COX’S CLINICAL APPLICATIONS OF NURSING DIAGNOSIS, 2007
PREFACE TO THE FOURTH EDITION
The North American Nursing Diagnosis Association (NANDA) has been identifying, classifying, and testing diagnostic nomenclature since the early 1970s. In our opinion, use of
nursing diagnosis helps define the essence of nursing and give direction to care that is
uniquely nursing care. If nurses (in all instances we are referring to registered nurses) enter the medical diagnosis of, for example, acute appendicitis as the patient’s problem, they have met defeat before they have begun. A nurse cannot intervene for this medical diagnosis; intervention. requires a medical practitioner who can perform an appendectomy. However, if
the nurse enters the nursing diagnosis “Pain,” then a number of nursing interventions
come to mind. Several books incorporate nursing diagnosis as a part of planning care.
However, these books generally focus outcome and nursing interventions on the related
factors; that is, nursing interventions deal with resolving, to the extent possible, the
causative and contributing factors that result in the nursing diagnosis.
The Expert Nurse Profile and Diagnostic Content Validity of Sedentary Lifestyle: The Spanish Validation
Josep Adolf Guirao-Goris, MSN, RN, and Gonzalo Duarte-Climents, MSN, RN
PURPOSE. To identify the diagnostic content validity of Sedentary Lifestyle and to identify the expert nurse profile in validating this nursing diagnosis in the
Spanish cultural context.
Fehring’s Diagnostic Content Validity (DCV), the factorial validity of the defining
characteristics, the analysis of convergent validity, and the expert profile were assessed.
The DCV index for experts was .70. The factorial validity showed two different factors: the
expression of laziness and the performance of activities of daily living. On the expert profile related factors analysis, two factors, experience and education, were identified.
The DCV for Sedentary Lifestyle was high among the expert nurses. A nurse was
considered to be an expert who was able to accurately answer the four labels identified as nursing diagnoses, had read at least one nursing process article in the past
year, and was able to list three nursing process reference books.
IMPLICATIONS FOR PRACTICE.
Clarifying themanifestations of sedentary lifestyle will assist clinical nurses in determining this diagnosis, and the expertprofiles will assist in the selection of participants forcontent validity studies.
Application of Nursing Process and Nursing Diagnosis
An Interactive Text for Diagnostic Reasoning
F O U R T H E D I T I O N, 2003
Marilynn E. Doenges, RN, BSN, MA
Adult Psychiatric/Mental Health Nurse, retired
Beth-El College of Nursing & Health Science,
Colorado Springs, Colorado
Mary Frances Moorhouse, RN, BSN, CRRN, CLNC
Pikes Peak Community College
Colorado Springs, Colorado
The nursing process has been used for over 25 years as a systematic approach to nursing practice. The process is an efficient and effective method for organizing nursing knowledge and clinical decision making in providing planned client care. Although it has been undergoing constant re-evaluation and revision, the concepts within the process still remain central to nursing practice. Healthcare accrediting agencies and nursing organizations have developed standards of nursing practice that focus on the tenets of the nursing process, that is, assessing, diagnosing, planning, implementing, evaluating, and documenting client care.
Although the formats used to document the plan of care may change with the interpretation
and evaluation of standards, the nursing responsibilities and interventions required for planned client care still need to be learned, shared, performed, evaluated, and documented.
Joseba Xabier Huitzi-Egilegor1
Maria Isabel Elorza-Puyadena1
Jose Maria Urkia-Etxabe2
Objective: to analyze what nursing models and nursing assessment structures have been used in the implementation of the nursing process at the public and private centers in the health area Gipuzkoa (Basque Country). Method: a retrospective study was undertaken, based on the analysis of the nursing records used at the 158 centers studied. Results: the Henderson model, Carpenito’s bifocal structure, Gordon’s assessment structure and the Resident Assessment Instrument Nursing Home 2.0 have been used as nursing models and assessment structures to implement the nursing process. At some centers, the selected model or assessment structure has varied over time. Conclusion: Henderson’s model has been the most used to implement the nursing process. Furthermore, the trend is observed to complement or replace Henderson’s model by nursing assessment structures. Descriptors: Models, Nursing; Nursing Theory; Nursing Process; Nursing Assessment; History of Nursing; Nursing Methodology Research.
Corresponding Author: Joseba Xabier Huitzi-Egilegor Universidad del País Vasco. Departamento de Enfermería II Paseo Doctor Beguiristain, 105 20014, Donostia - San Sebastián, España
Purpose: To determine the sensitivity and responsiveness of the Outcome and Assessment
Information Set (OASIS) and the Nursing Outcomes Classification (NOC) to the effects
of home healthcare nursing interventions.
