Nursing Interventions Classification Research Articles

High prevalence of skin and wound care of hospitalized elderly in Brazil: a prospective observational study

BackgroundSkin changes caused by aging increase the risk of skin damages, such as pressure ulcers, during hospitalization of elderly patients. There is few information about the cost of wound treatment in Brazil. Conversely, skin and wound problems are highly reported among hospitalized elderly patients and caregivers. The purpose is to analyze the socio-demographic and clinical profile associated with skin and wound care in hospitalized elderly.MethodsThis is a prospective observational study. The sample consisted of 75 patients, aged 60 years or more, randomly selected in three hospitals in Rio de Janeiro, Brazil. Data extraction from nursing records of the sample, using cross mapping with Nursing Interventions Classification. Data Synthesis supported by SAS 6.11 (SAS Institute, Inc. Cary North Carolina) in association with SPSS version 14.0 and statistics analysis.ResultsThe findings were: age standard deviation 7.8, with minimum as 60, and maximum as 91 years old. Prevalence of women and married seniors. High prevalence of long-term hospitalization. There were 21 Nursing Interventions in the nursing records and seventeen of them related to skin and wound care. They were described in 57 nursing activities, present during 376 evaluations and repeated 1756 times. A significant difference was obtained between age and the presence of the nursing interventions “Positioning” (p-0.004), Eye Care/Hygiene (p- < 0.0001) and Oral Health Maintenance (p-0.0003).ConclusionThe skin care to prevention and treatment of skin damages represented the major demand of nursing interventions in different clinical conditions of hospitalized elderly.

Study in frequently-used standardized nursing language for postpartum care after caesarean section applying NANDA-I,NIC and NOC

Objective To identify the most frequently used nursing diagnoses, interventions, outcomes, and linkages using North American Nursing Diagnosis Association International (NANDA-I), Nursing Interventions Classification (NIC), Nursing Outcomes Classification (NOC) for puerperas after caesarean section. Methods For this study a descriptive design was used. The frequently used NANDA-I, NIC, NOC, and NNN linkages were identified through 63 puerperas after caesarean section who were admitted in hospital from February to April in 2016. Results The finding showed the most frequently used 6 nursing diagnosis were ineffective breastfeeding, readiness for enhanced breastfeeding, deficient knowledge, risk for bleeding, acute pain,impaired tissue integrity; the most frequently used 11 nursing outcomes were breastfeeding establishment: infant, breastfeeding establishment:maternal, wound healing: primary intention, and so on; the most frequently used 26 nursing interventions were promoted voiding, environmental management: comfort, massage, and so on. The most frequently used top 38 NNN linkages were also identified in this study. Conclusions The most frequently used NANDA-I, NIC, NOC, and NNN linkages for puerperas after caesarean section from this study not only offer new standardized nursing terminology to nurses but also provide reference for cost accounting of postpartum care. Key words: Nursing diagnosis; Nursing care; Postpartum care after caesarean section; Nursing outcome; NNN linkage

Initially identification of core interventions to pediatric nursing based on Nursing Interventions Classification

Objective To identify the core interventions preliminarily performed by pediatric nurses for hospitalized children. Methods Based on Nursing Interventions Classification (NIC), the data of survey related to the factors of representation and frequency derived from the definition of Core Nursing Interventions were collected from 59 pediatric senior nurses above the 3rd clinical ladder, working in one of Shanghai university affiliated and tertiary children hospitals. The data was analyzed by L type of Metric Diagram. The intervention with product of two factors above 12 was selected as the core intervention. Results A total of 109 interventions were selected as core interventions on pediatric nursing from 497 interventions of NIC. The top 3 domains in quantity of interventions were physiological complex domain (36 items), physiological basic domain (26 items) and health system domain (19 items). The domain with the highest score (16.79±3.42) was safety domain, followed by physiological complex domain (16.19±2.98), while domain with the lowest score (13.62±2.05) was family domain. Conclusions The initial and systematic pediatric nursing core interventions were identified based on NIC and definition of core intervention. Part of core interventions reflects the characteristics of pediatric nursing practice, but more is requested to reflect the pediatric-specific care related to family-center and age-appropriated concepts. Some of inefficient interventions remind nursing administers further reflect thinking, especially on human resource management. Key words: Pediatric nursing; Nursing interventions classification

Nursing diagnoses and interventions in children submitted to cochlear implantation.

