Nursing Outcomes Classification Outcomes Research Articles

Intensive nurse-led follow-up in primary care to improve self-management and compliance behaviour after myocardial infarction.

To assess the effects of intensive follow-up by primary care nurses on cardiovascular disease self-management and compliance behaviours after myocardial infarction. Although cardiovascular disease prevention and cardiac rehabilitation take place in hospital settings, a nurse-led approach is necessary in primary care during the first few months after a myocardial infarction. Therefore, it is important to assess self-management of cardiovascular disease and levels of compliance with the prescribed diet, physical activity, and medication. The study used a multicentre, quasi-experimental, pre-post design without a control group. Patients with acute coronary syndrome from 40 healthcare facilities were included in the study. A total of 212 patients participated in a programme including 11 interventions during the first 12-18 months after myocardial infarction. The following Nursing Outcomes Classification (NOC) outcomes were assessed at baseline and at the end of the intervention: Self-management: Cardiac Disease (1617) and Compliance Behaviour: Prescribed Diet (1622), Compliance Behaviour: Prescribed Activity (1632), and Compliance Behaviour: Prescribed Medication (1623). Marjory Gordon's functional health patterns and a self-care notebook were used in each intervention. Pre-post intervention means were compared using Student's t-tests for related samples. The results of the study are reported in compliance with the TREND Statement. A total of 132 patients completed the intervention. The indicators for each NOC outcome and the variations in scores before and after the intensive follow-up showed a statistically significant improvement (p-value = 0.000). Compliance Behaviour: Prescribed Diet (pre = 3.7; post = 4.1); Compliance Behaviour: Prescribed Activity (pre = 3.9; post = 4.3); Compliance Behaviour: Prescribed Medication (pre = 3.9; post = 4.7). Intensive, immediate follow-up after myocardial infarction improves compliance behaviours and self-management of heart disease. A combined self-care and family care approach should be encouraged to empower post-myocardial infarction patients. To facilitate patients' self-efficacy, the use of health education tools such as a cardiovascular self-care notebook can also be helpful. This study highlights the benefits of intensive, protocolised, comprehensive patient follow-up in primary care during the first few months after an acute myocardial infarction (AMI). Primary care nurses train patients in cardiovascular self-care. Patients were not involved in either the design or the carrying out of the study. However, at the end of the study, they participated in an evaluation process about the utility of the research study and their satisfaction with it. This process was carried out using an ad hoc survey consisting of 10 questions assessing the nursing care and follow-up inputs that were received.

Nursing Diagnoses, Planned Outcomes and Associated Interventions with Highly Complex Chronic Patients in Primary Care Settings: An Observational Study.

The information logged by nurses on electronic health records (EHRs) using standardised nursing languages can help us identify the characteristics of highly complex chronic patients (HCCP) by focusing on care in terms of patients' health needs. The aim of this study was to describe the profile of HCCPs using EHRs from primary care (PC) facilities, presenting patients' characteristics, functional status based on health patterns, NANDA-I nursing diagnoses, health goals based on Nursing Outcomes Classification (NOC), and care interventions using Nursing Interventions Classification (NIC). With an observational, descriptive, cross-sectional, epidemiological study design, this study was carried out with a sample of 51,374 individuals. The variables were grouped into sociodemographic variables, clinical variables, resources, functional status (health patterns), nursing diagnoses, outcomes, and interventions. A total of 57.4% of the participants were women, with a mean age of 73.3 (12.2), and 51% were frail or dependent. Prevalent conditions included high blood pressure (87.2%), hyperlipidaemia (80%), osteoarthritis (67.8%), and diabetes (56.1%). The participants were frequent users of healthcare services, with 12.1% admitted to hospital in the past year. Some 49.2% had one to four health patterns assessed, with more information on biological and functional aspects than on psychosocial aspects. The mean number of nursing diagnoses was 7.3 (5.2), NOC outcomes 5.1 (4.1), and NIC interventions 8.1 (6.9). Moderately and highly significant differences were observed between dysfunction in physical activity/exercise health pattern and age group, and between dysfunction in other health patterns and classification as a frail or dependent elderly person. Regarding the presence of certain nursing diagnoses, significant differences were observed by age group, classification of elderly person status, and presence of diseases. A total of 20 NIC interventions showed moderately or relatively strong associations for older age groups, higher levels of dependency, and chronic health conditions.

