NANDA Research Articles

Perfil sociodemográfico, diagnósticos e cuidados de enfermagem propostos para idosos institucionalizados que utilizam múltiplos medicamentos

Objective: to characterize elderly residents in a long-term institution and identify the nursing diagnoses and related care to the use of multiple drugs. Methods: cross-sectional study using secondary data from 39 elderly living in the institute, it was analyzed though descriptive statistics. Aiming the identification of nursing diagnoses, it was considered the Risner’s model of diagnostic reasoning and NANDA International taxonomy. Care were proposed according to the Classification of Nursing Interventions - CNI. Results: the most part of elderlies were women, 29 (74.4 %),andaverage used was 3.7 drugs/day. Ten nursing diagnoses were identified: Risk of falls, Chronic Sadness, Impaired urinary elimination, Anxiety, Constipation, Impaired memory, Ineffective protection, activity intolerance, Fatigue and wandering. Different care have been proposed for these nursing diagnoses. Conclusions: data reflects the clinical practice of nursing in the care of elderly in institutions who use several medicines.

Nursing diagnoses of newborns with sepsis in a Neonatal Intensive Care Unit.

Objectives to elaborate the Nursing Diagnoses of newborns with sepsis in a neonatal intensive care unit and characterize the profile of the neonates and their mothers. Method a cross-sectional and quantitative study, with a sample of 41 neonates. A physical examination and consultation of the hospital records were undertaken, using an instrument. The elaboration of the Nursing Diagnoses followed a process of diagnostic inference and was based on the North American Nursing Diagnosis Association 2012-2014. Results the mothers were around 25 years old, had a low average number of pre-natal consultations, and various complications during the pregnancy; and the newborns were predominantly premature and with very low birth weights. Five Nursing Diagnoses predominated, and all the neonates presented Risk of Shock and Risk of fluid volume imbalance. Conclusion the Nursing Diagnoses of the neonates with sepsis can guide the formulating of specific assistential plans. The study contributes to the generation of new knowledge and found various relationships between the Nursing Diagnoses and the variables selected in the characterization of the neonates, which deserve to be elucidated in greater detail based on further research on the issue.

Diagnósticos de Enfermería en Pacientes Sometidos a Hemodiálisis

Objective: To determine the most common nursing diagnoses in patients under hemodialysis treatment, based on the nomenclature of the North American Nursing Diagnosis Association - International (NANDA-I) 2009-2011. Method: This is a quantitative, descriptive and exploratory study, accomplished in a hemodialysis clinic in the State of São Paulo, Brazil, with a sample of 50 patients. The study was approved by the Committee of Ethics in Research of the University of Vale do Paraíba, under protocol No. H236/CEP/2009. Results: We identified 24 most frequent diagnoses, of which six were found in 100% of the sample studied; they were: impaired urinary elimination; impaired skin integrity; risk of infection; risk of ineffective renal perfusion; impaired physical mobility; and risk of electrolyte imbalance. Conclusion: Determining nursing diagnoses common to subjects submitted to hemodialysis will help nursing professionals deal with chronic renal patients care by providing tools for planning assistance.

Development of Algorithm and System for Automatic Generation of Nursing Summaries from Nursing Care Plans

A nursing care planning system that automatically generated nursing summaries from information entered into the Psychiatric Outcome Management System (PSYCHOMS?, Tanioka et al.), was developed to enrich the content of nursing summaries at psychiatric hospitals, thereby reducing the workload of nurses. Preparing nursing summaries entails finding the required information in nursing records that span a long period of time and then concisely summarizing this information. This time consuming process depends on the clinical experience and writing ability of the nurse. The system described here automatically generates the text data needed for nursing summaries using an algorithm that synthesizes patient information recorded in electronic charts, the Nursing Care Plan information or the data entered for North American Nursing Diagnosis Association (NANDA) 13 domains with predetermined fixed phrases. Advantages of this system are that it enables nursing summaries to be generated automatically in real time, simplifies the process, and permits the standardization of useful nursing summaries that reflect the course of the nursing care provided and its evaluation. Use of this system to automatically generate nursing summaries will allow more nursing time to be devoted to patient care. The system is also useful because it enables nursing summaries that contain the required information to be generated regardless of who prepares them.

