Nursing Care Plan Research Articles

PSYCHIATRIC NURSING CARE PROCESS WITH NANDA, NIC, and NOC CLASSIFICATIONS: CASE EXAMPLE

Nursing care plans present a systematic way and standard language for nurses. Standardized care terminology and evaluations are important in providing a common language globally and showing nursing care outcomes. NANDA, NIC, and NOC (NNN) form the structure of the nursing care plans. This standardized nursing process language provides a system that supports individualized care, allowing us to visualize and formulate a nursing process. The use of the NNN system in psychiatric patient care may increase both patient safety and the quality of nursing care. The outcomes of nursing care also gain a measurable dimension by being evaluated quantitatively. On the other hand, there are a number of difficulties in the implementation of the NNN system in inpatient services. Since there are no sufficient amount practice examples, the usage of the whole system is not common. Case studies will be guiding for the solution of issues preventing psychiatric nurses' use.

Association between peripheral venous catheter failure and care complexity factors in emergency department: a cross-sectional study

ObjectiveThe objective was to determine the prevalence of peripheral venous catheter (PVC) failure and its association with care complexity individual factors (CCIFs) in emergency department (ED) patients.DesignA cross-sectional, descriptive-correlational study...

A Study to Determine Consensus for Nursing Documentation Reduction in Times of Crisis.

Nurses faced numerous challenges during the pandemic, particularly with the increased burden of electronic documentation. Surges in patient volume and visits led to rapid changes in nursing documentation, prompting diverse responses from regulatory and healthcare organizations. Nurses expressed safety concerns and struggled with changes, calling for national standards and regulatory support. Policy relaxations, such as the 1135 Waiver, sparked debate on the future of nursing care plan documentation. Using mixed-methods exploratory design, the study identified modifications of nursing documentation during crises, commonalities in documentation burden reduction for applicability beyond pandemics, and consensus on the definition of "surge." Documentation patterns were assessed from February to November 2022, involving 175 North American nurse leaders and informaticists. Data analysis included descriptive statistics, thematic analysis, and Pearson correlation coefficient. Significant differences were found between rural and urban settings (P = .02), with urban areas showing higher odds of changes to care plans (odds ratio, 4.889; 95% confidence interval, 1.27-18.78). Key findings highlighted the persistence of postcrisis documentation changes and varied definitions of surge criteria based on organizational leadership, policy, and mandates. The study yielded insights for modifying documentation, offering policy recommendations, and emphasizing ongoing collaboration and evidence-based approaches for future nursing practices.

Implementation of an electronic nursing care plan in a training and research hospital: qualitative examination of nurses' experiences and opinions

Implementation of an electronic nursing care plan in a training and research hospital: qualitative examination of nurses' experiences and opinions

The Effect of Family-Centered Empowerment Program on Husbands' Understanding of Illness, Perceived Stress and Self-care Behaviors of Type 2 Diabetes Patients

Background: Comprehensive support from individuals with whom one has a deep emotional connection can significantly improve the management of life's stresses. Objectives: This study aims to investigate the impact of a family-oriented empowerment program for husbands on the illness understanding, perceived stress, and self-care behaviors of patients with type 2 diabetes. Methods: In this semi-experimental study, 72 spouses of diabetic patients who met the inclusion criteria were randomly selected and divided into intervention and control groups. The intervention group received an educational program based on the family-centered empowerment model, which consisted of six 60-minute training sessions over six consecutive weeks. The control group received usual care. Data were collected using questionnaires on self-care behaviors, disease understanding, and perceived stress, administered before, immediately after, and three months after the intervention. Data were analyzed using independent t-tests, paired t-tests, and repeated measures ANOVA. Results: There were no significant differences between the intervention and control groups in terms of demographic characteristics and baseline variables (P = 0.11). The Mann-Whitney test revealed significant differences between the two groups in terms of disease understanding, perceived stress, and self-care behaviors after the intervention (P < 0.001). The independent t-test confirmed significant changes in the mean scores for disease perception, perceived stress, and self-care behaviors between the two groups (P < 0.001). Conclusions: The results indicate that a family-centered empowerment program can enhance illness understanding, reduce perceived stress, and improve self-care behaviors among the spouses of diabetic patients. Given the increasing prevalence of diabetes, incorporating such programs into nursing care plans is recommended.

