Standardized Nursing Care Plans Research Articles

Assessment of Standardized Care Plans for People with Chronic Diseases in Primary Care Settings.

Aging populations are driving a shift in emphasis toward enhancing chronic disease care, reflected in Catalonia's regional plan which prioritizes standardized nursing care plans in primary care settings. To achieve this, the ARES-AP program was established with a focus on harmonizing standards and supporting routine nursing clinical decision-making. This study evaluates nurses' perceptions of ARES-AP's standardized care plans for chronic diseases. A mixed-methods approach based on an ad hoc questionnaire (n = 141) and a focus group (n = 14) was used. Quantitative data were statistically analysed, setting significance at p < 0.05. Qualitative data were explored via content analysis. ARES-AP training was assessed positively. The resources for motivational interviewing and care plans for the most prevalent chronic diseases were rated very positively. This study identified key factors influencing program implementation, including facilitators such as structured information and nursing autonomy, barriers such as resistance to change, motivators such as managerial support, and suggested improvements such as technological improvements and time management strategies. This study identifies areas for improvement in implementing standardized nursing care plans, including additional time, motivation, enhanced IT infrastructure, and collaboration among primary care professionals. It enhances understanding of these plans in primary care, especially in managing chronic diseases in aging populations. Further research should assess the program's long-term impact on chronic patients. This study was not registered.

Effectiveness of Standardized Nursing Care Plan on Nurses’ Usability Regarding Quality Nursing Care in Private Tertiary Care Hospital Lahore

Nursing care entails both an art and a science, involving the provision of tailored patient care based on individual healthcare requirements. The nursing care plan is instrumental, serving as a precise guide for nurses in delivering patient-centered, high-quality care. It functions as a roadmap, enabling nurses to monitor the patient's response to treatment and make necessary adjustments to meet medical needs. Challenges such as excessive workload, absence of policies, inadequate resources, understaffing, and unavailability of assessment forms hinder the effective utilization of nursing care plans Objective: To evaluate the effect of standardized nursing care plan on nurses` usability of nursing process during patient care. Methods: A quasi-experimental study was conducted at a Tertiary Care hospital Lahore Pakistan. A stratified Random sample of n=47 participants intervention group was recruited. A validated questionnaire of Nurses’ usability of standardized nursing care plan consisted of 23 items. Data were analyzed through SPSS version 21. Results: Majority of the participants 44.7% (n=21) were between 26-30 years of age, 46.8% of the participants (n=22) had working experience between 1-4 years, 70.2% (n=33) of them having nursing diploma, 23.4% (n=11) were attained Post RN BSN. A significant difference was found between Nurses` usability scores before and after intervention as evident by p=0.000 with mean and SD of 2.8085+0.79778 and 3.7872+0.41369, respectively. Conclusions: It is evident from results that standardized nursing care plan has a significant effect on nurse’s usability that improve the quality of nursing care in Hospital.

Nursing Care Plan for Patients with Tay-Sachs-A Rare Paediatric Disease.

Tay-Sachs disease is classified as a rare paediatric disease of metabolic origin. It is an autosomal recessive inherited disease. The gene responsible for the disease is known as HEXA, and it is located on chromosome 15(15q23). There is currently no effective treatment for Tay-Sachs disease; hence, it is an incurable disease in which patients do not live for more than five years, meaning that nursing care takes on greater importance to maintain quality of life. The main objective of this work is to develop a specific standard nursing care plan by applying an inductive research method supported by nursing methodology using the NANDA-NIC-NOC taxonomy and validated by the Delphi method. This care plan will improve the knowledge of health professionals on this topic and support future studies on the disease. Following its implementation, the care plan proposed in this study aims to increase the quality of life of patients diagnosed with this disease.

Challenges to sustainability of standardized nursing care plan in selected tertiary health institutions in Nigeria.