Nursing approaches for pain diagnosis and classification of outcomes

BACKGROUND AND OBJECTIVES: Nurses, as members of the health team, have to play their role to control pain, and are accountable for diagnostic evaluation, intervention and monitoring of treatment outcomes. This study aimed at identifying nursing students' approaches on interventions as from pain nursing diagnosis, according to taxonomy II of the North American Nursing Diagnosis Association and the association of nursing outcomes regarding interventions. METHODS: This is a transversal and quantitative study using as tool a clinical case. Studied sample was made up of 60 nursing students in the last graduation period. The research was carried out in two Public Universities, both in the state of Pernambuco. RESULTS: From the evaluated sample, most students (69%) have not presented interventions for the clinical case. From 31% presenting interventions, only 58% have presented expected outcomes, according to Nursing Outcomes Classification based on planned interventions. It is worth stressing the large number of students (42%) who have not performed the Nursing Outcomes Classification. CONCLUSION: Based on the results of this research, it is necessary a reflection about painful patients' evaluation, as well as about nursing approaches needed to solve or minimize such problem. One should add to this research the lack of qualification of future professionals and the need to change posture with regard to technical-scientific knowledge required by the profession.

Review of interrelationnursingdiagnosis Sedentary

In the new edition of NursingDiagnoses 2012-2014 from NANDA International, Sedentary Diagnostic is shown under a new LEVEL/DOMINIUM, from level 4:Activity-Rest to level 1: Health promotion. This fact may imply some modifications with respect to the interrelations proposed for the NOCs (interrelations, 2006). The aim of this study is that of obtaining new results that might cover psychosocial aspects of Sedentary Diagnostic. Material and methods; 25 nurses were chosen, to whom a questionnaire was sent in which 78 answers were specified, with their definition and a scale going from 1 to 5, where 1 means Not representative at all, 2 Some importance, 3 relatively important, 4 Quite important and 5 Very important. The value of the answers given to each of them is that of 0, 0.25, 0.5, 0.75, 1. Results according to Fehring technique (1987). Among all of them, three of the results were considered to obtain high punctuations: Motivation (0,88), Quality of life (0,88) and Health Condition (0,88). As a conclusion, the results obtained seem to propose changes in the interrelations within NOCs in sedentary diagnosed. A new set of NOCs ought to be included in

Diagnósticos de enfermagem do domínio Nutrição identificados em idosos da comunidade

The objective of this descriptive study was to identify the nursing diagnosis under the Nutrition domain, according to NANDA International Taxonomy II, in elderly patients of primary health care units in Fortaleza, Ceará, Brazil. The intentional sample consisted of 52 subjects. Data collection was performed at the elderly’s home, in May and June of 2011, by means of the application of a nursing history, following the theoretical framework proposed by Henderson. The nursing diagnoses were established following the stages proposed by Risner. Nine nursing diagnoses were identified among the 14 listed under the Nutrition domain. The main were: Risk for electrolyte imbalance (50%), Risk for deficient fluid volume (50%) and Imbalanced nutrition: less than body requirements (32.7%). These diagnoses can support health/nursing interventions focused on elderly nutrition, aiming to meet the real needs of this group, from a comprehensive and resolving perspective. Descriptors: Aged; Nursing Diagnosis; Elderly Nutrition; Primary Health Care; Nursing.

Diagnósticos reais e proposta de intervenções de enfermagem para os pacientes vítimas de múltiplos traumas

This descriptive quantitative study was performed at a reference trauma hospital emergency room with the objective to identify the nursing diagnoses presented by multiple trauma victims treated between February and April of 2012 and, next, propose nursing interventions. Evaluations were conducted with 41 patients referred by pre-hospital care services. All patients were 18 years of age or older, male and female, not pregnant and using the NANDA International Taxonomy II and Nursing Interventions Classification. Among the 25 identified diagnoses, the most prevalent were: acute pain; impaired physical mobility; impaired walking; bathing self-care deficit; dressing self-care deficit; intimate hygiene self-care deficit; impaired bed mobility; impaired transfer ability; impaired skin integrity; impaired tissue integrity; feeding self-care deficit; and ineffective respiratory pattern. Nest, 82 nursing interventions were proposed aiming to reduce patient harm. Descriptors: Multiple Trauma; Nursing Diagnosis; Emergency Nursing.

