Effect of a Nursing Process Training Program on Nurses’ Knowledge and Skills in Primary Healthcare in Albania: A Quasi-Experimental Study

Abstract

Background: The nursing process provides a structured framework for delivering safe, holistic, and patient-centered care; however, its implementation in primary healthcare settings, particularly in low-resource systems, remains inconsistent due to limited training and institutional support. Objectives: This study aimed to evaluate the effectiveness of a structured educational intervention in improving nurses’ knowledge and practical competencies in applying the nursing process in primary healthcare centers in Vlora, Albania. Methods: A quasi-experimental study was conducted with 32 nurses from five public primary healthcare centers. Sixteen nurses received a structured training program consisting of theoretical instruction and case-based practice, while sixteen nurses served as a control group. Pre- and post-intervention assessments were performed using standardized questionnaires and skill evaluation tools, and differences were analyzed using nonparametric statistical tests. Results: The results showed clear improvements in the intervention group across all domains, after the training. The reported use of the nursing process increased from 62.5% to 100%, while the use of Gordon’s Functional Health Patterns increased from 6.3% to 93.7%. The use of NANDA nursing diagnosis increased from 62.5% to 100%. The proportion of nurses reporting written nursing care plans increased from 62.5% to 93.7%, and the implementation and evaluation of care plans increased from 62.5% to 100%. The control group showed no comparable progress. Nurses who participated in the training also reported increased confidence and consistency in applying the nursing process in daily practice. Conclusions: These findings suggest that structured, competency-based training programs may improve immediate nurses’ theoretical knowledge and practical skills. Such training may contribute to improving the quality of nursing care, but further studies and longer follow-up and patient-related results are needed.