Page 378 - Encyclopedia of Nursing Research

NuRSING PROCeSS n 345

tested to expand nursing knowledge and there was widespread implementation
inform clinical practice. underway. early writings began to emerge
With the continued emphasis on health in the literature at this time. Although little N
care reform, cost savings, and quality, it is research appeared in publications, writings
essential that practice be implemented within in journals and textbooks were abundant,
a framework that is realistic and useful. For promoting the process as a useful tool for
nursing, the continued creation of practice teaching and understanding nursing. It was
models will promote quality care and facili- commonly held that full implementation of
tate the articulation of nursing’s contribution the nursing process would bring about radi-
to care outcomes. emerging practice models cal changes in nursing education and nursing
that are patient centered and respectful of practice. In the late 1970s, the World Health
the contribution of all providers will foster Organization endorsed the use of the nurs-
quality health care for all and initiate crea- ing process.
tive approaches to practice that can main- A large amount of the research con-
tain and sustain individuals in less costly ducted on the nursing process has come
environments. Through teamwork, coopera- from the united Kingdom. However, stud-
tive planning, and increased participation in ies on the implementation of the nursing
decision making, system members can move process in both the united States and the
the organization toward a shared vision and united Kingdom reveal that nursing pro-
new directions in care delivery. cess has not been implemented. Researchers
have attempted to identify and study what
Dorothy A. Jones barriers exist to the full use of the nursing
Jane Flanagan process as identified by educators and clini-
cians in both countries. Studies focused on
the attitudes of nurses, environmental fac-
tors, educational preparation, strategies to
NursiNg process promote and encourage use, and instrument
development to measure the concept more
empirically. The reports were very consistent
Nearly all authors define the nursing process in finding that nurses placed a high value on
as a problem-solving process composed of the nursing process as a vehicle to provide
the elements of assessment, planning, imple- quality, individualized patient care, although
mentation, and evaluation. Many a priori they did not implement the nursing process
assumptions have been identified and stud- regardless of their preparation and knowl-
ied concerning the nursing-process approach edge of the process or their educational level
to patient care that includes decision mak- or years of experience. The data indicate that
ing as a characteristic of the process. These even those novice nurses recently educated
assumptions are that the nursing process is within the nursing process did not use it in
a holistic, scientific, individualized, prob- actual patient situations when providing
lem-solving approach with an emphasis on independent nursing care.
diagnosing. There are problems with the evaluation
Interest in the type of systematic identi- and study of such a multidimensional con-
fication of a nursing process spread rapidly, cept as the nursing process. A review of the
as evidenced in many proceedings, posi- literature reveals few objective indicators or
tion statements, and policies from groups criteria to measure this concept. A variety
as influential as the American Nurses of research designs and methodologies have
Association and the Joint Commission on the been described in the literature primarily
Accreditation of Hospitals. By the mid-1970s, aimed at investigating the implementation