American Nursing Diagnosis Association International Research Articles

The analysis of nursing diagnoses determined by students for patients in rehabilitation units.

This study aimed to analyze nursing diagnoses determined by the nursing students for patients in rehabilitation unit. Data were collected from 190 case reports submitted by the nursing students who practiced in the rehabilitation unit, and analyzed on the basis of North American Nursing Diagnosis Association (NANDA) International, Inc. nursing diagnoses. Thirty different diagnoses were documented in rehabilitation unit. The most frequent nursing diagnosis was impaired physical mobility (n=68, 14.6%). The 30 diagnoses were grouped into 10 domains and 20 classes of the NANDA International, Inc. human response patterns. The average quality of nursing statements corresponded to a score of 8.63, indicating relatively good quality. The results of this study will help to improve the quality of nursing process education and provide guidelines to improve the quality of nursing care for the rehabilitation nursing situation in Korea.

Taxonomic Triangulation of Care in Healthcare Protocols: Mapping of Diagnostic Knowledge From Standardized Language.

Taxonomic triangulation is a data mining technique for the management of care knowledge. This technique uses standardized languages, such as North American Nursing Diagnosis Association International, Nursing Outcomes Classification, and Nursing Interventions Classification, as well as logic. Its purpose is to find patterns in the data and identify care diagnoses. Triangulation can be applied to databases (clinical records) or to bibliographic sources (eg, protocols). The objective of this study is to identify the care diagnoses implicit in the nursing care protocols of the Community of Madrid. The method followed has three phases: knowledge extraction for mapping of variables, linking to diagnoses, and triangulation with analysis. The study analyzes six protocols, and 344 variables (167 assessment, 29 planning, and 148 intervention) and 6118 links have been extracted. Triangulation identified 165 NANDA diagnoses (68.48%), and only 25 labels were not revealed through this process. As a limitation, the results depend on the knowledge presented in protocols and change with language editions. Some labels included in the sample are recent and are not included in the links with nursing outcomes classification and nursing interventions classification. In conclusion, taxonomic triangulation makes it possible to manage knowledge, discover data patterns, and represent care situations.

Diagnósticos de enfermagem no período transoperatório: mapeamento cruzado

Objetivo: Mapear os diagnósticos de enfermagem da taxonomia NorthAmerican Nursing Diagnosis Association International (NANDA-I) em pacientes no período transoperatório. Método: Estudo do tipo transversal, documental, dos registros de enfermagem no período transoperatório de um hospital da rede suplementar de saúde do município de Niterói, Rio de Janeiro, desenvolvido por meio da ferramenta metodológica mapeamento cruzado. Resultados: Foram avaliados 65 prontuários. A maior parte da amostra foi composta de mulheres com média de idade de 50,1 anos e submetidas a cirurgias eletivas. Quanto à especialidade cirúrgica, os procedimentos mais realizados foram gerais e urológicos. Os termos mais encontrados foram bisturi elétrico, placa de bisturi, anestesia geral e entubação. Pelo painel de especialistas, obtiveram-se como diagnósticos prevalentes: risco de infecção de sítio cirúrgico (84,6%), risco de integridade da pele prejudicada (78,5%), integridade tissular prejudicada (63,1%) e risco de aspiração (58,5%). Conclusão: Os diagnósticos de enfermagem encontrados são prioritariamente de risco. Logo, carecem de identificação precoce e de intervenções para evitar danos e prevenir complicações, como o retardamento na recuperação cirúrgica.

NOC/NIC Linkages to NANDA-I for Continence Care of Elderly People with Urinary Incontinence in Nursing Homes: A Systematic Review

The aim of this study was to review interventional studies conducted by nurses about elderly people with urinary incontinence in nursing homes and to match the results to standardized nursing terminology using the Nursing Interventions Classification and the Nursing Outcomes Classification Linkages to the NANDA-I diagnoses guidelines.A systematic review of quantitative intervention studies was conducted using the PRISMA statement as a guide. The interventional research in English was scanned using the MEDLINE and CINAHL databases from January 2005 to May 2015. Fourteen studies that had at least one nurse researcher were conducted in nursing homes, excluding surgical and pharmacological interventions. The Nursing Outcome Classification and Nursing Intervention Classification Linkages to NANDA-I diagnoses and the Clinical Conditions Part II-U List were used as a guide to select North American Nursing Diagnosis Association International nursing diagnoses, Nursing Outcome Classification Scales, and Nursing Interventions from the data.We found the frequency of use of various NANDA-I diagnoses, Nursing Interventions, and Nursing Outcomes based on the Nursing Outcomes Classification and Nursing Interventions Classification Linkages to NANDA-I diagnoses and the Clinical Conditions List for incontinence.Using the Nursing Outcomes Classification and Nursing Interventions Classification Linkages to NANDA-I diagnoses guide may provide new nursing perspectives on non-standardized research. In future studies, this may allow a comparison of data worldwide, enabling nurses to use the results in evidence-based practices.

