Nursing Outcomes Classification Research Articles

Nursing Interventions Related to the Need for Oxygenation in Severe COVID-19 Disease in Hospitalized Adults: A Retrospective Study.

To describe the nursing interventions related to the need for oxygenation in hospitalized adults with severe COVID-19 disease in the Intensive Care Unit. This was an observational, retrospective and descriptive study in a population of 2205 patients with a convenience sample of n = 430 and based on the North American Nursing Diagnosis Association (NANDA), the Nursing Interventions Classification (NIC) and the Nursing Outcomes Classification (NOC). The analysis was performed with a non-parametric test to determine the association between the nursing interventions and the need for oxygenation. The findings are aimed at improving nursing interventions with statistical associations as follow: oxygen therapy (p < 0.000), airway suctioning (p < 0.000), airway management (p = 0.029), invasive mechanical ventilation (p < 0.000) and non-invasive mechanical ventilation (p = 0.022). NOC taxonomy expected outcomes in ventilation, 34% (146), alteration in gas exchange, 33.7% (145), and respiratory status, 558.9% (253), were severely compromised. The nursing interventions to maintain the respiratory status are focused on airway care and oxygen therapy in order to increase the oxygen saturation level and decrease the severity of the need for oxygenation.

Nursing outcomes and social support intervention for diabetes self-management: consensus study

Highlights Self-management of type 2 diabetes allows for better health outcomes, maintains independence, and improves quality of life for longer periods of time. Nursing interventions help professionals accurately assess the health status and outcomes of the target population while providing scientific evidence. The nursing professional is a significant source of social support in the self-management of diabetes mellitus. The outcomes achieved by patients are the most important indicators of quality in health care, allowing clarifying nursing knowledge and determining the effectiveness of care. Introduction: Diabetes mellitus is one of the most prevalent chronic noncommunicable diseases in the world. Objective: To validate by expert consensus the Nursing Outcomes Classification (NOC) self-management: diabetes (1619) and social support (1504), as well as to validate the intervention of social support for adults in the self-management of type 2 diabetes mellitus (DM2). Materials and Methods: A consensus study. Several phases were delimited for validation: the first was to validate the results and indicators; the second was to construct and validate the conceptual and operational definitions; and the magnitude of the selected indicators; and the third was to design and validate the intervention of social support for adults in the self-management of DM2. Results: 28 indicators were selected and validated by experts out of the 44 that make up the nursing outcome of self-management: diabetes, and 9 indicators out of the 12 that make up the social support outcome, both with a Content Validity Index (CVI) of 0.98. As for the intervention, a social support intervention was designed for the self-management of DM2, individualized, and made up of 4 sessions. The components of the intervention include generalities of DM2, healthy life habits, safe care, and emotional support. Discussion: Nursing professionals must evaluate people who experience diabetes, and their capacity for self-management and social support in order to provide appropriate interventions and evaluate their effectiveness. Conclusions: The study significantly evidenced the validation of the two nursing outcomes and their respective indicators, added to the conceptual and operational definitions, and their magnitude. How to cite this article: Garizábalo-Dávila Claudia Milena, Cañon-Montañez Wilson, Rodríguez-Acelas Alba Luz. Nursing Outcomes and Social Support Intervention for Diabetes Self-management: Consensus Study. Revista Cuidarte. 2024;15(3):e3742. https://doi.org/10.15649/cuidarte.3742

Efficacy of the Simulation-Based Education Approach Enhanced by Music on Anxiety, Physical Activity, and Respiratory Outcomes in Patients under Open Heart Surgery: A Randomized Three-Group Clinical Study.

