Risk For Impaired Skin Integrity Research Articles

Nursing diagnoses identified in records of hospitalized elderly.

To identify nursing diagnoses (ND) formulated for elderly patients in a quaternary healthcare institution. This was a descriptive cross-sectional study, conducted based on information contained in the records of 112 elderly patients, admitted from January to July 2011, in a public teaching hospital of Belo Horizonte, Minas Gerais (Brazil). 53% of patients were female and were 70 years or older. The most common diseases that led to hospitalization were cardiac (31%), neoplasms (22%), lung (10%) and vascular diseases (10%). Only 44% of the patients had a ND identified. After exclusion of repetitions, 36 different diagnosis labels were identified. The primary ND were: risk for infection (78%), impaired physical mobility (69%), risk for impaired skin integrity (59%), risk for falls (57%), imbalanced nutrition: less than body requirements (57%), risk for unstable blood glucose (51%) and self-care deficit (51%). In this study, the ND were linked to human responses related to the causes of hospitalization. These diagnoses are the basis for planning nursing interventions and provide improved quality of life, independence and preservation of functionality for these people.

Mapping the nursing care with the NIC for patients in risk for pressure ulcer

To identify the nursing care prescribed for patients in risk for pressure ulcer (PU) and to compare those with the Nursing Interventions Classification (NIC) interventions. Cross mapping study conducted in a university hospital. The sample was composed of 219 adult patients hospitalized in clinical and surgical units. The inclusion criteria were: score ≤13 in the Braden Scale and one of the nursing diagnoses, Self-Care deficit syndrome, Impaired physical mobility, Impaired tissue integrity, Impaired skin integrity, Risk for impaired skin integrity. The data were collected retrospectively in a nursing prescription system and statistically analyzed by crossed mapping. It was identified 32 different nursing cares to prevent PU, mapped in 17 different NIC interventions, within them: Skin surveillance, Pressure ulcer prevention and Positioning. The cross mapping showed similarities between the prescribed nursing care and the NIC interventions.

Nursing Diagnosis in Intensive Care Unit

The purpose of this study was to determine intensive care unit nurses diagnostic abilities and diagnoses that they provide. A vignette study was performed. The vignette contained a patient's history, treatment, and signs/symptoms of 18 nursing diagnoses based on NANDA-I as the criterion standard. Turkish intensive care unit nurses (N = 45) stated nursing diagnoses described by patient data in the vignette. The resulting nursing diagnoses were grouped into Gordon's Functional Health Patterns, and descriptive analyses were performed. One-way analysis of variance was used to detect possible differences in diagnostic abilities based on nurses' education levels. Nurses identified 14 nursing diagnoses. Four of the predetermined psychosocial nursing diagnoses were not identified. The highest percentage of diagnoses was risk for impaired skin integrity (62.2%) and impaired oral mucous membrane (60.0%). The lowest number of diagnoses was impaired verbal communication (2.2%). A statistically significant difference was found between the educational level of nurses and their abilities to determine nursing diagnoses (P < .05). The findings are important for nursing education. They demonstrate the need to focus on patients as complete human beings, covering not only biological aspects but also cultural and social values, as well as emotional and spiritual care needs.

Nursing Intervention Classifications (NIC) validated for patients at risk of pressure ulcers

to validate the Nursing Intervention Classifications (NIC) for the diagnosis 'Risk of Impaired Skin Integrity' in patients at risk of pressure ulcers (PU). the sample comprised 16 expert nurses. The data was collected with an instrument about the interventions and their definitions were scored on a Likert scale by the experts. The data was analyzed statistically, using the calculation of weighted averages (WA). The study was approved by the Research Ethics Committee (56/2010). nine interventions were validated as 'priority' (WA ≥0.80), among them Prevention of PU (MP=0.92); 22 as 'suggested' (WA >0.50 and <0.80) and 20 were discarded (WA ≤0.50). the prevention of PU results from the implementation of specific interventions related to the risk factors for development of the lesion, with implications for nursing practice, teaching and research.

