NANDA Research Articles

Nursing Interventions Related to the Need for Oxygenation in Severe COVID-19 Disease in Hospitalized Adults: A Retrospective Study.

To describe the nursing interventions related to the need for oxygenation in hospitalized adults with severe COVID-19 disease in the Intensive Care Unit. This was an observational, retrospective and descriptive study in a population of 2205 patients with a convenience sample of n = 430 and based on the North American Nursing Diagnosis Association (NANDA), the Nursing Interventions Classification (NIC) and the Nursing Outcomes Classification (NOC). The analysis was performed with a non-parametric test to determine the association between the nursing interventions and the need for oxygenation. The findings are aimed at improving nursing interventions with statistical associations as follow: oxygen therapy (p < 0.000), airway suctioning (p < 0.000), airway management (p = 0.029), invasive mechanical ventilation (p < 0.000) and non-invasive mechanical ventilation (p = 0.022). NOC taxonomy expected outcomes in ventilation, 34% (146), alteration in gas exchange, 33.7% (145), and respiratory status, 558.9% (253), were severely compromised. The nursing interventions to maintain the respiratory status are focused on airway care and oxygen therapy in order to increase the oxygen saturation level and decrease the severity of the need for oxygenation.

Determining awareness of and readiness for standardized nursing languages in a mid-level midwestern hospital and associated school of nursing.

The purpose of this study was to examine knowledge, attitude, and barriers toward care planning documentation practices with standardized nursing languages (SNLs) of nurses and nursing students at a midwestern healthcare system, comparing student and nurse responses. Cross-sectional surveys were given over a 2-month period with nurses and nursing students at different sites in a midwestern healthcare system, using convenience sampling. The Knowledge, Attitude, and Barriers to Using Standardized Nursing Languages and Current Practices Survey was adapted for use and re-tested for validity/reliability (Content Validity Index 0.81-1.00; Cronbach alpha=0.82-0.99) with 28 Likert scale items measuring knowledge, attitude, and barriers. Descriptive statistics, composite scores, correlations, t-tests, and multiple regression were used to analyze the concepts of the tool. 134/400 RNs responded (34%); 109/116 students responded (93.9%). Data analyses indicate adequate to superior levels of knowledge related to SNLs and NANDA International, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC), collectively referred to as NNN (NANDA, NIC, & NOC), positive attitudes toward SNLs/NNN and for adopting SNLs/NNN into documentation practices, but moderate to great barriers for implementation in practice. Barriers included lack of financial resources for change, lack of mentors, and lack of mandates to use SNLs. Students scored significantly higher than nurses in attitude only. Perceptions of nurses and student nurses for current documentation indicate awareness of inadequacy in existing systems and willingness to change existing systems for standardized languages, with perceived barriers to change/implementation of SNLs. Students were more positive about SNLs than nurses. Major implications for nursing are to reevaluate electronic documentation systems and determine how to insert and easily apply SNLs in these systems, such that nursing care documentation is standardized, interoperable, effective, time-saving, and attainable.

Using Principles of Digital Development for a Smartphone App to Support Data Collection in Patients With Acute Myocardial Infarction and Physical Activity Intolerance: Case Study.