An examination of the coverage of the SNOMED CT coded nursing problem list subset.

ObjectiveThe purpose of this article is to describe the current nursing problem list subset of Systematized Nomenclature of Medicine Clinical Terms (NPLS) coverage of the American Nurses Association (ANA) recognized standardized nursing terminologies (SNTs) and to identify potential ways to expand and enhance the utility of this list.Materials and MethodsThe study is a cross-sectional exploratory design. We mapped the content of the North American Nursing Diagnosis Association International (NANDA-I) (2018–2020), International Classification for Nursing Practice (ICNP) (2017 AB), Clinical Care Classification (CCC) (2018 AA), and Omaha System (2007AC) terminologies with each other and into NPLS (August 2017 edition) using Unified Medical Language System (UMLS) (release 2018AA) as the intermediary.ResultsWe identified a total of 1470 unique nursing diagnosis concepts across SNTs in UMLS, including 175 in CCC, 840 in ICNP, 244 in NANDA-I, 418 in Omaha System, and 631 in NPLS. The NPLS covers approximately 43% of the 1470 concepts—coverage for SNT content is 90% for CCC, 47% for ICNP, 59% for NANDA-I, and 32% for the Omaha System.Discussion/RecommendationsThe NPLS version 2017 coverage of SNT nursing diagnoses included in the UMLS is incomplete and equivocal. Recommendations: (1) ensure all SNT concepts in the UMLS are represented by SNOMED CT terms, (2) devise a formal strategy of partial matching to further enhance interoperability, (3) add a classification structure to the NPLS to enhance the ease of use and utility of the list, and (4) minimize redundancy within NPLS.

Proposal of nursing diagnoses, outcomes and interventions for postoperative patients of orthognathic surgery.

To propose nursing diagnoses, outcomes and interventions for patients in the postoperative period of orthognathic surgery. Secondary analysis of an information bank of a focal group with five patients submitted to orthognathic surgery. The classifications of the North American Nursing Diagnosis Association International, Nursing Outcomes Classification and Nursing Interventions Classification were used for elaborating nursing diagnoses, outcomes and interventions. Nursing diagnoses were identified based on the transcription of the focus group and the expected outcomes and interventions were proposed. In the second stage, the material was submitted to an analysis by judges for validating the previous stage. After careful analysis of the retrieved information, nine nursing diagnoses that relate to both the difficulties already installed and to potential patient difficulties were identified. After this phase, the expected outcomes for nursing care and the appropriate interventions for the postoperative period at home were identified. Given the short hospital stay and the long postoperative period, the established actions have a strong educational focus.

Application of the Betty Neuman systems model in the nursing care of patients/clients with multiple sclerosis.

ObjectiveThis study aimed to assess the application of the Betty Neuman systems model to the care of patient/clients with multiple sclerosis.MethodsThis clinical study resulted from the application of the nursing process to a patient/client admitted with multiple sclerosis in the neurological ward of a hospital in an urban area of Iran.ResultsA patient/client was evaluated according to the Neuman model. Intrapersonal stressors (physiological, psychological, socio-cultural, and spiritual), interpersonal stressors (being away from family and children) and extra-personal stressors (aggression and psychological pressure from the spouse) were found. Based on the examination, 12 nursing diagnoses based on the taxonomy of the North American Nursing Diagnosis Association International, and nursing care based on three levels of prevention that are important in the view of Neuman, are presented. The results were used in the classification of nursing interventions and the classification and nursing outcomes respectively.ConclusionsThe results suggest the desirability of care and patient/client satisfaction in the evaluation of nursing care based on the Neuman model. The model can be used as a framework to help nurses care for patients/clients. Thus, the application of this model and other models is recommended in the nursing care of patients/clients.