Use of the Nursing Outcomes Classification (NOC) to measure perceived knowledge about the control of SARS-CoV-2 infection: The impact of a training program in primary healthcare professionals.

To analyze the impact of an online training intervention on primary healthcare professionals in Tenerife (Canary Islands, Spain), evaluating the perceived knowledge about prevention and control of SARS-CoV-2 infection using the NOC outcome "Knowledge: Infection management" [1842]. Quasi-experimental design with prepost analysis of 12 indicators. The participants were the 705 primary healthcare professionals, both healthcare professionals and nonhealthcare professionals, who completed the online training program prepared and implemented by nurses in the teaching and research fields between May and July 2020. The change in the perceived level of knowledge before and after, as well as other associations between this knowledge and the other variables included in the study, were confirmed. The results of the study describe significant differences in the change between pre- and posttraining for all indicators included in the comparison. This research shows the effectiveness of an online training program, appropriate for the need for social distancing required by the pandemic, in improving the knowledge of primary healthcare professionals about prevention and control of COVID-19. It also describes a new context for the use of the Nursing Outcomes Classification (NOC) through a training program organized and led by nurses. Our results suggest that the NOC classification is useful for assessing perceived knowledge about prevention and control of SARS-CoV-2 infection in the community among primary healthcare professionals. This study also provides evidence of the effectiveness of a nurse-led, nurse-designed online training intervention. To this end, the outcome criterion "Knowledge: Infection management" [1842] was used and its 12 original indicators were operationally defined. Overall, this study proposes a useful new framework for the NOC taxonomy, which, in addition to being intended for the assessment of outcomes among patients, families, and communities, is versatile enough to assess knowledge outcomes among professionals as well.

NANDA-I, NOC, and NIC linkages to SARS-CoV-2 (COVID-19): Part 3. Family response.

PurposeTo provide guidance to nurses caring for families with COVID‐19, we developed linkages using interoperable standardized nursing terminologies: NANDA International (NANDA‐I) nursing diagnoses, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC). In addition, we wanted to identify gaps in the terminologies and potential new nursing diagnoses, outcomes, and interventions for future development related to nurse roles in family care during a pandemic.MethodsUsing a consensus process, seven nurse experts created the linkages focused on families during the COVID‐19 pandemic using the following steps: (1) creating an initial list of potential nursing diagnoses, (2) selecting and categorizing outcomes that aligned with all components of each nursing diagnosis selected, and (3) identifying relevant nursing interventions.FindingsWe identified a total of seven NANDA‐I nursing diagnoses as the basis for the linkage work. These are distributed in three NANDA‐I Domains and based in the psychosocial dimension of the Nursing Care in Response to Pandemics model. Eighty‐nine different NOC outcomes were identified to guide care based on the nursing diagnoses, and 54 different NIC interventions were suggested as possible interventions. Fifteen new proposed concepts were identified for future development across the three classifications.ConclusionsThe linkages of nursing diagnoses, outcomes, and interventions provide a guide to enhance nursing practice and care documentation that could quantify the impact of nursing care to patient outcomes for families at risk for or infected by COVID‐19.Implications for Nursing PracticeNANDA‐I, NOC, and NIC linkages identified in this paper provide resources to support clinical decisions and guide critical thinking for nurses encountering care needs of families with COVID‐19. Documentation of these linkages provides data that can create new knowledge to enhance the care of families impacted by COVID‐19.

Content validation of the nursing outcome Knowledge Heart Failure Management: Brazilian nurses' opinions.