Analysis of Standard Nursing Statement Recorded in Electronic Nursing Record (ENR) System in Kidney Transplant Patients

Background and Purpose: The electronic nursing record (ENR), which includes a nursing process is an important data because it is the evidence of nursing care and nursing effect. Standard nursing statement is a template statement used in ENR system in many centers. But the frequency of standard nursing statement in ENR records, were not studied. The purpose of this study is to analyze the frequency of standard nursing statements used on ENR in kidney transplant (KT) patients. Material and methods: The Data were collected by retrospective review of ENR. 218 kidney transplant patients, whose transplantation was performed between Jan. 2010 and Dec. 2010 in a single center were enrolled. The nursing process statements, recorded in ENR system during admission for transplant surgery, were categorized by the International Classification for Nursing Practice (ICNP). This template was based on ICNP. Results: Total 291,674 nursing process statements were collected which means1337 statement per patients during 15days of admission. Diagnosis category was most frequent statement (33.9%). Five nursing diagnoses contents in the order of frequency were: risk for infection(12.55%), acute pain(11.9%), risk for impaired skin integrity(2.36%), ineffective tissue perfusion(1.77%), and deficient knowledge(1.61%). The greater part of nursing action statements were: assess for factor that increased the risk of infection, education and intervention for prevention of infection, and assessment of the pain. Standard nursing statements investigated the frequency of use as follows: standard nursing assessment statements(26.0%), standard nursing diagnosis statements(42.4%), standard nursing plan statements(26.5%), standard nursing intervention statements(36.2%), and standard nursing evaluation statements(21.6%). Discussion and conclusion: The main contents of ENR system in kidney transplant patient were prevention for infection, and pain management. Aside from these nursing care, succinct standardized nursing record guideline is needed specialized to kidney transplant patient. Education and further modification of standardized guidelines for the ideal nursing record, may be helpful in improving the quality of nursing records. This study will help nurses to perform their nursing processes more efficiently.

Nursing diagnoses related to skin: operational definitions

to validate the operational definitions of the defining characteristics and risk factors of the three NANDA International (NANDA-I) nursing diagnoses and to revise these diagnoses' definitions. content validation of nursing diagnosis. 146 defining characteristics and risk factors were identified in the literature in Brazilian and international databases. This was followed by content validation of the definitions of these diagnoses (presented by NANDA-I) and of the operational definitions (developed by the researchers) of the defining characteristics and risk factors, carried out by six expert nurses, regarding relevance, clarity and comprehensiveness. of the 146 defining characteristics and risk factors, 22 were considered redundant and were excluded. The experts proposed changing the definitions of the diagnoses of Impaired Tissue Integrity and Risk for Impaired Skin Integrity. It was possible to identify various defining characteristics and risk factors which are not present in the NANDA-I taxonomy but which are indicated in the literature. the process attained its objective of producing valid operational definitions for defining characteristics and risk factors, which will permit the undertaking of validation studies for these diagnoses. The study's contribution to advancing scientific knowledge consists in its presenting clearer operational definitions for these diagnoses and a higher number of defining characteristics and risk factors, which will assist the nurses in the identification and use of the same with greater accuracy in clinical practice.

Diagnósticos de enfermería en pacientes dados de alta, con enfermedades crónicas, según taxonomía Nanda-I (North American Nursing Diagnosis Association)

The study aims to identify the most frequent nursing diagnoses recorded on discharge reports for patients with chronic diseases. We conducted a cross sectional study on all patients discharged during the retrospective period 2009-2010. Data collection and analysis of variables was done by reviewing discharge reports. The main results identified that the most common diagnoses were impaired physical mobility, anxiety, risk of falls, risk of impaired skin integrity, activity intolerance, risk of constipation, poor knowledge, acute pain and fatigue in the performance the role of caregiver. There is a significant need for care in patients with chronic diseases resulting from the existence of assets that need continuity problems between levels of care.