Identifying the main nursing diagnoses and interventions in children submitted to cochlear implant in the immediate postoperative period. A cross-sectional study conducted between February and April 2016, considering nursing history (anamnesis and physical examination) and nursing diagnoses (NANDA - International) with their respective interventions (Nursing Intervention Classification - NIC). Descriptive statistical analysis was used to construct the results. A total of 19 children participated in this study. The main nursing diagnoses listed were: impaired verbal communication, impaired skin integrity, risk for infection, risk for falls, and risk for bleeding (n=19; 100%). Regarding the nursing interventions, the following prevailed: Improvement in communication: auditory deficit, Skin surveillance, Protection against infection, Prevention of falls and Precautions against bleeding (n=19; 100%). Nursing diagnoses and interventions related to the cochlear implant postoperative period were related to communication, bleeding control, surgical wound care, infection prevention, comfort and well-being. Identificar os principais diagnósticos e intervenções de enfermagem em crianças submetidas a implante coclear em pós-operatório imediato. Estudo transversal realizado entre fevereiro e abril de 2016. Foram considerados o histórico de enfermagem (anamnese e exame físico) e os diagnósticos de enfermagem (NANDA - Internacional) com suas respectivas intervenções (Nursing Intervention Classification - NIC). Para construção dos resultados utilizou-se da análise estatística descritiva. Participaram do presente estudo 19 crianças. Os principais diagnósticos de enfermagem elencados foram: Comunicação verbal prejudicada, Integridade da pele prejudicada, Risco de infecção, Risco de queda e Risco de sangramento (n=19; 100%). Quanto às intervenções de enfermagem, prevaleceram: Melhora na comunicação: deficit auditivo, Supervisão da pele, Proteção contra infecção, Prevenção de quedas e Precauções contra sangramento (n=19; 100%). Os diagnósticos e as intervenções de enfermagem referentes ao pós-operatório de implante coclear relacionaram-se com comunicação, controle de sangramento, cuidados com a ferida operatória, prevenção de infecção, conforto e bem-estar.

The Effectiveness or Efficacy of Modified Nursing Interventions Classification (NIC) in Reducing the Severity of Depression among Patients with Myocardial Infarction

Background: Post myocardial infarction depression is common and puts a negative effect on recovery. Modified Nursing interventions effectively reduce the frequency and severity of depression in such patients. Objective: The study aimed to determine the effectiveness of Modified Nursing Interventions Classification (NIC) in reducing the severity of depression among patients with Myocardial Infarction. Methods: Sixty-eight stable patients with myocardial infarction (>1 month history) having mild to moderate depression in accordance to Patient Health Questionnaire-9 (PHQ-9) [with a score of 5 to 14] were enrolled. Patients were assorted into interventional and control group. Modified Nursing Intervention was offered in Interventional Group. The frequency and effectiveness of Modified Nursing Intervention among the groups were determined and compared. Results: Both moderate and mild level depression was decreased in Intervention Group as compare to Control Group. Baseline mean depression PHQ-9 score was 2.35 point statistically significantly higher in the Control Group than Interventional Group (Conclusion: Modified Nursing intervention is effective in reducing the frequency and severity of depression compared to routine care in patients with Myocardial infarction.

Proceso de enfermería aplicado al paciente con tetralogía de Fallot

Objective: To describe the steps of the nursing process applied to patients with tetralogy of Fallot, based on NANDA-I, Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC). Method: This is a clinical case developed in a university hospital located in Northeast Brazil. It should be noted that this study was appreciated by the Ethics Committee of the Federal University of Rio Grande do Norte, which it approved it with number of Certificate of Presentation for Ethical Assessment: 07614812.6.0000.5537. Results: Among the four identified nursing diagnoses, has listed is a priority, which was intolerant of activity. The result, compromised moderately fatigue and activity of level, and interventions accounted for cardiac care: acute phase. Conclusions: After the execution of the care plan, it was observed that the actions taken have contributed significantly to the improvement of the health status of the patient, in order to contribute to increasing confidence and independence of it, despite the limitations inherent to the disease.

