The study was conducted at Dalal Jamm Hospital and Dakar Main Hospital. Dalal Jamm Hospital is located in the commune of Guédiawaye in the northeastern suburbs of Dakar, about 15 kilometers from the city center. Located in a densely populated area, it is one of the country’s newest modern level 3 hospitals. It has a capacity of over 300 beds and covers all medical and surgical specialties. Its design and layout meet international standards for safety, hygiene, and quality of care.

The Dakar Main Hospital is located in the heart of the Senegalese capital, in the Plateau district, close to the autonomous port of Dakar and the Presidency of the Republic. It is a level 3 military teaching hospital, built in 1884. It has more than 400 beds and offers highly specialized care.

This is a descriptive cross-sectional study conducted from June 1 to June 30, 2025, at Dalal Jamm Hospital and Dakar Main Hospital among nurses.

All nurses were included in this study who:

who had been working for at least one year at Dalal Jamm Hospital or the Main Hospital;who had been working for at least one year in a hospital in the study area and who agreed to participate in the study.

Less than one year of clinical practice experience in a hospital in the study area.Being on extended leave or not present at the time of the study;Not agreeing to participate in the study

This was a comprehensive study. All individuals who met the selection criteria were surveyed by identifying 101 nurses from the human resources rosters via the Head of the department.

A questionnaire was designed and tested to identify perceptions and practices regarding NP. It consisted of three parts: one on the participant’s sociodemographic information, one on perceptions, and the last on practical. This tool was digitized using the Open Data Kitand loaded onto the investigators’ Android tablets. The investigators were trained on the collection tool and ethical considerations. During collection, the data collected was instantly saved on the ONA online server.

The data were extracted in the form of an Excel file before being imported into R software for statistical analysis. The arithmetic mean, standard deviation, and frequencies were used for the description.

This study was approved by the local authorities of the hospitals concerned, respectively by note no. 00255/MSAS/CHNDJ/DIR/SP and no. 00246/HPD/MC/SF dated March 12, 2025.

Participants were informed of the objectives of this study and informed consent was obtained by signature. The study was anonymous and the information collected was only accessible to members of the research team.

The participation rate was 74.25%; of the 101 nurses working at the study sites, 75 agreed to participate in the study.

The age of participants ranged from 20 to 54 years, with a median age of 31 years. The mean age was 32.3 years ± 7.8 years. The sex ratio was 1.78 in favor of women.

Those with a state diploma represented 56.0% of participants. In terms of professional seniority, 68% had less than 10 years of experience.

Table 1 presents all the sociodemographic data for the participants.

Table 1. Sociodemographic data (N = 75).

The results in Table 2 below show that most respondents (86.7%) indicated that they had received specific training on the NP and almost 90% were familiar with its stages. This indicates that theoretical integration is largely possible. In addition, 69.3% said they talked about the NP “very often” and 22.7% said “often,” indicating that there is indeed interest in the tool.

Table 2. Nurses’ perceptions of the nursing process (NP) (N = 75).

Regarding their level of knowledge, most respondents rated themselves as “good” (38.7%) or “very good” (37.3%), while 21.3% rated their knowledge as average and 2.7% as poor. This divergence highlights the need for convergence in skills. According to another single-answer question, 97.3% of participants believe that continuing education and training are essential, reinforcing the belief that learning never stops.

Overall, motivation is high, with 92% of professionals who responded to the survey indicating that they are motivated or highly motivated, contrasting with only 8% who are less motivated. 93.3% also believe that NP significantly improve the quality of care, and 97.3% consider them to be very valuable in clinical care.

But at the institutional level, there are constraints: just under 24% of participants say that management is not committed and that the application of NP is not monitored. This may indicate that, from an individual perspective, there may be strong buy-in, but organizational support is still not in place for effective and structured use.

The results in Table 3 below show the application of the nursing care approach (NP) in the departments. More than half of the respondents (52%) apply the NP, while less than half (48%) do not, with a slight imbalance between them in certain practices.

