Effectiveness of Standardized Nursing Care Plan on Nurses' Usability Regarding Quality Nursing Care in Private Tertiary Care Hospital Lahore

s response to treatment and make necessary adjustments to meet medical needs. Challenges such as excessive workload, absence of policies, inadequate resources, understa�ng, and unavailability of assessment forms hinder the effective utilization of nursing care plans Objective: To evaluate the effect of standardized nursing care plan on nurses` usability of nursing process during patient care. Methods: A quasi-experimental study was conducted at a Tertiary Care hospital Lahore Pakistan. A strati�ed Random sample of n=47 participants intervention group was recruited. A validated questionnaire of Nurses' usability of standardized nursing care plan consisted of 23 items. Data were analyzed through SPSS version 21. Results: Majority of the participants 44.7% (n=21) were between 26-30 years of age, 46.8% of the participants (n=22) had working experience between 1-4 years, 70.2% (n=33) of them having nursing diploma, 23.4% (n=11) were attained Post RN BSN. A signi�cant difference was found between Nurses` usability scores before and after intervention as evident by p=0.000 with mean and SD of 2.8085+0.79778 and 3.7872+0.41369, respectively. Conclusions: It is evident from results that standardized nursing care plan has a signi�cant effect on nurse's usability that improve the quality of nursing care in Hospital.


M E T H O D S
effect of standardized nursing care plan on nurses` usability of nursing process during patient care.This study also showed that participants need more instruction and hands-on practice with the nursing approach.The utilization of the nursing process is severely hampered by non-nursing factors such as a lack of policies, reference materials, incentives, supplies, staff, patient charts and printed nursing care plans.Utilization of the nursing process was further hampered by a lack of performance contracts and opposition from other disciplines [8][9][10].

R E S U L T S
A quasi-experimental study (one group pre / post design) was conducted in Tertiary Care Hospital Lahore.The duration of data collection was 09 months after the approval of synopsis from Research Ethical Committee (REC), The University of Lahore.The rules and regulations set by the Researcher Ethical Committee of The University of Lahore were followed while conducting the research and the rights of the research participants were respected.Permission was taken from head of the departments and Medical Superintendent.Written informed consent was taken from all the Nurses.A strati ed random sample 50% (medical and surgical ward of cardiac unit) 25% (coronary care unit) 25% (intensive care unit).Sample size of 47 cases is calculated with 95% con dence interval, 5% margin of error and expected percentage of knowledge (pre-post difference) regarding nursing care plan utilization among staff nurses is 15.8%.All registered Nurses` of cardiac unit, Nurses` who have more than 6 months clinical experience in cardiac unit, Both female and male nurses` of cardiac unit, Nurses` who are more than 20 year of age.The Exclusion Criteria was Nurses who are on Leave during data collection and Nurses who are working in post-operative unit of angiography and OPD.All information and data collection was kept con dential.Participants were kept a n o n y m o u s t h r o u g h o u t t h e s t u d y.A v a l i d a t e d questionnaire of Nurses' usability of standardized nursing care plan consisted of 23 items had a four-point scale like Always use (4points), sometime use (3points), rarely use (2 points), never use (1 point).Standardized nursing care plan utilization maximum score is 92, minimum score is 23.Scoring criteria is >75%.Always use of standardized nursing care plan > 50% -75% sometime use of standardized nursing care plan > 25%-50%.Rarely use of standardized nursing care plan < 25% Never use of standardized nursing care plan.Data collection was carried out in three phases.Assessment phase for pre assess the Nurses usability and intervention phase consist of three sessions in 16 weeks and evaluation phase for post intervention assessment.Data were collected by primary researcher and analyzed into SPSS version 21.0.Majority of research participants 44.7% (n=21) were between 26-30 years of age, 29.8% (n=14) were between 31-35 years, 21.3% (n=10) were between and 20-25 years, 4.3% (n=2) were 36-40 years of age.The 57.4% (n=27) were single and 42.6% (n=20) were married.In relation to the position of staff nurses 95.7% (n=45) and head nurse 4.3% (n=2).Results further indicate that 46.8% of the participants (n=22) had working experience between 1-4 years, 23.4% (n=11) had working experience between 5-9 years, 23.6% (n=11) had working experience 10-14 years and 2.1% (n=1) research participants had less than 6 months of working experience in cardiac unit.were found always used the SNCP in pre intervention which was improved to 78.7% (n=37) after intervention.Only 6.4% (n=3) research participants said never use of SNCP in pre intervention but after intervention it found zero.These ndings are consistent with the study conducted in Jaipur Sikar in 2017.According to the ndings, the nursing inter vention effectiveness in form of knowledge enhancement and training practice associated with implication of nursing care plan in providing quality nursing care to cardiac patients [16].On the contrary, a study was conducted in Kenya in 2022.Descriptive statistics were used to summarize the data and Pearson's correlation coe cient was used to establish correlation between variables.Factors are associated with hindrance the implementation of nursing care plan [17.Proper Implementation of the nursing care plan can be promoted through focusing on bene cial factors such as adequate sta ng, training, administrative support, and providing resources [18,19].Similarly, in 2017, a study was conducted in Greece to examine the impact of educational intervention on nursing care plans using the NANDA, a structured questionnaire that was given before and after educational intervention.The intervention boosted their capacity for making accurate nursing diagnoses and nursing care plans.A strong impact of educational intervention on nursing care plans was shown to improve nurses' knowledge and skills in using nursing care plans and incorporating documentation into the nursing process [20].
intervention detail given in Table 2.This Table is represented the effect of educational intervention on standardized nursing care plan on Nurses` usability among staff nurses working in cardiac unit departments.A signi cant difference was found between Nurses` usability scores before and after intervention as evident by p=0.000 with mean and SD of 2.8085+0.79778and 3.7872+0.41369,respectively.It was further found that the mean difference between pre and post scores of nurses` usability.It was evident from the above result that effectiveness of standardized nursing care plan based educational intervention has a signi cant effect on nurses` usability among staff nurses working in cardiac unit departments.In similar way, a paired sample t-test was used to see the effect of standardized nursing care plan b a s e d e d u c at i o n a l i n te r ve n t i o n i n c a rd i a c u n i t departments.It is evident from above result that standardized nursing care plan has a signi cant effect on nurses' usability that directly effect on quality of nursing care in cardiac unit departments.
+0.79778 3.7872 +0.41369 −7.484 0.001C O N C L U S I O N SIt is concluded majority of participants were between 26-30 years of age having 1-4 years of working experience and had diploma level education.Nurses usability of standardized nursing care plan concluded majority of the

Table 1 :
Demographic characteristics of participants In relation to the level of education, majority 70.2% (n=33) of them having nursing diploma, 23.4% (n=11) were attained Post RN BSN, 6.4% (n=3) only were attained generic BSN education in clinical setting of cardiac unit.Detail is given in Table1.
advised increasing the number of quali ed nurses in specialized care units, noting that there is a strong correlation between nursing education levels and the quality of care provided[12, 13].Results further indicate

Table 2 :
Nurses Usability of Standardized Nursing Care Plan (n=47)