Advances in health have highlighted the need to implement technologies as a fundamental part of the diagnosis, treatment, and recovery of patients at risk of or with health alterations. For this purpose, digital platforms have demonstrated their applicability in the identification of care needs. Nursing is a fundamental component in the care of patients with cardiovascular disorders and plays a crucial role in diagnosing human responses to these health conditions. Consequently, the validation of nursing diagnoses through ongoing research processes has become a necessity that can significantly impact both patients and health care professionals. We aimed to describe the process of developing a mobile app to validate the nursing diagnosis "intolerance to physical activity" in patients with acute myocardial infarction. We describe the development and pilot-testing of a mobile system to support data collection for validating the nursing diagnosis of activity intolerance. This was a descriptive study conducted with 11 adults (aged ≥18 years) who attended a health institution for highly complex needs with a suspected diagnosis of coronary syndrome between August and September 2019 in Floridablanca, Colombia. An app for the clinical validation of activity intolerance (North American Nursing Diagnosis Association [NANDA] code 00092) in patients with acute coronary syndrome was developed in two steps: (1) operationalization of the nursing diagnosis and (2) the app development process, which included an evaluation of the initial requirements, development and digitization of the forms, and a pilot test. The agreement level between the 2 evaluating nurses was evaluated with the κ index. We developed a form that included sociodemographic data, hospital admission data, medical history, current pharmacological treatment, and thrombolysis in myocardial infarction risk score (TIMI-RS) and GRACE (Global Registry of Acute Coronary Events) scores. To identify the defining characteristics, we included official guidelines, physiological measurements, and scales such as the Piper fatigue scale and Borg scale. Participants in the pilot test (n=11) had an average age of 63.2 (SD 4.0) years and were 82% (9/11) men; 18% (2/11) had incomplete primary schooling. The agreement between the evaluators was approximately 80% for most of the defining characteristics. The most prevalent characteristics were exercise discomfort (10/11, 91%), weakness (7/11, 64%), dyspnea (3/11, 27%), abnormal heart rate in response to exercise (2/10, 20%), electrocardiogram abnormalities (1/10, 9%), and abnormal blood pressure in response to activity (1/10, 10%). We developed a mobile app for validating the diagnosis of "activity intolerance." Its use will guarantee not only optimal data collection, minimizing errors to perform validation, but will also allow the identification of individual care needs.

Construction and validation of checklist for referral to the hyperbaric oxygen therapy unit

The objective was to build and validate a checklist for referring hospitalized patients to the hyperbaric oxygen therapy unit. This is a methodological study with a quantitative approach carried out in three stages: 1) scoping review on the topic, including the taxonomies of the North American Nursing Diagnosis Association and Nursing Interventions Classification; 2) construction of the instrument based on the characterization of the checklist items with the cross-mapping between the results of the scoping review and the titles of the diagnoses from the NANDA I taxonomy, choosing the NIC interventions; and 3) content and appearance validation process using the Delphi technique composed of a panel of judges. Items with a Content Validity Index ≥ 0.90 and checklist reliability based on Kappa agreement ≥ 0.80 were considered valid. After constructing and structuring the checklist, the Delphi stage was carried out with the responses of 10 judges, to validate the content and appearance. The checklist was categorized into 14 items. The 1st round evaluated the individual content of the items, the 2nd round evaluated the attributes of the instrument and the 3rd round the appearance and general evaluation. The level of agreement between the judges and the validation of content and appearance reached final values of 1.00. The checklist for referral to Hyperbaric Oxygen Therapy Units was considered an important support instrument and favors the communicative process between health teams.

The data analysis of the functional health patterns model for nursing care plans

ABSTRACT Introduction: Clinical practices constitute an important part of nursing education and students are expected to gain the ability to plan patient care during nursing education. Aim: It aimed to construct North American Nursing Diagnosis Association (NANDA) nursing diagnoses in nursing students’ patient care plans according to the Functional Health Patterns model and to evaluate them according to the Nursing Intervention Classification (NIC) and Nursing Outcomes Classification (NOC) classification systems. Methods: The descriptive study's population included 198 second-year nursing students from a university. Students' care plans were used as a data gathering form, and 176 care plans were included in the research. The data was gathered from functional health patterns, NIC, and NOC system questionnaires. Results: Nursing diagnoses were listed as infection risk (88.6%), fall risk (79.5%), and bleeding (56.8%). Nursing diagnoses belonging to sexuality-reproductive, coping-stress tolerance, and value-belief sub-categories of functional health patterns could not be reached from the care plans. Conclusion: There is a need for classification methods to objectively evaluate nursing practices, make quantifiable contributions to care, and improve the profession's scientific underpinnings. It is hoped that evidence-based care can be provided by raising pupils' knowledge of classification systems.

