ArticleBMC nursing2026
Perceived barriers and facilitators to nursing process usage: a narrative review.
Article in BMC nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe nursing process (NP) is a systematic, patient-centred framework fundamental to professional nursing practice, yet its implementation remains suboptimal, particularly in low- and middle-income countries (LMICs). This narrative review examines the global implementation of the NP, with a focused case analysis of evidence from Pakistan (n = 2 studies) and other LMICs, and identifies barriers, facilitators, and research gaps. Pakistan was selected for focused analysis due to the authors' direct knowledge of its healthcare system and the absence of any previous synthesis of NP implementation evidence in this context.
methodsThis narrative review employed a literature search across PubMed, CINAHL, and Google Scholar using Boolean operators with keywords including "Nurses' Perceptions," "Nursing Process," "Barriers," and "Facilitators." Inclusion criteria captured original research and reviews published between January 2017 and September 2023, with seminal older studies included for theoretical context. EXCLUSION CRITERIA: editorials, commentaries, non-English publications, and studies without original data on NP barriers or facilitators. The search prioritized evidence from LMICs, with additional Pakistan-specific database searching. Twenty-six studies were included in the final synthesis.
resultsThe synthesis reveals a stark disparity in NP implementation. While high-income countries report adoption rates exceeding 80%, implementation in LMICs including Ethiopia, Ghana, and Nigeria is inconsistent (approximately 50-60%). Key facilitators identified included supportive supervision (reported in 4 studies), availability of documentation tools (6 studies), and continuing education (5 studies). Thematic analysis identified critical barriers across four domains: (1) systemic and resource-related factors, (2) educational and knowledge-based factors, (3) administrative and socio-cultural factors, and (4) nurse-related individual factors. In Pakistan, two studies suggest good theoretical knowledge among nurses (86.7-89.5%), but practical application is hindered by similar systemic barriers.
conclusionThe nursing process remains a cornerstone of high-quality care, yet its potential is unrealized in many resource-constrained settings. To address the implementation gap, strategic investments in administrative support, continuous professional development, and resource allocation are needed. This review identifies an urgent need for qualitative inquiry in Pakistan to explore nurses' lived experiences regarding NP implementation in clinical settings-specifically, how contextual factors (workload, supervision, resource availability) shape daily practice decisions. CLINICAL TRIAL NUMBER: Not applicable.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.