Model klinické rozvahy v ošetřovatelském procesu (předvýzkum)

summary The aim of this contribution is to present pilot research of accuracy of clinical balance in teaching students the particular steps of nursing process. The pilot study includes set of 15 full-time students of the Bachelor study branch General Nurse. For each step of the nursing process were prepared sets of records whose content and structure were motivated by principles OPT model of clinical balance of the authors Pesut and Herman. The protocols were used to record defining characteristics, relating or risk factors NANDA International, which were concluded by students from the patient's description (case interpretation). Further to recorded diagnostic conclusion students recorded chosen NOC areas for evaluating the patient and chosen NIC of nursing intervention. As a supporting instrument they obtained files of NOC areas for evaluating the patient and NIC interventions in Czech language. In total, there were prepared four sets of files following different patient description. Set of protocols following the description of the same patient was included at the beginning and at the end of practice. This set was marked as testing one. In testing protocols the accuracy of records was monitored. In order to put the rate of accuracy was used the evaluating instrument OPT model which was modified by the authors of the research. The reliability of this instrument was assessed by Coeficient Cronbach alfa. To judge test-retest reliability was used Spearman correlation coefficient. Obtained data were analysed by Student pair t-test and Wilcoxon pair test level of significance 0.05. It is interesting that in contrast to foreign studies conducted by the authors Kautz, Barlett or Bland the significant difference between the studentsresults before and after exercise block was proved only in one evaluating area.

Indicadores clínicos do diagnóstico de enfermagem processos familiares disfuncionais em alcoolistas: revisão integrativa

Alcoholism is a public health problem that affects the alcoholic and his/her family, and, thus, requires nursing care. An integrative literature review was performed with the objective to investigate the scientific evidence regarding the defining characteristics of the nursing diagnosis dysfunctional family processes in alcoholics. The search on the LILACS, PubMed, Scopus and CINAHL databases, by crossing the keywords alcoolismo/alcoholism, enfermagem/nursing and família/family, resulted in thirteen articles. The most common defining behavioral characteristics were alcohol abuse and verbal abuse, those of roles and relationships were conjugal problems and economic problems, and those of feelings were depression and insecurity. The also study identified characteristics present in the alcoholic family that are not listed on NANDA International. These findings help guide nurses in the clinical judgment and point at the need for more studies with a view to analyzing and validating the diagnosis. Descriptors: Alcoholism; Nursing Diagnosis; Nursing; Family; Family Relations.

Nursing Diagnoses in Pemphigus Vulgaris: A Case Study

This case study illustrates the use of the nursing process based upon the standardized nursing diagnoses approved by NANDA International (NANDA-I), and using the Nursing Outcomes Classification (NOC) and the Nursing Interventions Classification (NIC) in the care of a patient with pemphigus vulgaris (PV). The published literature on PV and the experience and expertise of the authors in working with people with impaired skin integrity and PV were used to develop this case study. The accuracy of nursing diagnoses and appropriateness of the nursing interventions were supported by the positive health outcomes of the patient. Impaired skin integrity is a human response diagnosed by nurses, and early treatment is important due to the vulnerability of these patients. The case study contributes to nursing knowledge for professionals who care for patients with PV.