Surveillance: A Nursing Intervention for Improving Patient Safety in Critical Care Environment.

Nursing surveillance has been identified as a key intervention in early recognition and prevention of errors/adverse events. Nursing Intervention Classification (NIC) defines surveillance as "the purposeful and ongoing acquisition, interpretation, and synthesis of patient data for clinical decision making." Because nurses are the main staffing constant in the critical care environment, the importance of surveillance as an intervention is fundamental. The aim of this study was to explore how surveillance is expressed by critical care nurses. A descriptive exploratory research design was used. Think-aloud was used for data collection. Twenty-one registered nurses from 3 critical care units participated in the study. Participants were asked to say out loud whatever they were thinking as they performed patient care at 3 time points: during handoff, initial patient assessment, and after 4 hours of care. Think-aloud (saying aloud what one is thinking) represents the information (cues) that is attended to in short-term memory, before it has been processed and stored. Data were analyzed using content analysis with key concepts and themes identified. The expression of surveillance was through the main theme of finding meaning. Surveillance involved (a) knowing the patient, (b) shared understanding and decision making, and (c) thinking ahead. The outcomes of these activities were aimed at finding meaning in the cues that emerged as the overarching theme. Surveillance was expressed through nurses' gathering cues, reflecting on past knowledge, asking questions, verifying, and pulling it all together to find meaning. During handoff, surveillance involved collaborative cognitive work to find meaning in cues.

Atenção à saúde do trabalhador: instrumento para subsidiar a consulta de enfermagem

Objetivo: descrever a construção de impressos para coleta de dados, diagnósticos, prescrições e resultados de enfermagem para subsidiar a consulta a trabalhadores. Método: relato de experiência da construção de um instrumento para sistematizar a assistência de enfermagem na consulta ao trabalhador. Resultados: foram criados três impressos: o primeiro destinado ao histórico de enfermagem; segundo, lista de 26 diagnósticos de enfermagem e terceiro, lista de 22 intervenções de enfermagem e 23 resultados de enfermagem esperados, os dois últimos impressos alinhados segundo as taxonomias North American Nursing Diagnosis Assosciation International (NANDA I), Nursing Intervention Classification International (NIC), Nursing Outcome Classification (NOC). Considerações Finais: as contribuições para a enfermagem e a saúde do trabalhador foram: criação de um instrumento para subsidiar a consulta de enfermagem sistematizada a trabalhadores; atendimento à legislação vigente da implementação do processo de enfermagem.

Estimated Time to Complete Direct Nursing Interventions Using the Nursing Interventions Classification (NIC) at Eight Hospitals in South Korea.

Without data on the average time for performing nursing interventions, it is not possible to identify the cost-effective nursing practices, nurse staffing levels, and skill mix that are associated with improved patient outcomes, nor can reimbursement rates be accurately determined. The purpose of this study was to estimate the time needed to perform direct nursing interventions in Korea using the Nursing Interventions Classification (NIC) system, and then compare the findings with time estimates made by U.S. nurses. Data were collected from 721 registered nurses working in eight hospitals in South Korea. Each nurse was asked to choose the 30 most frequently used direct nursing interventions from a list of 433 from the Korean version of the NIC and to estimate the time needed to perform their selections. The U.S. data from the second edition of NIC were used for comparative purposes. Among the 92 nursing interventions studied, the majority were in the physiological domain, with 46 (50%) in Physiological: Basic and 25 (27%) in Physiological: Complex. In Korea, the intervention reported as taking the shortest time was Tube Care: Umbilical Line, while the intervention reported as taking the longest time was Bowel Irrigation. Comparisons of the time to perform interventions in the two countries indicated that only 38 (41.3%) interventions are performed in 15 min or less in both countries. Of the remainder, six interventions showed considerable variation in time to perform between the two countries. Findings from the study will provide fundamental data for calculating the cost of nursing interventions, which is critical for the establishment of reimbursement rates for interventions provided.

