FACTOR AFFECTING THE IMPLEMENTATION OF NURSING PROCESS IN TERTIARY CARE HOSPITAL

Abstract

Background: The nursing process is a systematic and structured framework that enables nurses to deliver patient-centered, evidence-based care. Its effective implementation supports improved patient outcomes, enhances clinical decision-making, and contributes to the overall quality of healthcare services. However, institutional, professional, and patient-related factors may hinder the consistent application of the nursing process in clinical practice, particularly in resource-constrained healthcare settings. Objective: To assess the factors affecting the implementation of the nursing process among nurses working in a tertiary care hospital in Lahore. Study Design: Descriptive cross-sectional study. Setting: Ittefaq Hospital Trust, Lahore, Pakistan. Duration of Study: Over six months from February 2025 to July 2025. Methods: A total of 153 staff nurses were recruited using convenience sampling from a population of 250 nurses, with the sample size calculated using Slovin’s formula. Data were collected using an adopted structured questionnaire that included demographic variables and items assessing administrative, professional, and patient-related factors influencing the implementation of the nursing process. Data were analyzed using SPSS version 23. Descriptive statistics, including frequencies and percentages, were calculated to summarize the findings. Results: Most participants were aged 21–30 years (77.8%), and the majority were female (95.4%). Staff shortages were identified as a major barrier, with 45.1% of respondents strongly agreeing that insufficient staffing affected the implementation of the nursing process. Lack of cooperation among nurses was reported by 58.2% of participants as a contributing factor. More than half of the nurses (53.6%) agreed that the lack of motivation negatively influenced implementation. Additionally, 35.3% of respondents disagreed that the nurse-to-patient ratio was adequate. Patient-related factors, such as disease severity (47.7%) and patient participation in treatment decisions (52.9%), were also perceived as influencing the application of the nursing process. Conclusion: The implementation of the nursing process is influenced by multiple organizational, professional, and patient-related factors. Addressing staffing shortages, strengthening administrative support, enhancing professional development opportunities, and promoting teamwork may improve the effective application of the nursing process and ultimately enhance the quality of patient care.