Study in frequently-used standardized nursing language for postpartum care after caesarean section applying NANDA-I,NIC and NOC

Objective To identify the most frequently used nursing diagnoses, interventions, outcomes, and linkages using North American Nursing Diagnosis Association International (NANDA-I), Nursing Interventions Classification (NIC), Nursing Outcomes Classification (NOC) for puerperas after caesarean section. Methods For this study a descriptive design was used. The frequently used NANDA-I, NIC, NOC, and NNN linkages were identified through 63 puerperas after caesarean section who were admitted in hospital from February to April in 2016. Results The finding showed the most frequently used 6 nursing diagnosis were ineffective breastfeeding, readiness for enhanced breastfeeding, deficient knowledge, risk for bleeding, acute pain,impaired tissue integrity; the most frequently used 11 nursing outcomes were breastfeeding establishment: infant, breastfeeding establishment:maternal, wound healing: primary intention, and so on; the most frequently used 26 nursing interventions were promoted voiding, environmental management: comfort, massage, and so on. The most frequently used top 38 NNN linkages were also identified in this study. Conclusions The most frequently used NANDA-I, NIC, NOC, and NNN linkages for puerperas after caesarean section from this study not only offer new standardized nursing terminology to nurses but also provide reference for cost accounting of postpartum care. Key words: Nursing diagnosis; Nursing care; Postpartum care after caesarean section; Nursing outcome; NNN linkage

Accuracy of nursing diagnosis "readiness for enhanced hope" in patients with chronic kidney disease.

To analyse the accuracy of the nursing diagnosis readiness for enhanced hope in patients with chronic kidney disease. This is a cross-sectional study with 62 patients in the haemodialysis clinic conducted from August to November 2015. The Hearth Hope Scale was used to create definitions of the defining characteristics of the North American Nursing Diagnosis Association International. We analysed the measures of sensitivity, specificity, predictive value, likelihood ratio, and odds ratio of the defining characteristics of the diagnosis. Of the characteristics, 82.22% presented the diagnosis. The defining characteristics "Expresses the desire to enhance congruency of expectations with desires" and "Expresses the desire to enhance problem solving to meet goals" increased the chance of having the diagnosis by eleven and five, respectively. The characteristics, "Expresses desire to enhance congruency of expectations with desires" and "Expresses desire to enhance problem solving to meet goals" had good accuracy measures.

Proceso enfermero de tercera generación

Introduction: As a result of changes in its scientific guiding methodology, the nursing process has evolved into its third generation. Its implementation in five stages (assessment, diagnosis, planning, execution, and evaluation) is based on the best scientific evidence in agreement with the discipline-internationally-recognized nursing taxonomies of the North American Nursing Diagnosis Association International , the Nursing Outcomes Classification, and the Nursing Interventions Classification. Development: The third generation nursing process carefully focuses on the benefits of the actual, expected and achieved care outcomes, rather than conducting diagnostics and problem- solving tasks which characterize the first and second generation nursing processes. Conclusion: While the approach is gradually emerging in institutions of health and education in Mexico, the third generation nursing process requires a careful use of cognitive and critical thinking skills.

Nursing diagnoses in patients with immune-bullous dermatosis.

ABSTRACTObjective: identify nursing diagnoses in patients with immune-bullous dermatosis. Method: a quantitative and descriptive research, carried out in three institutions located in Rio de Janeiro and Mato Grosso do Sul, Brazil, using the Client Assessment Protocol in Dermatology during a nursing consultation. Simple descriptive statistics was used for data analysis. Results: 14 subjects participated in the study, nine with a diagnosis of pemphigus vulgaris, pemphigus two and three of bullous pemphigoid. The age ranged between 27 and 82 years, predominantly females (11). 14 nursing diagnoses were discussed and identified from a clinical rationale in all study participants, representing the most common human responses in this sample. The application of the Assessment Protocol in Dermatology facilitated the comprehensive assessment, in addition to providing the identification of diagnostics according to the North American Nursing Diagnosis Association International. Conclusion: the nursing diagnoses presented confirm the necessity of interdisciplinary work during the care for this clientele. For better description of the phenomena related to the client in question, it is suggested the inclusion of two risk factors related in three diagnoses of this taxonomy. It is worth noting the contribution of the findings for the care, education and research in nursing in dermatology.

Evaluation of defining characteristics of nursing diagnosis Impaired Comfort

The nursing diagnosis Impaired Comfort (00214) is one of the new diagnoses in NANDA International 2009–2011 (North American Nursing Diagnosis Association International). Its holistic focus containing physical, psycho-spiritual and social dimensions correlates with the problems in menopausal women. The objective of the study was to validate the nursing diagnosis Impaired Comfort (00214) with the focus on menopause. We identified the diagnosis in a selected group of menopausal women (n=80); their responds were used for evaluation of the defining characteristics of the diagnosis. The patient-focused clinical diagnostic validity model by Fehring was used. A questionnaire-type evaluation tool containing 23 items and identification data was designed to evaluate the defining characteristics. Women evaluated the defining characteristics on the Likert-type scale. After collecting the data, weighted scores (WS) were calculated for each defining characteristic. The research results on major defining characteristics were consistent with the results of other studies. The major defining characteristics selected by women were: Disturbed sleep pattern (WS=0.76), Reports being hot (WS=0.76), and Reports being uncomfortable (WS=0.75). Women described ten defining characteristics as minor, and discarded ten defining characteristics as irrelevant for the nursing diagnosis Impaired Comfort (00214). The research results show the diversity of symptomatology in menopause. The roles of nursing include support for and education of menopausal women focused on positive attitude towards menopause and improvement of bio-psycho-social and spiritual experiencing in women.