Many patients with advanced cardiovascular disease need Coronary Artery Bypass Graft (CABG) surgery, indicating the importance of cardiac rehabilitation. Our study explored the combined efficacy of simulation (using demonstration and return-demonstration approach) with music on post-Open Heart Surgery (OHS) outcomes. This randomized, controlled trial was conducted at Imam Reza Hospital, Mashhad, Iran, on 90 patients awaiting OHS. The participants were allocated to 3 groups: education via simulation, education via simulation enhanced by instrumental music, and conventional instruction. Evaluations were performed pre-education and 2-days post-surgery using the activity measure for post-acute care (AM-PAC) "6-Clicks" Questionnaire, 18-item Nursing Outcomes Classification (NOC) index, and State-Trait Anxiety Inventory (STAI). JASP software (JASP Team, 2023, Version 0.17.3) was employed for statistical analyses, using RM-ANOVA and ANCOVA test. The results revealed a significant effect in immediate post-intervention and 2-day follow-up periods across all outcome measures (all p < 0.05), except for activity. Post hoc tests demonstrated substantial variations in effect sizes between intervention and control groups. Both intervention groups had significantly greater impact than the control group, particularly the composite group, showing heightened effects in state and trait anxiety and respiratory scores (p < 0.05). The combined use of the simulation with rhythmic music in phase one cardiac rehabilitation notably improved post-surgical outcomes, outperforming the method without music. This approach shows promise as an effective instructional strategy in cardiac rehabilitation stages.

Determining awareness of and readiness for standardized nursing languages in a mid-level midwestern hospital and associated school of nursing.

The purpose of this study was to examine knowledge, attitude, and barriers toward care planning documentation practices with standardized nursing languages (SNLs) of nurses and nursing students at a midwestern healthcare system, comparing student and nurse responses. Cross-sectional surveys were given over a 2-month period with nurses and nursing students at different sites in a midwestern healthcare system, using convenience sampling. The Knowledge, Attitude, and Barriers to Using Standardized Nursing Languages and Current Practices Survey was adapted for use and re-tested for validity/reliability (Content Validity Index 0.81-1.00; Cronbach alpha=0.82-0.99) with 28 Likert scale items measuring knowledge, attitude, and barriers. Descriptive statistics, composite scores, correlations, t-tests, and multiple regression were used to analyze the concepts of the tool. 134/400 RNs responded (34%); 109/116 students responded (93.9%). Data analyses indicate adequate to superior levels of knowledge related to SNLs and NANDA International, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC), collectively referred to as NNN (NANDA, NIC, & NOC), positive attitudes toward SNLs/NNN and for adopting SNLs/NNN into documentation practices, but moderate to great barriers for implementation in practice. Barriers included lack of financial resources for change, lack of mentors, and lack of mandates to use SNLs. Students scored significantly higher than nurses in attitude only. Perceptions of nurses and student nurses for current documentation indicate awareness of inadequacy in existing systems and willingness to change existing systems for standardized languages, with perceived barriers to change/implementation of SNLs. Students were more positive about SNLs than nurses. Major implications for nursing are to reevaluate electronic documentation systems and determine how to insert and easily apply SNLs in these systems, such that nursing care documentation is standardized, interoperable, effective, time-saving, and attainable.

Evaluating the knowledge of pain management and the impact of PASHA (Pain Assessment Stimulation and Healing Application) on pain intensity among Indonesian adolescents

Background: Effective pain management for adolescents is essential because it significantly affects their quality of life and can prevent the development of chronic pain. Although there have been advancements in this field, managing pain effectively remains challenging, highlighting the need for innovative approaches that combine technology with clinical practice. Objective: This study aimed to assess adolescents’ pain management knowledge and evaluate the effectiveness of the PASHA (Pain Assessment Stimulation and Healing Application) in reducing pain intensity among adolescents. Methods: A combination of a cross-sectional design (N = 461) and one group pretest-posttest approach (N = 60) were employed in a Junior High School at Bukittinggi, West Sumatera, Indonesia. Data were collected from June to August 2022 using the Nursing Outcomes Classification (NOC) to assess pain management knowledge and the Numeric Rating Scale (NRS) to measure pain intensity. The intervention involved using the PASHA application for three days, with pain intensity assessed before and after. Descriptive statistics and Paired t-test were used for data analysis. Results: Headaches were the most prevalent pain type among adolescents (60.5%). Many adolescents lacked adequate knowledge about pain management (57.7%) and self-medication practices (49.2%). Massage/acupressure therapy was the most recognized pain management strategy (39.1%), while aromatherapy was the least known (4.8%). The PASHA application significantly reduced pain intensity (Mean difference = 0.567, p &lt;0.001). Conclusion: Adolescents had moderate knowledge gaps in pain management, particularly in chronic pain and non-pharmacological strategies. The PASHA application effectively reduced pain intensity, suggesting its potential to enhance pain management outcomes. Future research is necessary to validate the findings.