The purpose of this study was to assess the challenges to sustainability of standardized nursing care plan in selected tertiary health institutions in Nigeria. Using convergent mixed method design, the qualitative and quantitative data were collected from 427 nurses and nine stakeholders. This was done in one phase with the use of validated questionnaires and in-depth interview guide/key informant interview guide. Data were collected for 5 months and analyzed with SPSS version 25. Qualitative data were analyzed using themes. The explored significant challenges by stakeholders and nurses to sustainability of standardized nursing care plan (SNCP) in all the selected hospitals were inadequate knowledge of standardized nursing languages (SNLs), inadequate staffing, lack of motivation, lack of mandate to use SNLs by the educational system, lack of computers on the wards, weakness of previous training on SNL/SNCP, lack of interest, and high patient load. The study concludes that inadequate knowledge of SNLs and inadequate staff could contribute to non sustainability of SNCP. Nurses should be continuously trained on standardized nursing languages. Staff motivation and increasing the number of staff on the wards would increase the interest of the nursing staff. This will in turn improve the quality of documentation and patient care.

Nursing Care Plan for Patients with Hajdu-Cheney Syndrome.

Hajdu–Cheney syndrome is a rare genetic disease. Its main features include phenotypic variability, age-dependent progression and the presence of acroosteolysis of the distal phalanges and generalized osteoporosis, which have significant disabling potential. Currently, there is no effective curative treatment, so nursing care is essential to ensure the maintenance of the quality of life of these patients. The main objective of this study was to establish a specific standardized nursing care plan using the NANDA–NIC–NOC taxonomy. The application of a care plan as such would improve the quality of life of patients affected by this rare disease, will contribute to increasing healthcare professionals’ knowledge on this matter and will support future studies on this disease.

Acceptance of electronic and paper-based standardized Nursing Care Plans Documentation System among nurses in a Tertiary Health Facility in North-Central Nigeria

Acceptance is important for successful adoption of new technology. This study assessed the level of acceptability of electronic and paper-based Standardized Nursing Care Plans templates among nurses in a tertiary health facility in North Central Nigeria. Adopting a comparative design, data were collected from 32 nurses working in two medical units of a tertiary health facility who had earlier been introduced to an electronic and Paper-based Standardized Nursing Care plan (SNCPs) templates. A structured questionnaire was used to collect data from the nurses. Data was computed using Statistical Package for Social Sciences (SPSS) version 20 and analyzed using frequency distribution, independent t-test, and Multiple Regression. The result showed that the electronic SNCPs were accepted by all nurses working in the electronic ward while only 2(12.5%) of nurses in the paper word did not accept the paper SNCPs. There was no significant difference in the level of nurses’ acceptability of SNCPs (t-value = 1.400, p = 0.172). Also, only nurses’ years of experience had a statistically significant relationship with acceptance. Providing adequate training would enhance nurses use SNCPs in either electronic or paper formats.

Use of machine learning to transform complex standardized nursing care plan data into meaningful research variables: a palliative care exemplar.

The aim of this article was to describe a novel methodology for transforming complex nursing care plan data into meaningful variables to assess the impact of nursing care. We extracted standardized care plan data for older adults from the electronic health records of 4 hospitals. We created a palliative care framework with 8 categories. A subset of the data was manually classified under the framework, which was then used to train random forest machine learning algorithms that performed automated classification. Two expert raters achieved a 78% agreement rate. Random forest classifiers trained using the expert consensus achieved accuracy (agreement with consensus) between 77% and 89%. The best classifier was utilized for the automated classification of the remaining data. Utilizing machine learning reduces the cost of transforming raw data into representative constructs that can be used in research and practice to understand the essence of nursing specialty care, such as palliative care.

Nursing care plan for patients operated on for Lumbar Herniated Disc at CCOI Frank País

Introduction: lumbar disc herniation is as old as mankind. It has been described since ancient times, when man began to adopt the bipedal position and to support the entire weight of the body on his spine. According to the World Health Organization, herniated discs represent a great universal health problem. Objective: To design a care plan for patients operated on for lumbar disc herniation in the International Medical Attention Service (AMI) of the Frank País International Orthopedic Scientific Complex, deepening the knowledge of said pathological entity and identifying the socio-demographic characteristics of the staff, as well as the needs affected in patients during the period 2018-2019. Methodology: Descriptive cross-sectional study at the Frank País International Orthopedic Scientific Complex during the period 2018-2019. The sample was represented by all the nurses who work in the service (N = 13). The following variables were taken into account: age, sex, nursing degree, postgraduate completion, assessment of the physical and emotional needs of the patient, and the actions of the nursing staff to meet the needs. Results: The age of 40 to 45 years predominated (61.5%), 100% belonged to the female sex and all were professionally overcome by training. 61.5% were graduates. The needs in patients operated on for lumbar disc herniation were pain, physical activity and personal hygiene, which were found in all the patients studied. 38.4% of the personnel carried out insufficient actions, this corresponded to those who were technician qualifications. Conclusions: The design of a standardized nursing care plan regulated by the taxonomies NANDA, NIC, NOC, allowed structuring the scientific practice from the assessment to the evaluation of the results in the patient operated on for lumbar disc herniation admitted to the service of International Medical Care.

