Background The nursing process is an evidenced-based tool that guides the sequence of clinical reasoning and the delivery of quality nursing care. Nursing practice authorities worldwide, including Ghana, make it a standard of practice in the clinical setting for professional nurses. Despite this, only a few studies have attempted to assess the use of the nursing process in the country. This study, sought to assess the knowledge level, extent of use, as well as, barriers associated with the use of the nursing process at the Tamale Teaching Hospital in Ghana. Method A quantitative cross-sectional survey of 286 registered nurses and midwives, chosen by stratified random sampling, was undertaken using a questionnaire with a Cronbach’s alpha of 0.83. Data was fed into SPSS version 24 for analysis. A questionnaire return rate of 98.6% was realized. Descriptive statistics, as well as, Kruskal-Wallis H test of association was used to check for the presence of statistically significant associations between some selected independent variables and the use of the nursing process. Results Knowledge level of the nursing process was high (71.0%), while use of the nursing process was low (32.3%). Major barriers were stressful work environment (96.8%), absence of nursing process policy (94.7%), lack of further nursing process training (91.5%), inadequate supply of consumables (81.2%) and lack of nursing process clinical skills (42.9%). Participants age (p = 0.020), academic qualification (p = 0.038), work experience (p = 0.033), rank (p = 0.011) and the possession of nursing process clinical skills (p = 0.016) were significantly associated with the use of the nursing process for patient care. Conclusion A nursing process theory–practice gap exist in the hospital, occasioned by a high level of theoretical knowledge but low level of use of the nursing process in the hospital. Barriers such as stressful work environment, absence of nursing process policy, lack of further nursing process training, inadequate supply of consumables and lack of nursing process clinical skills also existed in the hospital. There is the need for the hospital management and health authorities to develop a nursing process policy, supply adequate quantities of consumables and conduct periodic nursing process clinical skills training for all nurses to enhance its use for improved patient outcomes.
