Application Of Nursing Process And Nursing Diagnosis Pdf
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- Challenges associated with the implementation of the nursing process: A systematic review
- Application of the nursing process in a complex health care environment
- How to Develop a Nursing Care Plan for Your Hospital
The acuity of patient care in the hospital setting has grown significantly over the last 10 years.
Challenges associated with the implementation of the nursing process: A systematic review
Metrics details. Registered nurses in Ghana are trained to plan the care that they provide to their patients in a systematic and organized manner. This scientific approach to care is known as the nursing process. There is evidence that the nursing process is not being practised by professional nurses in Ghana, as expected.
This research seeks to explore what informs nursing interventions in the clinical area. A qualitative study was conducted with ten registered nurses; and this was descriptive in nature. One-on-one interviews were conducted with the research participants, as a means of collecting the data.
A semi-structured interview guide was used as the data-collecting tool. The collected data were analysed by using latent-content analysis. Three main themes emerged from the data analysis. It was found that registered nurses did not plan their nursing care. Registered nurses are taught the nursing process; and they are expected to implement the acquired knowledge in the clinical area. The failure of nurses to practise the expected standard of care results in their relying on the decision of other health-care professionals, such as doctors.
This makes registered nurses appear to be assistants to doctors. We, therefore, conclude that nurse leaders must supervise nurses to put into practice what they were taught during their training; so that they can have professional autonomy in their practice as nurses. It is also suggested that nurses must show evidence of using the nursing process in their daily work by the use of the nursing care-plan form.
Peer Review reports. The nursing process provides a framework that can be used in all nursing situations [ 2 ]. Nursing students are therefore guided by their tutors to learn how to make medical diagnoses; and they are left on their own to learn nursing diagnosis. Thus, in the end, medical diagnoses guide their practices, leaving nursing diagnoses as only an unpleasant memory. Often, the nursing tutors teaching the nursing process do not understand nursing diagnoses; and therefore, do not embrace, value, or teach them.
It is evident that nurses find it difficult to implement the nursing process; because some professional nurses do not quite understand it [ 5 ]. A study conducted in Ghana on factors that influence clinical utilization of the nursing process found that, registered nurses were not formulating, or stating the nursing diagnosis. They carried out various nursing interventions that were not based on the nursing diagnosis.
They were also not evaluating the rendered care; thus the nursing process in totality was not being implemented [ 6 ]. If professional nurses in Ghana are not implementing the nursing process, what then informs their practice? The purpose of this study was to explore and describe the extent to which registered nurses working at the 37th Military Hospital implement the nursing process in the clinical area. The study aimed to explore what informs nursing interventions in the clinical area.
A qualitative research design was employed, which was descriptive in nature. This design gave the participants the opportunity to express their opinion on the situation being studied.
The study was conducted at the 37 Military Hospital. This is a bed hospital located in Accra, the capital of Ghana. The participants consisted of five nursing officers, two senior staff nurses and three staff nurses.
The male-to-female ratio of the participants was The participants were selected by using the purposive-sampling technique. Arrangements were made with those who expressed interest in the research.
The researcher met them; and they were briefed about the research. They were informed about the purpose of the study; and how the data would be collected from them. They were assured of their confidentiality. How the data would be managed was also explained to them.
They were informed that their participation in the research would not affect their employment in the hospital. Their right and freedom to withdraw from the study, at any time, was explained to them. The research participants were also given the opportunity to ask any questions to clarify any issues related to the study. Those willing to participate in the study were given the consent form to read; and further explanation was given on what was stated in the form.
Those who accepted to participate in the study were allowed to sign the consent form. They were given a copy of the signed consent form to keep. An arrangement was made with the participant for a convenient time and place for the interview. A semi-structured interview guide was used as the data-collecting tool attached as an Additional file 1 This interview guide was first piloted in a public hospital in Accra, in order to test the validity of the tool.
After the pilot study, the interview guide was slightly amended. The participants were interviewed until the tenth participant, after which no new information was forthcoming.
The data analysis was done concurrently with the data collection. The researchers observed from the data analysis that no new themes or concepts were emerging from the interview; and therefore, the researchers stopped the interviews.
The interviews were recorded on a voice recorder with the permission of the participants; and points on key issues were also written down as part of the field notes during the interview. Each interview lasted for approximately forty-five minutes to one hour.
The data in this study were analysed by using latent-content analysis [ 7 ]. Immediately after the interview session, the recorded interviews were replayed and transcribed verbatim. The data were then coded; and during the coding, the data were read by the researcher several times. Sections of the text were highlighted; and comments were made regarding anything that was striking. These comments included overall impressions; and points of interest were written in a margin created at the right side of the sheets.
After coding, the data were organised with related codes; and they were put into categories [ 7 ]. The coding and analysis of the data was done by an independent coder. Consensus was reached between the researchers and the independent coder, before the themes were finalized.
A label was given to each category. Once the data were categorized, a summary for each of the categories was written. How the categories relate to each other was carefully analysed; and then the themes were developed. These were: nursing care is not planned by nurses; alternatives to the nursing care plan and means of communicating nursing care.
Two of the main themes had their respective sub-themes. These are described below:. Unplanned nursing care was a major theme that emerged from the analysis. By this it is meant that nursing care is provided to the patient, without any formal care plan as a guide. Nurses stated they knew they must plan care; but they did not do it. Instead, they provided nursing care, based on what they perceived the patient needed at that time.
