Benefits of Nursing Process

Benefits of Nursing Process

Nursing Process utilization ensures that there is comprehensive patient care whereby

the nursing care plans are both administrative and enabling achievement of realistic

patient goals (Butcher, Bulechek, Dochterman, & Wagner, 2018). It enables the nurse

to make a meaningful evaluation of care, patients should be involved in their plan of

care and that in-patient care there should be less writing and more action. The nursing

process has two main impacts on clinical nursing practice, which is the emergence of

managed care as the dominant force in health care financing and emphasis on quality

of care (Butcher, et al, 2018). Through the NP, the nurses can gain confidence and

Indicators of NP practice

Effective implementation of the nursing process translates in improved patient care

and stimulates construction of both theoretical and scientific knowledge based on

optimal clinical practices (Pokorski, et al., 2009). This will ensure patients’

satisfaction, reduced workload as well as improved communication amongst the

nurses. Habermann and Uys, (2005), Wiscombe, (2001) cited that nursing process

applied in clinical settings provides a basic framework that facilitates quality nursing

care and patient management. This was further supported by Afolayan, et al, (2013)

who found out that through nursing process, patient satisfaction and attainment of

global standards of nursing was achieved. NP has? also been established to improve

(MOH) as a scheme of service in the nurse practice and key criteria for promotion. In

incorporated the NP as a framework in developing of nursing care plans. This is aimed

at enhancing how it is utilized in improving quality of nursing care in patient

management (Wagoro&Rakuom, 2015). However, Mahmoud and Bayoumy (2014)

established that the use of nursing process began and stopped while in another

instances NP is fully not employed in the patient care. This could be due to the

challenges that are experienced.

Implementation of NP in Mental Health Practice

The implementation of nursing process in Mental Health was first introduced in 1973

by the psychiatric and mental health practice of the American Nurses Association

(ANA). This was brought about by the need to provide standard nursing care towards

and 2007 (ANA, 2012). Thus, NP becomes central to the establishment of nursing

South Africa, the mental health hospitals use the 2007 international classification of

nursing practice to determine the stages of the nursing process which include,

assessment, diagnosis, planning implementation and evaluation (World Health

Organization, 2013).

However, many mental health hospitals in sub-Sahara Africa and other poor and

developing nations still experience challenges such as shortage of adequate financial,

material and human resources. Afoi, Emmanueul, Garba, Gimba and Afuwai (2012)

observed that mental disorder was both rampant medical condition as well as

increasingly disabling. The magnitude of the burden is because most people with such

disorder do not get treatment from specialized mental healthcare systems. Others fail

diagnosis procedures, or the nurses have high workloads. While in the United States,

barriers facing the nursing process was inability of some nurses to accurately

diagnose the mental disorder and their failure to offer appropriate management due to

limited resources, excess workload and lack of technical support from the department.

WHO (2012) further adds that inadequate resources currently constitute the main

challenge facing proper nursing practice in the mental health units.

and implementing therapeutic actions for attaining, maintaining and promoting

optimal bio psychosocial functioning. The steps of the nursing process include

assessment, diagnosis, planning, implementation, and evaluation and documentation.

Assessment

Assessment describes the process through which the nurse collects information about

the patient’s health in a structured way through observation, examination, and

interviews (Chabeli, 2007). Hamilton and Price (2013) argue that the assessment is a

very crucial step through which the patient’s need are identified and determines the

effectiveness of the entire nursing process. It is an ongoing process in any nursing

intervention. The data collected can either be subjective or objective or both (Kozier,

physical examination, mental status examination, laboratory and psychological tests in

addition to the other assessment data as observed in other general patients. According

demographic data, presenting complaints and duration, history of present illness, past

psychiatric history, family history, personal history and premorbid personality. The

observation will entail inquiring the situation that enhanced the behaviour, what the

patient was thinking the moment he or she fell sick, the sensibility of the behaviour in

that context and if the conduct was adaptive or dysfunctional.

Diagnosis

A diagnosis is the statement of the nursing problem of the patient that encompasses

both adaptive and maladaptive responses to health problem which contribute to the

stressors (Newfield, Hinz, Scott Tilley, Sridaromont, & Joy Maramba, 2007). The

nursing problems entail the health aspect of the patient that requires intervention. The

diagnosis may be an actual or a potential health problem regarding the situation

(Yildirim & Ozkahraman, 2011). A diagnosis statement consists of health problem,

contributing factors and defining characteristics. The defining features offer specified

indicators the purpose of evaluating the results of nursing interventions as well as

The diagnosis is accompanied by outcome identification where the nurse identifies the

outcomes individualized to patients within the context of offering care and the main

goal is to influence health outcomes and enhance the health status (Peate, 2013). The

result, effectiveness, and efficiency of the intervention should be mutually identified

with the patient. Prior to the identification of the expected outcomes, nurses must

understand that patients usually seek treatment with personal goals and the

clarification of goals is a vital step in a therapeutic process. Therefore, the relationship

should be in connection with mutually acceptable goals. The goals should be in

realistic terms, and they should describe what the nurse needs to accomplish within a

to the expected outcomes that are long term.