To estimate the content validity of the outcome Knowledge: Heart Failure Management (1835) of the Nursing Outcomes Classification (NOC). A methodological study conducted in Brazil with nurses with expertise in cardiovascular nursing and nursing process. The nurse experts evaluated the relevance of the indicators for the nursing outcome on a 5-point Likert scale. A total of 55 indicators were analyzed, including 50 NOC indicators, four indicators located from a scoping review, and one suggested by an expert during the content validation process. The relevance ratio supported the categorization of indicators as critical, supplemental, or unnecessary. Relevance ratios of critical and supplemental indicators were summed and divided by the total number of the indicators to calculate the outcome content validity (OCV) score of the nursing outcome. Fifteen nurse experts, mostly females (n = 13) with a mean age of 36.0±6.3years, 13.9±6.5 years of professional experience, and extensive use of the nursing process in their clinical practice (n = 10), teaching (n = 13), and research (n = 11), participated in this study. Regarding the content validation, 43 (78.2%) out of 55 indicators were categorized as critical (relevance ratio .80-.98), 11 (20%) as supplemental (relevance ratio .67-.79), and one indicator (1.8%) was categorized as unnecessary (relevance ratio .48). The OCV score of the nursing outcome was .87. The study provided evidence of content validity of 49 indicators of the NOC outcome, Knowledge: Heart Failure Management, and five new indicators identified through the validation process based on nurse experts' opinions. These findings provide evidence-based indicators for the measurement of heart failure patients' knowledge about disease management. As a result, nurses can test the effectiveness of nursing interventions based on valid outcome indicators.

NANDA-I, NOC, and NIC linkages to SARS-CoV-2 (COVID-19): Part 2. Individual response.

To provide guidance to nurses caring for individuals with COVID-19, we developed linkages using interoperable standardized nursing terminologies: NANDA International (NANDA-I) nursing diagnoses, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC). We also identified potential new NANDA-I nursing diagnoses, NOC outcomes, and NIC interventions for future development related to nurses' role during a pandemic. Using a consensus process, seven nurse experts created the linkages for individuals during the COVID 19 pandemic using the following steps: (a) creating an initial list of potential nursing diagnoses, (b) selecting and categorizing outcomes that aligned with all components of each nursing diagnosis selected, and (c) identifying relevant nursing interventions. A total of 16 NANDA-I nursing diagnoses were identified as the foundation for the linkage work, organized in two dimensions, physiological and psychosocial. A total of 171 different NOC outcomes were identified to guide care based on the nursing diagnoses and 96 NIC interventions were identified as suggested interventions. A total of 13 proposed concepts were identified for potential future development across the three classifications. The linkages of nursing diagnoses, outcomes, and interventions developed in this article provide a guide to enhance nursing practice and determine the effectiveness of nurses' contribution to patient outcomes for individuals at risk for or infected by COVID-19. NANDA-I, NOC, and NIC linkages identified in this paper are an important example of the value of using standardized nursing terminologies to guide and document nursing care. When included in electronic health record databases and used widely, the data generated from the care plans can be used to create new knowledge about how to better improve outcomes for patients with COVID-19.

Fall prevention in hospitalized patients: Evaluation through the nursing outcomes classification/NOC

ObjectiveTo evaluate the nursing outcomes of hospitalized patients at high risk for falls through NOC and correlate NOC outcomes called Knowledge: Fall Prevention and Fall Prevention Behavior with patients' sociodemographic and clinical variables. BackgroundFalls represent one of the major safety incidents in the hospital setting. The role of nursing is fundamental in preventing these events, from risk assessment to outcome evaluation. One of the strategies for evaluating nursing outcomes is the use of Nursing Outcomes Classification (NOC). MethodsA cross-sectional study conducted with a sample of 68 adult patients at high risk for falls admitted to clinical and surgical units. The patients received three evaluations. Data collect was prospective with an instrument containing five results and 28 NOC indicators. Descriptive and analytical analysis considered the NOC 5-point Likert scale. ResultsEvaluation of the Knowledge: Fall Prevention and Fall Prevention Behavior outcomes showed that patients have a limited level of knowledge and rarely demonstrated preventive behavior. Vital Signs (0802), Medication Response (2301) and Safe Health Care Environment (1934) pointed to the existence of adequate patient monitoring and safe environment. ConclusionThe evaluation of patient outcomes supported by a standardized classification system such as the NOC highlights the patient's clinical evolution and produces data that support the planning of care and management interventions, providing more effective and safer practices.