Aplicando o Processo de Enfermagem no Cuidar de um Paciente com Lúpus Eritematoso Sistêmico

Objective: To implement the nursing care process in a user with Systemic Lupus Erythematosus in the light of the basic human needs that underlie the nursing care. Material and Methods: This was a case study carried out in a teaching hospital. The data were collected through the admission form used by the nurses in the clinics. The nursing diagnoses were prepared based on the NANDA Taxonomy II (North American Nursing Diagnosis Association). Results: A total of thirteen nursing diagnoses were identified, which were subjected to specific interventions according to the needs with subsequent evolution of the user. Conclusion: The nursing process when applied systematically and continuously provides satisfactory results evidenced by significant improvements in relation to biological, psychological and social state of the user. DESCRIPTORS Nursing Care. Lupus Erythematosus, Systemic. Case Study.

Revisão do diagnóstico de enfermagem Estilo de Vida Sedentário em pessoas com hipertensão arterial: análise conceitual

This study aims to review the components of the nursing diagnosis Sedentary Lifestyle (SL) proposed by NANDA (North American Nursing Diagnosis Association)-l in individuals with hypertension. The review was developed based on a concept analysis and supported by the Integrative Literature Review method, through which 43 articles were surveyed from five databases (LILACS, CINAHL, PUBMED, SCOPUS and COCHRANE). The following combinations of descriptors and their English and Spanish equivalents were used: Sedentary Lifestyle and Hypertension and Sedentary and Hypertension. Based on the review process, we found that the SL definition has changed, some clinical indicators have been identified and other indicators have been added to the definition. The study promotes a direction for diagnostic efficiency of clinical SL indicators, contributing to the refinement and improvement of this diagnosis and its components.

Sistematização da Assistência de Enfermagem para acompanhamento ambulatorial de pacientes com esclerose múltipla

An experience report of nurses in the implementation of care systematization in ambulatory care in an interdisciplinary care center for patients with multiple sclerosis of a public hospital in Fortaleza, Ceará, Brazil. This implementation is based on the NANDA International, Inc., Nursing Interventions Classification, and Nursing Outcomes Classifications. One of the results concerns systemized nursing care, which has enabled the identification and understanding of the responses of MS patients to potential and current health problems. Systematization entails expanding knowledge through a practice based on approach and encourage further research scientific evidence, in addition to promoting the role of the nurse in acomprehensive approachand encourage further research.

Revisión crítica de la taxonomía enfermera NANDA Internacional 2009-2011

Objetivos: Analizar el instrumento taxonómico enfermero NANDA 2009-2011, con el propósito de promover la reflexión, concienciación y sensibilización de los profesionales de enfermería sobre la eficacia y aplicabilidad del mismo. Método: Análisis descriptivo, crítico-reflexivo de la clasificación de diagnósticos enfermeros NANDA Internacional 2009-2011, así como de los artículos publicados relacionados con el tema. Resultados: Se realizó el análisis de un total de 201 diagnósticos de los cuales se identificó que sólo 46 tenían algún tipo de relación con la disciplina enfermera. Menos del 23% del total de los diagnósticos pertenecientes a la NANDA está relacionado con los metaparadigmas de las actuales teorías y modelos de enfermería. Conclusiones: Los antecedentes históricos de los diagnósticos de enfermería requieren buscar un marco conceptual más actualizado y vincular otros profesionales sanitarios pero sobre todo, tratando de disminuir así la dependencia histórica con las otras ciencias de la salud (Medicina); ya que los diagnósticos de enfermería han de permitir individualizar el cuidado y cumplir con los principios de la autonomía, la beneficencia y no maleficencia de nuestra profesión. Dado el análisis realizado se debe revisar y repotenciar los diagnósticos de enfermería puesto que la mayoría de ellos no son de la disciplina enfermera y aquellos que son no están acorde con una sintaxis propia de la ciencia.

Nursing diagnoses of diabetic patient medical charts: a descriptive study

Aim: identifying taxonomy II nursing diagnoses from the North American Nursing Diagnoses Association International using nursing records associated with outpatient diabetic treatment. Method: a descriptive and retrospective study. Data obtained from 35 patients’ medical charts, using a tool devised by the authors and analyzed using relative and absolute frequencies. Result: from eight diagnoses, three of the following showed up in more than 50% of the samples: Ineffective health maintenance; Imbalanced nutrition - more than body requirements; Sedentary lifestyle. Discussion: The findings show that these three diagnoses relate to a very important and unique issue in treating diabetic patients: the difficulty on the part of patients to adhere to treatment and self-care. Conclusion: The findings show that nursing diagnoses are useful with regard to identifying phenomena that require attention in specific treatment contexts, as well as acting as a guide in terms of the assistance offered.

