Nursing Diagnosis Research Articles

Pengaruh Kepuasan Dan Citra Rumah Sakit Terhadap Kepercayaan Dan Loyalitas Pasien

The hospital is an organization that provides health services carried out by professional medical personnel who are organized both from permanent medical facilities, medical services, continuous nursing care, diagnosis and treatment of diseases suffered by patients. This study aims to examine the effect of patient satisfaction and hospital image on patient loyalty with patient trust as an intervening variable. The object of this research are inpatients who seek treatment at the Fatimah Islamic Hospital in March – April 2022. The number of respondents is 100 people. The results showed: Patient satisfaction has a positive and significant effect on patient confidence in Fatimah Islamic Hospital Banyuwangi. Hospital image has a positive and significant effect on patient confidence in Fatimah Islamic Hospital Banyuwangi. Hospital patient satisfaction has a positive and significant effect on patient loyalty at the Fatimah Islamic Hospital Banyuwangi. Hospital image has a positive and significant effect on patient loyalty at the Fatimah Islamic Hospital in Banyuwangi. Patient trust has a positive and significant effect on patient loyalty at the Fatimah Islamic Hospital in Banyuwangi. Patient satisfaction has a positive and significant effect on patient loyalty which is strengthened by patient trust as an intervening variable at Fatimah Islamic Hospital Banyuwangi. Hospital image has a positive and significant effect on patient loyalty with patient satisfaction as an intervening variable at Fatimah Islamic Hospital Banyuwangi.

Standardized Nursing Diagnoses in a Surgical Hospital Setting: A Retrospective Study Based on Electronic Health Data.

In electronic health records (EHRs), standardized nursing terminologies (SNTs), such as nursing diagnoses (NDs), are needed to demonstrate the impact of nursing care on patient outcomes. Unfortunately, the use of NDs is not common in clinical practice, especially in surgical settings, and is rarely included in EHRs. The aim of the study was to describe the prevalence and trend of NDs in a hospital surgical setting by also analyzing the relationship between NDs and hospital outcomes. A retrospective study was conducted. All adult inpatients consecutively admitted to one of the 15 surgical inpatient units of an Italian university hospital across 1 year were included. Data, including the Professional Assessment Instrument and the Hospital Discharge Register, were collected retrospectively from the hospital's EHRs. The sample included 5,027 surgical inpatients. There was a mean of 6.3 ± 4.3 NDs per patient. The average distribution of NDs showed a stable trend throughout the year. The most representative NANDA-I ND domain was safety/protection. The total number of NDs on admission was significantly higher for patient whose length of stay was longer. A statistically significant correlation was observed between the number of NDs on admission and the number of intra-hospital patient transfers. Additionally, the mean number of NDs on admission was higher for patients who were later transferred to an intensive care unit compared to those who were not transferred. NDs represent the key to understanding the contribution of nurses in the surgical setting. NDs collected upon admission can represent a prognostic factor related to the hospital's key outcomes.

Yoğun Bakım Ünitesinde COVID-19 Tanısı ile İzlenen Hastaların Hemşirelik Bakım Planlarının Değerlendirilmesi: Retrospektif Çalışma

Objective: This study aimed to examine electronic nursing care plans for patients who received treatment due to the diagnosis of coronavirus disease-2019 (COVID-19) in the intensive care units of a hospital. Material and Methods: The sample of this descriptive and retrospective study consisted of the electronic nursing care plans of 429 patients who received treatment due to the diagnosis of COVID-19 in the intensive care units of a hospital between 15 March, 2020 and 15 March, 2022. Data were collected between June and July 2022 using a descriptive characteristics form, a patient care plan evaluation form, and the quality measurement tool for nursing diagnosis, interventions, and outcomes. Results: The nurses were found to use 27 different nursing diagnoses in their care plans and they mostly preferred the nursing diagnoses of risk for infection (n=608), risk for ineffective breathing pattern (n=282), and risk for ımpaired oral mucous membrane integrity (n=233). The nurses labeled 87.66% of the nursing diagnosis correctly and identified 72.78% of the related factors and descriptive characteristics and 58.04% of the goals at an adequate level, 74.77% of the nursing interventions feasibly, and 47.26% of the evaluation at an adequate level. The mean score of the nurses for the quality measurement tool for nursing diagnosis, interventions, and outcomes was 51.82±6.89. Conclusion: It was seen that the nurses were sufficient in the electronic nursing process they prepared for the patients treated with the diagnosis of COVID-19, except for the evaluation, and the quality of the nursing process was above the average. It is recommended to provide training to nurses, especially for the evaluation stage of the nursing process.

