Title : Implementation of nursing process in Ethiopia and its association with working environment and knowledge: A systematic review and meta-analysis
Background: Nursing Process is a systematic method which utilizes scientific reasoning, problem solving and critical thinking to direct nurses in caring for patients effectively and to improve quality of health care service at large. However, the national pooled prevalence of implementation of nursing process remains unknown. Hence, the aim of this systematic review and meta-analysis was to determine implementation of nursing process in Ethiopia.
Methods: Studies were retrieved through search engines in PubMed, Scopus, Cochrane Library, Google Scholar,PsycINFO and CINAHL following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). All statistical analyses were done using STATA version 14 software. We checked the between-study heterogeneity using the I2 and examined a potential publication bias by visual inspection of the funnel plot and Egger’s regression test statistic. The random-effect model was fitted to estimate the summary effects, odds ratios (ORs), and 95% confidence interval (CIs) across studies.
Results: Out of the reviewing 648 studies, 7 studies fulfilled the inclusion criteria and were included in the meta-analysis. The estimated pooled prevalence of implementation of nursing process in Ethiopia was 42.44% (95% CI (36.91, 47.97%)). Based on the subgroup analysis, the estimated implementation of nursing process was 44.69% (95% CI: 35.34, 54.04) among studies their sample size were greater than or equals to 200. Nurse who had work in the stressful environment were 59% less likely [(OR 0.41, 95%CI (0.08, 2.12)] to implement nursing process than their counter part. In contrary, nurses who had high knowledge in nursing process were 2.44 times more likely [(OR 2.44, 95%CI (0.34,17.34)] to implement nursing process as compared with low knowledge even though it was not statistically significant.
Conclusion: The overall prevalence of implementation of nursing process in Ethiopia was significantly low. Nurses who work in the stressful environment had a negative influence on the implementation of nursing process. On the other hand Nurses who had high knowledge on nursing process were more likely to implement nursing process. Therefore, policymakers could give more emphasis to the implementation of nursing process in order to improve the overall quality of healthcare service.