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.

Pain Management on Elderly People: Caregivers Readiness on Managing Pain at Home

&lt;p&gt;&lt;strong&gt;Background&lt;/strong&gt;: The diseases that appear in the elderly tend to create excessive and chronic pain with the prevalence of pain occurs in people over 65 years of age. Families as caregivers have to pay more attention to the condition of the elderly so that they need readiness and skills on managing pain at home. Caring on the elderly was very complex and requires patience, including in pain treatment. This study was to overview the family readiness on managing pain for the elderly people.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods&lt;/strong&gt;: This study used an analytic descriptive design with a sample of 98 caregivers who cared for the elderly with pain at home. The research instrument used the &lt;em&gt;Nursing Outcomes Classification&lt;/em&gt; on a 5-likert scale which asked about family readiness in caring for the family. Data analyzed by using descriptive frequency analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results&lt;/strong&gt;: A total of 53 people (54.1%) caregivers stated that they were not prepared to care for elderly people with pain at home. It was explained that caregivers mostly stated that they did not know about the disease process of elderly pain and the recommended treatment procedures on managing the pain (each mean of 1.923 and 2.000). Meanwhile, caregivers generally accepted the condition as taking on the role of home care (mean: 3.317).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;It was concluded that caregivers tended to not have the readiness in taking care of elderly pain at home. It is expected that caregivers can increase knowledge about pain management and be ready to provide home care to the elderly.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Keywords&lt;/strong&gt;: Pain management, caregivers, readiness, elderly, home&lt;/p&gt;

Validation of the Health Index in the Postoperative Period: Use of the Nursing Outcome Classification to Determine the Health Level.

The postoperative period is the recovery time after surgery and is defined as an individual process whose purpose is to return the person to the state of normality and integrity that they had prior to surgery. Demonstrate the modification of the level of health of people in the early postoperative period through the development and validation of the Health Index Instrument, which is built from the Nursing Outcomes Classification (NOC) standardized language. The design used a mixed method, which involved a first phase of instrument development and a second phase of instrument validation. The methods was based on focus group techniques with text analysis techniques, internal validation with a group of care language experts, external validation with a group of clinical nursing experts and a clinical validation with quantitative and qualitative analysis. A panel of experts in Language of Care evaluated the (NOC) labels and their correlation with the 11 Health Variables to construct the instrument. The instrument developed was subjected to external validation with a panel of clinical nurse experts in post-anesthesia care. The clinical validation included a cross-sectional descriptive study in a postoperative unit. The final sample of the cross-sectional descriptive study was 139 cases. Of the 89 NOCs proposed in the preliminary construction phase of the instrument, 36 passed through the first round. Of those 36 NOCs, 25 passed through to the second round with a review performance and 11 directly as approved. The total number of approved NOCs were 4. The results of the research show that there are changes in the global score of the health level and in each health variable. It is observed that there was a significant increase in the scores of the health variables at admission and discharge (p < 0.001). The results of the data analysis show that six groups present a similar pattern of evolution of the health variables. A correlation was found between the time of stay in the unit with the scores obtained in the health variables, the physical functioning, comfort status and the presence of symptoms being particularly significant.

Using interoperable nursing care data to improve outcomes for multiple traumas patients with Impaired Physical Mobility.