Cuidados de enfermería en el adulto mayor con hiperplasia prostática benigna y alcoholismo en la costa Oaxaqueña

A clinical case diagnosed with benign prostatic hyperplasia (BPH), reflects the increasing prevalence of this condition in relation to age. Urinary flow obstruction due to prostatic enlargement results in lower urinary tract symptoms (LUTS), significantly impacting the quality of life of men over 45 years of age. The patient, due to his age is in a risk group, so a nursing care plan (PLACE) was designed to promote his autonomy and well-being, based on Virginia Henderson's 14 needs and using taxonomies of diagnoses, outcomes and nursing interventions to address the patient's needs. As a result of these interventions, an improvement in the user's health status was observed, demonstrating the effectiveness of the patient-centered nursing care process (NCP) and their ability to manage their condition autonomously resident of the Oaxaqueña Coast.

Nursing Care of the Patient Diagnosed with Multiple Myeloma as a Result of Trauma-Induced Fracture Development: A Case Report

Multiple myeloma is a neoplasm of plasma cells. Observed usually in patients over 65 years of age. This case report 41 year old has been prepared in order to determine the nursing diagnoses grouped according to the "Functional Health Patterns" model and to evaluate them in the nursing care plan of a patient who was diagnosed with multiple myeloma as a result of the examination which is that were noticed during a different examination. In the case for the problems; diagnoses of acute pain, sleep disturbance, undernutrition, deterioration of oral mucous membrane, constipation, fatigue, activity intolerance, risk of deterioration in individual identity, risk of deterioration in individual resistance, and nursing interventions for these diagnoses were planned and implemented. Before the study, verbal and written consent was obtained from the patient, and the data were collected by face-to-face interview method. As a result; the patient care process, which was planned and applied in line with the functional health patterns model, provided a positive improvement in the patient's behaviors that would negatively affect the disease process such as facilitated discharge, and guided nurses about care, effectiveness and follow-up of treatment. This model is recommended for the effective implementation of nursing care in clinics such as hematology, oncology, palliative care, where patients need to be followed actively.

Traces of spiritual care in nursing records: A qualitative study of cancer care.

Serious illnesses, such as cancer, bring the threat of loss of health and life closer. This may compromise spiritual well-being. Addressing patients' spirituality is essential in nursing care. Therefore, nursing records should reflect, clarify, and enable spiritual-care follow-up. The aim of this study is to explore how spiritual care is expressed in nursing records in cancer care. This study adopted a hermeneutic approach, and a qualitative content analysis was used to explore the nursing records of 43 inpatients with cancer from Norway. Ethical approval was obtained, and the privacy of the patients and healthcare professionals was safeguarded in line with the applicable legislation. Spiritual care was rarely reported in the nursing records (i.e., the nursing care plans and the progress notes). However, traces of spiritual care appeared in the records of everyday nursing. Four themes emerged from the analysis: (1) relieving life pain and mitigating loss, (2) facilitating faith support, (3) welcoming family and friends, and (4) sustaining normality and sharing joy. This study showed that the nursing records of cancer care seldom expressed spiritual care concerning patients' life pain, loss, or faith support. Increasing nurses' competencies in mapping, documenting, and attending to spiritual care, as well as overcoming the limitations of documentation systems, could help address the spiritual needs of cancer patients.

Nursing Care in Prevention of Post-Operative Pulmonary Complications among High-Risk Hospitalized Patients: A Case Study Design