Advanced Nursing Process quality: Comparing the International Classification for Nursing Practice (ICNP) with the NANDA-International (NANDA-I) and Nursing Interventions Classification (NIC).

To assess the quality of the advanced nursing process in nursing documentation in two hospitals. Various standardised terminologies are employed by nurses worldwide, whether for teaching, research or patient care. These systems can improve the quality of nursing records, enable care continuity, consistency in written communication and enhance safety for patients and providers alike. Cross-sectional study. A total of 138 records from two facilities (69 records from each facility) were analysed, one using the NANDA-International and Nursing Interventions Classification terminology (Centre 1) and one the International Classification for Nursing Practice (Centre 2), by means of the Quality of Diagnoses, Interventions, and Outcomes instrument. Quality of Diagnoses, Interventions, and Outcomes scores range from 0-58 points. Nursing records were dated 2012-2013 for Centre 1 and 2010-2011 for Centre 2. Centre 1 had a Quality of Diagnoses, Interventions, and Outcomes score of 35·46 (±6·45), whereas Centre 2 had a Quality of Diagnoses, Interventions, and Outcomes score of 31·72 (±4·62) (p<0·001). Centre 2 had higher scores in the 'Nursing Diagnoses as Process' dimension, whereas in the 'Nursing Diagnoses as Product', 'Nursing Interventions' and 'Nursing Outcomes' dimensions, Centre 1 exhibited superior performance; acceptable reliability values were obtained for both centres, except for the 'Nursing Interventions' domain in Centre 1 and the 'Nursing Diagnoses as Process' and 'Nursing Diagnoses as Product' domains in Centre 2. The quality of nursing documentation was superior at Centre 1, although both facilities demonstrated moderate scores considering the maximum potential score of 58 points. Reliability analyses showed satisfactory results for both standardised terminologies. Nursing leaders should use a validated instrument to investigate the quality of nursing records after implementation of standardised terminologies.

Maintenance of functional capacity in cognitive stimulation subgroups.

To evaluate the improvement of the elderly's functional capacity before intervention in cognitive stimulation workshops, according to subgroups. uantitative study, by before and after evaluation, following during one year the cognitive stimulation intervention, conducted according to recommendations of NIC (Nursing Interventions Classification) Domain 3 - Behavior, Class P, Cognitive Therapy "interventions to reinforce or promote desirable behaviors or to change undesirable behaviors". Participants were 67 people, with ages between 60 and 88. The criteria for subgroups were: healthy= memory complaint and Mini Mental State Exam (MMSE) score above or equal to 26 (n = 20); low education level = memory complaint and up to 5 years of study (n = 11); depression = memory and humor complaint, and Geriatric Depression Scale (GDS) score ≥ 4 (n = 25); and the control group (n = 11), which did not receive the intervention, just the conventional treatment. Although statistically significant differences have been observed in specific scores at each subgroup: MMSE (greater improvement in healthy elderly); GDS (greater improvement in the depression group); and the Word recall test (lower at the "low education level" group); it was noticed that at all intervention subgroups the functional capacity was maintained when compared to the control group. The cognitive stimulation workshops were useful to the elderly, who received the nursing intervention, the cognitive therapy. It is recommended adoption of the intervention in specific subgroups, according to their own cognitive limitations.

