Implementation of the nursing process in a hospital according to Wanda Horta and Donabedian

Abstract

This study aimed to report on the experience of implementing the Nursing Process in a medium-sized hospital in Metropolitan Region II of Rio de Janeiro, using Donabedian's framework and with technical-pedagogical support from the council's oversight. This is an experience report based on Donabedian's model. Data collection occurred through document analysis, direct observation, and monitoring of institutional indicators in the years 2024.2 and 2025. Structural weaknesses, lack of standardization, scarcity of technological resources, training deficits, and team resistance were identified. Strategies adopted included training, adaptation of digital tools, continuous supervision, and validation of the Nursing Process steps in the electronic medical record, with the active participation of the council's inspector. The implementation promoted significant advances in the dimensions of structure and process, strengthening professional practice and reorganizing care. The consolidation of the nursing process depends on the continuous monitoring of results and the parameterization of the North American Nursing Diagnosis Association International taxonomies, classification of nursing interventions, and classification of nursing outcomes.