Challenges to Effective Nursing Assessment Practice in a Selected Public Hospital in South Africa: A Qualitative Study

Abstract

Background Efficient and practical nursing assessment is essential for developing accurate care plans, serving as the foundation for clinical decision-making, and ensuring optimal patient outcomes. This study aimed to explore and describe the challenges professional nurses face when performing nursing assessments in a selected public hospital in the Northwest Province, South Africa. Methods A qualitative, exploratory, and descriptive design grounded in Orlando’s Deliberative Nursing Process Theory (1961) was employed. Participants were purposively sampled. Data were collected from 20 professional nurses through semi-structured individual interviews and analysed using Tesch’s open coding method to identify themes and sub-themes. Trustworthiness was maintained through credibility, dependability, transferability, and confirmability criteria. Ethical principles were strictly observed throughout. Results Two main themes emerged: nurse-related and institution-related challenges affecting effective nursing assessment. Equally, six sub-themes were identified and supported by relevant literature. Conclusion Nursing assessment practices at the selected public hospital are hindered by negligence, limited competencies, staffing shortages, inadequate resources, and lack of managerial support. These challenges obstruct the application of Orlando’s Deliberative Nursing Process Theory in practice. Addressing these barriers through competency enhancement, improved staffing, and supportive leadership is critical. Strengthening these areas will improve healthcare quality, align with national and global health objectives, and ultimately enhance patient outcomes by delivering safe, comprehensive nursing care.