Abstract
BackgroundThis paper reports a study about the effect of knowledge sources, such as handbooks, an assessment format and a predefined record structure for diagnostic documentation, as well as the influence of knowledge, disposition toward critical thinking and reasoning skills, on the accuracy of nursing diagnoses.Knowledge sources can support nurses in deriving diagnoses. A nurse’s disposition toward critical thinking and reasoning skills is also thought to influence the accuracy of his or her nursing diagnoses.MethodA randomised factorial design was used in 2008–2009 to determine the effect of knowledge sources. We used the following instruments to assess the influence of ready knowledge, disposition, and reasoning skills on the accuracy of diagnoses: (1) a knowledge inventory, (2) the California Critical Thinking Disposition Inventory, and (3) the Health Science Reasoning Test. Nurses (n = 249) were randomly assigned to one of four factorial groups, and were instructed to derive diagnoses based on an assessment interview with a simulated patient/actor.ResultsThe use of a predefined record structure resulted in a significantly higher accuracy of nursing diagnoses. A regression analysis reveals that almost half of the variance in the accuracy of diagnoses is explained by the use of a predefined record structure, a nurse’s age and the reasoning skills of `deduction’ and `analysis’.ConclusionsImproving nurses’ dispositions toward critical thinking and reasoning skills, and the use of a predefined record structure, improves accuracy of nursing diagnoses.
Highlights
This paper reports a study about the effect of knowledge sources, such as handbooks, an assessment format and a predefined record structure for diagnostic documentation, as well as the influence of knowledge, disposition toward critical thinking and reasoning skills, on the accuracy of nursing diagnoses
A regression analysis reveals that almost half of the variance in the accuracy of diagnoses is explained by the use of a predefined record structure, a nurse’s age and the reasoning skills ofdeduction’ andanalysis’
Aim The aim of the study was twofold: (1) to determine whether the use of handbooks in nursing diagnoses, an assessment format subdivided in eleven health patterns and a predefined record structure subdivided in three sections ((1) problem label or diagnostic label, (2) aetiology of the problem and/or related factors and (3) signs/symptoms), affects the accuracy of nursing diagnoses; (2) to determine whether knowledge, disposition towards critical thinking, or reasoning skills influence the accuracy of nursing diagnoses
Summary
This paper reports a study about the effect of knowledge sources, such as handbooks, an assessment format and a predefined record structure for diagnostic documentation, as well as the influence of knowledge, disposition toward critical thinking and reasoning skills, on the accuracy of nursing diagnoses. Nurses constantly make knowledge and skill-based decisions on how to manage patients’ responses to illness and treatment. Accurate formulation of nursing diagnoses is essential, since nursing diagnoses guide intervention [1,2,3,4] It is part of a nurse’ professional role to verify his or her diagnosis with the patient, ‘to be sure that, in the patient’s judgement, the cue cluster represents a problem’ [5]. Several authors have reported that patient records contain relatively few precisely formulated diagnoses, related factors, pertinent signs and symptoms, and poorly documented details of interventions and outcomes [13,14,15]
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