Nursing process implementation and associated factors in public hospitals of west wollega zone; oromia regional state; west Ethiopia-from nurses prespective

Abstract

Background: Evidence in the literature shows that implementation of the nursing process leads to improved quality of care and stimulates the construction of theoretical and scientific knowledge based on the best clinical practice. However, this critical aspect of health care delivery did not subjected to empirical assessment in the study area. Objective: To assess nursing process implementation status and associated factors in public hospitals of West Wollega Zone Oromia Regional State, West Ethiopia-from nurse’s perspective. Methods: Facility based cross-sectional study design with quantitative data collection method supported with qualitative. The research conducted on four public hospitals of West Wollega Zone from March 04 – March 29, 2019. The sample size was all one hundred eighty-three nurses working in the hospitals taken by census. Two hundred patients’ cards selected. Nine key informants selected purposively for qualitative data collection. Self -administered structured questionnaire open-ended questions and checklist used for data collection. The data entered using EP-data version 3.1, then exported into SPSS version 25 for analysis. Both bivariate and multivariate logistic regression model fitted to identify possible factors associated with nursing process implementation. Statistical significance was declared with adjusted odd ratio at 95% confidence interval (CI) and p-value of <0.05 Result: 183 nurses were participated in the study with a response rate of 97.8. From the participants (92(50.3%) of them were implemented nursing process. In multivariable logistic regression analysis regular monitoring(AOR=6.872, 95%CI=1.752-26.951),daily working hours (AOR=6.250,95% CI=1.205-32.406),nurses’ turnover due to NGO attractive payment (AOR=3.479,95% CI=1.035- 11.695),monthly income of nurses (AOR=8.398,95% CI=1.305-54.033),patient turnover due to missunderstanding of modern medicine(AOR=0.152,95% CI=0.037-0.625) were factors statistically associated with the implementation of nursing process. Data obtained from medical record showed that the implementation status was 41.5%.The qualitative finding also showed that nursing process implementation not monitored regularly. Conclusion: The result showed that the nursing process implementation in the study hospitals was low. Lack of regular monitoring, monthly income of nurses, nurses’ turnover due to NGO attractive payment, daily working hours were positively associate factors and patient turnover due to miss-understanding of modern medicine was negatively associated with the implementation of nursing process.