Implementation of transoperative and immediate postoperative nursing diagnoses in the computerized management system.

To implement, on health management software, electronic records of the perioperative nursing process and the stages of transoperative and immediate postoperative nursing diagnoses, based on the NANDA International taxonomy. Experience report conducted from the completion of the Plan-Do-Study-Act cycle, which allows improvement planning with a clearer purpose, directing each stage. This study was carried out in a hospital complex in southern Brazil, using the software Tasy/Philips Healthcare. For the inclusion of nursing diagnoses, three cycles were completed, predictions of expected results were established, and tasks were assigned, defining "who, what, when, and where". The structured model covered seven possibilities of aspects, 92 symptoms and signs to be evaluated, and 15 nursing diagnoses to be used in the transoperative and immediate postoperative periods. The study allowed implementing electronic records of the perioperative nursing process on health management software, including transoperative and immediate postoperative nursing diagnoses, as well as nursing care.

Ocular dryness in intensive care: proposal for a new nursing diagnosis

RESUMO Objetivo: analisar o conceito associado à proposição do diagnóstico de enfermagem Ressecamento ocular em pacientes adultos internados em Unidade de Terapia Intensiva com identificação de seus atributos, antecedentes e consequentes. Métodos: estudo metodológico, realizado mediante análise de conceito operacionalizada por scoping review. Resultados: a análise dos 180 estudos permitiu identificação de dois atributos, 32 antecedentes e 12 consequentes. Os atributos foram deficiência do filme lacrimal e sinais e/ ou sintomas oculares. Os antecedentes prevalentes foram fechamento palpebral incompleto (lagoftalmia) e mecanismo de piscar diminuído. Os principais consequentes incluíram hiperemia conjuntival e volumetria lacrimal diminuída. Conclusões: este estudo permitiu a construção do diagnóstico de enfermagem Ressecamento ocular, integrante do domínio 11, classe 2, com 12 características definidoras, 12 fatores relacionados, sete populações em risco e 13 condições associadas. Essa proposta com foco no problema poderá proporcionar cuidado direcionado, promovendo detecção precoce e execução de intervenções que reduzam o risco de danos oculares.

PROPOSAL FOR A CLINICAL PROTOCOL FOR THE CONSERVATIVE TREATMENT OF URGE URINARY INCONTINENCE

Objective: To present a proposal for a clinical protocol for the conservative treatment of urge urinary incontinence. Method: Experience report based on existing scientific evidence and clinical experience of authors who perform nursing consultations for people with urge urinary incontinence, outlined in accordance with the Brazilian Ministry of Health’s proposal for the elaboration of clinical protocols. Results: A clinical protocol was proposed with nursing diagnosis and interventions based on the North American Nursing Diagnosis Association (NANDA) and Nursing Interventions Classifications (NIC), with systematized steps to verify the presence of related factors or conditions associated with the diagnosis, namely: hyperactive pelvic floor, anxiety, constipation, urinary tract infection, low fluid intake, inadequate sanitary behavior, diabetes mellitus, pelvic organ prolapse, high consumption of potential bladder irritants and persistence of symptoms. Soon after, the actions that should be implemented by the nurse were described in detail. Conclusion: It is considered that the flow and detailing of the actions presented can be adopted by nurses in order to identify and treat people with urge urinary incontinence, thus minimizing the prevalence of the problem and promoting the quality of life of these people.

Implementing nursing diagnoses and care for the spiritual dimension of people with cancer: educational actions.