Results of the Nursing Outcomes Classification/NOC for patients with obsessive-compulsive disorder.

To analyze the application of nursing outcomes and indicators selected from the Nursing Outcomes Classification (NOC) to evaluate patients with obsessive-compulsive disorder (OCD) in outpatient follow-up. Outcome-based research. First, a consensus was achieved between nurses specialized in mental health (MH) and in the nursing process to select NOC-related outcomes and indicators, followed by the elaboration of their conceptual and operational definitions. Then, an instrument was created with these, which was tested in a pilot group of six patients treated at a MH outpatient clinic. The instrument was applied to patients with OCD undergoing Group Cognitive Behavioral Therapy (GCBT). The study was approved by the Research Ethics Committee of the institution. Four NOC outcomes and 17 indicators were selected. There was a significant change in the scores of nine indicators after CBGT. The study showed feasibility for evaluating symptoms of patients with OCD through NOC outcomes and indicators in an outpatient situation.

Correspondence of nurses' and physiotherapists' records for orthopedic patients with the Nursing Outcomes Classification.

To evaluate the correspondence of the terms found in nurses' and physiotherapists' records for orthopedic patients with the Nursing Outcomes Classification (NOC). A descriptive study carried out in a university hospital in southern Brazil. The sample consisted of 392 records of 49 patients submitted to Total Hip Arthroplasty (THA). Data collection was retrospective in the electronic health record. Data was analyzed and compared with the NOC outcomes using the cross-mapping method. The most prevalent outcomes were the following: Pain Level, Falls Occurrence and Mobility. There was sharing of outcomes between the two categories, except for Falls Occurrence and Respiratory Status. Conclusion: Standardizing nurses' and Physiotherapists' records according to the NOC can improve the quality of the clinical documentation of the outcomes of patients undergoing THA.

Cultural Adaptation and Psychometric Properties Assessment of the NOC Outcome "Cognition" in a Sample of Portuguese Adults With Mental Illness.

Cultural adaptation and psychometric properties assessment of the Nursing Outcomes Classification (NOC) outcome "Cognition" in a sample of Portuguese adults with mental illness. Methodological study. The final European Portuguese version of the NOC outcome "Cognition", consisting of 13 items, showed good psychometric properties. An exploratory factor analysis was performed from which only one factor was established. The European Portuguese version of the NOC outcome "Cognition" seems to gather very satisfactory psychometric properties for assessing cognition in the Portuguese population. This study contributed to advance the nursing body of knowledge and to better assess cognition in a clinical context.

Evaluation of Acute Pain in Patients Undergoing Total Hip Arthroplasty: A Cohort Study.

To evaluate pain levels in patients who underwent total hip arthroplasty (THA) using the Nursing Outcomes Classification (NOC). Prospective cohort study conducted in the surgical hospitalization units of a university hospital in southern Brazil. Twenty-four patients were evaluated and followed-up for four consecutive days after THA. A significant difference was found between the first and last evaluations for the outcome pain level (2102). Two indicators also showed statistically significant differences overtime. The NOC outcome and indicators demonstrated the different pain levels of patients who underwent THA. The NOC system is applicable to clinical practice, because it facilitated the follow-up of patient progression.

Measuring Nursing Sensitive Outcomes in Patient with Acute Myocardial Infarction: Tool Development and Validation


 
 
