a computerized nursing care planning system. J Clin Nurs 2006;15(11):1376-82.
Lee TT, Yeh CH , Ho LH. Application of a computerized nursing care plan system in one hospital: experiences of ICU nurses in Taiwan. J Adv Nurs 2002;39(1):61-67.
Lee TT, Lee TY, Lin KC, Chang PC. Factors affecting the use of nursing information systems in Taiwan. J Adv Nurs 2005;50(2):170-178.
Kiani F. Inhibiting factors of utilizing nursing process in Tabriz educational hospitals. Proceeding of National Congress of Clinical Nursing and Midwifery issues; June 4-5; Hamadan, Iran.1996. [Persian].
Naji S, Sharif F. Barriers to the standard review process from the perspective of nursing personnel and nurse managers. Proceeding of the first Comprehensive Nursing Conference; Feb 28-29; Tehran, Iran.1996.[Persian].
Vanaki Z, Memarian R. The effect of implementing the nursing process on the quantity and quality nursing care. Kowsar Medical Journal 1999;4(3):20-26.[Persian].
Abbasi M, Motevaselian M. Affecting factors on the nursing care based on nursing process from the view of head nurses, nurses and senior nursing students of Shahid Sadooghi Medical Sciences University. Proceeding of Coordination Education, Health and Treatment in the Nursing and Midwifery Congress; Nov 8-10, Tehran, Iran.2000.[Persian].
Haghighi Moghddam Y. A survey on nursing process barriers from nurses’ view in selected hospitals of Urmia [dissertation]. Urmia Med Sci Univ; 1997.p.5.[Persian].
Polit DF, Beck CT, editors. Study guide for essentials of nursing research: appraising evidence for nursing practice. 7th ed, Philadelphia: Lippincott Williams & Wilkins Co;2010.p.26-42.
Streubert J, Carpenter DR, editors. Qualitative research in nursing. 4th ed. Philadelphia: Lippincott Press;2007. p.134-36.
Strauss AC, Corbin JM, editors. Basics of Qualitative Research. 3rd ed. Los Angeles:CA Sage Press;2008. p.102-103.
Adib Haj- Bagheri M, Parvizi S, Salsali M. Qualitative Research. Tehran: Boshra publications;2007.p.128.[Persian].
Voutilainen P, Isola A, Muurinen S. Nursing documentation in nursing homes--state-of-the-art and implications for quality improvement. Scand J Caring Sci 2004;18(1):72-81.
Akbari M, Shamsi A. A survey on nursing process barriers from the nurses’ view of Intensive Care Units. Iranian Journal of Critical Care Nursing 2011;3(4):181-186.[Persian].
Akbari M. The effect of nursing process education to nurses on quality of nursing cares [dissertation]. Tehran: Branch of Medicine, Islamic Azad Univ.; 2009. p.5.[Persian].
Castledine G. Updating the nursing process. Br J Nurs 2011;20(2):131.
Bahn D. Orientation of nurses towards formal and informal learning: motives and perception. Nurse Educ Today 2007;27(7):723-30.
Palese A, De Silvestre D, Valoppi G, Tomietto M. A 10-years retrospective study of teaching nursing diagnosis to baccalaurate students in Italy. Int J Nurs Terminol Classif 2009;20(2):64-75.
Hasson H, Arnetz JE. The impact of an educational intervention on nursing staff ratings of quality of older people care: A prospective, controlled intervention study. Int J Nurs Stud 2009;46(4):470-478.
McKenna H, Ashton S, Keeney S. Barriers to evidence based practice in primary care: A review of the literature. Int J Nurs Stud 2004;41(4):369-378.
Junttila K, Salantera S, Huplimi M. Perioperative nurses’ attitudes toward the use of nursing diagnoses in documentation. J Adv Nurs 2005;52(3):271–280.
Siders A, Jones PC, Marin H, Venkatraman R, Cross M, Safran Ch. Internet Implementation of nursing process using standardized coding. Proc AMIA Symp 1998;1111. PMCID:PMC2232350.
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