To demonstrate how interoperable nursing care data can be used by nurses to create a more holistic understanding of the healthcare needs of multiple traumas patients with Impaired Physical Mobility. By proposing and validating linkages for the nursing diagnosis of Impaired Physical Mobility in multiple trauma patients by mapping to the Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC) equivalent terms using free-text nursing documentation. A descriptive cross-sectional design, combining quantitative analysis of interoperable data sets and the Kappa's coefficient score with qualitative insights from cross-mapping methodology and nursing professionals' consensus. Cross-mapping methodology was conducted in a Brazilian Level 1 Trauma Center using de-identified records of adult patients with a confirmed medical diagnosis of multiple traumas and Impaired Physical Mobility (a nursing diagnosis). The hospital nursing free-text records were mapped to NANDA-I, NIC, NOC and NNN linkages were identified. The data records were retrieved for admissions from September to October 2020 and involved medical and nursing records. Three expert nurses evaluated the cross-mapping and linkage results using a 4-point Likert-type scale and Kappa's coefficient. The de-identified records of 44 patients were evaluated and then were mapped to three NOCs related to nurses care planning: (0001) Endurance; (0204) Immobility Consequences: Physiological, and (0208) Mobility and 13 interventions and 32 interrelated activities: (6486) Environmental Management: Safety; (0840) Positioning; (3200) Aspiration Precautions; (1400) Pain Management; (0940) Traction/Immobilization Care; (3540) Pressure Ulcer Prevention; (3584) Skincare: Topical Treatment; (1100) Nutrition Management; (3660) Wound Care; (1804) Self-Care Assistance: Toileting; (1801) Self-Care Assistance: Bathing/Hygiene; (4130) Fluid Monitoring; and (4200) Intravenous Therapy. The final version of the constructed NNN Linkages identified 37 NOCs and 41 NICs. These valid NNN linkages for patients with multiple traumas can serve as a valuable resource that enables nurses, who face multiple time constraints, to make informed decisions efficiently. This approach of using evidence-based linkages like the one developed in this research holds high potential for improving patient's safety and outcomes. In this study, there was no direct involvement of patients, service users, caregivers or public members in the design, conduct, analysis and interpretation of data or preparation of the manuscript. The study focused solely on analysing existing de-identified medical and nursing records to propose and validate linkages for nursing diagnoses.

The use of standardized nursing languages in electronic medical records: an exploratory study on opportunities, limitations, and strategies

Standardized nursing languages (SNLs) have found increasing application in electronic medical records in recent years. In Italy their use is still uneven and accompanied by a silent debate between positions 'against' and 'for' their use. To render visible the debate regarding SNLs in Italy, and the strategies to consider when digitized records are based on a SNL. Data has been collected through audio-recorded semi-structured interviews, selecting three Italian nursing professors, four managers representing Italian healthcare settings that used a SNT and a representative of the Central committee of the National federation of orders of nursing professions. The thematic approach was used to analyze the data. Participants reported having introduced digitized records based on nursing diagnoses, integrated with the Nursing Interventions Classification System and Nursing Outcome Classification, Clinical Care Classification System, Nursing Sensitive Outcomes or mixed models. Divergent aspects emerge regarding: (1) using nursing languages vs a common language to other healthcare professions; (2) planning care vs enhancing clinical reasoning; (3) measuring nursing care vs accepting the variability of the practice, and (4) making documentation efficient vs dedicating more time. Some convergences have emerged and a set of indications for introducing electronic records when based on standardized languages. The introduction of electronic documentation requires the use of homogeneous languages. The debate on the potential and limits of SNL is still open and requires reflection among researchers, trainers, clinicians, and coordinators/managers of nursing care regarding the choices to be made which may have long-term effects on many nurses.