To establish the implementation of nursing diagnoses and care for the spiritual dimension of people with cancer. Action research in a university hospital in the north-east of Brazil. Nine nurses and thirteen nursing technicians from the Onco-hematology and Bone Marrow Transplant Unit of this hospital took part. Data collection took place in four phases and involved the talking map technique, pedagogical workshops and a logbook. The groups' speeches were coded using Maxqda software, subjected to Braun and Clarke's thematic analysis and interpreted in the light of Paulo Freire's constructs. Phase 1 sought to apprehend the participants' prior knowledge on the subject; in phase 2, proposals emerged for spiritual care organized in the Nursing Process; in phase 3, the diagnoses and care plan for the spiritual dimension for clinical practice were contemplated; and in phase 4, through the final evaluation, it was possible to see the transformations that occurred in the nursing team's practice with the proposed implementation. The educational actions provided significant learning for the nursing team and the implementation of diagnoses and nursing care for the spiritual dimension of people with cancer.

Content validation of the nursing diagnosis "inadequate social support network".

To evaluate evidence of content validity of the nursing diagnosis "inadequate social support network". A methodological study of the content validation type, carried out with 23 judges who evaluated the adequacy of the title, definition, class and domain of the nursing diagnosis "inadequate social support network". The judges also assessed the relevance of 28 clinical indicators and 32 etiological factors, which were considered valid when the Content Validity Index was ≥ 0.9. The judges agreed with the proposed title and suggested changes to the definition of the nursing diagnosis. They recommended its inclusion in Domain 7 - "Roles and relationships" and Class 3 - "Role performance" of the NANDA-I taxonomy. In addition, 19 clinical indicators and 27 etiological factors were considered relevant. The nursing diagnosis "inadequate social support network" had its theoretical structure validated in terms of content, which can support the practice of nurses in the operationalization of the Nursing Process.

Sociodemographic profile, diagnoses and nursing care in post-COVID-19 patients in a Brazilian university hospital.

to analyze the sociodemographic profile, diagnoses and nursing care of post-COVID-19 patients admitted to a university hospital in southern Brazil. a retrospective cohort study. The sample consisted of 1,467 medical records, from January 2020 to January 2021. from the analyzed medical records, the most prevalent profiles, respectively, included: males (52.9%); white (81.1%); with Impaired Physiological Balance Syndrome* Nursing Diagnosis (77.3%); nursing care implementing aerosol precautions (94.5%); implementing droplet precautions (93.4%); checking vital signs (91.9%); applying standard disinfectant to equipment and surfaces (89.6%). the analysis of the sociodemographic profile, diagnoses and nursing care of patients in this study may contribute to implementing the Nursing Process in the coronavirus pandemic context.

Implementation of transoperative and immediate postoperative nursing diagnoses in the computerized management system

RESUMO Objetivo: Implementar, em um software de gestão em saúde, os registros eletrônicos do processo de enfermagem perioperatório e a etapa de diagnósticos de enfermagem transoperatório e pós-operatório imediato, fundamentados na taxonomia NANDA International. Método: Relato de experiência conduzido a partir da realização do ciclo PDSA (Plan-Do-Study-Act), o qual permite o planejamento de melhoria com um propósito mais claro, direcionando cada etapa. Este estudo foi realizado em um complexo hospitalar da região sul do Brasil, utilizando o software Tasy/Philips Healthcare. Resultados: Para a inclusão dos diagnósticos de enfermagem, rodaram-se três ciclos, estabeleceram-se previsões de resultados esperados, e as tarefas foram atribuídas, definindo “quem, o quê, quando e onde”. O modelo estruturado contemplou sete possibilidades de aspectos, 92 sinais e sintomas a serem avaliados e 15 diagnósticos de enfermagem para serem utilizados no transoperatório e pós-operatório imediato. Conclusão: O estudo possibilitou implementar, em um software de gestão em saúde, os registros eletrônicos do processo de enfermagem perioperatório, compreendendo diagnósticos de enfermagem do transoperatório e pós-operatório imediato, além de cuidados de enfermagem.

Development and Evaluation of a Web-Based Application for Trauma Nursing Documentation in Thailand: A Feasibility Study.

