The Theory-Practice Gap in the Initial Assessment Phase of the Nursing Process: A Survey of Clinical Practices in a Hospital in the North-West Region of Cameroon

Initial nursing assessment is the first and most critical step of the nursing process, providing essential data for planning patient care. It is typically conducted at admission within 8 hours for stable patients and within 24 hours for unstable patients. Despite its importance, gaps between theory and practice persist, potentially affecting patient outcomes. This study aimed to examine nurses’ conceptual understanding, practices, and challenges related to the initial assessment phase of the nursing process in a hospital in the North-West Region of Cameroon. A descriptive cross-sectional design was used among 119 nurses selected through convenience sampling. Data were collected using a semi-structured questionnaire and checklist and analyzed using SPSS version 25. Statistical significance was set at p < 0.05. Findings revealed that 82.4% (n = 98) of participants correctly identified assessment as the first phase of the nursing process, and 97.5% (n = 116) acknowledged its importance in improving patient outcomes. However, only 61.3% (n = 73) defined assessment as data collection, while a concerning minority of 38.7% (n = 46) viewed it as a systematic problem-solving process, indicating a gap in comprehensive conceptual depth. Physical assessment (56.3%) was more emphasized than psychosocial (42.9%) and spiritual/cultural (43.7%) dimensions. Major challenges included workload (90.1%), lack of documentation tools (74.3%), and inadequate administrative support (51.5%). It was also noted that there was no statistically significant relationship between demographic variables and activities implemented (all p > 0.05). The study concludes that although nurses demonstrate good theoretical awareness of initial assessment, gaps remain in conceptual depth and holistic practice. Strengthening training, supervision, and resource availability is recommended.