Content Validity of a Psychotherapeutic Intervention Model in Nursing: A Modified e-Delphi Study

AimTo estimate the content validity of a psychotherapeutic intervention model in nursing. BackgroundMental health nurses encounter great extrinsic difficulties when it comes to providing psychotherapeutic interventions due to the fact that they are not allowed to perform such practice in some countries. In this light, the pursuit of a psychotherapeutic intervention model in nursing seems germane to guide the professionals' psychotherapeutic practice, contributing hereof to increase mental health nurses' professional autonomy. DesignModified e-Delphi. MethodsData were collected from October 2015 to January 2016 by means of three rounds of online questionnaires. The initial questionnaire was structured into five sections: general structure of the model, patients' exclusion criteria, assessment framework, nursing diagnoses, and nursing psychotherapeutic interventions. From the 42 experts invited, at least twenty (20) participated in each round. ResultsThe experts achieved consensus with regard to the conclusion that nursing psychotherapeutic interventions should always seek to address a nursing diagnosis. These defined furthermore that a psychotherapeutic intervention model in nursing should be exercised by means of 3 to 12 sessions using Nursing Interventions Classification (NIC) as a resource. Finally, experts deemed that the model should follow the principles of integrative psychotherapy, so that techniques from different schools of psychotherapy could therefore be used in conjunction to promote the resolution of a nursing diagnosis. ConclusionAchieving consensus about the structure of a psychotherapeutic intervention model in nursing is imperative to guide nurses in the provision of nursing psychotherapeutic interventions and to enable an effective evaluation of the health gains associated with its implementation.

Documented Nursing Interventions in Inpatient Psychiatry.

This study explored how well the Nursing Interventions Classification (NIC) covers adult inpatient psychiatric care. By systematic analyses and a mapping approach, documented nursing interventions were assessed on concurrencies with the NIC. From 2,153 intervention descriptions in nursing notes, 1,924 were recognizable as NIC interventions, and 229 did not match the NIC. 89.4% of all identified descriptions of interventions were recognizable as NIC interventions on the level of definition. This study demonstrates that the NIC describes adult inpatient psychiatric care to a large extent. Nevertheless, further development of the classification is important. The study results provide a basis for further developing the NIC and to reinforce its use in inpatient psychiatric settings.

Cuidado de enfermería en la salud comunitaria

El Proceso de Atención de Enfermería (PAE) es una herramienta sistemática que facilita la cientificidad de los cuidados en las prácticas comunitarias del profesional de enfermería, la aplicación del método científico en la práctica comunitaria, permite a la enfermería brindar cuidados de forma lógica, sistemática e integral, revaluando las intervenciones para alcanzar los resultados planteados. Se inició con la valoración de Patrones Funcionales de Marjory Gordon y luego en la etapa de diagnóstico y planificación, se interrelacionó con North american nursing diagnosis association (NANDA), Nursing interventions classification (NIC) y Nursing outcomes classification (NOC). Es un estudio descriptivo y prospectivo. Se efectuó un análisis por medio de la aplicación de métodos: escala de medición de los rasgos socio demográfico, estudio de sintomatologías para el descubrimiento prematuro de trastornos mentales en la comunidad y la valoración por patrones funcionales. El PAE incluye diagnósticos más frecuentes, criterios de Resultados, indicadores, intervenciones y actividades para manejar la problemática comunitaria. Se evidenció alteración en los Patrones: Adaptación y Tolerancia al Estrés, Autopercepción-Autoconcepto, Rol-Relaciones, Sueño y Descanso y Percepción y Manejo de la Salud. Un cuidado estandarizado con la interrelación NANDA-NIC-NOC permite brindar un cuidado holístico desde el punto de vista de la salud mental comunitaria con un grado de cientificidad que enmarca el quehacer profesional proyectando el cuidado individual, familiar y comunitario

A Client-Centered Community Engagement Project: Improving the Health and Wellness of Older Adults in an Assisted Living Facility.

Central to nursing practice is the promotion of health and wellness practices. Drawing on the Community as Partner Model, nursing process, Nursing Interventions Classification, and Logic Model, second-year nursing students collaborated with staff and residents of an assisted living facility to promote health and wellness in the older adult population. Windshield surveys, resident surveys, key informant interviews, and focus group interviews were conducted to gain insight into the perceptions and experiences of staff and residents. The majority of residents indicated they were satisfied with life at the facility and their needs have been adequately met. Strengths and areas for improvement were identified in several aspects, including the facility atmosphere and location, quality of staff and health care services, recreational and dietary services, and social support networks. By partnering with community key stakeholders, valuing all different perspectives, and connecting theory to practice, a successful client-centered community clinical project was demonstrated. [Journal of Gerontological Nursing, 42(8), 44-51.].