Clinical profile and nursing diagnosis of patients at risk of pressure ulcers

This cross-sectional study characterizes patients at risk of Pressure Ulcers (PUs) and identifies their corresponding Nursing Diagnoses (NDs). The sample consisted of 219 hospitalizations of adult patients at risk for developing a PU established through the Braden Scale. Data concerning the results of the application of the Braden Scale were retrospectively collected from the patients’ medical files and statistically analyzed. Most patients were elderly women hospitalized for an average of nine days, affected by cancer, cerebrovascular, lung, cardiovascular and metabolic diseases. The most frequent NDs were Risk for infection, Self-care deficit syndrome, Bathing/hygiene self-care deficit, Impaired physical mobility, Imbalanced nutrition: less than body requirements, Ineffective breathing pattern, Impaired tissue integrity, Acute pain, Impaired urinary elimination, Impaired skin integrity, and Risk for impaired skin integrity. We conclude that most NDs are common in clinical nursing practice.

Nursing Diagnoses (NANDA-I) in Hematology-Oncology: A Delphi-Study

To identify NANDA-I diagnoses that are most relevant to hematology-oncology nursing in Europe. In a two-round, electronic, quantitative Delphi study, 28 experts from nine European countries assessed the relevance of NANDA-I diagnoses and health problems. This study identified 64 relevant diagnoses and three health problems. All experts listed 11 diagnoses: "imbalanced nutrition: less than body requirements,""diarrhea,""fatigue,""risk for bleeding,""risk for infection,""impaired oral mucous membrane,""risk for impaired skin integrity,""impaired skin integrity,""hyperthermia,""nausea,""acute pain," and the health problem "pruritis." The "NANDA-I classification 2009-2011" describes, in almost all disease- and treatment-related problems, nursing diagnoses as relevant to the adult patient with hematological malignancy. These diagnoses are therefore recommended.

Diagnósticos de enfermagem para o planejamento da alta de homens prostatectomizados: um estudo preliminar

O câncer de próstata e a hiperplasia prostática benigna são citados como importantes problemas entre a população masculina. O procedimento cirúrgico é uma forma de tratamento, realizado de acordo com o estadiamento da doença e presença de determinadas complicações. Este estudo descritivo objetivou identificar diagnósticos de enfermagem em pacientes prostatectomizados com vistas a oferecer subsídios para a elaboração de planos de cuidados para a alta hospitalar. Foram coletados dados de 8 pacientes, no período de agosto a novembro de 2006. Utilizou-se a taxonomia II da Associação Norte Americana de Diagnósticos de Enfermagem (NANDA-I). Os diagnósticos identificados em todos os pacientes foram: conhecimento deficiente (acerca dos cuidados pós-operatórios e com sonda vesical de demora) risco de volume de líquidos deficiente, risco de lesão, risco de infecção, integridade tissular prejudicada. Menos frequentemente foram identificados: ansiedade risco de baixa auto-estima situacional, disposição para bem-estar espiritual aumentado, mobilidade física prejudicada, recuperação cirúrgica retardada, risco de sentimento de impotência e risco de integridade da pele prejudicada. Os diagnósticos elaborados possibilitaram um detalhamento das condições dos sujeitos, favoreceram a utilização de uma abordagem individualizada, a identificação de importantes necessidades para a alta e puderam oferecer um adequado embasamento para a elaboração de planos de cuidados.

Diagnósticos de enfermagem em idosos de instituição de longa permanência

Objective: To identify the prevalence of nursing diagnoses (ND) in elderly residents of Long Term Institutions for Elderly (LTIE) and assign them to sex and age. Materials and Methods: A retrospective study, with quantitative approach. Data collection from medical records of 71 senior citizens in a LTIE in Porto Alegre. Descriptive and inferential analysis of data through the SPSS 11.5. Results: Of 173 DES NANDA was the prevalence of 34 diagnoses. There was an association between sex and Self-care deficit – bathing / Hygiene (p = 0,037); between age and Self Health Management (p = 0,009), Impaired Locomotion (p = 0,042), Risk for Impaired Skin Integrity (p = 0,008). Conclusions: The NDs identified highlight the need for continuous nursing care and gerontological systematization of care, ensuring full care to the elderly, something inherent in the light of these institutions.