Introduction: Post-operative pulmonary complications (PPCs) such as pneumonia, atelectasis, and respiratory failure significantly impact surgical outcomes, especially among high-risk patients with pre-existing respiratory conditions, advanced age, or those undergoing major surgeries. Effective prevention of PPCs is critical for improving patient outcomes. Nursing care plays a pivotal role in this prevention through early mobilization, respiratory exercises, proper positioning, and vigilant monitoring.Objectives :This study investigates the effectiveness of nursing care in preventing PPCs among high-risk hospitalized patients.Methods: A descriptive case study design was used, involving 15 patients from a multispecialty hospital in Trivandrum who met the inclusion criteria of having more than four risk factors for PPCs and consented to participate. Data collection tools included demographic variables, clinical manifestation checklists, risk factors for PPCs, and an individualized nursing care plan. Over six weeks, patients were selected through convenience sampling and a 24-hour nursing care plan was implemented. Descriptive statistics were used for data analysis. Results: The study sample consisted predominantly of elderly patients (73.3% aged above 60 years), with males constituting 66.7%. Significant risk factors included smoking history (66.7%) and elevated BMI (53.3%). All surgeries were performed under general anesthesia, with 60% lasting over 3-4 hours. Nursing interventions included deep breathing and coughing exercises, frequent position changes, early ambulation, use of an incentive spirometer, prophylactic antibiotics, and strict aseptic techniques. Most severe PPC symptoms were absent; however, mild symptoms like elevated temperature and cough were observed in 20% of patients. Discussion: The results indicate that the comprehensive nursing care strategies effectively prevented most significant PPCs. The absence of severe symptoms suggests the success of interventions such as early mobilization and respiratory exercises. The occurrence of mild symptoms in some patients highlights the need for ongoing refinement of nursing protocols. Conclusion: Effective nursing care significantly reduces PPC incidence in high-risk postoperative patients. This study supports the development of best practice guidelines for nursing care, emphasizing individualized care plans to improve patient outcomes and ensure high-quality healthcare services.

Mindfulness-based intervention as a symptom management strategy in patients with end-stage renal disease: A controlled clinical trial.

The study's purpose was to examine the effect of mindfulness-based intervention (MBI) on physical and psychological symptoms in patients with end-stage renal disease (ESRD) in Jordan. A repeated-measure randomized control study was conducted in a haemodialysis unit in Jordan between April 2023 and July 2023. Participants (N= 61) were selected using convenience sampling and then randomly assigned into experimental and control groups. The experimental group performed 30-min MBI, three times a week for 8weeks during haemodialysis sessions. The Depression, Anxiety and Stress Scale-21 and the Patient Health Questionnaire-15 were used to measure the outcomes at baseline, after 5weeks of the intervention and at the end of the intervention. Mixed-model repeated-measure ANOVAs revealed that the experimental group showed significantly lower levels of stress, depression and physical symptoms than the control group over time. Within-subject repeated-measure ANOVAs revealed that, in the experimental group, physical symptoms improve significantly over the three points of time. However, significant reductions in psychological symptoms occurred 5weeks after initiating the intervention, but there was no further significant improvement at the end of the intervention. The study supports the integration of MBI as a symptom management strategy into nursing care plans of patients with ESRD. Clinical trial.gov; registration ID: NCT06064708.

Exploring the mediating influence of acceptance of change: A study on gerontechnology acceptance, mental well-being, and urban–rural disparities among older adults

BackgroundThe global aging population necessitates leveraging technology for older adults' independence and mental well-being. Gerontechnology, tailored for older users, thrives when accessible and accepted, with the pivotal role of acceptance of change shaping its adoption. AimsThis study investigates the mediating role of acceptance of change in the relationship between gerontechnology acceptance and mental well-being among older adults and explores disparities in urban and rural settings Design & MethodsA cross-sectional, correlational design adhering to STROBE guidelines collected data through an interview survey from 802 older adults. Instruments included the Older Adult Structured Survey, Short Version of Senior Technology Acceptance, Acceptance of Change Scale, and the World Health Organization Well-Being Index. ResultsThe results underscore a significant correlation between technology adoption, adaptability, and mental well-being among 60-year-olds and older. Notably, an individual's openness to change significantly influences the technology-mental well-being relationship, emphasizing its impact on overall health. Urban areas exhibit a stronger positive correlation between technology acceptance and mental well-being, whereas rural regions demonstrate a more pronounced negative correlation. ConclusionThis research contributes valuable knowledge for addressing the unique challenges older adults face in diverse geographic settings, paving the way for targeted and effective initiatives. ImplicationsNurses should prioritize understanding the nexus between gerontechnology acceptance, change adaptability, and mental wellness, integrating technology education and culturally sensitive interventions to enhance care strategies for older adults in diverse geographic settings. This study lays the groundwork for developing person-centered geriatric nursing care plans, underscoring the importance of harnessing technology for improved mental well-being.

