Barriers to the Implementation of the Nursing Approach in Public Hospitals in Lubumbashi in the Democratic Republic of Congo: A Cross-Sectional Descriptive Study

摘要

Introduction: The nursing approach (NA) is the essence of the nursing profession. However, its implementation is almost absent in the hospitals of the Democratic Republic of Congo (DRC). Objectives: The aim of thi s study was to determine nurses’ knowledge, attitudes and practices in relation to the nursing approach and to identify barriers to the implementation of this approach. Methods: To achieve these objectives, we carried out a cross-sectional descriptive study among the nurses of the 11 public hospitals of Lubumbashi, from June to September 2015. Thanks to a validated questionnaire, we collected the data by interview, supported by participatory observation. Results: The results showed that 67.6% of respondents were trained on NA; However, 99.3% did not know the exact number of NA steps and 62.6% did not cite any steps; The majority (93.5%) of trainees on NA find that this process provides quality patient care; 100% of the sample wish to put it into practice; 100% of the sample need continuous training on NA including 67.6% to improve knowledge and 32.4% to learn; 89.1% of those trained reported not practicing NA, but participating direct observation gave 100% of non-practice. The barriers to implementation of the NA were inadequate nursing staff (75.6%), inadequate equipment (71.5%), lack of time (62.6%), lack of theoretical and practical knowledge (47.2%), lack of nursing records (26%) and lack of institution for nursing care within the hospital (17%). Conclusion: Therefore, capacity building of nurses through continuing education, as well as initial training on NA, would increase their knowledge, reinforce positive attitude and promote its implementation, all supported by improved working conditions and the implementation of a professional nursing quality assurance organization.