Abstract
Background:
Nursing care plans (NCPs) are necessary tools that facilitate clinical analyzing, promote evidence-based practice, and ensure patient safety (Doenges et al., 2019). Undergraduate Nursing students often struggle with formulating comprehensive Nursing care plans despite its importance and the Common challenges include inaccurate assessments, poorly constructed nursing diagnoses, vague goal-setting, and inadequate evaluation methods and as well as the difficulties point to a persistent disconnect between theoretical instruction and its practical application in clinical environments (Dalton et al., 2018). The present study aims to identify documentation deficiencies and explore the underlying factors influencing students' performance to inform targeted educational strategies. To assess the types of deficiencies in nursing care plans among undergraduate nursing students. To explore nursing students' cognitive, emotional, and contextual experiences in developing care plans.
Methods:
An explanatory sequential mixed-methods design was utilized. During the quantitative phase,
120 nursing care plans were evaluated using structured rubric based on the VIPS (wellbeing, integrity, prevention, and security) model (2009). By assessing five key components: assessment, diagnosis, goal setting, intervention, and evaluation. Statistical analysis was conducted to identify differences by academic year and clinical area.
The qualitative phase, data was collected through three focus groups of nursing students (from 2nd, 3rd, and 4th year cohorts) and 10 semi-structured individual faculty interviews conducted in Rawalpindi and Islamabad. Thematic analysis followed Braun and Clarke’s (2006) framework, and results were integrated at the interpretation stage.
Results:
Quantitative data revealed major deficits in risk diagnosis (2%), time-bound goal setting (34%), and outcome evaluation (4%), with marked variations across academic levels and clinical settings (excluding pediatrics). Key student-derived themes included: Diagnostic and Planning Difficulties, Theory-Practice Gap, Skills Development Over Time, Instructional Support, Emotional Challenges, and Technology Use. Faculty themes were Teaching Barriers, Nursing Curriculum Deficiencies, Errors in Students Assessment, Faculty Development plans, and Clinical Integration Issues.
Conclusion:
Both student learning gaps and systemic educational barriers contribute to poor care plan documentation. Effective improvement requires curriculum reforms, faculty development, and
stronger clinical-academic alignment.