Death anxiety in hospitalized end-of-life patients as captured from a structured electronic health record: differences by patient and nurse characteristics.

The nursing outcomes of hospitalized patients whose plans of care include death anxiety, which is a diagnosis among patients at the end-of-life, are obscure. The authors of the current article applied data mining techniques to nursing plan-of-care data for patients diagnosed with death anxiety, as defined by North American Nursing Diagnosis Association International, from four different hospitals to examine nursing care outcomes and associated factors. Results indicate that <50% of patients met the expected outcome of comfortable death. Gerontology unit patients were more likely to meet the expected outcome than patients from other unit types, although results were not statistically significant. Younger patients (i.e., age <65) had a lower chance of meeting the outcome compared with older patients (i.e., age ≥65) (χ(2)(1) = 9.266, p < 0.004). Longer stays improved the chances of meeting the outcome (χ(2)(2) = 6.47, p < 0.04). Results indicate that death anxiety outcomes are suboptimal and suggest the need to better educate clinicians about diagnosing and treating death anxiety among patients who face the end-of-life transition.

Nursing Diagnoses, Interventions, and Patient Outcomes for Hospitalized Older Adults with Pneumonia

A study was conducted by academic and community hospital partners with clinical information systems that included the standardized nursing language classifications of the North American Nursing Diagnosis Association International (NANDA-I), Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC). The aim of the study was to determine the frequency of NANDA-I, NIC, and NOC (NNN) terms documented for older adults with pneumonia who were discharged from three hospitals during a 1-year period. NNN terms were ranked according to frequency for each hospital, and then the rankings were compared with previous studies. Similarity was greater across hospitals in rankings of NANDA-I and NOC terms than in rankings of NIC terms. NANDA-I and NIC terms are influenced by reimbursement and regulatory factors as well as patient condition. The 10 most frequent NNN terms for each hospital accounted only for a small to moderate percentage of the terms selected.

Perspective: Implementation of Nursing Language in Long‐Term Care and Nursing Education

This article describes one nurse's experiences of returning to school after a 10-year absence, her introduction to nursing theory and terminology, and her subsequent implementation of nursing language in a long-term care setting and later experiences in teaching nursing language to students. A 21-year career as a long-term care nurse coincided with the evolution of the new organization North American Nursing Diagnosis Association International, and she found herself in a position to implement nursing diagnosis in the long-term care setting. Practice experiences and pertinent nursing references and resources were used in clinical implementation and in teaching nursing students. The author reviewed the implementation and teaching of nursing language from a personal historical perspective. The author's experiences and perspectives on implementation of nursing language in clinical practice and in teaching provide information and a perspective for nurses and students involved in these processes.

Helping a Man with Leprosy: A Case Study

This case study illustrates nursing diagnoses and interventions for a man with leprosy. Data sources were published literature on the disease of leprosy, and the experience and expertise of the authors in working with people with leprosy. Data were synthesized using the standardized nursing languages of North American Nursing Diagnosis Association International and the Nursing Interventions Classification. The accuracy of the diagnoses and the appropriateness of the nursing interventions were supported by the positive health outcomes of the patient. Although leprosy has been eradicated in some countries, the risk of new cases is present anywhere that Mycobacterium leprae still exists. The recommended treatment of multibacilar polychemotherapy has lowered the rate of new cases in Brazil. Nurses need to incorporate evidence-based practice interventions for leprosy-based wound care, and nurses should encourage persons with leprosy to maintain regular medical care with multibacilar polychemotherapy.