 Context: The outcomes movement is a young science, improving care by determining the outcomes of nursing interventions will give scientific validity to strategies that are used by nursing in a variety of venues. Cardiovascular nurses contribute significantly to health outcomes and frequently assume responsibility for the clinical and organizational processes to ensure positive outcomes for patients and families
 Aims: The aims of this study were to identify nursing-sensitive outcomes in patients with acute myocardial infarction, to develop a tool to measure nursing-sensitive outcomes of caring patients with myocardial infarction, and to evaluate the content, face validity, reliability and nursing sensitivity of 46 nursing sensitive-outcomes concerning bio-psycho-socio- educational aspects of care for patients with myocardial infarction from the Nursing Outcomes Classification (NOC). Methods: A survey research design was used in this study to assess the content and face validity of the designed instrument and inter-rater reliability was utilized to assure its reliability. Thirty patients with acute myocardial infarction subjected to measuring their nursing-sensitive outcomes during their stay in the CCUs or intermediate units. Fifty-nine experts were invited to participate in this study. Nursing-Sensitive Outcomes Measuring Scale was developed and subjected to testing reliability, validity, and sensitivity
 Results: Most of the studied outcomes showed a high degree of consistency as indicated by ICC that was above 0.900. 100% of the experts rated 14 out of 46 outcomes as very important; the remaining outcomes were assessed by more than 75% of the experts as important. Also, 18 out of 46 outcomes were rated by the 100% experts as very sensitive to the contribution of nursing intervention; no one outcome was rated as not important or not sensitive for nursing contribution. Conclusions: The study provided evidence of outcomes content validity, reliability, and nursing sensitivity of the studied outcomes. The study recommended the testing of NOC outcomes in various clinical settings with appropriate training for nurses, and the inclusion of NOC into nursing curricula to utilized in clinical education as a continuum for nursing diagno- ses classification.
 
 

Evaluation of Patients in a Smoking Cessation Support Group Using the Nursing Outcomes Classification.

To evaluate patients in a smoking cessation support group using the Nursing Outcomes Classification (NOC). Prospective observational cohort study conducted with 21 patients participating in a smoking cessation support group. Data were collected using an instrument consisting of 2 NOC outcomes and 20 indicators, applied during each of the six support group meetings. The two NOC outcomes, Smoking Cessation Behavior (1625) and Substance Withdrawal Severity (2108), showed statistically significant differences over time in many of their indicators. The NOC outcomes demonstrated the clinical evolution and behavioral improvement of patients during the smoking cessation process. The findings highlight important elements of the evaluation of behavioral change and severity of withdrawal symptoms.

Use of the Nursing Outcomes Classification for Falls and Fall Prevention by Nurses in South Korea.

To estimate the use of the Nursing Outcomes Classification (NOC) for falls and fall prevention. This cross-sectional, descriptive study enrolled 196 registered nurses in South Korea. Outcome assessments for falls and fall prevention were performed for 30-50% of hospitalized patients. The NOC outcomes related to falls and fall prevention were used more in surgical units than medical units. The performance rates of the outcomes related to falls and fall prevention were not high in hospitalized patients. Strategies should be developed to increase the use of the NOC by nurses for fall prevention. In this way, nurses' contributions to patient outcomes would be recognized and the safety of patients would be enhanced.

Nursing Outcomes for the Evaluation of Patients During Smoking Cessation.

To select outcomes of the Nursing Outcomes Classification (NOC) and develop operational definitions for their indicators in order to evaluate patients during smoking cessation. A consensus study among experts, involving eight nurses. A 100% consensus was required to select the outcomes. Operational definitions were developed based on the literature. Two outcomes were selected, Smoking Cessation Behavior (1625)-with nine indicators, and Substance Withdrawal Severity (2108)-with 11 indicators, for which we developed operational definitions. Consensus allowed the selection of NOC outcomes and indicators, which will allow us to evaluate patients during smoking cessation using a standardized classification. A standardized classification provides a more qualified evaluation of patients during smoking cessation.

Development and Psychometric Evaluation of a Questionnaire Based on the Nursing Outcomes Classification to Determine the Knowledge of Parents on Breast-Feeding: Research Protocol.

To develop and psychometrically evaluate a questionnaire based on the outcome "Knowledge: Breast-feeding" of the Nursing Outcomes Classification (NOC) to determine the knowledge of parents on breast-feeding. The NOC outcome "Knowledge: Breast-feeding" allows for nurses/midwives to assess the efficacy of interventions aimed to improve the knowledge on breast-feeding in parents thought the clinical interview/observation. However, the use of self-administered questionnaires by patients could facilitate its evaluation. Two-phased study: (1) Development of the questionnaire based on experts' opinions; (2) Methodological design to assess its psychometric properties. The availability of tools that enable the determination of the knowledge of patients would facilitate nurses/midwives to set objectives, individualize interventions, and measure their effectiveness.

