Use and Significance of Nursing Diagnosis in Hospital Emergencies: A Phenomenological Approach.

Jose Miguel Cachón-Pérez,Marta Rodriguez-Garcia,Purificación Gonzalez-Villanueva,Oscar Oliva-Fernandez,Juan Carlos Fernandez-Gonzalo,Esther Garcia-Garcia

doi:10.3390/ijerph18189786

Abstract

Background: Professional nursing organizations recommend the use of nursing diagnosis to enhance and facilitate the standardization of care and the development of a common language used by nursing practitioners. In the clinical reality of hospital emergency departments, however, its use is controversial. The objectives of the research are (a) to explore the use of nursing diagnosis in hospital emergency departments, and (b) to describe the meaning of nursing diagnosis for hospital emergency nurses. Methods: A qualitative phenomenological study was conducted. A purposeful sampling and snowball technique were used. Data were collected using in-depth interviews, researchers’ field notes, and documental analysis. An inductive analysis based on Giorgi´s proposal was used to identify significant emerging themes from interviews and field notes. Seventeen participants with a mean age of 40 were recruited. Results: Three themes were identified. The results showed how the use of nursing diagnosis in hospital emergency departments depends on nurses to apply a working methodology in their practice, along with other dimensions such as the characteristics of emergency care, the type of health problems, and the complexity of care. Conclusions: The use of standardized language in emergency departments is complex due to the overcrowded nature of care in these settings.

Highlights

The nursing process and the use of nursing diagnosis in favor of a homogenization and standardization of the care we provide to patients and the use of a common and universal language used by nursing professionals are recommended by NANDA International and previous studies and other national associations in Spain, such as the Spanish Association of Nomenclature, Taxonomy, and Nursing Diagnosis (AENTDE) and the Spanish Society of Emergency Nursing (SEEUE) [1,2,3]
The results of the study describe the difficulties experienced by nurses in emergency departments in using nursing diagnoses, the opportunity to work under a nursing methodology, and the dilemmas and conflicts involved in providing care in services saturated by the demand for care and the management of nursing taxonomy
Based on the results obtained, we observed that standardized nomenclatures and taxonomies such as NANDA, Nursing interventions classification (NIC), nursing outcomes classification (NOC) are not the methodological tool used by nurses in hospital emergency departments; we found that it is a language that is difficult to use and is not adapted to the practice and casuistry of patients attending these hospital emergency departments

Summary

Introduction

The nursing diagnosis is a clinical judgment that identifies a health problem and is the basis for the nurse to describe the objectives and interventions to be performed [4,5]. In Spain, in the field of emergency care, the SEEUE recommends that it is necessary to use the nursing process along with nursing diagnoses to maintain scientific, professional, and quality assurance [6] in order for a nursing language with a high degree of consensus and standardization to be achieved, thanks to the different international taxonomies and classifications which reflect the stages of the nursing practice process, understanding the nursing diagnosis and its language as a development opportunity for the nursing profession [5].

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Results

Discussion

Conclusion