Planning

According to (Doenges, Moorhouse, & Murr, 2008), planning contains setting the

priorities, establishing goals, consideration of proper patient outcomes and

determination of the necessary interventions to be made. The planning phase of the

nursing process use problem-solving techniques in which strategies are developed to

approach is essential in meeting the goals or objectives in the management of patients

with mental disorders. The nursing process offers systematic framework that helps

care planning. (Leach, 2008).

Implementation

Implementation is termed as a specific nursing action which is designed to achieve an

outcome to a nursing diagnosis, or medical action which the nurse is accountable

(Saba, 2007). The key point of initiating nursing care plan is the implementation phase

of the nursing process, and in that stage, the nurse still assesses the patient to

determine if interventions are effective. Nurses may choose interventions within their

level of practice, for instance, counseling, self-care activities, case management and

actions which include nursing diagnosis, care plan and nursing of the patient to attain

the equal involvement of all the involved stakeholders such as the nurses themselves,

the hospital facilities and the patients’ corporation as well (Saba, 2007;2012).

The purpose of evaluation is to determine whether the patient centered goals were met,

it is primarily directed at evaluating the outcomes of care, and not the plan of care or

the care delivered. (Yildirim & Ozkahraman, 2011). This is a continuous phase in

the progress of a patient shows what the problems that the nursing process has solved

(Hogston, 2011). It also indicates the issues that need reassessment, re-planning,

implementation, and re- evaluation. Although intervention would not help patient, the

knowledge from evaluating the intervention helps the nurses to develop care. Through

evaluation, the patient's progress towards attainment of known outcomes and

monitoring of the patient's reactions towards the preferred interventions is achieved

(Carpenito, 2015).

Documentation

Documentation is a step by step activity in every phase of NP, but its addition as an

independent stage offers room for compressive discussion. Besides, nurses will have

the opportunity to examine the principles and techniques of documentation

comprehensively and make it meet its crucial purpose in demonstrating NP

implementation (Wagoro & Rakuom, 2015). Though documentation constitutes an

ensuring demonstration of proper nursing process.

facilitate or hinder the Nursing Process Practice. The main structural factors

established to influence Nursing Process Practice include; the organization structure,

support, culture, resources, Patient-Nurse Ratio and policies. The organization

structure is how the entire hospital facility is organized from the top management to

excessive task allocations, failure to clearly specify the roles of the nurses, and

inadequate budgetary allocation. Hermida and Araujo, (2006; 2016) further add that

failure to comprehensively understand the organization structure will act as the start to

all the other implementation challenges in the nursing process.

Strong organizational support is essential in the facilitation of multidisciplinary and

interdisciplinary learning opportunities which aid in the integration of the NP role in

the health care (Jooste, Vanil & Vandyk, 2010). The support could be in terms of

financial support, provision of training opportunities, close monitoring of the NP and

ensuring that the nurses’ needs are well catered for. Keating, Thompson and Lee

These resources are in terms of insufficient finances, high workload, inadequate

conduct their operations as most end up improvising leading to neglect of the NP

entirely. Governments as well do not emphasize on the provision of adequate

resources to the hospital facilities making it a critical obstacle to NP implementation

and patient management in general.

The number of workforce dedicated to wards nursing and management of the

patients also acts to greatly affect its level of implementation and sustainability

(Marnseri, 2012). This is largely attributed to the fact that inadequate nurse staff will

Process Factors

management of patient with mental disorders. They further indicated that lack of the

implementation of the NP in the daily routine patient care (Herr, et al, 2015).

Therefore, having the appropriate qualifications and skills will highly improve the

implementation of NP while Lack of adequate training is thus an extensive barrier to

the implementation of the NP in clinical environment and ought to be addressed.

On the other hand, Lack of previous experience entails previous exposure to the use

and implementation of the nursing process (Brandalize et al, 2005). This tends to

implementation of the NP especially on management of patients with mental

disorders. This coincides with Agunwah, (2010) who also found out that lack of

experience of practical use of the nursing process tends to negatively affect its

utilization.

Huguchi, Dulburgen and Duff, (1999) also linked ineffective nursing process to lack

of prior exposure to the framework. In addition, the patients may not be fully

compliant or willing to corporate with the nurses resulting to patient related barriers as

the entire NP is interfered with. The patient may not be completely willing to

provide the necessary information pertaining to their medical condition causing

difficulties in the diagnosis (Yeboah, 2017). More specifically, the perception,