Cross Mapping Between the Priority Nursing Care for Stroke Patients Treated With Thrombolytic Therapy and the Nursing Interventions Classification (NIC).

To verify the correspondence between the priority nursing care for stroke patients treated with thrombolytic therapy and the Nursing Interventions Classification (NIC). A cross-mapping study with a semi-structured interview was conducted with 11 expert nurses who described priority nursing care in clinical practice, and mapped it to the NIC. Eleven nursing care priorities cited by the nurses were mapped to eight NICs, including Thrombolytic Therapy Management (4270). There was correspondence between all priority nursing care interventions for stroke patients treated with thrombolytic therapy and the NIC. The nursing care cited by the nurses was corroborated by the NIC, providing evidence for the clinical practice. Verificar a correspondência entre os cuidados de enfermagem prioritários a pacientes com acidente vascular encefálico tratados com terapia trombolítica e a Classificação das Intervenções de Enfermagem (NIC). MÉTODOS: Estudo de mapeamento cruzado com uma entrevista semi-estruturada aplicada a 11 enfermeiros especialistas que descreveram os cuidados de enfermagem prioritários na prática clínica, e mapeados para a NIC. Onze cuidados de enfermagem prioritários foram citados pelos enfermeiros e mapeados em oito intervenções de enfermagem NIC, incluindo a Thrombolytic Therapy Management (4270). CONCLUSÕES: Houve correspondência entre todos os cuidados de enfermagem prioritários para pacientes com acidente vascular encefálico tratados com a terapia trombolítica e as intervençães de enfermagem NIC. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: Os cuidados de enfermagem citados pelos enfermeiros foram corroborados pela NIC, produzindo evidências para a prática clínica.

Content validation study of nursing interventions intended to prevent cardiovascular events in diabetic patients.

To validate nursing interventions from the Nursing Interventions Classification for preventing cardiovascular events in outpatients with diabetes. Cardiovascular disease is the main cause of death among diabetic patients. Although nurses play an important role in preventing cardiovascular events in this population, their specific contribution is difficult to measure. Documenting nursing interventions using a standardised nursing system may provide nursing visibility. However, there are no studies that analysed which nursing interventions would be the most relevant, based on expert opinion, aimed at preventing cardiovascular events in diabetic patients. This is a content validation study, which was designed as a descriptive one. For this content validation study, we used the Fehring model. Nursing interventions were selected from the Nursing Intervention Classification. Experts were asked to analyse the degree of relevance of 225 nursing interventions regarding the prevention of cardiovascular events in diabetic patients, considering its title and definition. We considered nursing interventions which obtained weighted arithmetic averages >0·80 to be valid. Among 50 invited experts, 14 (71·4% female; 36·5+9·7years) responded and agreed to participate in this study. They analysed 225 preselected nursing interventions, and validated 29. The validated nursing interventions included documentation as well as biological, social and spiritual issues. The validated nursing interventions encompass a wide range of nursing knowledge, and these results provide empirical evidence for further studies.

Proceso enfermero de tercera generación

Introduction: As a result of changes in its scientific guiding methodology, the nursing process has evolved into its third generation. Its implementation in five stages (assessment, diagnosis, planning, execution, and evaluation) is based on the best scientific evidence in agreement with the discipline-internationally-recognized nursing taxonomies of the North American Nursing Diagnosis Association International , the Nursing Outcomes Classification, and the Nursing Interventions Classification. Development: The third generation nursing process carefully focuses on the benefits of the actual, expected and achieved care outcomes, rather than conducting diagnostics and problem- solving tasks which characterize the first and second generation nursing processes. Conclusion: While the approach is gradually emerging in institutions of health and education in Mexico, the third generation nursing process requires a careful use of cognitive and critical thinking skills.