Electronic nursing documentation has advantages for monitoring and improving the quality of trauma nursing documentation. However, electronic nursing documentation has rarely been implemented in Thailand. This study aimed to assess the feasibility and nursing satisfaction of a web-based trauma nursing documentation application. A descriptive cross-sectional survey design was used to assess the feasibility and nursing satisfaction with a web-based trauma nursing documentation application. The application was based on literature review, Advanced Trauma Life Support principles, and the North American Nursing Diagnosis Association. The survey was administered to trauma and emergency department registered nurses in a hospital in Thailand from November 2021 to January 2022. Patient data were also extracted from the web application system for analysis. A total of 59 nurses piloted the web-based application on 79 trauma patients. Of 59 nurses, 45 (76.3%) were female, 44 (74.6%) had worked in the emergency department for more than 5 years, and 49 (83.1%) had no prior experience with using web-based applications. The nurses were satisfied with the application (M = 3.51, SD = 0.62), and they suggested that it was feasible to apply in practice (M = 3.46, SD = 0.79). These preliminary data demonstrate that implementing a web-based application for trauma nursing documentation in the emergency department is feasible and satisfactory to nurses.

POTENCIAIS DOADORES DE ÓRGÃOS EM MORTE ENCEFÁLICA: CARACTERIZAÇÃO E IDENTIFICAÇÃO DE DIAGNÓSTICOS DE ENFERMAGEM

ABSTRACT Objective: To identify the nursing diagnoses of potential organ donors in brain death according to the NANDA-I Taxonomy. Method: Observational, cross-sectional study conducted in a public hospital in the interior of Ceará, Brazil. Data collection was realized in October and November 2021 in 23 medical records of potential organ donors. Descriptive statistics analyzed data. Results: Twenty-two diagnoses were identified in five of the 13 domains of the NANDA-I taxonomy. The following were prevalent: risk of unstable blood glucose; risk of impaired liver function; impaired gas exchange; impaired bed mobility; ineffective breathing pattern; risk of infection; risk of pressure injury; risk of aspiration; risk of decreased cardiac output; risk of falls, impaired urinary elimination; risk of electrolyte imbalance and risk of unstable blood pressure. Conclusion: The identification of diagnoses may favor the improvement of practice and the application of the nursing process in the care of potential organ donors.

Implementing nursing diagnoses and care for the spiritual dimension of people with cancer: educational actions

RESUMO Objetivo: Estabelecer a implementação de diagnósticos e cuidados de enfermagem à dimensão espiritual da pessoa com câncer. Método: Pesquisa-ação, em um hospital universitário do Nordeste do Brasil. Participaram nove enfermeiros e treze técnicos de enfermagem da Unidade de Oncohematologia e Transplante de Medula Óssea do referido hospital. A coleta de dados aconteceu em quatro fases e envolveu a técnica do mapa falante, oficinas pedagógicas e o diário de bordo. As falas dos grupos foram codificadas com auxílio do software Maxqda, submetidas à análise temática de Braun e Clarke e interpretadas à luz dos construtos de Paulo Freire. Resultados: A fase 1 buscou apreender o saber prévio dos participantes sobre a temática; na fase 2, surgiram propostas para o cuidado espiritual organizado no Processo de Enfermagem; na fase 3, contemplou-se os diagnósticos e plano de cuidados à dimensão espiritual para a prática clínica; e na fase 4, através da avaliação final, foi possível constatar as transformações ocorridas na prática da equipe de enfermagem com a implementação proposta. Conclusão: As ações educativas proporcionaram a aprendizagem significativa da equipe de enfermagem e implementação dos diagnósticos e cuidados de enfermagem à dimensão espiritual da pessoa com câncer.

Ressecamento ocular em terapia intensiva: proposta de novo diagnóstico de enfermagem

ABSTRACT Objective: to analyze the concept associated with diagnostic proposition Ocular dryness in adult patients hospitalized in an Intensive Care Unit, identifying its attributes, antecedents and consequences. Methods: a methodological study carried out through concept analysis, operationalized by scoping review. Results: the analysis of 180 studies allowed the identification of two attributes, 32 antecedents and 12 consequences. The attributes were tear film deficiency and ocular signs and/or symptoms. The prevalent antecedents were incomplete eyelid closure (lagophthalmos) and blinking mechanism decrease. Major consequences included conjunctival hyperemia and decreased tear volume. Conclusions: this study allowed constructing nursing diagnosis Ocular dryness, part of domain 11, class 2, with 12 defining characteristics, 12 related factors, seven populations at risk and 13 associated conditions. This problem-focused proposal may provide targeted care by promoting early detection and implementing interventions that reduce the risk of ocular damage.