The ChatGPT effect and transforming nursing education with generative AI: Discussion paper

AimThe aim of this study is to present the possibilities of nurse education in the use of the Chat Generative Pre-training Transformer (ChatGPT) tool to support the documentation process. BackgroundThe success of the nursing process is based on the accuracy of nursing diagnoses, which also determine nursing interventions and nursing outcomes. Educating nurses in the use of artificial intelligence in the nursing process can significantly reduce the time nurses spend on documentation. DesignDiscussion paper. MethodsWe used a case study from Train4Health in the field of preventive care to demonstrate the potential of using Generative Pre-training Transformer (ChatGPT) to educate nurses in documenting the nursing process using generative artificial intelligence. Based on the case study, we entered a description of the patient's condition into Generative Pre-training Transformer (ChatGPT) and asked questions about nursing diagnoses, nursing interventions and nursing outcomes. We further synthesized these results. ResultsIn the process of educating nurses about the nursing process and nursing diagnosis, Generative Pre-training Transformer (ChatGPT) can present potential patient problems to nurses and guide them through the process from taking a medical history, setting nursing diagnoses and planning goals and interventions. Generative Pre-training Transformer (ChatGPT) returned appropriate nursing diagnoses, but these were not in line with the North American Nursing Diagnosis Association – International (NANDA-I) classification as requested. Of all the nursing diagnoses provided, only one was consistent with the most recent version of the North American Nursing Diagnosis Association – International (NANDA-I). Generative Pre-training Transformer (ChatGPT) is still not specific enough for nursing diagnoses, resulting in incorrect answers in several cases. ConclusionsUsing Generative Pre-training Transformer (ChatGPT) to educate nurses and support the documentation process is time-efficient, but it still requires a certain level of human critical-thinking and fact-checking.

Revisão da prevalência de diagnósticos de enfermagem em diferentes populações e cenários de cuidado à saúde

Abstract Objective To provide an overview of the prevalence of nursing diagnoses in different patient populations and healthcare settings, and on the methods identifying nursing diagnoses. Methods A descriptive review with a systematic method was applied according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All studies, in Medline and CINAHL databases from January 2007 to January 2020, reporting nursing diagnoses prevalence were included regardless of population and setting retrieving 1839 articles. Results After the screening, 328 articles were included for the analysis. Twenty different patient populations with their respective nursing diagnoses prevalence were identified. Most studies were conducted in inpatient settings (e.g., intensive, and surgical units). NANDA International was a widespread standard nursing language used, and risk for infection was the most frequently identified nursing diagnosis. Several gaps were identified regarding the methods used in the articles analyzed. Conclusion The most prevalent nursing diagnoses in different patient populations were identified. Moreover, the nursing diagnoses in the five standard nursing languages recognized by the American Nurses Association were summarized. Advances, gaps, and a call to action were identified.

Standardizing nursing data extracted from electronic health records for integration into a statewide clinical data research network

BackgroundCare plans documented by nurses in electronic health records (EHR) are a rich source of data to generate knowledge and measure the impact of nursing care. Unfortunately, there is a lack of integration of these data in clinical data research networks (CDRN) data trusts, due in large part to nursing care being documented with local vocabulary, resulting in non-standardized data. The absence of high-quality nursing care plan data in data trusts limits the investigation of interdisciplinary care aimed at improving patient outcomes. ObjectiveTo map local nursing care plan terms for patients’ problems and goals in the EHR of one large health system to the standardized nursing terminologies (SNTs), NANDA International (NANDA-I), and Nursing Outcomes Classification (NOC). MethodsWe extracted local problems and goals used by nurses to document care plans from two hospitals. After removing duplicates, the terms were independently mapped to NANDA-I and NOC by five mappers. Four nurses who regularly use the local vocabulary validated the mapping. Results83% of local problem terms were mapped to NANDA-I labels and 93% of local goal terms were mapped to NOC labels. The nurses agreed with 95% of the mapping. Local terms not mapped to labels were mapped to the domains or classes of the respective terminologies. ConclusionMapping local vocabularies used by nurses in EHRs to SNTs is a foundational step to making interoperable nursing data available for research and other secondary purposes in large data trusts. This study is the first phase of a larger project building, for the first time, a pipeline to standardize, harmonize, and integrate nursing care plan data from multiple Florida hospitals into the statewide CDRN OneFlorida+ Clinical Research Network data trust.

