Nursing Classification System Research Articles

Acupressure, a promising intervention for fatigue, within the European nursing care pathways (ENP): An integrative review.

The aim of this study is to test whether acupressure for patients with fatigue is an efficient nursing intervention and if it can be implemented into the European nursing care pathways (ENP) nursing classification system. Previously, interventions for acupressure were included nonspecifically in ENP and therefore were not available for standardized nursing documentation in an electronic health record (EHR). Acupressure is a nursing intervention that is increasingly used in specific settings. ENP is a nursing classification system that provides evidence-based nursing interventions for nursing diagnoses. A systematic international literature search was conducted from May 2021 to December 2021. An iterative, hierarchical search process according to the 6S evidence pyramid was chosen. The results were reported following the PRISMA statement. Findings of 49 included publications that studied a total of 1,716 patients indicate that certain acupressure points may be efficient in treating fatigue. Acupressure is a useful nursing intervention and can really help patients experiencing fatigue. It is illustrated how the findings have been implemented in the development of ENP nursing interventions to document acupressure. The acupressure points most frequently used on the ear with positive effects in improving fatigue are Shen Men, liver, spleen, subcortex, endocrine, heart, and sympathetic, while the most common points on the body are ST 36, SP 6, LI 4, HT 7, KID 1, Ex-HN 3, Ex-HN, and KID 3. In the future, nurses will be able to use ENP to quickly and easily document acupressure interventions for fatigue in the EHR. In the EHR, the documentation of the nursing process with ENP could help to promote research into evidence-based approaches to fatigue by generating mass data on the different concepts of acupressure, which could lead to a clearer determination of the evidence and contribute to the safety of care and patients.

Development and assessment of a curriculum model for virtual simulation in nursing: curriculum development and pilot-evaluation

BackgroundTo introduce virtual simulation as a strategy of nursing education and provide valid educational content, the best curriculum model of virtual simulation needs to be developed.MethodsCurriculum development process and pilot evaluation was used. The curriculum content and structure was developed by analyzing literature including previous studies and major nursing classification systems, and key words derived from focus group interviews of 14 nurses and 20 faculty members with expertise in simulation education. 35 nursing students participated in the evaluation of the developed virtual simulation curriculum.ResultsThe curriculum developed for virtual simulation in nursing education contained three domains of content areas: (1) enhancing clinical decision-making, (2) experiencing low-exposed situations, and (3) building professional resilience. In addition, seven subdomains of content areas and 35 representative topics in the virtual simulation curriculum were derived. Scenarios of nine representative topics were created, translated into 3D modeling and pilot-evaluated.ConclusionsConsidering that nursing education is encountering new demands and challenges from students and the changing society, the newly suggested curriculum for virtual nursing simulation can help nurse educators to plan better educational opportunities for students.

Eletroconvulsoterapia, implicações éticas, legais e a sistematização da assistência de enfermagem

The aim was to discuss the ethical and legal implications of electroconvulsive therapy and the Nursing work involved. It is a theoretical reflection. The critical conceptualization was based on readings of Ministerial Ordinances, Technical Reports, Resolutions of the Federal Councils of Nursing and Medicine, scientific literature, those current and considered classic for the understanding and discussion of the proposed theme. Finally, the NANDA International nursing classification systems were used for the formulation of Diagnoses, Classification of Results and interventions. The results and discussions were presented dialogically in three thematic units: ethical and legal implications of carrying out ECT; differences in conception between groups that support ECT and groups that condemn it and contributions to nursing practice. ECT is accepted as a form of treatment by world institutions, however, it is quite controversial and the work of nursing is little discussed but is still systematized and extremely important.

Availability of Standardized Electronic Patient Data in Nursing: A Nationwide Survey of Austrian Acute Care Hospitals.

A large amount of patient data is produced and documented in patient care. Health care professionals expect that this routinely collected patient data can also be used for secondary purposes such as measuring the quality of care or to gain new knowledge. Routine data needs to be documented in a standardized form, based on clinical terminologies, to allow this secondary use of data. In Austria, hospitals are currently moving from paper-based documentation to computer-based documentation, but parts of the documentation are still done in paper-based form or without using clinical terminologies, especially in nursing. This study aims to analyze the availability of standardized electronic patient data in nursing in Austria. We conducted an online survey of 32 senior nursing managers at 32 Austrian hospitals. The study showed that 79% of hospitals use electronic health records for nursing documentation, but only 29% of the nursing care plans are documented in a standardized way using standardized nursing classification systems such as NANDA-I.