Content validation of the nursing diagnosis “inadequate social support network”

RESUMO Objetivo: Avaliar evidências de validade de conteúdo do diagnóstico de enfermagem “rede social de apoio inadequada”. Método: Estudo metodológico do tipo validação de conteúdo, realizado com 23 juízes que avaliaram a adequação do título, da definição, da classe e do domínio do diagnóstico de enfermagem “rede social de apoio inadequada”. Os juízes também avaliaram a relevância de 28 indicadores clínicos e de 32 fatores etiológicos, os quais foram considerados válidos quando o Índice de Validade de Conteúdo foi ≥ 0,9. Resultados: Os juízes concordaram com o título proposto e sugeriram alterações na definição do diagnóstico de enfermagem. Recomendaram a sua inserção no Domínio 7 – “Papéis e relacionamentos” e na Classe 3 – “Desempenho de papéis” da taxonomia da NANDA-I. Ademais, 19 indicadores clínicos e 27 fatores etiológicos foram considerados relevantes. Conclusão: O diagnóstico de enfermagem “rede social de apoio inadequada” teve sua estrutura teórica validada quanto ao conteúdo, a qual pode subsidiar a prática do enfermeiro na operacionalização do Processo de Enfermagem.

Perceptions of Turkish Nursing Students on Nursing Diagnose

Objective: This study aimed to determine how Turkish nursing students’ perceived nursing diagnosis. Methods: This descriptive and cross-sectional study was carried out with 655 nursing students in the Departments of Nursing in the Health Sciences Faculties of two universities, in the Aegean and western Black Sea Region, between 15 February and 5 April 2020. The Students Information Form and Perceptions of Nursing Diagnosis Scale were used for data collection. The independent samples t-test, one-way ANOVA test, and the Mann-Whitney U-test with Bonferroni-correction were used to determine the differences between the groups. Pearson correlation analysis was used to determine the effects of independent variables Results: The mean age of the nursing students was 21.12±1.39; 76.6% of them were female and 36.8% were in the second-year. 53.7% of the nursing students reported that they had difficulty in making nursing diagnoses. The overall Perceptions of Nursing Diagnosis Survey score of the nursing students was found to be 2.46±051. Statistically significant difference was found between Perceptions of Nursing Diagnosis Survey scores in terms of gender (p=0.012), the necessity of nursing diagnosis (p<0.001), and having sufficient knowledge about nursing diagnosis (p=0.019). Conclusions: The findings of this study have revealed that Turkish nursing students’ perceptions of nursing diagnoses are positive. It is important that use effective teaching methods in teaching nursing diagnoses in fundamental nursing education, to give more importance to nursing diagnoses. It is recommended to plan qualitative studies to in-depth examine students’ perceptions with randomized controlled studies involving innovative educational interventions in the future

The Effectiveness of the Siriraj Stroke Score (SSS) and National Institute of Health Stroke Scale (NIHSS) Assessment Methods in Determining the Actual Nursing Diagnosis of Stroke Patients in the Emergency Room

Background: stroke is a disease of the brain in the form of focal nerve function disorders caused by disruption of blood circulation to the brain and causing symptoms in the form of neurological deficits. As the number of stroke patients increases, the assessment needs to focus on neurology and is an emergency.Purpose: analyzing the effectiveness of the assessment method NSSS and NIHSS in determining the number of diagnoses actual nursing and the speed of time to determine the diagnosis of stroke patients in the Emergency Room.Methods: this study used a pre-experimental approach. Theerty sample were used from a new patient with a medical diagnosis of stroke, while the sampling technique in this study was accidental sampling. Data collection on each sample was directly carried out using two assessment methods. The SSS assessment consists of 5 components and the NIHSS 11 components. Data analysis used sperm correlation and correlation coefficient interpretation test.Results: the results of the sperm correlation test in the SSS and NIHSS methods both show p=0.000. The level of closeness were analyzed using the correlation coefficientthere is a very strong relationship is NIHSS to the length of the duration of determination (r = 0.858).Conclusion: the SSS and NIHSS assessment methods are effective in establishing the diagnosisactual nursingin stroke patients in the Emergency Department, however, in terms of duration of assessment and determination of the number of diagnoses, SSS is more effective, while from the duration of determining nursing diagnoses, NIHSS is more effective.

