Increasing the rate of nursing process implementation: a quality improvement project at Wollega University Comprehensive Specialized Hospital, 2025.

Abstract

The nursing process is sytematic patient centered care that promotes a holistic approach, enhances communication and collaboration among healthcare professionals and ensures the delivery of high-quality, individualised care. Despite different efforts to improve the nursing process in Wollega University Comprehensive Specialized Hospital, the rate of its implementation is very low due to different factors. This quality improvement project aimed to increase the rate of nursing process implementation at Wollega University Comprehensive Specialized Hospital from 1 August 2024 to 30 January 2025.The team project identified root causes by using a fishbone diagram and a driven diagram. Six interventions were introduced over 6 months using Plan-Do-Study-Act cycles. The interventions were training of nurses and leaders, shifting of nurses to wards with more workload, providing clear job descriptions for nurses, availing of protocols and work aids, availing of nursing process formats and providing regular supportive supervision.Finally, the rate of nursing process implementation increased from 27% to 87.5%, with assessment performed properly in 93%, diagnosis increased to 89.5%, planning reached 86.5%, implementation 85.5% and evaluation 83%. The highest (96%) performance was observed in the orthopaedic ward, whereas the lowest (79%) was in the gynaecological ward.This project improved the implementation of the nursing process, demonstrating the importance of capacity building for staff, leadership engagement, effective communication, regular discussion and supervision, as well as collecting feedback and incorporating it for the next interventions. The project significantly improved nursing process implementation by introducing change ideas, and it now needs to be expanded to other units. The management of the hospital and all stakeholders owned the project to maintain its sustainability.