N29 Application of the AREA model to a standard care plan for patients with inflammatory bowel disease

Abstract Background The clinical characteristics of the inflammatory bowel disease (IBD), its psychosocial/occupational impact and the increase in its incidence and prevalence, justify the proliferation of Multidisciplinary Care Units (with reference nurses for patients). The standardisation of care and the recording of the performance of the professionals that integrate them are necessary to give continuity to the care, to value the role of each of them in these, to reduce the variability in clinical practice and the collection of data that allow decision-making at the management and research assistance level. All of the above plus the existence in our country of legal regulations that define and regulate the records of mandatory existence and completion in the medical records, of our patients has made us set ourselves as a general objective: Develop a standard nursing care plan for the care of patients with IBD. Methods A literature review of the literature published in the last 10 years in the Medline, Cocharane, Cinahl and Cuiden databases is carried out. The search criteria establish the existence of the words ‘Care plan’ ‘nursing care’ and ‘nursing diagnoses’, all of them combined with IBD. Natural words bounded by the limits determined in the inclusion criteria. The needs model of Virginia Henderson (Institutional model) is used for the assessment and for the diagnosis, objectives and planning of nursing interventions the taxonomies NANDA, NOC, and NIC (NNN). Finally, in order to achieve a realistic and applicable plan of care taking into account, criteria of average hospital stay per process, and average time of outpatient care, we apply the AREA model (Analysis of Current State Outcomes) of Pesut1. Results The assessment highlights the altered needs: food, disposal, safety mobility, self-realisation, values and communication beliefs. In relation to the diagnoses, we classify them into clinical, psychosocial and secondary to the treatment, discriminating those written as diagnosed by nurses and therefore resolved or minimised autonomously by the nurses from whom they should be considered as collaborative problems. Normality characteristics are defined by protocol. Conclusion The model favours a broad and comprehensive view of the situation, leading to the selection of the diagnosis (or more than three) that allows the holistic approach to be effective and efficient. It would allow us to know the prevalence and incidence of diagnoses and agree on objectives and activities to establish comparison patterns.

Use of Electronic and Paper-based Standardized Nursing Care Plans to Improve Nurses' Documentation Quality in a Nigerian Teaching Hospital.

To evaluate the effect of electronic and paper-based standardized nursing care plans (SNCPs) use on quality of nurses' documentation. Using quasi-experimental design, two wards were grouped into electronic and paper-based wards. Nurses were trained to use electronic- and paper-based SNCPs for care-planning and documentation. Data was collected before, 3, and 6 months postintervention and analyzed with SPSS version 20. There was improvement in documentation quality in the two wards after introducing SNCPs with higher quality scores in the electronic ward postintervention. Providing SNCPs in electronic and paper formats is critical to improving nursing documentation. Adequate training and support for nurses are needed for successful implementation of SNCPs in electronic health records (EHRs) in developing nations.

Effectiveness of standardized nursing care plans to achieve A1C, blood pressure, and LDL-C goals among people with poorly controlled type 2 diabetes mellitus at baseline: four-year follow-up study

