Barriers to Integrating Nursing Knowledge and Clinical Skills into Clinical Practice Among Nursing Interns at the Government Tertiary Care Hospital, Swat

Background: Integrating nursing theory with clinical skills ensures safe patient care. However, interns face theory-practice gaps due to limited supervision, heavy workload, resource shortages, and psychological stress, particularly in low-resource government hospitals. Aim: This study aimed to evaluate the individual, institutional, and environmental barriers affecting the integration of nursing knowledge and clinical skills into clinical practice among nursing interns at Saidu Group of Teaching Hospital (SGTH), Swat, and to examine the association between these barriers and theory–practice integration. Methodology: The study was a quantitative analytical cross-sectional study and involved 147 nursing interns in SGTH, Swat. The data were gathered through a validated self-administered questionnaire that consisted of demographics, theory-practice integration, and barriers (individual, institutional, and environmental), which were analyzed using descriptive statistics and Chi-square tests. Results: Most of the interns were males (76.2%) and those with an average age of 24-26 (46.3%). There were moderate to high barriers: individual (86.4%), institutional (87.7%), and environmental (89.1%). The majority of interns (60.5%) identified a gap between theory and practice, and stress and the use of trial-and-error techniques were observed. The chi-square test indicated that perceived barriers were significantly related to theory-practice integration (² = 29.84, df = 4, p = 0.001), with more barriers being associated with less knowledge and skills integration. Conclusion: Individual, institutional, and environmental barriers hinder the application of nursing knowledge in practice. Targeted interventions, structured supervision, improved resources, and mentorship programs are essential to bridge the theory–practice gap, enhance clinical competence, and ensure patient safety.