Fonksiyonel Sağlık Örüntüleri Modeli ve Hemşirelik Sınıflama Sistemlerinin Kullanıldığı Hemodiyaliz Tedavisi Uygulanan Hastanın Bakımı

Fonksiyonel Sağlık Örüntüleri Modeli ve Hemşirelik Sınıflama Sistemlerinin Kullanıldığı Hemodiyaliz Tedavisi Uygulanan Hastanın Bakımı

Reporting Nursing Interventions Classification and Nursing Outcomes Classification in Nursing Research: A Systematic Review.

Nursing classification systems are used to report nursing practices and maintain a unified documentation language. Nursing interventions classification (NIC) and nursing outcomes classification (NOC) are among the recognized terminology systems. To examine the extent of reporting NIC/NOC in nursing research. A systematic review following PRISMA guidelines. A literature search in three electronic databases was performed. A total of (18) articles were included. Nine studies were conducted to describe the commonly used NIC/NOC, six studies validated the effectiveness of classification systems, and two studies compared different nursing classification systems. The available evidence is limited by the quality of the studies. We recommend examining the use of NIC/NOC in nursing documentation using an experimental design.

Construction of perioperative urinary incontinence nursing plan based on nursing outcomes classification system for elderly patients with rectal cancer

Objective To construct the perioperative urinary incontinence nursing outcomes intervention plan suitable for elderly patients with rectal cancer. Methods From December 2017 to June 2018, we preliminarily developed the perioperative urinary incontinence nursing plan for elderly patients with rectal cancer by literature review and case investigation. We selected 11 experts undertaking rectal cancer and urinary incontinence clinical care, clinical nursing and nursing management by purpose sampling in Shanghai to demonstrate the intervention plan with the method of expert meeting so as to confirm the final intervention plan. Results The expert authority coefficient was 0.93. The nursing plan included 4 primary indexes, 9 secondary indexes and 42 tertiary indexes. Conclusions The expert authority coefficient is high in this study. The construction of perioperative urinary incontinence nursing plan based on nursing outcomes classification system for elderly patients with rectal cancer provides the reference for carrying out practice and researches of perioperative urinary incontinence management for elderly patients with rectal cancer. Key words: Rectal neoplasms; Aged; Perioperative period; Urinary incontinence; Nursing outcomes; Nursing plan

Evaluation of nursing students’ diagnoses using the Omaha System

Objectives: Nursing process guides the students in the diagnosing, planning, intervention and evaluation of patients/families, and it also gives a systematic point of view. The Omaha System is used as a nursing classification system in public health nursing course practice areas. It was conducted in order to examine the nursing diagnoses identified by the students according to the Omaha System. Methods: It was a retrospective, analytical research. Practice files of 51 students who took the public health nursing course created the sample. Results: According to the Omaha problem classification list (PCL), the students in the study identified a total of 412 problems. According to Omaha PCL, the students mostly used the area of health behavior, followed by the physiological, psychosocial and environmental areas respectively. It was determined that 73% of the students had sufficient skills to use the Omaha System and 26.8% of them were inadequate. Conclusion: It was observed that the nursing diagnoses identified by the students in line with the determined learning targets were sufficient.

Application of nursing outcome classification system oriented nursing intervention in postoperative rehabilitation of patients with thoracolumbar tuberculosis

Objective To explore the effects of nursing outcome classification system oriented nursing intervention on postoperative rehabilitation in patients with thoracolumbar tuberculosis. Methods A total of 144 patients with thoracolumbar tuberculosis treated in Central Hospital of Binzhou, Shandong Province, from June 2016 to May 2017 were selected as the research subjects. All the patients were divided into two groups by to the random number table method, with 72 cases in each group. The control group was treated with routine care. The observation group was given nursing based on the classification of nursing outcomes. All the intervention lasted for 8 weeks. Visual Analogue Scale (VAS) , Frankel classification, Barthel index and improved Fugl-Meyer score were used to compare the pain relief, nerve function, motor function, the difference of living ability and complications between the two groups. Results The VAS scores of the observation group and the control group were (2.82±0.76) and (3.92±0.57) respectively, and the difference was statistically significant (t=9.825, P 0.05) . The incidence of complications in the observation group was 16.67%, while that in the control group was 29.17%, and the difference was statistically significant (P<0.05) . Conclusions Nursing outcome classification has positive significance in perioperative nursing of patients with thoracolumbar tuberculosis, which can promote the recovery of neurological function. Key words: Perioperative nursing; Thoracic vertebral; Tuberculosis; Nursing outcome classification