The Problem of Nursing Care in Commune I of the District of Bamako

Nursing is an integral part of the health care system, providing support for people who are ill or in good health. It helps to provide comprehensive care for all users of care facilities. The overall aim is to help improve nursing practice in health care institutions. Methodology: we carried out a qualitative, quantitative and explanatory study using a field study in private and one public facilities involving 17 doctors and 25 nurses based on non-random sampling from 1er July to 31 August 2022 after obtaining informed consent. Results: The study revealed that 76% of nurses were unaware of the existence of their establishment's internal regulations and 60% were unaware of the description of their tasks in the department. Similarly, 25% of these nurses concluded that there was no reception procedure in their department. 72% of nurses stated that they did not have an identifier for their facility. While we found that only 4% of the nurses in our study had correctly defined the basis of nursing practice and the components of a nursing care plan, none of the nurses used a care plan in their department. As regards the doctor-nurse relationship within the care team, 29% of doctors treated nurses as subordinates. In conclusion, the problem of nursing care in Commune I is very real, and only strong administrative policies can improve it.

Investigating key factors of feeding intolerance in severe acute pancreatitis: A scoping review.

The complexity of severe acute pancreatitis (SAP) and the stress caused by the disease is associated with a high incidence of feeding intolerance. However, the factors influencing feeding incontinence in patients with SAP are diverse. To systematically analyse relevant studies that investigate the occurrence of feeding intolerance in patients with SAP, identify the relevant factors of feeding intolerance in such patients and provide a reference for nursing staff to develop relevant intervention measures. This scoping review followed the approach proposed by Arksey and O'Malley. Seven electronic databases were searched from their establishment until August 2023. This included research on the factors influencing feeding intolerance in patients with SAP, determining research questions, completing literature screening and quality evaluation, extracting data and summarizing and analysing the data. The PRISMA extension for scoping reviews (PRISMA-ScR)statement has also been included. A total of 23 articles were included. The factors influencing feeding intolerance in patients with SAP included the patient's condition, disease, treatment, feeding management and follow-up care. The factors affecting feeding intolerance in patients with SAP are multifaceted. A personalized nursing care plan should be developed based on relevant risk factors to improve feeding tolerance and comfort in patients with SAP and shorten hospitalization time. Intensive care nurses should identify the risk factors for feeding intolerance in patients with SAP and implement appropriate interventions. To identify the risk factors, nurses must be updated with courses and training. Moreover, a systematic feeding intolerance prediction program can help intensive care nurses effectively identify the risk factors for feeding.

Evaluation of child with asthma and her caregivers based on the Pender health promotion model, and linkages of NANDA, NIC-NOC: A case presentation.

Despite highly effective asthma treatments, the prevalence of asthma is increasing in children and adolescents. Despite easy access to asthma control, sufficient control and management are not achieved. Asthma management is crucial to prevent the development of asthma symptoms and attacks, reduce repeated hospitalizations, and prevent a decrease in the quality of life for both the child and caregivers. This case study aims to increase the utilization of theories, models, and classification systems by evaluating a child diagnosed with asthma for 6 years and their caregivers based on Pender's health promotion model (PHPM). Furthermore, the study aims to establish a connection with NANDA, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC), thereby formulating a nursing care plan. This case study evaluated a child diagnosed with asthma for 6 years and their caregivers based on PHPM. A nursing care plan was developed by establishing connections with NANDA, NIC, and NOC and based on Pender's health promotion. By establishing connections with NANDA, NIC, and NOC, a nursing care plan of a total of six included nursing diagnoses has been created as five based on the PHPM. The care plan implemented improved S.B.K.'s clinical condition. Furthermore, the mother's social support increased, and her confidence in managing asthma improved. As a result of implementing the model, the mother reached the potential to develop healthy behaviors for S.B.K. and make future-oriented plans. It is recommended that NANDA-I, NIC, and NOC, along with PHPM, be used in clinical nursing care and scientific research to enhance the presentation of quality care and the individual's future health potential.