When examining the frequency of application, only 34.7% and 30.7% report applying it “always” and “often,” respectively, compared to 29.3% who apply it “rarely” and 5.3% who “never” apply it. This suggests that the NP, although recognized and considered applicable, is not yet well integrated into daily routines.

Nearly three-quarters of participants reported serious implementation problems (72%).

In fact, these difficulties seem to be closely linked to other aspects of the organization: for example, continuing education is not available to nearly 70% of respondents, and information collection systems are lacking in more than half (53.3%) of these institutions, calling into question the ease with which it would be possible to transition to true NP procedures in such circumstances.

The main obstacles therefore lie in both organizational processes and educational requirements.

On the other hand, there was very strong conceptual identification: 89.3% of respondents consider the integration of NP with technology to be “very useful.” This shows openness and a willingness to change.

Table 3. Application of the nursing care approach by nurses (N = 75).

Continued

The results of this study indicate that knowledge remains one of the determining factors in the application of the nursing care process. 89.3% of nurses are familiar with the stages of the nursing care process. And among these nurses, 86.7% reported having received specific training on the nursing process during their studies. Contrary to the results of the study conducted by Hagos et al., which measured the level of knowledge of the nursing care process, revealed that 90% of participants had insufficient knowledge of the NP [12]. Similarly, the study conducted in sub-Saharan Africa showed that nurses lack sufficient knowledge to enable them to implement the nursing process [13].

In general, the nurses who participated in the study had a good knowledge of the nursing process. Despite this, 97.3% of them expressed a need for continuing education. 69.3% said they had no continuing education. According to current practice standards in the United States and Canada, nursing practice requires the effective use of the nursing process and professional participation in activities that contribute to the ongoing development of knowledge about this methodology [14].

Carrying out a nursing process means doing all the thinking necessary to identify nursing care problems and find personalized and effective solutions to them. The perception of the nursing process is essential in nursing science, as it provides an understanding of acceptance, resistance, and issues surrounding professional change. In this study, 97.3% of nurses believe that the nursing process is very important. It therefore follows that nurses have a good perception of this process.

The nursing process is a widely accepted method and has been proposed as a scientific method for guiding procedures and qualifying nursing care [15]. The results showed that only 52% of nurses apply the nursing process. This shows that the implementation is not fully effective in these facilities. These results are comparable to those found in the study conducted in northern Ethiopia, where the majority of respondents, 150 (75%), stated that the nurse/patient ratio was not optimal for applying the nursing process. Although about 118 (59%) of respondents affirmed that their level of education was adequate to apply the nursing process [12]. These studies strengthen the research conducted in sub-Saharan Africa, which has shown that stressful working environments (high workload, limited nursing care resources, lack of organizational support) hinder the implementation of the nursing process, and that low staffing levels limit its execution [13]. Another study conducted in South Africa also showed that the main barriers to applying the nursing process are the lack of continuing education, insufficient resources, and the absence of a structured program [16].

The majority (76%) of nurses stated that management was involved in supervising the nursing process, which should in fact facilitate its implementation in these structures. This contrasts with the study conducted in Ethiopia, which found that only 47% of respondents stated that hospital administrations supported the application of the nursing process [12].

The study showed that 72% had difficulties implementing the nursing process. These results differ from a study conducted in the central part of Taiwan region, which found that nurses generally followed the nursing process and documentation sequence to establish care plans [17]. These findings also contrast with results from Ethiopia, where a cross-sectional study reported that 73.9% of nurses implemented the nursing process in their daily practice, highlighting a higher adherence compared to our context [18].

The majority (89.3%) of participants find the integration of technological tools in the application of the nursing process very useful. These variations can be explained by differences between study sites, changes in the nursing profession, variations in resources and technologies, government commitment, level of nursing practice, and the lack of clear nursing standards [12].