Ontology elements identified in different nursing classification systems

Introduction: The International Classification for Nursing Practice (ICNP®) includes an ontology to represent the terms contained within it. In Brazil, in order to contribute to the development of this classification, an ontology was elaborated, comprising the representation of concepts and terms from the International Classification of Public Health Nursing Practice (Classificacao Internacional para as Praticas de Enfermagem em Saude Coletiva – CIPESC®). The identification of ontology elements in the aforementioned classification systems helps to understand how they might be used to represent the elements of nursing practice in an automated manner. Objectives: To identify ontology elements in the ICNP® and CIPESC®. Methods: Documentary, exploratory, and descriptive study. Data collection was based on the capture of structural characteristics of the various versions of the ICNP® and of the CIPESC®, including axis structure and term hierarchy structure. Data analysis was performed by comparing the elements of the captured characteristics with the following ontology elements: concepts, instances, properties, relationships, constrains and axioms. Results: The structural characteristics of ICNP® and CIPESC® are presented. Concepts, properties, relationships, constrains, and axioms were identified in both classifications. Conclusions: An ontology ensures consistency to nursing terminologies, providing evidence for practice and contributing to the unification of the nursing language. This research facilitates the development of ontologies for nursing practice based on nursing terminologies, contributing to the development of health policies by using ontologies in information systems.

Influences of Social Support, Self-esteem and Hope on Health Conservation of the Vulnerable Elderly with Diabetes

Purpose: The purpose of this study was to investigate the influence of social support, self - esteem, hope, and health conservation of the vulnerable elderly people with diabetes. Methods: Participants were 100 vulnerable elderly people with diabetes living in D or K cities. Data collection was done through interviews from February to March, 2016. Social support was measured with the MOS-SSS (Medical Outcomes Study Social Support Survey), self-esteem with Self-Esteem Scale, hope with the Nowotny Hope Scale, and health conservation with the Sung’s Health Conservation Scale. IBM SPSS 20.0 was used to analyze descriptive statistics, one-way ANOVA, independent t-test, Pearson correlation, and stepwise multiple regression. Results: Factors affecting the health conservation of the vulnerable elderly people were social support, hope, education level and subjective health status. These factors explained 64.9% of the health conservation. Conclusion: It is necessary to construct a comprehensive nursing classi-fication system for elderly people with diabetes in vulnerable class and to develop integrated health conservation program and nursing care as a new social support resource.

Implementation of the Austrian Nursing Minimum Data Set (NMDS-AT): A Feasibility Study.

BackgroundAn Austrian Nursing Minimum Data Set (NMDS-AT) has been developed to describe the diversity of patient populations and variability of nursing care based on nursing diagnoses, nursing interventions, and nursing outcomes. The aim of this study is to test the feasibility of using this NMDS-AT by assessing the availability of data needed for the NMDS-AT in routine nursing documentation, and to assess its reliability and usefulness.MethodsData were collected in a general hospital from patient records of 20 patients representing 457 patient days. Availability of needed data was assessed by two raters in a chart review based on an NMDS-AT form. The interrater reliability (n = 20) and intrarater reliability (n = 5) was assessed using Cohen’s kappa coefficient and intraclass correlation coefficient (ICC). Usefulness was assessed by verifying whether typical analysis questions can be answered by the documented NMDS-AT data.ResultsIn the 20 patient records, thirteen nursing diagnoses, 50 nursing interventions, and five nursing outcomes occurred, representing 68 (58.6 %) of the overall 116 data elements of the NMDS-AT. The data were found at different data sources (e.g., electronic nursing record or paper-based fever chart) and in various forms (e.g., standardized or free text).The interrater reliability of the thirteen nursing diagnoses showed kappa values (percentage of agreement) ranging from 0.35 (85 %) to 1.00 (100 %). The 50 nursing interventions showed ICCs ranging from 0.03 to 1.00. All nursing outcomes showed an ICC of 1.00. The intrarater reliability showed 100 % agreement. Performing typical analysis questions showed that the extracted NMDS-AT data are able to answer questions of clinical management, of policy makers, and of nursing science.ConclusionsThe NMDS-AT was found to be feasible: needed data was available in the analysed patient records, data extraction showed good reliability, and typical analysis could be performed and showed interesting results. Before the NMDS-AT can be introduced in healthcare institutions, the following challenges need to be addressed: 1. improve the quality of nursing documentation; 2. reduce fragmentation of documentation; 3. use a standardized nursing classification system; and 4. establish mappings between nursing classification systems and the NMDS-AT.

