Thesis (Ph. D.)--University of Washington, 1997. / Vita. Includes bibliographical references (leaves [151]-164).

Background: The nursing process is a widely accepted method and has been suggested as a scientific method to guide procedures and qualify nursing care. More recently, the process has been defined as a systematic and dynamic way to deliver nursing care. This process is performed through five interrelated steps, namely: assessment, diagnosis, planning, implementation and evaluation, with subsequent modifications used as feedback mechanisms that promote the resolution of the nursing diagnoses. The Lesotho Nursing Council (LNC) adopted the nursing process over a decade ago and the LNC mandated nurse training institutions and clinical settings to utilise this methodology. However, there is a reluctance to implement the nursing process despite its importance in nursing care (LNC, 2009:7). Purpose: The primary purpose of this research was to explore and describe the perceptions and experiences of nurses in implementing the nursing process in a district public hospital in Lesotho. On the grounds of these findings, the researcher ultimately makes recommendations for nursing education, nursing practice and nursing research. Methodology: To explore and describe the perceptions and experiences of nurses implementing the nursing process in a district public hospital in Lesotho, the researcher chose a qualitative, exploratory, descriptive and contextual research design. The researcher used voluntary purposive sampling to identify participants who complied with the set selection criteria. The sample comprised of professional nurses with varying years of working experience and qualifications. The data was collected by means of narratives and two focus group interviews; n=10 and n=6. The data was captured on a digital audio recorder and was transcribed verbatim. The researcher took field notes during each focus group. Both the researcher and independent co-coder analysed the narratives and transcribed data together, using narrative analysis and open coding (Creswell, 2009:185). Three main themes and nine subthemes emerged from the data collected from the narratives and focus groups. The researcher illustrated these themes through direct quotes by the participants. Each of these themes was discussed accompanied by relevant data obtained from literature, and reduced to conclusive statements, which serve as a basis for the derived recommendations to nursing education, nursing practice and nursing research. Trustworthiness was ensured in accordance with the principles of credibility, transferability, dependability and confirmability. Conclusions: The researcher reached a number of conclusions. The participants perceived several factors and experienced them as interfering with the efficient implementation of the nursing process. Operational difficulties experienced in the systematisation of nursing care in practice, are amongst others a lack of knowledge of the steps involved in the process, an excessive number of tasks assigned to the nursing team, the poor quality of professional education, insufficient reports on the physical examination related to the disease and difficulty to formulate the nursing diagnosis. The research report concluded with the researcher’s evaluation of the research and recommendations for nursing practice, nursing education and nursing research with the purpose of improving the implementation of the nursing process. / MCur, North-West University, Potchefstroom Campus, 2014

Background: The nursing process is a widely accepted method and has been suggested as a scientific method to guide procedures and qualify nursing care. More recently, the process has been defined as a systematic and dynamic way to deliver nursing care. This process is performed through five interrelated steps, namely: assessment, diagnosis, planning, implementation and evaluation, with subsequent modifications used as feedback mechanisms that promote the resolution of the nursing diagnoses. The Lesotho Nursing Council (LNC) adopted the nursing process over a decade ago and the LNC mandated nurse training institutions and clinical settings to utilise this methodology. However, there is a reluctance to implement the nursing process despite its importance in nursing care (LNC, 2009:7). Purpose: The primary purpose of this research was to explore and describe the perceptions and experiences of nurses in implementing the nursing process in a district public hospital in Lesotho. On the grounds of these findings, the researcher ultimately makes recommendations for nursing education, nursing practice and nursing research. Methodology: To explore and describe the perceptions and experiences of nurses implementing the nursing process in a district public hospital in Lesotho, the researcher chose a qualitative, exploratory, descriptive and contextual research design. The researcher used voluntary purposive sampling to identify participants who complied with the set selection criteria. The sample comprised of professional nurses with varying years of working experience and qualifications. The data was collected by means of narratives and two focus group interviews; n=10 and n=6. The data was captured on a digital audio recorder and was transcribed verbatim. The researcher took field notes during each focus group. Both the researcher and independent co-coder analysed the narratives and transcribed data together, using narrative analysis and open coding (Creswell, 2009:185). Three main themes and nine subthemes emerged from the data collected from the narratives and focus groups. The researcher illustrated these themes through direct quotes by the participants. Each of these themes was discussed accompanied by relevant data obtained from literature, and reduced to conclusive statements, which serve as a basis for the derived recommendations to nursing education, nursing practice and nursing research. Trustworthiness was ensured in accordance with the principles of credibility, transferability, dependability and confirmability. Conclusions: The researcher reached a number of conclusions. The participants perceived several factors and experienced them as interfering with the efficient implementation of the nursing process. Operational difficulties experienced in the systematisation of nursing care in practice, are amongst others a lack of knowledge of the steps involved in the process, an excessive number of tasks assigned to the nursing team, the poor quality of professional education, insufficient reports on the physical examination related to the disease and difficulty to formulate the nursing diagnosis. The research report concluded with the researcher’s evaluation of the research and recommendations for nursing practice, nursing education and nursing research with the purpose of improving the implementation of the nursing process. / MCur, North-West University, Potchefstroom Campus, 2014

