Dissertation (Msc. Nursing Education)Background: Nursing care plan has been identified as critical nursing practice and as a specified individualized model of a patient-centered care approach. Although several challenges, such as an inadequateness of implementation fidelity during nursing care plan, an excessive number of tasks assigned to the nursing team, poor quality of professional education and insufficient reports on the physical examination related to the disease and health determination haunt its effectiveness. This raises several inquiries on whether the way of teaching and learning procedures offered to students meets the current societal needs. Objective: To determine the implementation fidelity of the nursing care plan for hospitalized patients among nurses in Tanzania. Methods: Educational based analytical cross-sectional study conducted from April to May 2019.among 422 complete filled files with nursing care plan in line with nurses who filled the audited the provided care. Implementation fidelity checklist was used to collect the data which were analyzed using the Statistical Package for Social Sciences (SPSS, version 23) software program me .chi squire and fisher’s exact tests were used to compare categorical variable. A p<0.05 was considered as statistically significant. Results: Findings indicates RN were found to be more times likely to provide care among hospitalized patients using nursing care plan as recommended than EN (AOR = 2.010, 95%CI = 1.308-3.090, p<0.01). Nevertheless, nurses with working experiences of >5 years were less times likely to provide care to hospitalized patients using nursing care plan as suggested (AOR = 0.394, 95%CI=0.249-0.625,P=<0.01). Moreover nurse who were working in medical and surgical ward were 1.9 and 1.8 times more likely to adhere to the implementation fidelity of nursing care plan compared to nurses who were working in other types of ward (AOR = 1.903, 95%CI = 1.130-3.207, p<0.01) and (AOR = 1.835, 95%CI = 1.041-32.35, P<0.01) respectively Conclusion: Despite the importance and the emphasis put on the use of nursing care plan in caring for patients, it was observed that, EN did not adequately adhere to the recommended implementation fidelity. Nursing curriculum for enrolled nurses and on job trainings need to emphasize the implementation fidelity of nursing care plan.