Table 2.

Effects of implementing the nursing process in clinical settings

Author(s)/ year & country	Research aim	Study design	Study population	Data collection	Setting	Results/key findings	MMAT score
(Rasouli, Hagiamiri, Mahmoudi, & Mostoufian, 1996) Iran	In order to use the nursing process to prevent and reduce pressure ulcers in orthopaedic wards	Semi‐experimental	Nurses (n = 30) Convenience sampling method	Multichoice questionnaire	Orthopaedic wards of hospitals affiliated to Tehran University of Medical Sciences	Training based on the nursing process increased nurses' knowledge and change in the degree of pressure ulcer.	50%
(Rahgooy, Vanaki, Golestan, & Soulati, 1999) Iran	For the effect of nursing process education on the quality of care provided to psychiatric patients	Experimental with control group	Nurses (n = 44) Random sampling method	The QualPaks standard checklist	Razi Psychiatric Center of Tehran	The quality of nursing care after the training of the case group was improved from moderate to good rather than before training and the control group.	50%
(Vanaki & Zamanzadeh, 1994) Iran	In order to investigate the effect of nursing process implementation using problem‐based recording in quantity and quality of nurses documentation	Semi‐experimental	Nurses (n = 42) Convenience sampling method	Researcher checklist	The Imam Hussein Hospital Tehran	The urgent need for an accurate documentation system and the improvement in the quality and quantity of nursing documentation after the implementation.	75%
(Akbari & Farmahani, 2011) Iran	In order to influence the nursing process on the quality of care of schizophrenic patients	Semi‐experimental with control group	Nurses (n = 30) Convenience sampling method	The QualPaks standard checklist	Shaheed Lavasani Hospital of Tehran	The quality of care provided in the physical–psychological needs and the relationship of the patient well‐promoted.	50%
(Oshvandi, PourYousef, & Bikmoradi, 2013) Iran	To effect of clinical education by exploration on the skill of using nursing process by nursing students	Semi‐experimental with control group	Nursing students (n = 38) Convenience sampling method	Checklist	Surgical wards of Besat hospital in Hamadan	Exploration education has a more positive effect on nursing students' clinical skills learning than conventional education.	50%
(Aein & Frouzandeh, 2012) Iran	Determining the effectiveness of conceptual mapping in nursing process learning in clinical nursing education in children	Semi‐experimental	Nursing students (n = 30) Convenience sampling method	Checklist	Shahrekord Children's Hospital	Quantitative and qualitative evaluation of conceptual maps showed a statistically significant progression of students in understanding the nursing process, which improved from the weak level on the first day to the excellent level on a ninth day.	50%
(Habibzadeh, Khajehali, Khalkhali, & Mohammadpour, 2013) Iran	To analyse the impact of evidence‐based nursing education on five scopes of nursing process among nursing students.	Quasi‐experimental study with control group	Nursing students (n = 48) Convenience sampling method	Checklist	Orthopaedic wards of Orumieh Hospital	Members of the intervention group had better performance in all five scopes of the nursing process in comparison with the control group.	50%
(Rastian, Borzabady Farahani, Rasouli, Sarbakhsh, & Niromand, 2014) Iran	To determine the effect of nursing process implementation on quality of nursing care of patients hospitalized in surgical wards	Quasi‐experimental study with before–after design	Nurses (n = 48) Purposive sampling method	Quality patient care scale (QualPacS) checklist	Surgical wards of teaching hospitals affiliated to Yasoj Medical University	Nursing process implementation can improve the quality of nursing care of patients in surgical wards.	50%
(Zamanzadeh et al., 2015) Iran	Carried out to assess the key challenges associated with the implementation of the nursing process	Systematic review	125 articles were selected from databases of Iranmedix, SID, MagIran, PUBMED, Google scholar and ProQuest, which were assessed using the main keywords of nursing process and nursing process systematic review	‐	Tabriz University of Medical Sciences	Main challenges include intangible understanding of the concept of the nursing process, different views of the process, lack of knowledge and awareness among nurses related to the execution of process, supports of managing systems and problems related to recording the nursing process.	50%