Applicability of the Nursing Outcomes Classification (NOC) to the evaluation of cancer patients with acute or chronic pain in palliative care

ObjectiveThe aim of this study was to verify the clinical applicability of the Nursing Outcomes Classification (NOC) to the evaluation of cancer patients with a nursing diagnosis of acute or chronic pain in a palliative care unit. MethodA prospective longitudinal study performed on a sample of 13 adult cancer patients in a palliative care unit. Patients were followed for at least 4days. Data were collected with an instrument containing eight nursing outcomes and nineteen NOC indicators. Statistical analysis was performed using generalized estimating equation models. ResultsThe following outcome and indicator scores changed significantly over the course of the study: reported pain and length of pain episodes in the pain level outcome; social relationships in the personal well-being outcome; respirator rate in the vital signs outcome; and describes causal factors in the pain control outcome. ConclusionThe NOC outcomes and indicators included in this study were able to successfully evaluate the clinical evolution of cancer patients in palliative care. These scores proved to be applicable for use in palliative nursing care.

Clinical applicability of nursing outcomes in the evolution of orthopedic patients with Impaired Physical Mobility.

AIM: to evaluate the clinical applicability of outcomes, according to the Nursing Outcomes Classification (NOC) in the evolution of orthopedic patients with Impaired Physical Mobility METHOD: longitudinal study conducted in 2012 in a university hospital, with 21 patients undergoing Total Hip Arthroplasty, evaluated daily by pairs of trained data collectors. Data were collected using an instrument containing five Nursing Outcomes, 16 clinical indicators and a five point Likert scale, and statistically analyzed. RESULTS: The outcomes Body Positioning: self-initiated, Mobility, Knowledge: prescribed activity, and Fall Prevention Behavior presented significant increases in mean scores when comparing the first and final evaluations (p<0.001) and (p=0.035). CONCLUSION: the use of the NOC outcomes makes it possible to demonstrate the clinical progression of orthopedic patients with Impaired Physical Mobility, as well as its applicability in this context.

Systematization of Nursing Care in undergraduate training: the perspective of Complex Thinking.

AIM: to evaluate the clinical applicability of outcomes, according to the Nursing Outcomes Classification (NOC) in the evolution of orthopedic patients with Impaired Physical Mobility METHOD: longitudinal study conducted in 2012 in a university hospital, with 21 patients undergoing Total Hip Arthroplasty, evaluated daily by pairs of trained data collectors. Data were collected using an instrument containing five Nursing Outcomes, 16 clinical indicators and a five point Likert scale, and statistically analyzed. RESULTS: The outcomes Body Positioning: self-initiated, Mobility, Knowledge: prescribed activity, and Fall Prevention Behavior presented significant increases in mean scores when comparing the first and final evaluations (p<0.001) and (p=0.035). CONCLUSION: the use of the NOC outcomes makes it possible to demonstrate the clinical progression of orthopedic patients with Impaired Physical Mobility, as well as its applicability in this context.

Relationships among NANDA-I diagnoses, nursing outcomes classification, and nursing interventions classification by nursing students for patients in medical-surgical units in Korea.

The purpose of this study was to identify NANDA-I, Nursing Outcomes Classification (NOC), and Nursing Interventions Classification (NIC; NNN) linkages used by Korean nursing students during their clinical practice in medical-surgical units. A comparative descriptive research design was used to measure the effects of nursing interventions from 153 nursing students in South Korea. Nursing students selected NNN using a Web-based nursing process documentation system. Data were analyzed by paired t-test. Eighty-two NANDA-I diagnoses, 116 NOC outcomes, and 163 NIC interventions were identified. Statistically significant differences in patients' preintervention and postintervention outcome scores were observed. By determining patient outcomes linked to interventions and how the degree of outcomes change after interventions, the effectiveness of the interventions can be evaluated.