It is not sufficient to just make changes in a nursing curriculum without a plan to evaluate the impact on program outcomes. This study sought to determine the outcomes of teaching the nursing process to Foundation of Nursing students in an Associate Degree Nursing program using a factorial design study. Four groups of students were taught the nursing process as follows: case study and concept mapping; case study, concept mapping with a pocket reference; case study, two hours HFHS, concept mapping with a pocket reference, or four hours of HFHS, concept mapping with a pocket reference. The Simulation Design Scale (SDS) measured the perceptions of the simulation groups for design elements. The four hour group mean was significantly lower on both the importance of the objectives and information and importance of fidelity design elements (p < .05). This suggests that as time in a simulation increases more attention to these elements is required. There was not a significant difference between the four study groups on the Nursing Process or the Assessment Technology Institute (ATI) RN Fundamentals 2010 Assessment Form B examinations individual scores. Two sub-categories on the ATI were significant. Planning was significantly higher for fall 2012 cohort (p = .024) and analysis/diagnosis was almost significant for fall 2011 cohort (p = .054). The results for Factorial Groups was not significant. The National League for Nursing (NLN) PAX-RN entrance examination had a significant correlation with students passing onto the second semester in a nursing program (p < .001). The ATI results of students were the same without regard to the Factorial Group assigned in relation to instructor employment status of full time versus part time. / School of Nursing; / Nursing / PhD; / Dissertation;

The nursing process is the espoused problem solving framework that forms the basis of the way in which patient care is determined, delivered, and communicated in a multiplicity of health care settings. Although its use is widespread in educational and clinical settings, some nurse clinicians display negative attitudes towards the use of the nursing process. They claim that both the structure and language that underpins this process is cumbersome and unreflective of the way in which nursing care is planned and delivered. To date, there has been no study cited that has examined its use within a clinical setting and determined if and how the nursing process is being used and whether there is substance in the clinicians' claims. Additionally, some of the research on problem solving has used laboratory based designs that are limited as they are not sensitive to contextual factors that affect the use of a problem solving process, nor are they sensitive to the efficacy of the communication process. As patient care involves many nurses working under diverse contextual conditions, these factors need to be taken into consideration when studying this phenomenon.Using grounded theory methodology, this study examined the clinical application of the nursing process in acute care hospital settings. Specifically, it sought to answer the following two questions: (1) How is the nursing process used by nurse clinicians in acute care hospital settings? and in the absence of its use, (2) How is nursing care determined, delivered, and communicated in acute care hospital settings in Western Australia?Data were obtained from semi-structured interviews with predominantly nurse clinicians, patients, and patients' relatives, as well as participant field observations of nurse clinicians, and in-depth audits of patient records. Textual data were managed using NUD-IST and analysed using constant ++ / comparative method. Data generation and analysis proceeded simultaneously using open coding, theoretical coding, and selective coding techniques until saturation was achieved. This resulted in the generation of a substantive theory explaining clinical nursing in acute care hospital settings.The findings of this study revealed several problems with the clinical application of the nursing process. It also revealed a process used by nurses to overcome many difficulties they experienced as they tried to determine, deliver, and communicate patient care. Specifically, nurses in this study experienced the basic social problem of being in a state of "Unknowing". Properties and dimensions of unknowing were found consistently in the data and this problem was labelled as the core category. This state of "unknowing" was linked to a number of factors, such as, the existence of a fragmented and inconsistent method of determining and communicating patient care and work conditions of immense change and uncertainty. In order to deal with this problem, the nurses in this study used a basic social process termed: "Enabling Care: Working through obscurity and uncertainty". The first phase of the core process, termed: Putting the pieces together: making sense, involved four subprocesses. These subprocesses were labelled: drawing on the known, collecting and combining information, checking and integrating information, and sustaining communication. The second phase of the core process was termed Minimising uncertainty. It involved three subprocesses which were named: adapting work practices, taking control, and backing-up.The findings of this study have implications for nursing practice, research, theory, and education, as it exposes problems with the clinical application of the nursing process in acute care settings. In addition, it further explicates a substantive theory that describes a ++ / process of nursing used by nurses in these settings. As the articulated process was supported by a number of studies and opinions of nurse scholars it is worthy of being considered as being foundational to an understanding of a process of nursing used in acute care hospital settings in Western Australia.

Thesis (M.P.H.M.)--Mahidol University, 2000.

Thesis (M.S.)--University of Michigan, 1980.

Thesis (M.S.)--University of Wisconsin--Madison, 1984. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 53-56).

Thesis (M.S.)--University of Wisconsin--Madison, 1986. / Typescript. Thesis approval page has authors' names reversed. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 195-201).

In this study, I analyze a discourse that emerged during the 1970s and 1980s in German nursing. At that time, the German healthcare system underwent dramatic changes and economic reorganization, which can be understood as the emergence of the neoliberal rationale in Germany. The argument of cost explosion was used to restructure hospitals into enterprises that were to operate based on the logic of the market. At the same time, the nursing process was introduced into German nursing. The nursing process is a cybernetic, problem-solving cycle containing distinct steps of assessing the patient, planning nursing goals, executing and documenting nursing interventions, and evaluating performance. German nurses valued the nursing process as a central component of the professionalization of the nursing vocation. However, in neoliberalism, professions are seen as obstacles to free competition in marketized areas, and thus strategies such as accounting mechanisms were implemented to decrease their power. Using the historical approach of the history of the present, the perspective of governmentality and insights from critical accounting, this study analyzes the impact of the nursing process on the German nursing vocation. The nursing process needs to be understood as an accounting tool and hence, as a component of neoliberal strategies to make formerly intangible fields of work like nursing service calculable. As an accounting tool, the nursing process does not represent reality in a neutral manner but affects the areas to which it is applied in a constitutive way. As this study shows, the implementation of the nursing process led to reconstituting the nursing vocation into a calculable entity. And while German nurses valued the potential that the call for increased accountability and transparency in nursing care held for their professionalization, the findings suggest that a newly constituted accountable nursing vocation can instead be considered as de-professionalizing.