The data analysis of the functional health patterns model for nursing care plans

ABSTRACT Introduction: Clinical practices constitute an important part of nursing education and students are expected to gain the ability to plan patient care during nursing education. Aim: It aimed to construct North American Nursing Diagnosis Association (NANDA) nursing diagnoses in nursing students’ patient care plans according to the Functional Health Patterns model and to evaluate them according to the Nursing Intervention Classification (NIC) and Nursing Outcomes Classification (NOC) classification systems. Methods: The descriptive study's population included 198 second-year nursing students from a university. Students' care plans were used as a data gathering form, and 176 care plans were included in the research. The data was gathered from functional health patterns, NIC, and NOC system questionnaires. Results: Nursing diagnoses were listed as infection risk (88.6%), fall risk (79.5%), and bleeding (56.8%). Nursing diagnoses belonging to sexuality-reproductive, coping-stress tolerance, and value-belief sub-categories of functional health patterns could not be reached from the care plans. Conclusion: There is a need for classification methods to objectively evaluate nursing practices, make quantifiable contributions to care, and improve the profession's scientific underpinnings. It is hoped that evidence-based care can be provided by raising pupils' knowledge of classification systems.

Standardizing nursing data extracted from electronic health records for integration into a statewide clinical data research network

BackgroundCare plans documented by nurses in electronic health records (EHR) are a rich source of data to generate knowledge and measure the impact of nursing care. Unfortunately, there is a lack of integration of these data in clinical data research networks (CDRN) data trusts, due in large part to nursing care being documented with local vocabulary, resulting in non-standardized data. The absence of high-quality nursing care plan data in data trusts limits the investigation of interdisciplinary care aimed at improving patient outcomes. ObjectiveTo map local nursing care plan terms for patients’ problems and goals in the EHR of one large health system to the standardized nursing terminologies (SNTs), NANDA International (NANDA-I), and Nursing Outcomes Classification (NOC). MethodsWe extracted local problems and goals used by nurses to document care plans from two hospitals. After removing duplicates, the terms were independently mapped to NANDA-I and NOC by five mappers. Four nurses who regularly use the local vocabulary validated the mapping. Results83% of local problem terms were mapped to NANDA-I labels and 93% of local goal terms were mapped to NOC labels. The nurses agreed with 95% of the mapping. Local terms not mapped to labels were mapped to the domains or classes of the respective terminologies. ConclusionMapping local vocabularies used by nurses in EHRs to SNTs is a foundational step to making interoperable nursing data available for research and other secondary purposes in large data trusts. This study is the first phase of a larger project building, for the first time, a pipeline to standardize, harmonize, and integrate nursing care plan data from multiple Florida hospitals into the statewide CDRN OneFlorida+ Clinical Research Network data trust.

The Impact of Nurse Education on Patient Safety and Quality Control

In this review we explain the role of nurses in improving healthcare in hospitals and how the interest of nurse education make different in increasing patient safety especially in ICU and in cases of thrombosis, stroke and all dangerous cases need to speed and skill. The role of nurses is as important as the role of doctor as they cable of diagnoses and this role not limited to doctors. The searches have proven that the quality care and patient safety has been highly improved after the nurse education in all over the world. Nursing students need to be taught how to ensure and improve patient safety since nurses play a critical role in enhancing patient safety. Many nursing students contest their competency in patient safety issues, despite the fact that educators have long recognized that undergraduate education is crucial in providing nurses with the patient safety competencies required to practice. Among hospital workers, nurses make up the largest single component. The planning stage of the educational program is where to start when deciding which outcomes to assess. To design a worthwhile educational activity, educators need to be able to precisely pinpoint students' knowledge or skill deficiencies. The Nursing Outcomes Classification (NOC), which is "a comprehensive, standardized classification of patient outcomes developed to evaluate the effects of interventions provided by nurses and other healthcare professionals," can be consulted by nurse educators since education is built upon foundations.