Nursing diagnoses as factors associated with delirium among intensive care unit patients with sepsis: A retrospective correlational study.

To examine whether nursing diagnoses were associated with delirium in patients with sepsis. Nursing diagnosis is a nurse's clinical judgement about clients' current or potential health conditions. Delirium is regarded as an important nurse-sensitive outcome. Nonetheless, nursing diagnoses associated with delirium have not yet been identified. Retrospective correlational study. This study was carried out from December 2021 to January 2023. We analysed electronic health records of patients with sepsis admitted to the intensive care units (ICUs) of a tertiary hospital in Seoul, South Korea. Delirium was defined based on the Intensive Care Delirium Screening Checklist score. Nursing diagnoses established within 24 h of admission to the ICU were included and were based on the North American Nursing Diagnosis Association diagnostic classification. The data were analysed using logistic regression. Demographics, comorbidities, procedures and physiological measures were adjusted. Regression model was evaluated via receiver operating characteristic curve, Nagelkerke R2, accuracy and F1 score. The prevalence of delirium in patients with sepsis was 51.8%. Ineffective breathing patterns, decreased cardiac output and impaired skin integrity were significant nursing diagnoses related to delirium. Age ≥ 65 years, Acute Physiology and Chronic Health Evaluation II score, mechanical ventilation, continuous renal replacement therapy, physical restraint and comatose state were also associated with delirium in patients with sepsis. The area under the receiver operating characteristic curve was 0.806. Ineffective breathing patterns, decreased cardiac output and impaired skin integrity could manifest as prodromal symptoms of delirium among patients with sepsis. The prodromal symptoms of delirium revealed through nursing diagnoses can be efficiently used to identify high-risk groups for delirium. The use of nursing diagnosis system should be recommended in clinical practice caring for sepsis patients. STROBE checklist. No patient or public involvement.

Indicadores clínicos nutricionais da nanda internacional em pacientes no pós-operatório

Aim: to describe the nutritional clinical indicators of post operatory patients based on the nutrition field of NANDA International. Method: cross-sectional descriptive study conducted in a university hospital from October to December2012. Astructured script was used to investigate sociodemographic and clinical indicators. The sample consisted of 80 individuals. A descriptive statistical analysis and data were arranged in tables. Results: Eight diagnoses were identified with a predominance of: unbalanced nutrition: lower than body requirements (00002) (58.8%); Excessive volume of liquid (00026) (43.8%) and risk of impaired hepatic function (00178) (42.5%). Conclusion: the individual nutritional status is an important parameter in the surgical process, either for the procedure or after it. Thus, care and nursing actions must prioritize and meet the needs of diagnoses identified in order to avoid postoperative complications.

Nursing care plan on gas exchange impairment due to SARS-CoV-2: case report

INTRODUCTION: Over the years, mankind has been in contact with several viruses, which have threatened human existence by becoming pandemics such as influenza in 1918. However, in January 2020, the Chinese Centre for Disease Control and Prevention identified SARS-CoV-2 as the etiological agent of the 2019 coronavirus. So far it is known that 5% of patients with severe COVID-19 will require attention in intensive care units. To this end, critical care nursing staff use the nursing care process to prioritize the care of the critically ill patient. OBJECTIVE: To develop a nursing care plan by analyzing a clinical case of an adult patient with a diagnosis of COVID-19. METHODOLOGY: The case of a patient with a diagnosis of COVID-19 was analyzed to develop a nursing care process using the taxonomies of the North American Nursing Diagnosis Association, Nursing Interventions Classification and Nursing Outcomes Classification. Documentary research was carried out through a literature search in databases such as: Scielo, Medicgraphic, Google Scholar and PubMed. RESULTS: Three real nursing diagnoses and seven risk diagnoses were identified. The priority nursing diagnostic label based on Maslow's pyramid of needs was deterioration of related gas exchange. CONCLUSIONS: The critical care nurse takes a leading role in the care of patients with a diagnosis of COVID-19, the development of the nursing care process contributes to providing quality care focused on the well-being of the user.

Fatigue in patients with heart failure: A study of diagnostic accuracy fatigue in patients with heart failure.