Clinical nursing manpower: development and future prospects

The significant changes in nursing manpower utilization in Taiwan over the past two decades are due in large part to the implementation of the National Health Insurance program and the rising need for long-term care. The changes have impacted clinical nursing manpower utilization in two important ways. Firstly, there has been a substantial increase in overall demand for nursing manpower. In particular, the need for clinical nurses has nearly quadrupled during this time period. Secondly, the level of difficulty involved in patient care has risen dramatically, with factors including increased disease severity and increased care quality expectations, among others. These changes, coupled with demands on nursing manpower imposed from other sectors, underpin and further exacerbate the problem of nursing manpower shortages throughout the healthcare system. To raise the quality of the nursing work environment, the Ministry of Health and Welfare (MOHW) brought together Taiwan's key professional nursing organizations to promote 10 care-reform strategies, establish the nursing-aid manpower system, and create the nursing classification system as an approach to effectively attract nurses to take positions in the medical system.

Representing the Nursing Process With Nursing Terminologies in Electronic Medical Record Systems

This article describes a framework model within a selected nursing classification system for the integration of nursing care processes into a clinical information system. The "Electronic Nursing Process Data Model," project was carried out from July 2004 to October 2006 in the Canton of Zurich in Switzerland. The Zurich Electronic Nursing Process Data Model integrates the nursing diagnosis, outcomes, and intervention terminologies in a standardized manner into the nursing care process within the electronic patient record. Findings of the pretest application in clinical nursing practices revealed that (1) functionalities are logically structured, (2) it is difficult to overview many details of the documentation, (3) a specific "to-do list" retrieved from the electronic system is needed, and (4) free-text entries are important to add description of the patient's situation. Furthermore, a consistent assessment terminology needs to be linked to the nursing diagnosis, outcomes, and intervention terminologies and the descriptions of nursing care process within the Electronic Nursing Process Data Model. As the project team, we recommend to implement the developed Electronic Nursing Process Data Model into professional software of clinical information systems and gradually into clinical practice. Therefore, an appropriate utilization strategy includes issues to improve nurses' understanding of the nursing care process and critical-thinking skills: not even the most comprehensive software program can substitute for facilitation.

An Analysis of Nursing Diagnoses for Patients Undergoing Procedures in a Brazilian Interventional Radiology Suite

Innovations in minimally invasive surgery have led to more procedures being performed in the interventional radiology suite. It, therefore, is essential that nurses in radiology departments be competent to care for all types of patients. Use of nursing classification systems can improve care by providing standardized language for documentation. We conducted a project that involved 25 patients undergoing interventional radiology procedures between August and October 2006 in São Paulo, Brazil, to identify the most frequent North American Nursing Diagnosis Association (NANDA) nursing diagnoses used and then compared the NANDA diagnoses to Perioperative Nursing Data Set diagnoses. The most frequent nursing diagnoses in the participants were anxiety, chronic pain, inefficient tissue perfusion–peripheral, deficient knowledge, and risk for falls. These results are similar to diagnoses that have been reported in outpatient centers. The NANDA and Perioperative Nursing Data Set diagnoses were found to be similar.