Nursing care plan on gas exchange impairment due to SARS-CoV-2: case report

INTRODUCTION: Over the years, mankind has been in contact with several viruses, which have threatened human existence by becoming pandemics such as influenza in 1918. However, in January 2020, the Chinese Centre for Disease Control and Prevention identified SARS-CoV-2 as the etiological agent of the 2019 coronavirus. So far it is known that 5% of patients with severe COVID-19 will require attention in intensive care units. To this end, critical care nursing staff use the nursing care process to prioritize the care of the critically ill patient. OBJECTIVE: To develop a nursing care plan by analyzing a clinical case of an adult patient with a diagnosis of COVID-19. METHODOLOGY: The case of a patient with a diagnosis of COVID-19 was analyzed to develop a nursing care process using the taxonomies of the North American Nursing Diagnosis Association, Nursing Interventions Classification and Nursing Outcomes Classification. Documentary research was carried out through a literature search in databases such as: Scielo, Medicgraphic, Google Scholar and PubMed. RESULTS: Three real nursing diagnoses and seven risk diagnoses were identified. The priority nursing diagnostic label based on Maslow's pyramid of needs was deterioration of related gas exchange. CONCLUSIONS: The critical care nurse takes a leading role in the care of patients with a diagnosis of COVID-19, the development of the nursing care process contributes to providing quality care focused on the well-being of the user.

Validation of Nursing Outcome Indicators in Patients with Postsurgical Delirium.

To validate the content of the indicators proposed from the Nursing Outcome Classification in a care plan for delirium management in older adults. Content validity study, conducted under the expert judgment technique. The procedure was developed in five moments: organization of indicators that respond to the nursing outcome classification for delirium management, support with literature of the indicators that responds to the result, selection of experts, establishment of agreements, and discussion. Quality criteria evaluated: pertinence and relevance, the Content Validity Coefficient and average scores assigned by the experts were calculated. The study had the participation of 14 experts. The indicators, according to criteria of pertinence and relevance evaluated by experts showed a global average content index value of 0.93; 97.05% (66) of the indicators had Content Validity Coefficient > 0.75. The quantitative findings of the indicator validation process showed high relevance and pertinence index, which favors their being applied to measure care changes in patients with delirium.

Resilience in Older People: A Concept Analysis.

(1) Background: Resilience has been presented as a potential protective factor to be promoted in difficult experiences in older people. However, further clarification of the concept of resilience for this population is required, as this is of critical interest for nursing care. (2) Aim: To develop the concept of resilience in older people to establish the elements that refer to the nursing outcome. Personal resilience (1309) from the Nursing Outcomes Classification (NOC), specifically in older people. (3) Methods: Concept analysis using Beth Rodgers' evolutionary model. The attributes, antecedents, consequents, and empirical elements were described in the integrative review, with searches in PubMed, CINAHL, PsycINFO, LILACS, and Embase databases. A total of 2431 citations have been identified, and 110 studies were included. (4) Results: The concept of "resilience in older people" is composed of two attributes, available resources and positive behaviors, and is defined as positive attitudes of older people with the assistance of resources available from experiences of adversity. Conclusion: This analysis and concept development of resilience in older people provided sensitive indicators for nursing care in the context of adversity, considering available resources and with positive attitudes during this phase of life span.

Reduction of patients' bed rest time after percutaneous renal biopsy evaluated by the Nursing Outcomes Classification: Randomized clinical trial.

To evaluate the reduction of patients' bed rest time after percutaneous renal biopsy (PRB) from 24 to 8h using the Nursing Outcomes Classification (NOC). This was a randomized clinical trial registered with Clinical Trials number NCT04629235. The sample comprised 16 patients in the intervention group and 18 in the control group. In the intervention group, the rest time was modified to 8h, and afterward, the patients were released to ambulate, whereas the control patients remained at absolute rest for 24h after PRB according to institutional protocol. All patients were observed for 24h and evaluated at five time points with the outcomes and indicators of the NOC: before the biopsy, immediately after, at the 8th hour, at the 12th hour, and at the 24th hour after the procedure. In the 170 evaluations performed, statistically significant differences were identified in the outcome Comfort status: physical and the indicators "physical well-being and comfortable position." None of the complications were related to reduced bed rest time. Reducing patients' bed rest time from 24 to 8h did not increase complications from PRB, and using the NOC provided a standardized and reliable assessment. Important evidence was identified for patient care after PRB, demonstrating the positive impact on patient comfort and the possibility of reducing costs to the institution and the workload of the multidisciplinary team. In addition, these findings may contribute to strengthening the use of NOC in clinical practice, teaching, and research.