To analyze the accuracy of defining characteristics of the NANDA International nursing diagnosis, fatigue (00093), in patients with heart failure. A cross-sectional study on the diagnostic accuracy of the defining characteristics of the nursing diagnosis. The sample consisted of 96 patients with heart failure in treatment in a public hospital. The latent class analysis method was used to test the accuracy measurements and estimate the prevalence of the diagnosis. The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte. The prevalence of the fatigue nursing diagnosis was 42.54%. Increased physical symptoms (0.9988) and tiredness (0.9988) were the sensitive defining characteristics. Disinterested in surroundings (0.9999) was the specific defining characteristics. A set of three defining characteristics of the nursing diagnosis of fatigue was accurate in patients with heart failure. Thus, this set can be used by nurses to confirm nursing diagnosis fatigue in patients with heart failure. This research contributes by providing accurate defining characteristics of fatigue in patients with heart failure. Thus, nurses should recognize the nursing diagnosis of fatigue in patients with heart failure through accurate defining characteristics and propose rapid and effective nursing interventions that have positive health results.

Effectiveness of a Standardized Nursing Process Using NANDA International, Nursing Interventions Classification and Nursing Outcome Classification Terminologies: A Systematic Review.

The decision-making in clinical nursing, regarding diagnoses, interventions and outcomes, can be assessed using standardized language systems such as NANDA International, the Nursing Interventions Classification and the Nursing Outcome Classification; these taxonomies are the most commonly used by nurses in informatized clinical records. The purpose of this review is to synthesize the evidence on the effectiveness of the nursing process with standardized terminology using the NANDA International, the Nursing Interventions Classification and the Nursing Outcome Classification in care practice to assess the association between the presence of the related/risk factors and the clinical decision-making about nursing diagnosis, assessing the effectiveness of nursing interventions and health outcomes, and increasing people's satisfaction. A systematic review was carried out in Medline and PreMedline (OvidSP), Embase (Embase-Elsevier), The Cochrane Library (Wiley), CINAHL (EbscoHOST), SCI-EXPANDED, SSCI and Scielo (WOS), LILACS (Health Virtual Library) and SCOPUS (SCOPUS-Elsevier) and included randomized clinical trials as well as quasi-experimental, cohort and case-control studies. Selection and critical appraisal were conducted by two independent reviewers. The certainty of the evidence was assessed with the Grading of Recommendations Assessment, Development and Evaluation Methodology. A total of 17 studies were included with variability in the level and certainty of evidence. According to the outcomes, 6 studies assessed diagnostic decision-making and 11 assessed improvements in individual health outcomes. No studies assessed improvements in intervention effectiveness or population satisfaction. There is a need to increase studies with rigorous methodologies that address clinical decision-making about nursing diagnoses using NANDA International and individuals' health outcomes using the Nursing Interventions Classification and the Nursing Outcome Classification as well as implementing studies that assess the use of these terminologies for improvements in the effectiveness of nurses' interventions and population satisfaction with the nursing process.

The Curious Case of Alagille Syndrome: A Case Report With NANDA-I Classification, NIC, and NOC Linkage to the Patient Care Plan.

Alagille syndrome is a rare and complex pleiotropic multisystem disorder caused by an autosomal dominant genetic mutation of JAG1 (90%) and NOTCH2 (1%-2%) genes located on the short arm of chromosome 20. This case is reported as per the CAse REports (CARE) guidelines (2013). A 14-year-old boy who is a known case of chronic cholestatic liver disease of neonatal onset, was diagnosed with Alagille syndrome as evident from a NOTCH 2 mutation in genetic analysis and paucity of intrahepatic bile ducts on biopsy. He presented with portal hypertension, growth failure, and persistent hyperbilirubinemia. This case highlights the gamut of multisystem dysfunctions faced by this child. He is currently on conservative management and worked up for liver transplantation. The condition is often rare and challenging due to the multisystem pathogenesis. Thus, the nursing care is also multifaceted. This case study identified relevant North American Nursing Diagnosis Association (NANDA) Classification, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC) concepts to describe care of children with Alagille syndrome based on actual patient data.