Proceso de cuidados en un paciente con espina bífida. Caso clínico

Spina bifida is a congenital malformation of the lumbar spine. We developed a nursing care plan in a 12-year-old girl with this malformation who attended a special education school. Using Gordon's health patterns, we assessed the patient and identified the following nursing diagnoses: imbalanced nutrition: more than body requirements, urinary incontinence, impaired transfer ability, risk for infection, risk of impaired skin integrity, risk for latex allergy, readiness for enhanced urinary elimination, and readiness for enhanced self-concept. Each nursing diagnosis was individualized, and related factors, risk factors and defining characteristics were identified for each. Likewise, we established the Nursing Outcomes Classification (NOC) outcomes and Nursing Intervention Classification (NIC) interventions, with descriptors and activities, respectively. The use of the nursing process will improve patient care and team work.

Fatores de risco para úlcera de pressão: subsídios para a prevenção

Pressure ulcers is one of the most severe complication in the spinal cord injured patients begin the prevention aspects and the early identification of the risk factors are imperative action for the nursing assistance of these patients. This study evaluated the nursing care plans for these patients that at the time of the study were already included in the rehabilitation program in order to identify the risk factors for the pressure ulcer development by analysing the nursing documentation adapting the Taxonomy of NANDA. Evaluate the nursing procedures proposed to the diagnosis risk for impaired skin integrity. The identified risk factors are referred to the physical alterations determinate by the neurologic lesion, wound's history and initial lesions. The proposed nursing procedures were sixteen (16) that emphasized patient and family's instructions on body cleaning, position on bed and wheel chair based on the diagnosis established.

Wound Assessment and Decision-making Options

The increasing presence of multiple, chronic disease states among critically ill patients compounds care of their acute or traumatic conditions. These patients may be admitted with existing wounds and they may develop impaired skin integrity due to a variety of factors related to their illness and treatment. Whereas maintenance of vital functions is the priority of care, critical care nurses are more frequently faced with the challenges presented by pressure ulcers and various other surgical, traumatic, and vascular wounds. These wounds increase morbidity and mortality and result in higher costs for health care. Education in assessment of risk, pathophysiology, the healing process, comprehensive assessment, and efficient, effective wound management contribute to optimal patient outcomes and cost-effective delivery of care.

The relationships among nursing diagnoses in discharge planning for patients with lung cancer.

An explanatory study was designed to investigate whether nursing diagnoses present at discharge from the hospital accurately describe the complexity of care required in the community. A sample of 196 patients with lung cancer referred to community agencies at discharge was described by types of nursing diagnoses; types of agencies needed and services required; and by age, gender, race, economic status, and hospital length of stay. Using multiple logistic regression, a model for home care referral resulted in four significant predictor diagnoses: altered nutrition: less than body requirements, bathing/hygiene self-care deficit, high risk for infection, and high risk for injury. The model for hospice referral resulted in four significant predictor diagnoses: anticipatory grieving, impaired skin integrity, high risk for impaired skin integrity, and pain. The data suggest that the nursing diagnoses described the discharge planning needs, which predicted the type of agency referral needed.

IATROGENESIS IN THE ELDERLY: Impaired Skin Integrity

Risk factors that contribute to pressure ulcer formation include immobility and inactivity, age, malnutrition, fecal and urinary incontinence, and a decreased level of consciousness. Gerontological nurses should collaborate with other health disciplines (eg, the physician, physical therapist, and dietitian) to plan and provide preventive treatment measures for the elderly person with potential for impaired skin integrity: pressure ulcers. Gerontological nurses must continue the development and refinement of tools with which to predict the degree of risk for impaired skin integrity, as well as use a consistent method of grading pressure ulcers.