Implementation of nursing process in Ethiopia and its association with working environment and knowledge: a systematic review and meta-analysis

Abstract Background Nursing Process is a scientific problem solving approach to direct nurses in caring for clients effectively and to improve quality of health care service. In Ethiopia, the national pooled prevalence of implementation of nursing process remains unknown. Hence, the objective of this systematic review and meta-analysis was to estimate the level of implementation of nursing process and it association with knowledge and working environment. Methods PubMed, Scopus, Cochrane Library, Google Scholar, PsycINFO and CINAHL were systematically searched online to retrieve related articles. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guideline was followed. To investigate heterogeneity across the included studies, I 2 test was employed. Publication bias was examined using funnel plot and Egger’s regression test statistic. The random-effect model was fitted to estimate the summary effects, and odds ratios (ORs). All statistical analysis was done using STATA version 14 software for windows. Results Seven studies which comprises of 1,268 participants were included in this 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 highest implementation of nursing process was observed sample size greater than or equals to two hundred, 44.69% (95% CI: 35.34, 54.04). Nurses who have been work in the stressful environment [(OR 0.41, 95%CI (0.08, 2.12)] and having good knowledge about nursing process [(OR 2.44, 95%CI (0.34,17.34)] was not significant associated with the implementation of nursing process. Conclusion The overall implementation of nursing process in Ethiopia is relatively low. Nurses who have been work in the stressful environment have less likely implement nursing process. On the other hand, Nurses who had good knowledge on nursing process were more likely to implement nursing process. Therefore, policymakers (FMOH) and other concerned body need give special attention to improve the implementation of nursing process.