title: Strategies to develop the nursing process and nursing care plans in the health system in Bolivia.
abstract: BACKGROUND
  Care plans provide guidelines to offer all patients the same quality assistance. Care plans constitute a base where every stage of the nursing process can be recorded, which will save time when handling documentation. Bolivian nurses are very keen to participate in this global trend in order to grasp the opportunity offered by the international cooperation programmes carried out between Spain and South America.
  
  
  OBJECTIVE
  To identify obstacles and enablers encountered when implementing the nursing process and to set clear strategies and actions so as to develop the nursing process and care plans in Santa Cruz department (Bolivia) both in hospitals and universities.
  
  
  METHODS
  The participatory action research was conducted between the Autonomous University of Gabriel René Moreno (Bolivia) and the University of Almería (Spain). The procedure for data collection included meetings with key informants, interviews, observation and workshops. Data were analysed using the constant comparison and categorized by common themes.
  
  
  RESULTS
  Lack of time and instruments, shortage of resources and the need for continuous training came up as obstacles, whereas enablers were the nurses' involvement, the university-hospital coordination and the support given by institutions. Actions taken were the creation of a care plan unit, the implementation of a training programme, design of instruments and meetings held with authorities and institutional representatives.
  
  
  CONCLUSIONS
  Conducting action research schemes within international cooperation programmes signifies an excellent opportunity for the nursing system in less-developed countries to be included in international plans with the aim of standardizing the nursing practice.
authors.affiliation: Nursing and Physiotherapy Department, University of Almería, Almería, Spain. cfernan@ual.es
authors.forename: C
authors.initials: C
authors.lastname: Fernández-Sola
authors.forename: J
authors.initials: J
authors.lastname: Granero-Molina
authors.forename: G
authors.initials: G
authors.lastname: Aguilera-Manrique
authors.forename: M H
authors.initials: MH
authors.lastname: Peredo-de Gonzales
authors.forename: A M
authors.initials: AM
authors.lastname: Castro-Sánchez
authors.forename: A
authors.initials: A
authors.lastname: Pérez Galdeano
mesh_terms: D001838:Bolivia; D055812:Community-Based Participatory Research; D006284:Health Plan Implementation / Q000458:organization & administration*; D006801:Humans; D007391:International Cooperation; D009736:Nursing Process / Q000592:standards*; D010347:Patient Care Planning / Q000592:standards*; D012015:Reference Standards; D013030:Spain