(Khosravan, Saadat, & Moradi Kosha, 2014) Iran	To determine the effect of nursing process on job satisfaction of employed nurses	Semi‐empirical study	Nurses (n = 47) by census methods	Manokian questionnaire and process registration checklists of Hasson and Arnetz	Intensive care units of Gonabad hospitals	The nursing process is beneficial in clinical settings also leads to job satisfaction of nurses.	75%
(Lotfi Mojgan, 1998) Iran	In order to effect the implementation of the nursing process on the quality of nursing care from patients admitted in critical care units	Quasi‐experimental study	Patients (n = 52) Convenience sampling method	Questionnaire made by researcher	Intensive care units	The implementation of the nursing process showed a small effect on the quality of nursing care in critical care units.	75%
(Rahmani et al., 2016) Iran	To determine the effect of nursing process the way "accessible care cards" on patients' satisfaction from care in intensive care units	Cross‐sectional interventional study	patients (n = 76)	Questionnaire made by researcher	Intensive care units in the Golestan hospital in Ahwaz	Implementation of the nursing process, in a manner of available cards, led to an increase in patient satisfaction compared with the routine manner	50%
(Yeh et al., 2009) Taiwan	To develop and implement NPSSC enabling computerized documentation for nursing home residents, evaluate the efficiency of NPSSC, obstacles to the use of the NPSSC and assess nurse users’ satisfaction with the NPSSC	Quasi‐experimental one group pre‐/post‐test	Nurses (n = 27) & medical records (n = 396)	Satisfaction Questionnaire and checklist efficacy of the NPSSC	Nursing home residents in Taiwan	Obstacles use of the NPSSC was identified. The use of the NPSSC significantly improved nursing documentation in that resident's records were organized and consistent and nurses were able to complete a comprehensive care plan in 48 hr. Nurses' satisfaction with nursing documentation increased.	100%
(Semachew, 2018) Ethiopia	To evaluate the implementation of the nursing process at three randomly selected governmental hospitals	Hospital‐based descriptive and retrospective study design	Records (n = 338) Samples were proportionally allocated for each hospital based on the total number of inpatients in the last 6 months	Nursing process implementation checklist	Governmental hospitals	Nursing process documentation should be promoted and nursing managers should supervise the implementation of the nursing process and facilities its implementation.	50%
(Fernández‐Sola et al., 2011) Bolivia	To identify those factors that favours or hinder the NP implementation and the SCP both in the clinical areas and academic environment	Participatory action research	Research team and nurses (n = 35)	Meetings with key informants, Interviews, observation and workshops	Hospitals and universities	The implementation of standard care plans requires much effort. Making the most of cooperation projects to make improvements and undertake scientific research is an excellent opportunity to promote the nursing profession in less‐developed countries.	75%
(Lopes et al.., 2010) Brazil	To evaluate how the nursing process has been registered at a Brazilian teaching hospital	Descriptive and retrospective study	Medical records (n = 68).	Researcher‐made form	Women's Hospital CAISM/UNICAMP, a public tertiary university hospital	All steps in the nursing process were not documented, especially the nursing diagnosis.	50%
(Lima & Kurcgant, 2007) Brazil	To understand the meanings nurses at a university hospital attribute to the implementation process of the Nursing Diagnosis Classification System (DEn) as a phase in the Nursing Care System	Qualitative methodological approach	Nurses (n = 8)	Interviews	Hospital	Throughout the process, with the gradual increase in theoretical–practical training and participation, the collaborators became agents of change, disclosing a positive transformation in their feelings, after their initial discomfort and unfavourable perception about the implementation of the nursing diagnosis in the NCS.	50%
(Ledesma‐Delgado & Mendes, 2009) Mexican	To understand the meanings attributed to the nursing process by clinical nurses at a Mexican hospital	Qualitative study based on grounded theory	Nurses (n = 16)	Semi‐structured interviews, participant observation and document research	Medicine unit at the General Hospital	The nursing process was described as a nursing care routine that different from what was taught at the university.	75%