Factors Influencing Implementation of Nursing Process by Nurses: A Qualitative Study

Introduction: Nursing process is a systematic and dynamic method that will help to improve the quality of patient care. Reviewing the literature indicates that implementation of nursing process not only in Iran but also in many countries has encountered many challenges. Applying nursing process requires understanding the factors affecting its implementation from the perspective of nurses and understanding the way these factors influence the nursing process. The purpose of this study was to explore the factors that may influence the implementation of nursing process by nurses in Iran. Methods: A grounded theory was used to explore the nurses’ perspectives on implementation of nursing process. 18 clinical nurses, 12 nurse educators and 6 nurse managers participated in semi-structured interviews and data were simultaneously and constantly compared. Results: Personal-managerial factor was found as a core variable in this study. It means that a set of personal and managerial factors should be provided to help nurses apply nursing process to improve quality of nursing care. This variable includes two levels of axial codes: personal level and managerial level. Three categories in personal level code (awareness, attitude and skill) and five categories in managerial level code (supervision, adequate human resources, reinforcement and punishment, appropriate tools and conditions, and cooperation) emerged. Conclusion: Factors which influence the implementation of nursing process by nurses are varied and complex and related to personal and managerial factors. Therefore, nurse managers and nurse educators should try to remove barriers and provide facilities to promote implementation of nursing process and increase the quality of care based on nursing process.