BackgroundNo studies that have measured the role of nursing care plans in patients with poorly controlled type 2 diabetes mellitus. Our objectives were firstly, to evaluate the effectiveness of implementing Standardized languages in Nursing Care Plans (SNCP) for improving A1C, blood pressure and low density lipoprotein cholesterol (ABC goals) in patients with poorly controlled type 2 diabetes mellitus at baseline (A1C ≥7%, blood pressure ≥ 130/80 mmHg, and low-density lipoprotein cholesterol≥100 mg/dl) compared with Usual Nursing Care (UNC). Secondly, to evaluate the factors associated with these goals.MethodsA four-year prospective follow-up study among outpatients with type 2 diabetes mellitus: We analyzed outpatients of 31 primary health centers (Madrid, Spain), with at least two A1C values (at baseline and at the end of the study) who did not meet their ABC goals at baseline. A total of 1916 had A1C ≥7% (881 UNC versus 1035 SNCP). Two thousand four hundred seventy-one had systolic blood pressure ≥ 130 mmHg (1204 UNC versus 1267 SNCP). One thousand one hundred seventy had diastolic blood pressure ≥ 80 mmHg (618 UNC versus 552 SNCP); and 2473 had low-density lipoprotein cholesterol ≥100 mg/dl (1257 UNC versus 1216 SNCP). Data were collected from computerized clinical records; SNCP were identified using NANDA and NIC taxonomies.ResultsMore patients cared for using SNCP achieved in blood pressure goals compared with patients who received UNC (systolic blood pressure: 29.4% versus 28.7%, p = 0.699; diastolic blood pressure: 58.3% versus 53.2%, p = 0.08), but the differences did not reach statistical significance. For A1C and low-density lipoprotein cholesterol goals, there were no significant differences between the groups. Coronary artery disease was a significant predictor of blood pressure and low-density lipoprotein cholesterol goals.ConclusionsIn patients with poorly controlled type 2 diabetes mellitus, there is not enough evidence to support the use of SNCP instead of with UNC with the aim of helping patients to achieve their ABC goals. However, the use of SNCP is associated with a clear trend of a achievement of diastolic blood pressure goals.

Newborn physiological immaturity: a concept analysis.

Background:Most standardized nursing care plans for healthy neonates include multiple nursing diagnoses to reflect nurses' judgments on the infant's status; however scientific literature concerning this issue is scarce. Newborn physiological immaturity is a concept in the ATIC terminology (architecture, terminology, interface, information, nursing [infermeria], and knowledge [coneixement]) to represent the natural status of vulnerability of the healthy neonate.Purpose:To identify the essential attributes of the concept and provide its conceptual and operational definition, using the Wilsonian approach.Findings:The concept under analysis embeds a natural cluster of vulnerabilities and environmental interactions that enhance the evolving maturation process.Implications for Practice:The use of this diagnosis may simplify the process of charting the nursing care plans and reduce time needed for documentation while maintaining the integrity of the information.Implications for Research:Consistent development and use of nursing concepts is essential for knowledge building. Studies on the actual use of nursing diagnoses are needed to inform decision making.

Impact of an Educational Program on the Use of Standardized Nursing Languages for Nursing Documentation Among Public Health Nurses in Nigeria

To measure the effect of an educational package on documentation of care among public health nurses (PHNs). A quasi-experimental design was adopted. Forty PHNs working in primary healthcare settings were selected. Education was given through a 5-day workshop. Documentation of care was assessed using a modified "Muller-Staub Q-DIO instrument." Data were analyzed using t test third and twelfth months postintervention. There was a significant improvement on documentation of care at p = .0001. Educating PHNs and providing them with standardized nursing care plans enhance documentation of care. IMPLICATION TO PRACTICE: A combination of education on the use of standardized nursing languages and standardized nursing care plans can enhance documentation of care. There is a need for more research on the use of standardized nursing languages in developing nations.

Factors and Conditions that Influence the Implementation of Standardized Nursing Care Plans

Rationale and Aim: There is a lack of evidence about how to successfully implement standardized nursing care plans (SNCP) in various settings. The aim of this study was to use the “Promotion Action on Research Implementation in Health Services framework” (PARIHS) to explore important factors and conditions at hospital wards that had implemented SNCPs.Method: We employed a retrospective, cross-sectional design and recruited nurses from four units at a rural hospital and seven units at a university hospital in the western and southern region of Sweden where SNCPs had been implemented. Outcome was measured by means of a questionnaire based on the PARIHS-model.Result: In total, 137 nurses participated in the study. The main factors that had motivated the nurses to implement SNCPs were that they were easy to understand and follow as well as corresponding to organisational norms. The SNCPs were normally based on clinical experience, although research more frequently formed the basis of the SNCPs at the university hospital. Internal facilitators acted as important educators, who provided reminders to use the SNCP and feedback to the SNCP users. The patient experience was not considered valuable. Those who claimed that the implementation was successful were generally more positive in all measurable aspects. The use of SNCPs was rarely evaluated.Conclusions: Clinical experience was considered important by the nurses, while they attributed little value to the patient experiences. Successful implementation of research based SNCPs requires internal facilitators with knowledge of evidence-based nursing.