An example of leveraging AI for documentation: ChatGPT-generated nursing care plan for an older adult with lung cancer.

Our article demonstrates the effectiveness of using a validated framework to create a ChatGPT prompt that generates valid nursing care plan suggestions for one hypothetical older patient with lung cancer. This study describes the methodology for creating ChatGPT prompts that generate consistent care plan suggestions and its application for a lung cancer case scenario. After entering a nursing assessment of the patient's condition into ChatGPT, we asked it to generate care plan suggestions. Subsequently, we assessed the quality of the care plans produced by ChatGPT. While not all the suggested care plan terms (11 out of 16) utilized standardized nursing terminology, the ChatGPT-generated care plan closely matched the gold standard in scope and nature, correctly prioritizing oxygenation and ventilation needs. Using a validated framework prompt to generate nursing care plan suggestions with ChatGPT demonstrates its potential value as a decision support tool for optimizing cancer care documentation.

Supportive Care Needs of Patients With Temporary Ostomy in Enhanced Recovery After Surgery: A Mixed-Methods Study.

Enhanced recovery after surgery (ERAS), a global surgical quality improvement initiative, reduces the length of stay in the hospital. Temporary stoma care for rectal cancer is complex, and patients require prolonged care services to adjust to the stoma. The shorter stay durations in the new model challenge the conventional care pathways and create new patient needs. This study was designed to explore the supportive care needs of patients under the new surgical model to provide a reference for the design of ERAS nursing care plans. A convergent parallel mixed-methods design was used in this study. Patients with temporary stomas for rectal cancer were recruited using a convenience sampling method in gastrointestinal surgery wards and wound & stoma clinics in two public tertiary care hospitals in China. Standardized questionnaires were administered to 140 patients to collect quantitative data, and semistructured interviews were conducted individually with 13 patients to collect qualitative data. The questionnaire data were analyzed using descriptive statistics, and the interview data were analyzed using thematic analysis. "Health system and information needs" and "care and support needs" were identified in both the qualitative and quantitative analyses as the most significant unmet needs of the participants. In addition, the qualitative analysis identified receiving focused stoma care instructions and easily understandable information as essential to fulfilling health system and information needs. Care and support needs included access to continued postdischarge services and attention from medical professionals. The participants in this study experienced a variety of unmet supportive care needs under the ERAS protocol, with gaps particularly notable in two categories: "health system and information needs" and "care and support needs." Increased perioperative care and shorter hospital stays under the ERAS protocol reduce opportunities for patients to receive targeted instruction and shift much of the ostomy education and care workload out of the hospital, requiring greater attention from clinical nurses to ensure quality of care.

Evaluating the Quality of Postpartum Hemorrhage Nursing Care Plans Generated by Artificial Intelligence Models.

With the rapidly advancing technological landscape of health care, evaluating the potential use of artificial intelligence (AI) models to prepare nursing care plans is of great importance. The purpose of this study was to evaluate the quality of nursing care plans created by AI for the management of postpartum hemorrhage (PPH). This cross-sectional exploratory study involved creating a scenario for an imaginary patient with PPH. Information was put into 3 AI platforms (GPT-4, LaMDA, Med-PaLM) on consecutive days without prior conversation. Care plans were evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) scale. Med-PaLM exhibited superior quality in developing the care plan compared with LaMDA ( Z = 4.354; P = .000) and GPT-4 ( Z = 3.126; P = .029). Our findings suggest that despite the strong performance of Med-PaLM, AI, in its current state, is unsuitable for use with real patients.

Exploring the influence of nursing diagnosis education on Romanian nurses' intention, attitudes, and behavior: a cross-sectional study.