Nursing Acute Pain in Patients With Bladder Cancer: A Case Study

Background: Severe pain in the lower right abdomen is often found in bladder cancer patients. Bladder cancer is a complex disease associated with high morbidity and mortality if not treated optimally. Patients who suffer from bladder problems say that the influence of medical personnel influences the most significant role in pain control. Nursing care for acute pain in patients with bladder cancer is still unknown. This study aims to describe nursing care for acute pain in bladder cancer patients. Methods: This research uses a case study design. Data collection from assessment to nursing evaluation was carried out in the Punai room of the Simpang Lima Gumul Hospital, Kediri Regency, in December 2021. The bladder patient was observed or treated for at least two days. Data collection techniques used were interviews, observation, and documentation. Data analysis was carried out using narrative analysis. Results: Mr. R, the main complaint felt by the patient is a pain in the lower right abdomen penetrating to the back. The nursing diagnosis in the case of Mr. R is the actual diagnosis of acute pain associated with physical injury (D.0077). Nursing intervention for Mr. R was compiled based on the diagnosis of acute pain using pharmacological techniques. Conclusion: The nursing problems Mr. R resolved after 48 hours of nursing intervention. The patient shows a decreased pain level with a pain scale of 2, and the patient plans KRS after 2 days the problem is resolved.

Nursing of Hypovolemia in Patients with Melena’s Hematemesis: A Case Study

Background: Hematemesis melena is a patient’s condition with black stools or stools caused by upper gastrointestinal bleeding. Hypovolemic patients with hematemesis melena usually experience nausea, vomiting, and diarrhea. This study aims to describe nursing care for hypovolemia in patients with hematemesis melena. Methods: This research method uses a case study design. Data collection started from assessment to evaluation in the Kasuari ward of Simpang Lima Gumul Hospital in December 2021. The hematemesis melena patient was observed or treated for at least two days. Data collection techniques were carried out through interviews, observation, and documentation. Data analysis was carried out using narrative analysis. Results: assessment of Mr. P with the main complaint complaining of vomiting blood for ±10 days, abdominal pain, weakness, black stools for ±10 days, and urinating for five days. The nursing diagnosis in the case of Mr. P is the actual diagnosis with priority hypovolemia related to functional fluid loss (D.0023). Nursing intervention for Mr. P was compiled based on the diagnosis of hypovolemia using pharmacological techniques such as antibiotics. Conclusion: The patient showed a not-so-significant decrease because the patient still had time to vomit blood and bloody stool.

Description of COVID‐19 patients and mapping nursing data to ICNP 2021 reference set in SNOMED CT

To describe nursing care of COVID-19 patients with International Classification for Nursing Practice (ICNP) 2019, ICNP 2021 reference set, and Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT). From the beginning of the COVID-19 pandemic, nurses have realised the importance of documenting nursing care. It is important to recognise how real nursing data match the ICNP reference set in SNOMED CT as that is the terminology to be used in Iceland. A descriptive study with two methods: (a) statistical analysis of demographic and coded clinical data identified and retrieved from Electronic Health Record (EHR) and (b) mapping of documented nursing diagnoses and interventions in EHRs into ICNP 2019, ICNP 2021 and SNOMED CT 2021. The sample consisted of all (n = 91) adult COVID-19 patients admitted to the National University Hospital between 28 February and 30 June 2020. Nurses used 62 different diagnoses and 79 interventions to document nursing care. Diagnoses and interventions were best represented by SNOMED CT (85.4%; 100%), then by ICNP 2019 version (79.2%; 85%) and least by the ICNP 2021 reference set (70.8; 83.3%). Ten nursing diagnoses did not have a match in the ICNP 2021 reference set. Nurses need to keep up with the development of ICNP and submit to ICN new terms and concepts deemed necessary for nursing practice for inclusion in ICNP and SNOMED CT. Not all concepts in ICNP 2019 for COVID-19 patients were found to have equivalence in ICNP 2021. SNOMED CT-preferred terms cover the description of COVID-19 patients better than the ICNP 2021 reference set in SNOMED CT. Through the use of ICNP, nurses can articulate the unique contribution made by the profession and make visible the specific role of nursing worldwide.