Novel Nursing Terminologies for the Rapid Response System

Nursing terminology with implications for the rapid response system (RRS) is introduced and proposed: critical incident nursing diagnosis (CIND), defined as the recognition of an acute life-threatening event that occurs as a result of disease, surgery, treatment, or medication; critical incident nursing intervention, defined as any indirect or direct care registered nurse-initiated treatment, based upon clinical judgment and knowledge that a registered nurse performs in response to a CIND; and critical incident control, defined as a response that attempts to reverse a life-threatening condition. The current literature, research studies, meta-analyses from a variety of disciplines, and personal clinical experience serve as the data sources for this article. The current nursing diagnoses, nursing interventions, and nursing outcomes listed in the North American Nursing Diagnosis Association International Classification, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC), respectively, are inaccurate or inadequate for describing nursing care during life-threatening situations. The lack of such standardized nursing terminology creates a barrier that may impede critical communication and patient care during life-threatening situations when activating the RRS. The North American Nursing Diagnosis Association International Classification, NIC, and NOC are urged to refine their classifications and include CIND, critical incident nursing intervention, and critical incident control. The RRS should incorporate standardized nursing terminology to describe patient care during life-threatening situations. Refining the diagnoses, interventions, and outcomes classifications will permit nursing researchers, among others, to conduct studies on the efficacy of the proposed novel nursing terminology when providing care to patients during life-threatening situations. In addition, including the proposed novel nursing terminology in the RRS offers a means of improving care in such situations.

A 10-Year Retrospective Study of Teaching Nursing Diagnosis to Baccalaureate Students in Italy

The aim of this 10-year retrospective study was to evaluate the impact of teaching nursing process to students at different levels of baccalaureate education, using the North American Nursing Diagnosis Association International (NANDA-I) Taxonomy. Nursing care plans written between 1996 and 2006 by 3,784 students who had completed a baccalaureate course in nursing process at a university in northern Italy were evaluated. At least three of the four steps of the nursing process were included in the evaluation: assessing, planning, intervening, and evaluating. An average of 6.3 (range 0-31; +/-3.9; median 6) problems were identified in each care plan. Of these, 5.1 (range 0-29; +/-3.06; median 5) were related to nursing diagnoses concerning either an actual problem or the risk of developing a problem; the remaining 1.2 (range 0-20; +/-1.9; median 0) diagnoses were concerned either with collaborative problems or with potential complications. The students demonstrated significant improvement in accurately identifying 75 diagnostic titles from the NANDA-I Taxonomy as they progressed through their first, second, and third years of baccalaureate study. These findings suggest that the ability to use the NANDA-I Taxonomy accurately is acquired over time. Thus, the theory and practice of using nursing process should be introduced in a formal course during the first year of baccalaureate nursing education and should be reinforced throughout the remaining courses. Students can then progressively improve their knowledge, critical thinking abilities, and use of the NANDA-I Taxonomy during their second and third years of study. Teaching strategies to reinforce students' learning are recommended.

Revisão integrativa: etapa inicial do processo de validação de diagnóstico de enfermagem

O diagnóstico de enfermagem é a segunda etapa do processo de enfermagem e pode ser considerada uma fonte de conhecimento científico para a enfermagem, tornando-se fundamental para o planejamento e implementação de intervenções eficazes que proporcionem a melhoria da assistência prestada ao paciente. A revisão integrativa é um método de pesquisa que permite reunir e sintetizar as evidências disponíveis sobre o tema investigado. Assim, o presente artigo teve como objetivo apresentar a revisão integrativa da literatura como etapa inicial do processo de validação de diagnóstico de enfermagem. Por meio de um exemplo, apresentam-se aspectos importantes na construção da revisão integrativa e as contribuições deste método para aperfeiçoar e legitimar os diagnósticos de enfermagem descritos pela Taxonomia II da North American Nursing Diagnosis Association (NANDA), contribuindo para sua capacidade de generalização e de predição, visando à proposição de diretrizes para o cuidado.

Coining and Defining Novel Nursing Terminology. Part 1: Critical Incident Nursing Diagnosis

In the first of a three-part series, a novel nursing terminology is introduced and proposed for inclusion in the North American Nursing Diagnosis Association (NANDA) International Classification--Critical incident nursing diagnosis (CIND)--defined as the recognition of an acute life-threatening event that occurs as a result of disease, surgery, treatment, or medication. The literature, research studies, and meta-analyses from a variety of disciplines, and personal clinical experience serve as the data sources for this article. The current nursing diagnoses in the NANDA International Classification are inaccurate or inadequate for describing nursing care during life-threatening situations. The lack of standardized nursing terminology creates a barrier that may impede critical communication and patient care during life-threatening situations. Coining and defining a novel nursing terminology, CIND, for patient care during life-threatening situations are important and fill the gap in the current standardized nursing terminology. IMPLICATIONS FOR NURSING PRACTICE. Refining the NANDA International Classification will permit nursing researchers, among others, to conduct studies on nursing diagnoses in conjunction with the proposed novel nursing terminology: CIND. Parts 2 and 3 of this series will propose additional nursing terminology: critical incident nursing intervention and critical incident control, respectively.