Standardized Nursing Care Plan

The National Institutes of Health have developed a new organizational consortium through a funding mechanism called the Clinical and Translational Science Award. This program funds academic institutions to create a platform for research that expedites the development and delivery of new treatments through open interdisciplinary collaboration. As a result, the adult clinical research center at San Francisco General Hospital is now part of the Clinical and Translational Science Institute at the University of California San Francisco. Nurses on this research unit have begun to employ a standardized nursing care plan that focuses on the particular needs of the research participant, an advancement that if implemented nationwide among all adult clinical research centers will be of paramount importance in fostering a collaborative relationship within the new organizational structure. This standardized nursing care plan will provide research nurses with a tool that will enable them to provide safe and quality patient care.

Introduction and development of NCP using ICNP® in Pakistan

Traditionally, nursing care has been described as performing nursing tasks and often focused on nurses carrying out doctors' orders. In many countries of the world, including Pakistan, nurses do not document care in a standardized manner. Because of this limitation many health administrators, policy makers, and consumers make inadequate assumptions about nursing work, often regarding nurses as any other 'health care technician' who can be easily replaced by more economical health care workers. To overcome this problem, standardized documentation is being introduced into the Aga Khan University School of Nursing and hospital, Aga Khan Health Services, Public Health School in Karachi, and government colleges of nursing, using the International Classification for Nursing Practice (ICNP). The purpose of this paper is to highlight the process of introducing and developing standardized nursing care plans (NCP) using ICNP in Pakistan. The process for introducing ICNP consists of four components, including administrative planning, development, teaching and training, and testing. Subsets of the ICNP for (i) maternity: antenatal, postnatal and natal care; and (ii) cardiology were developed using standardized NCPs. The subsets were developed by nurse experts and introduced at the testing sites. The testing will be conducted as a pilot project. Findings from the pilot will be used to continue and expand standardized nursing documentation using the ICNP across Pakistan. Through this project, nurses, midwives and lady health visitors (midwives, vaccinator and health educators) will test standardization of documentation and begin to evaluate efficiency and effectiveness of clinical practice.

Nursing diagnoses: factors affecting their use in charting standardized care plans

The purpose of this study was to explore factors that may affect nurses' use of nursing diagnoses in charting standardized nursing care plans in their daily practice. Care plans have been viewed as providing a structured approach to the assessment, planning and delivery of patient care. Nonetheless, the challenge for many institutions is to help professional nursing staff refine their understanding of nursing diagnoses and charting skills, to identify patient problems and propose appropriate care plans. Twelve clinical nurses working at a medical center in Taiwan underwent one-on-one in-depth interviews from May to July 2000. Data analysis was based on Miles and Huberman's data reduction, data display, and a conclusion verification process to investigate the charting process. Nurses tended to match patient conditions to the designated nursing diagnoses, be unfamiliar with statements of related factors, use objective data to describe patient conditions, ignore descriptions of nursing goals, dutifully check interventions without always executing them, and choose the same evaluation to meet hospital requirements. These findings suggest that using educational programmes for enhancing nurses' ability to use nursing diagnoses and exploring the process of diagnostic reasoning would improve the quality of patient documentation. The trend in health care is to focus on chart audit to reveal indicators of quality of care. Therefore, the experience of nurses in this study could be applied to in-service training programmes by institutions that are replacing traditional, manually written care plans with a standardized care planning system, thus helping other nurses through this transition process.

