NURSING PROCESS UTILIZATION AND ITS PREDICTORS IN A KENYANHOSPITAL

Abstract

Background: The nursing process (NP) is an essential systematic framework for delivering high-quality, safe, and patient-centered care; however, its implementation is often inconsistent, particularly in resource-limited healthcare settings. This study aimed to identify nurse-associated predictors influencing the utilization of the NP among nurses from different departments at Mater Misericordiae Hospital, Nairobi, Kenya.

Methodology: An analytical cross-sectional study design was employed. Stratified random sampling was used to select 164 nurses from Specialized Care Units (Neonatal Intensive Care Unit [NICU] and Intensive Care Unit [ICU]), Medical, Surgical, Outpatients, Emergency, Maternity, and Paediatric departments. Data were collected using structured questionnaires and analysed using both descriptive and inferential statistics, including Mann-Whitney U tests, Kruskal-Wallis tests, and binary logistic regression.

Results: Of the 164 nurses surveyed, 76.2% (n=125) demonstrated high nursing process (NP) utilization. The diagnosis step had the lowest implementation rate (70.7%, n=116) among the NP steps. Bivariate analysis revealed significant associations between NP utilization and education level (p=.018), years of experience (p=.015), current role (p=.027), knowledge (p=.013), confidence (p=.001), training frequency (p=.005), and support (p=.012). Multivariate analysis identified confidence (AOR=4.13, 95% CI [1.14, 14.90], p=.030) and higher

education level (AOR=0.54, 95% CI [0.31, 0.94], p=.030) as significant

independent predictors. Staff nurses had significantly higher NP utilization than nurse managers (p=.027).

Conclusion: Overall, NP utilization was high, but the diagnosis step was poorly implemented. The most significant independent predictors of high-quality NP utilization were nurses' confidence and their level of education. Therefore, healthcare facilities should focus on implementing targeted interventions focusing on boosting nurses' confidence through regular hands-on training, mentorship programs, and a supportive work environment to enhance NP utilization.