Maternal near miss as a predictor of nursing diagnoses in critically ill newborns in intensive care

The aim of the present study was to analyze maternal near miss as a predictor of the Nursing Diagnoses of critically ill newborns admitted to intensive care. This cross-sectional, retrospective study was carried out by analyzing the medical records of mothers and their newborns born in a University Hospital and admitted to the Neonatal Intensive Care Unit in the period from January 2007 to December 2016. Newborn infants weighing less than 500 grams and with gestational age less than 22 weeks were excluded. Initially, mothers presenting maternal near miss criteria were identified. Subsequently, the newborns’ diagnoses were surveyed by screening their medical records for possible diagnostic indicators, carried out through the identification of defining characteristics and related or risk factors according to the Taxonomy of the North American Nursing Diagnosis Association (NANDA-I). Data referring to 47 diagnoses of 272 children were collected. A logistic regression model was used to assess whether the diagnosis of maternal near miss, present in 28 mothers, predicted each of the children’s diagnoses. The results suggest that the diagnosis of maternal near miss acts as a predictor of 12 diagnoses in newborns: Impaired Skin Integrity, Risk for Disproportionate Growth, Risk of Developmental Delay, Risk of Thermal Injury, Risk of Vascular Trauma, Risk of Infection, Risk of Hypothermia, Risk of Sudden Infant Death, Hypothermia, Risk of Aspiration, Risk of Damaged Oral Mucosa, and Risk of Unstable Blood Glucose.

Diagnostic concordance among nursing clinical decision support system users: a pilot study.

To analyze the nursing diagnostic concordance among users of a clinical decision support system (CDSS), The Electronic Documentation System of the Nursing Process of the University of São Paulo (PROCEnf-USP®), structured according to the Nanda International, Nursing Intervention Classification and Nursing Outcome Classification (NNN) Taxonomy. This pilot, exploratory-descriptive study was conducted from September 2017 to January 2018. Participants were nurses, nurse residents, and nursing undergraduates. Two previously validated written clinical case studies provided participants with comprehensive initial assessment clinical data to be registered in PROCEnf-USP®. After having registered the clinical data in PROCEnf-USP®, participants could either select diagnostic hypotheses offered by the system or add diagnoses not suggested by the system. A list of nursing diagnoses documented by the participants was extracted from the system. The concordance was analyzed by Light's Kappa (K). The research study included 37 participants, which were 14 nurses, 10 nurse residents, and 13 nursing undergraduates. Of the 43 documented nursing diagnoses, there was poor concordance (K = 0.224) for the diagnosis "Ineffective airway clearance" (00031), moderate (K = 0.591) for "Chronic pain" (00133), and elevated (K = 0.655) for "Risk for unstable blood glucose level" (00179). The other nursing diagnoses had poor or no concordance. Clinical reasoning skills are essential for the meaningful use of the CDSS. There was concordance for only 3 nursing diagnoses related to biological needs. The low level of concordance might be related to the clinical judgment skills of the participants, the written cases, and the sample size.

Improving Emotional Control And Activities of Daily Living (ADL) of Patients with Schizophrenia Using Spiritual Mindfulness Through SI-DEPAPU Application

Background: Schizophrenia is a major mental health problem in the world that requires more attention. Patients with schizophrenia are at higher risk of poor psychological well-being and violent behaviors as expression of anger and delusion. Mindfulness alone is considered less efficient so it needs to be developed with technology, as such further technological development regarding its application is needed.Objective: This study aimed to determine the effects of spiritual mindfulness intervention through the SI-DEPAPU application on the ability to control anger and perform activities of daily living (ADL) among schizophrenic patients.Methods: This study used a pretest-posttest quasi-experimental design with a control group. The samples were 60 schizophrenic patients randomly selected and divided into two groups. The intervention group was given four sessions of mindfulness in two weeks through the SI-DEPAPU application. This study used the anger management ability questionnaire developed by Sadipun et al. (2018) to measure the patient's ability to control anger and the North American Nursing Diagnosis Association (NANDA) questionnaire by Wilkinson (2016) to measure ADL. The instrument was tested for its validity among 20 schizophrenic patients with a risk of violent behaviors, and the results were valid and reliable in which the r-count r-table (0.444), the control group was given standard hospital care.Results: The results showed that the patient’s ability to control anger and perform ADL increased with p=0.000 and p=0.005, (p = 0,000 0,05) respectively. The intervention group had a higher mean score than the control group.Conclusion: Mindfulness spiritual interventions through the SI-DEPAPU application could help schizophrenic patients control anger and increase their ADL.