Utilization of Nursing Diagnoses by Students During a Pediatric Nursing Course in Turkey

PURPOSETo determine the utilization of nursing diagnoses by nursing students and their ability to formulate the NANDA nursing diagnoses under the functional health patterns to evaluate whether there is a link between documented nursing diagnoses and patients' assessment data.METHODSData were obtained from the standardized nursing assessment forms and care plans documented by 57 nursing students in a pediatric nursing course. A total of 569 care plans were documented for patients (children and their families).FINDINGSFor 569 children in 3 different pediatric clinics, 70 different nursing diagnoses were documented. Some of the nursing diagnoses were used in various frequencies for a total of 3,433 documented diagnoses in Nutrition‐Metabolic (n= 1,274), Activity‐Exercise (n= 594), Cognition‐Perception (n= 572), Role Relationships (n= 330), and Health Perception‐Health Management (n= 327) Health Patterns. The most frequently occurring NANDA diagnoses were knowledge deficit (n= 275), altered nutrition: less than body requirement (n= 265), risk for altered body temperature (n= 263), anxiety (n= 236), and altered comfort (n= 227).CONCLUSIONSThe majority of the students had adequate knowledge and ability to formulate nursing diagnoses according to NANDA, but documented diagnoses were not always supported by patients' assessment information. This might be a result of the inadequate diagnostic reasoning and teaching methods used, and being introduced to the diagnostic process for the first time in this course. Ultimately, consistent expectations and using the classification systems will lead to competency in diagnostic reasoning.

Translating Nursing Language Into Lay Language

PURPOSETo explore the meaning that patients undergoing total hip replacement ascribe to the lived experience of retaining and reading their nursing care plan in lay language before and after the surgery.METHODA standardized nursing care plan for patients undergoing total hip replacement was written in lay language and used as a perioperative teaching material. Qualitative data were collected with in‐depth interviews and analysed. The sample consisted of 6 patients undergoing total hip replacement.FINDINGSThe overriding theme, acquired knowledge, was the main meaning that participants ascribed to their experience of the care plan. Other issues or major themes that were of particular importance to participants were that the text of the care plan was understandable and meaningful, the care plan had empowering effects, and revision of the care plan was recommended. In addition, general satisfaction of the healthcare service was a significant part of the participants' experience.CONCLUSIONSPatients can acquire empowering knowledge from a patient version of their nursing care plan. Patient versions of care plans for total knee and hip replacements have been implemented in the hospital.

Vía clínica de la colecistectomía laparoscópica asociada a un plan de cuidados de enfermería

ObjectiveClinical pathways are standardized care plans for specific processes. They constitute a tool that coordinates all the professionals involved and consequently the joint work of doctors and nurses is fundamental. The objective of this study was to present the planning and evaluation of a clinical pathway for laparoscopic cholecystectomy and a standardized nursing care plan. MethodsPlanning of the clinical pathway was carried out through weekly meetings of the entire group for 3 months. The group was composed of surgeons, anesthetists, nurses from the various units involved, and quality coordinators for surgery and nursing. A series of patients that underwent laparoscopic cholecystectomy in the year before planning of the clinical pathway (n = 160) was evaluated and a list of weak points was identified using group techniques. A literature search for scientific evidence as well as for other published clinical pathways was performed. The main documents of the clinical pathway were then drawn up and discussed with the members of the surgery service and nursing units. The results were compared with the series of patients who underwent surgery in the year after the implementation of the clinical pathway (n = 140). ResultsThe protocols of care in the immediate postoperative period and antithrombotic prophylaxis, as well as the main documents of the clinical pathway are presented, including a standardized nursing care plan. The estimated length of hospital stay after surgery was 1 day. A series of 160 consecutive patients who underwent surgery during the year prior to the creation of the clinical pathway and who fulfilled the accepted inclusion criteria was evaluated, with a mean stay of 3.27 days. The mean stay of the patients included in the clinical pathway was 2.2 days (p < 0.001). The degree of compliance with length of hospital stay was 65.7%. The most frequent causes of breach were patient-related (vomiting, pain, etc.), followed by staff-related causes. ConclusionsLaparoscopic cholecystectomy is a suitable process in which to initiate systematization of clinical pathways. The incorporation of standardized nursing care plans adds value to the clinical pathway and helps to systematize nursing care. The results have significantly reduced the length of hospital stay without increasing morbidity. Patient satisfaction has been high.