Organ procurement and the body donor-family binomial: instruments to subsidize nursing approach

We aimed to describe the design of instruments to subsidize the care for the body donor-family binomial in the perspective of the process of organ procurement. The Activities of Living Model grounded the instruments for data collection. We identified 33 possible diagnoses, 14 associated to the body preservation and 19 to responses from family members facing grieving and the decision on whether to authorize the donation. We selected 31 interventions to preserve the body for organs/tissues procurement, and 25 to meet the needs for information, coping and support for the family decision. The nursing diagnoses, interventions, and outcomes were registered according to the North American Nursing Diagnosis Association, Nursing Intervention Classification, and Nursing Outcome Classification, respectively. The instruments follow the legislation of the Board of Nursing and the donor/organ procurement, needing to be validated by field experts.

Construction of the Nursing Diagnosis Ontology in Obstetric and Gynecologic Nursing Unit using Nursing Process and SNOMED CT.

This study was performed to propose an ontology methodology based on standardized nursing process as framework in obstetric and gynecologic nursing practice. The instrument used in this study was based on the nursing diagnosis classification established by North American Nursing Diagnosis Association (NANDA) (2009-2011), fifth edition of the Nursing Interventions Classification (NIC) (2008), forth edition of the Nursing Outcomes Classification (NOC) (2008) developed by Iowa State University and systematized nomenclature of medicine clinical terms (SNOMED CT). The nursing records data were collected from electronic medical records of one hospital from August to October 2010. One hundred and forty-one nursing diagnosis statements used in obstetric and gynecologic nursing unit were linked standardized nursing classifications and constructed nursing diagnosis ontology including interoperability. Not only will this result be helpful to complete nurse's lack of knowledge and experience, it will also help to determine nursing diagnosis logically by using standardized nursing process. It will be utilized as the method to construct ontology including interoperability in other nursing units. It will be presented nursing interventions according to nursing diagnosis and thus will be easier to establish nursing planning. This can provide immediate feedback of the nursing process application.

A review of neonatal literature to identify critical attributes for hypothermia nursing diagnoses

The aim of this study was to explore diagnostic indicators in the neonatal population for one nursing diagnosis approved by NANDA International, Inc., hypothermia, and for a proposed diagnosis, risk for hypothermia. In this integrative review, 23 articles were reviewed from the Cinahl, PubMed, and LILACS databases during the period of January through April, 2013. Data were drawn from the articles and synthesized to develop a list of potential related and/or risk factors, and defining characteristics. Potential newborn-related defining characteristics and related factors were identified for clinical testing in hypothermia, (23 and 17, respectively). Twenty-three risk factors were identified for risk for hypothermia. Diagnostic indicators for nursing diagnoses that place newborns at risk of morbidity and mortality will enable risk screening and more adequate assessments. These newly identified diagnostic indicators require research to validate their clinical usefulness.

Nursing diagnosis and Roy´s theoretical model in prostatectomized patients

A descriptive study aimed at identifying the profile of NANDA International nursing diagnoses in patients in the immediate post-operative prostatectomy and relates them to adaptive problems of the Roy Adaptation Model. Conducted in a university hospital in the Northeast of Brazil, between November, 2010 and April, 2011, with a sample of 50 subjects. The collected data were through interviews and physical examinations, with subsequent analysis by means of clinical reasoning. These relations were found: risk of falls and potential injury; impaired ambulation and mobility to walk and/or restricted coordination; self-care deficits and loss of ability to self-care; acute pain and acute pain; insomnia/impaired sleep patterns and sleep deprivation; constipation and constipation. Therefore, most of the nursing diagnoses identified are similar to adaptive problems according to Roy.