Removing the roadblocks to promoting health equity: finding the social determinants of health addressed in standardized nursing classifications.

Providing 80% of healthcare worldwide, nurses focus on physiologic and psychosocial aspects of health, which incorporate social determinants of health (SDOH). Recognizing their important role in SDOH, nurse informatics scholars included standardized measurable terms that identify and treat issues with SDOH in their classification systems, which have been readily available for over 5 decades. In this Perspective, we assert these currently underutilized nursing classifications would add value to health outcomes and healthcare, and to the goal of decreasing disparities. To illustrate this, we mapped 3 rigorously developed and linked classifications: NANDA International (NANDA-I), Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC) called NNN (NANDA-I, NIC, NOC), to 5 Healthy People 2030 SDOH domains/objectives, revealing the comprehensiveness, usefulness, and value of these classifications. We found that all domains/objectives were addressed and NNN terms often mapped to multiple domains/objectives. Since SDOH, corresponding interventions and measurable outcomes are easily found in standardized nursing classifications (SNCs), more incorporation of SNCs into electronic health records should be occurring, and projects addressing SDOHs should integrate SNCs like NNN into their ongoing work.

The nursing care for the medical device related pressure injury patient with a mucosal pressure injury due to an endotracheal tube: a case report

BACKGROUND: Pressure injury (PI) due to medical devices is one of the most common PIs, especially in patients treated in intensive care. Medical device-related pressure injuries (MDRPIs), as part of their treatment, require extra care and prevention interventions than injuries caused by immobilization. Standardized nursing models are needed to care for PIs caused by medical devices on mucous membranes. PURPOSE: To provide information about the evaluation and care of the MDRPIs in the mucosal membrane due to the endotracheal tube (ET). CASE REPORT: A 35-year-old male with chronic obstructive pulmonary disease (COPD) and coronavirus disease has MDRPIs on the lower lip edge due to the ET on the fifteenth day after intubation. North American Nursing Diagnosis Association (NANDA) diagnoses were determined by systematically analyzing the data using the Gordon’s Functional Health Patterns (GFHP) model in the patient. Nursing care was planned and applied in line with the determined NANDA diagnoses, Nursing Outcomes Classification (NOC) interventions, and using the recommendations of current PI guides for treatment of MDRPIs. CONCLUSION: This case report illustrates MDRPIs resulting from ET and provides information about the formation of MDRPIs and appropriate maintenance therapy. Future research is recommended to examine and evaluate the nursing care and outcome of MDRPIs in different mucosal membranes.

Nurses’ experiences of using the NANDA International taxonomy in mental healthcare

Background The lack of a standardised nursing taxonomy to clarify nurses’ assessments and other elements of the nursing process can potentially lead to a lack of care continuity and patient safety. The taxonomy published by NANDA International (NANDA-I) has been shown to improve the quality of mental health nurses’ documentation and clinical care.Aim To describe nurses’ experience of working in mental health inpatient care with a structured nursing taxonomy of diagnoses based on the NANDA-I taxonomy.Method Semi-structured interviews were conducted with five nurses working on three inpatient wards in a mental health unit in Sweden. The data were analysed using qualitative manifest content analysis.Findings The nurses’ experiences of using the NANDA-I taxonomy were described through three themes: ‘benefits of having a common language’, ‘usefulness of the NANDA-I taxonomy in the mental health context’, and ‘importance of how healthcare organisations apply the NANDA-I taxonomy’.Conclusion The common language provided by the NANDA-I taxonomy contributed to making nursing care more structured and person-centred. However, for the NANDA-I taxonomy to be effective, local nursing guidelines need to be synchronised with it.