Problems Expressed by Caregivers of Children With Fetal Alcohol Spectrum Disorder

The purpose of this study was to determine if use of a standardized classification system could help identify potential nursing sensitive problems for caregivers of children with fetal alcohol spectrum disorder (FASD). This study is a secondary analysis of data obtained from transcripts of public testimonies. Content analysis was conducted using a standardized classification system. The sample consisted of 376 statements from electronic transcripts of first person testimonies given by 48 caregivers of children with FASD in four states. Forty-eight caregivers expressed a total of 53 signs and symptoms. The majority was in the problem areas: communication with community resources, caretaking/parenting, mental health, and income. CONCLUSIONS AND IMPLICATIONS FOR NURSING PRACTICE: Using a nursing classification system, investigators were able to identify nursing sensitive problems expressed by caregivers of children with FASD. The information from this study can be used in future studies to confirm or revise the signs/symptoms identified in this study.

Nurses' perception of power regarding their clinical role

This article reports on a study on nurses' perception of power regarding their clinical role before and after implementation of a nursing diagnosis classification. Sixty clinical nurses (average age=37.2+/-7.0 years) from a Brazilian teaching hospital answered the Power as Knowing Participation in Change Tool (PKPCT) before and after the implementation of a diagnosis classification. PKPCT has four domains and provides total and partial scores. Reliability coefficients ranged from 0.88 to 0.98. Total scores were not statistically different between assessments (p=0.21), although scores in the 'Involvement in Creating Change' domain were higher in the second assessment (p=0.04). Further studies providing sound evidence regarding the impact of nursing classification systems on nurses' power perception are needed to guide decisions on teaching and clinical practice.

Viewpoint: Use of King's Conceptual System, Nursing Informatics, and Nursing Classification Systems for Global Communication

To propose a common nursing language for communication among members of the nursing community worldwide. The Taxonomy of Nursing Practice, nursing informatics literature, King's Theory of Goal Attainment applied to the nursing process. Several milestones in nursing in the 20th century indicated the need for a universal language for nursing. The nursing process provides a method for synthesis of nursing data, information, and knowledge and is congruent with Imogene King's Theory of Goal Attainment. The authors advocate for a common nursing language (nursing classification and terminology systems) that would unify nurses worldwide. Supported by nursing theory and technology, global communication would be enhanced for nurses and the interdisciplinary teams of which they are a part. Use of Imogene King's Conceptual System and Theory of Goal Attainment and the nursing specialty of Nursing Informatics are examples of nursing theory and technology to frame global communication.

More than terminology: using ICNP to enhance nursing's visibility in Italy

The International Council of Nurses (ICN) has elaborated an international terminology for nursing practice [International Classification of Nursing Practice (ICNP)] that can be useful to catalogue the problems of a nursing nature in diagnosis and also find a system for the classification of nursing activities. ICNP is also the reason why the Italian association Consociazione, representing Italian Nurses at ICN, through the School of Advanced Nursing of the University 'La Sapienza' of Rome, has set up a working group for the translation and experimentation of the ICNP version Beta 2. In this article the ICNP beta translation and validation into Italian is considered with some scenarios of how benefit could be derived by its utilization for nursing's visibility. The visibility of nursing care can be measured not only through patient outcomes but also by studying the existing data of patient care documentation. To have a common language and terminology in nursing is important for a universal understanding. Some philosophical reasoning on the genesis and development of ICNP is discussed along with arguments for and against nursing classification systems. Some findings on Italian experimentation for nursing documentation as well as economical analysis are reported along with a vision for future development and utilization.

Perspectivas de incorporação da Classificação Internacional para a Prática de Enfermagem (CIPE®) no Brasil

Neste artigo são discutidos alguns aspectos acerca dos sistemas de classificação em enfermagem, com ênfase na Classificação Internacional para a Prática de Enfermagem (CIPE®) e as suas perspectivas de incorporação na prática de enfermagem no Brasil. As autoras relatam três experiências brasileiras de incorporação desse sistema de classificação: o projeto de implantação da linguagem CIPE/CIPESC no prontuário eletrônico da Secretaria Municipal de Saúde de Curitiba-PR; o projeto de sistematização da assistência de Enfermagem em UTI, que vem sendo desenvolvido em Florianópolis-SC; e o desenvolvimento de um instrumental tecnológico, tendo por base os termos da linguagem dos componentes da equipe de enfermagem, para inserção em sistemas de informação de um hospital escola, em João Pessoa - PB.