Effectiveness of a Standardized Nursing Process Using NANDA International, Nursing Interventions Classification and Nursing Outcome Classification Terminologies: A Systematic Review.

The decision-making in clinical nursing, regarding diagnoses, interventions and outcomes, can be assessed using standardized language systems such as NANDA International, the Nursing Interventions Classification and the Nursing Outcome Classification; these taxonomies are the most commonly used by nurses in informatized clinical records. The purpose of this review is to synthesize the evidence on the effectiveness of the nursing process with standardized terminology using the NANDA International, the Nursing Interventions Classification and the Nursing Outcome Classification in care practice to assess the association between the presence of the related/risk factors and the clinical decision-making about nursing diagnosis, assessing the effectiveness of nursing interventions and health outcomes, and increasing people's satisfaction. A systematic review was carried out in Medline and PreMedline (OvidSP), Embase (Embase-Elsevier), The Cochrane Library (Wiley), CINAHL (EbscoHOST), SCI-EXPANDED, SSCI and Scielo (WOS), LILACS (Health Virtual Library) and SCOPUS (SCOPUS-Elsevier) and included randomized clinical trials as well as quasi-experimental, cohort and case-control studies. Selection and critical appraisal were conducted by two independent reviewers. The certainty of the evidence was assessed with the Grading of Recommendations Assessment, Development and Evaluation Methodology. A total of 17 studies were included with variability in the level and certainty of evidence. According to the outcomes, 6 studies assessed diagnostic decision-making and 11 assessed improvements in individual health outcomes. No studies assessed improvements in intervention effectiveness or population satisfaction. There is a need to increase studies with rigorous methodologies that address clinical decision-making about nursing diagnoses using NANDA International and individuals' health outcomes using the Nursing Interventions Classification and the Nursing Outcome Classification as well as implementing studies that assess the use of these terminologies for improvements in the effectiveness of nurses' interventions and population satisfaction with the nursing process.

Validation of Nursing Outcomes Classification: Knowledge and Self-management for Cardiac Disease.

The Nursing Outcomes Classification provides two outcomes, Knowledge: Cardiac Disease and Self-management: Cardiac Disease, to assess knowledge and self-management behaviors of adults with cardiac disease. The purpose of this study was to validate the two nursing-sensitive outcomes to establish content validity. A methodological design was used using the Delphi technique. A total of 13 nurse experts in two domains participated in this study: five in standardized nursing terminologies and eight in self-management. Descriptive statistics and the Nurse-Patient Outcome Content Validity method were used to validate four aspects: definition adequacy of each outcome, clinical usefulness of measurement scales, importance of outcome indicators, and content similarity between the two outcomes. The definition adequacy, clinical usefulness, and content similarity of both outcomes were acceptable. A total of 81 indicators from the two outcomes were validated, and 60 were designated as critical. Nurses can evaluate cardiac patient outcomes effectively and accurately using these validated outcomes. The validated Nursing Outcomes Classification outcomes will also support the clinical decision-making of nursing students when they learn about patients with cardiac disease.

Development and content validation of an NOC-based instrument for measuring knowledge and self-care behaviors in hypertensive disorders of pregnancy: CoNOCiTHE.

The aim of this study is to design and validate the content of an instrument based on the Nursing Outcomes Classification (NOC) "Knowledge: disease process" and "Risk control: hypertension" to measure pregnant women's knowledge and self-care behaviors about hypertensive disorders. The study was carried out in three phases: (a) content validity of the indicators, (b) construction, and (c) content validity of the instrument. The instrument contains 72 items with an average content validity ratio and representativeness of 0.92. The items that did not reach the established values were eliminated or reformulated according to the observations made by the experts. This study provides the first instrument for perinatal maternal care designed from the NOC that has demonstrated adequate content validity and representativeness of the NOCs on which it is based. The next phase in the development of the instrument is to test its validity and reliability. CoNOCiTHE is a tool that can be useful in assessing pregnant women's knowledge and self-care behaviors about hypertensive disorders, contributing to the documentation and quality of maternal perinatal nursing care.