The introduction of accreditation criteria for hospitals has generated increased interest in applying the nursing process to clinical practice and developing nursing care plans. Nursing diagnosis plays a pivotal role in the formulation of these care plans.The objective of the study is to investigate the correlation between nursing diagnosis education and nurses' intentions, attitudes toward the use of nursing diagnosis and the behavior in using it in practice; to explore the differences between nurses' intentions, attitudes and behavior, considering nurses' socio-demographic and professional data. A cross-sectional design was used. A web-based survey was applied to gather data. A sample of 664 hospital nurses was recruited from five Romanian hospitals. Education on nursing diagnosis showed significant results in relation to nurses' intentions (F(2,126.35) = 23.99, p < 0.001), attitudes (χ2 (2, N = 664) = 44.62, p < 0.001) and behavior (F(2,167.69) = 29.53, p < 0.001) in using it in clinical practice. Nurses with education highly focused on nursing diagnosis have significantly stronger intention to use it, more positive attitudes and higher behavior in using it in clinical practice compared to nurses whose education simply had included a nursing diagnosis course, or nurses without any education on the topic. Significant differences were identified in intention (t (83.86) = -4.49, p < 0.001) and attitudes (U = 12697.50, z = -3.99, p < 0.001, r = -0.0006) of management nurses compared to clinical nurses. Nursing education on nursing diagnosis significantly impacts nurses' intentions, attitudes, and behavior in their daily practice. Romanian nurses display slightly positive intention and attitudes toward nursing diagnosis but need more training for effective/practical clinical application.

Nursing care in a patient with hysterectomy for cervical cancer

Introduction: Cervical cancer continues to be the leading cause of death worldwide for many women, this type of cancer does not start suddenly, but has a previous evolution from precursor or precancerous lesions, the diagnosis is made in advanced stages of the disease, decreasing or canceling the chances of curative treatment. It is expected that by the year 2032 there will be 21.4 million new patients dealing with this disease in the world. Objective: To develop specialized and individualized comprehensive nursing care in patients with cervical cancer, based on scientific evidence recommendations and interventions. We present the assessment of a post-operative hysterectomy patient for cervical cancer where the nursing care process is applied. Methodology: A clinical case study, a 44-year-old patient was selected for convenience, applying the methodology of the nursing care process, the assessment was made through the 11 functional patterns of Marjory Gordon, the data were obtained from the clinical history, interview and physical examination of the patient. The main human responses are identified to analyze objective and subjective data, clinical judgments are made to implement care plans under the NANDA, NOC, NIC taxonomy. Results: 7 altered patterns were identified; considering as main diagnosis: acute pain and risk of complication; hemorrhage. Nursing care plans were implemented according to the Area model. A change score of +1 and +2 was obtained, which subsequently improved with nursing care. Conclusions: after the surgical procedure; According to the altered patterns, the nursing care process was carried out, observing improvement in the altered patterns, however, the patient remained hospitalized to continue with the specialized therapeutic plans, this implies that the gynecological-obstetric service must have professionals in nursing specialized in this area.

A Systematic Review of the Application of Artificial Intelligence in Nursing Care: Where are We, and What's Next?

Integrating Artificial Intelligence (AI) into healthcare has transformed the landscape of patient care and healthcare delivery. Despite this, there remains a notable gap in the existing literature synthesizing the comprehensive understanding of AI's utilization in nursing care. This systematic review aims to synthesize the available evidence to comprehensively understand the application of AI in nursing care. Studies published between January 2019 and December 2023, identified through CINAHL Plus with Full Text, Web of Science, PubMed, and Medline, were included in this review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines guided the identification, screening, exclusion, and inclusion of articles. The convergent integrated analysis framework, as proposed by the Joanna Briggs Institute, was employed to synthesize data from the included studies for theme generation. A total of 337 records were identified from databases. Among them, 35 duplicates were removed, and 302 records underwent eligibility screening. After applying inclusion and exclusion criteria, eleven studies were deemed eligible and included in this review. Through data synthesis of these studies, six themes pertaining to the use of AI in nursing care were identified: 1) Risk Identification, 2) Health Assessment, 3) Patient Classification, 4) Research Development, 5) Improved Care Delivery and Medical Records, and 6) Developing a Nursing Care Plan. This systematic review contributes valuable insights into the multifaceted applications of AI in nursing care. Through the synthesis of data from the included studies, six distinct themes emerged. These findings not only consolidate the current knowledge base but also underscore the diverse ways in which AI is shaping and improving nursing care practices.