Assessing time use in long-term institutional care: development, validity and inter-rater reliability of the Groningen Observational instrument for Long-Term Institutional Care (GO-LTIC).

BackgroundLimited research has examined what is actually done in the process of care by nursing staff in long-term institutional care. The applied instruments employed different terminologies, and psychometric properties were inadequately described. This study aimed to develop and test an observational instrument to identify and examine the amount of time spent on nursing interventions in long-term institutional care using a standardized language.MethodsThe Groningen Observational instrument for Long-Term Institutional Care (GO-LTIC) is based on the conceptual framework of the Nursing Interventions Classification. Developmental, validation, and reliability stages of the GO-LTIC included: 1) item generation to identify potential setting-specific interventions; 2) examining content validity with a Delphi panel resulting in relevant interventions by calculating the item content validity index; 3) testing feasibility with trained observers observing nursing assistants; and 4) calculating inter-rater reliability using (non) agreement and Cohen’s kappa for the identification of interventions and an intraclass correlation coefficient for the amount of time spent on interventions. Bland-Altman plots were applied to visualize the agreement between observers. A one-sample student T-test verified if the difference between observers differed significantly from zero.ResultsThe final version of the GO-LTIC comprised 116 nursing interventions categorized into six domains. Substantial to almost perfect kappa’s were found for interventions in the domains basic (0.67–0.92) and complex (0.70–0.94) physiological care. For the domains of behavioral, family, and health system interventions, the kappa’s ranged from fair to almost perfect (0.30–1.00). Intraclass correlation coefficients for the amount of time spent on interventions ranged from fair to excellent for the physiological domains (0.48–0.99) and poor to excellent for the other domains (0.00–1.00). Bland Altman plots indicated that the clinical magnitude of differences in minutes was small. No statistical significant differences between observers (p > 0.05) were found.ConclusionsThe GO-LTIC shows good content validity and acceptable inter-rater reliability to examine the amount of time spent on nursing interventions by nursing staff. This may provide managers with valuable information to make decisions about resource allocation, task allocation of nursing staff, and the examination of the costs of nursing services.

Acute lymphoblastic leukemia in children: NANDA, NIC-NOC care-givers intervention

Backgrou n d and objective : Childhood cancer is now considered a chronic cancer, and thanks to technological advances, survival has increased. Childhood cancer affects patients younger than 15 years. Acute lymphoblastic leukemia (ALL) is among the four primary causes of cancer-related mortality worldwide. ALL is a source of great concern, fear, and guilt for the caregiver due to the lack of knowledge regarding its complications and how to properly care for a child with this disease, highlighting the importance of caregiver education. An educational intervention was carried out according to the Nursing Interventions Classification (NIC): Teaching: Group intervention and based in the North American Nursing Diagnosis Association, Diagnostic: Disposition toward improving knowledge. To identify this program was named Acute Leukemia Program (Programa Leucemia Aguda “P-LEA”). The objective of this study was to analyze the effectiveness of group educational intervention in improving caregivers knowledge of the care of the child with ALL. Methods : A pre-experimental study with a pre-test/post-test group was performed in which a pre-intervention questionnaire and two post-intervention questionnaires at the time of intervention and one month following were administered. These questionnaires measured the level of caregiver knowledge (n = 30; 80% mothers, 7% fathers and 3.3% siblings). The results were based on the Nursing Outcomes Classification (NOC) labels (“management of the cancer”, “disease process”), in the following indicators: “disease process”; “precautions for preventing treatment complications”, and “adverse effects of the medication”. The scores varied from zero to six (no knowledge) to > 25 (extensive knowledge). Caregiver interest in learning was also evaluated using an affective learning instrument based on Patricia Potter’s theoretical contribution. Results: The mean level of knowledge prior to intervention was 16.63 (SD 3.6). The mean level immediately following intervention was 25.53 (SD 1.9). The mean one month following was 25.2 (SD 4.9), with 29 degrees of freedom ( p = .000). Conclusions: The group instructional intervention (NIC) “P-LEA” based on NANDA and NOC-NIC helps caregivers learn about the care of children with ALL.