Some nurses stated that this lack of formal plan of care was due to the high patient—nurse ratio and the inadequate time available. This was expressed by one participant as follows:. I think what we do is that from time-to-time, we meet the needs of the patient, as time goes on, or when the need arises; but ideally, we are supposed to plan the patient care, according to the diagnosis and treatment of the patient. Another participant also felt that they were not able to plan the care of the patient; because they needed to care for a lot of patients at a particular time; hence, they do not get the necessary time to plan the care; although they are aware that planning of the care is the correct thing to do.
One of them stated it in this way:. We usually care for the patient and what their needs are immediately; but we do not use the nursing process. It was evident from the data analysis that, when a patient comes for admission to the ward, the nurses do not plan the care of that patient with the patient. Instead, just as they decide the overall care for the patient, they again use their discretion. One participant indicated it this way:.
Although no planning is made in relation to the care that the patient receives; some of the participants did not really see this as a problem.
They indicated that it was a nation-wide situation; and that it was not peculiar to the institution in which they work. One of the participants expressed his view by stating that:. Planning is not done; we really care for the patient, but not with the care plan. I think the problem is not just with the 37 Military Hospital; but I think it is a nation-wide problem.
The nursing process in actual fact is not being used well in Ghana. I think it is a foreign concept; and also the high patient to nurse ratio is a contributing factor. The above statement from the participants reveals that they are aware of the existence of the nursing-care plan. They are also aware that they are supposed to plan the care of the patient; but they are not doing it.
This theme describes what nurses actually depend on to care for the patient instead of developing and using the care plan. Some of the participants indicated that the care that they provide to the patient is based on the daily routine care that they normally provide for all the patients, regardless of their medical diagnosis. This was how a participant stated it:. From the experiences that the nurses had, they knew what was normally done for the patients during the morning, afternoon or the night shift; hence when the nurses come to work, they go strictly according to the daily routines.
For patients who are able to verbalize their problems and request particular care; the nurses would attend to these requests and try to meet their needs. One of the participants had this to say:. If you come for afternoon shift too, the routines are the serving of medications, talking with the patients, turning those who are bed-ridden, or feeding them when necessary.
The nurses were aware of what they were expected to do for the patient, as a routine activity, depending on the shift in which they are working. Patients who were able to verbalize their problems receive the necessary care to assist them in solving their problem.
Application of the nursing process in a complex health care environment
Bernard W. Mbithi , Catherine S. Mwenda , Jane Karonjo. Nursing process is a systematic rational method which the nurse utilizes to plan and provide individualized care to clients. Therefore, this study was undertaken to determine the utilization of nursing process among nurses in selected health care facilities in Kenya. This study was conducted among nurses from five selected health care facilities in Kenya.
Nursing process is a scientific approach in the provision of qualified nursing cares. However, in practice, the implementation of this process is faced with numerous challenges. With the knowledge of the challenges associated with the implementation of the nursing process, the nursing processes can be developed appropriately. Due to the lack of comprehensive information on this subject, the current study was carried out to assess the key challenges associated with the implementation of the nursing process. The articles were retrieved in three steps including searching by keywords, review of the proceedings based on inclusion criteria, and final retrieval and assessment of available full texts. Systematic assessment of the articles showed different challenges in implementation of the nursing process.
Metrics details. Registered nurses in Ghana are trained to plan the care that they provide to their patients in a systematic and organized manner. This scientific approach to care is known as the nursing process. There is evidence that the nursing process is not being practised by professional nurses in Ghana, as expected. This research seeks to explore what informs nursing interventions in the clinical area. A qualitative study was conducted with ten registered nurses; and this was descriptive in nature.
Both nursing diagnoses and collaborative problems involve all steps of the nursing process: assessment, diagnosis, planning, implementation.
How to Develop a Nursing Care Plan for Your Hospital
Nursing process is considered as appropriate method to explain the nursing essence, its scientific bases, technologies and humanist assumptions that encourage critical thinking and creativity, and permits solving problems in professional practice. A cross sectional design employing quantitative and qualitative methods was conducted in Mekelle zone hospitals March Qualitative data was collected from14 head nurses of six hospitals and quantitative was collected from nurses selected by simple random sampling technique from the six hospitals proportional to their size. SPSS version All of the respondents said that they did not use the nursing process during provision of care to their patients at the time of the study.
Care plans are part of the core curriculum in most nursing schools. Yet, new hospital nurses often complain that despite all the hype and time spent learning how to make a nursing care plan, they never do it again after graduation. As a nursing leader, you might not have written one for a while, either. Why should you start now? Care plans help nurses focus on patients in a holistic, big-picture way so they can deliver evidence-based, patient-centered care.
Read reviews from world's largest community for readers. The nurse must give him more blankets and hot drinks. Looking for abbreviations of ND? It is Nursing diagnosis. Drafting hypothetical nursing care plans is a critical thinking exercise for nursing students.
Owned by Guilan University of Medical Sciences. Co-published by Negah Institute for Scientific Communication. Mon, Mar 8, Remember me Create Account Reset Password. J Holist Nurs Midwifery. Keywords: Nursing process , Hospital nursing staff , Nursing faculty , Nursing students. Its application helps to improve the quality of healthcare  by involving scientific and patient-based approaches to nursing care instead of the traditional methods .
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