Methods: A quasi-experimental before-after study was conducted using a sample of 106 home
healthcare participants referred to one of seven participating Midwest home healthcare
agencies for treatment of a cardiac condition. Patient outcomes data were collected at
home healthcare admission and discharge using OASIS and NOC. Nursing intervention
data were collected at each visit using the Nursing Interventions Classification (NIC).
Intervention intensity was calculated by totaling the number of NIC interventions provided
over the episode of care.
Findings: Neither OASIS norNOCwere sensitive to the effects of home healthcare nursing as
measured by intervention intensity. The OASIS was not responsive to clinically discernable
changes in patient outcomes; while the NOC was responsive to patient status change in
the outcome categories including activities of daily living, cardiopulmonary status, coping,
and illness management behavior.
Conclusions: Outcome measures that are more condition-specific and discipline-specific are
more responsive to the effects of home healthcare nursing. Further research is needed to
identify and refine outcome measures that are sensitive and responsive to the effects of
nursing care in home health and other nursing settings.
Clinical Relevance: The use of outcome measures that are more sensitive and responsive to
nursing are more effective in guiding nursing practice.
[Key words: home care, NOC, nursing-sensitive outcomes, OASIS, responsiveness,
Applications in A Nursing Practicum Course
Copyright, Kelly J. Smith RN, MSN, University of Iowa, College of Nursing
NIC & NOC are universal nursing classification standards that make it possible to
Evaluate cost effectiveness
Standardize the documentation of nursing care
Quantify and make nursing care costs visible
BUILDING QUALITY NURSING PRACTICE AMERICAN NURSES ASSOCIATION
The American Nurses Association (ANA) is the only full-service professional organization representing the interests of the nation's 3.1 million registered nurses through its constituent member nurses associations and its specialty nursing and workforce advocacy organizations that currently connect to ANA as affiliates. The ANA advances the nursing profession by facilitating development of the standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and lobbying the Congress and regulatory agencies on healthcare issues affecting nurses and the public. The ANA in such a leadership role must address the assurance of quality in the clinical, administrative, education, and research domains of nursing practice.
Zakboek verpleegkundige diagnosen, Lynda Juall Carpenito-Moyet
Vertaald en bewerkt door:
Margreet van der Cingel
Vierde druk, Vertaling van de 13e editie van Handbook of Nursing Diagnosis
(eerste deel van het boek dat iedere verpleegkundige zou moeten hebben)
Er zijn meer dan tweehonderd proefschriften over de verpleegkunde in Nederland en Vlaanderen. Dit platform wil deze wetenschappelijke kennis gemakkelijker toegankelijk maken voor studenten, docenten, verpleegkundigen en verpleegkundig specialisten. Zij kunnen zoeken naar kennis over verpleegkundige zorg bij patiëntproblemen: lichamelijk, psychisch, functioneel of sociaal. Daarnaast kan gezocht worden op algemene onderwerpen zoals patiëntcategorie, zorgsector, opleiden en beleid. Gepromoveerden en promovendi worden uitgenodigd hun dissertaties hier te uploaden. Hoe meer kennis op dit platform verzameld wordt, des te groter is de kans dat verpleegkundigen deze ook in de praktijk toepassen.
Deze site is een initiatief van Bureau Lambregts dat al meer dan 25 jaar met kennis en praktische steun bijdraagt aan de ontwikkeling van de verpleegkunde. De site is medemogelijk gemaakt door een bijdrage van Stichting Publicaties voor Verpleegkundigen en Verzorgenden.
Nursing Times is the voice for the nursing community and the leading source of nursing news and best practice in the United Kingdom. We unite nurses and student nurses through our content, face to face events, conferences, awards ceremonies and more.
Publishing nursing research, a host of double blind peer reviewed clinical articles and online CPD units, we are a must for those serious about improving their clinical practice and developing their careers.
We also offer a student subscription to Nursing Times. An online-only resource including access to all the clinical content from nursingtimes.net and a wealth of information designed specifically for students, such as placement advices and study tips.
There are also the Nursing Times Community Forums for discussing nursing related topics. Nursing Times has been in continuous publication since 1906 and is now published by EMAP Publishing Limited, one of the UK's largest publishers.
About the Nursing Diagnosis
What is a Nursing Diagnosis?
Simply put, a nursing diagnosis is a statement made by a Registered Nurse (RN) that addresses the focus of nursing care to be provided to a patient. The diagnosis reflects an issue or state of health to direct care planning that falls within the nurse’s Scope of Practice. The “patient” usually refers to an individual person but may also be used in regards to a family (family-based diagnosis) or a community (community-based diagnosis).
A nursing diagnosis is a professional judgment based on the application of clinical knowledge which determines potential or actual experiences and responses to health problems and life processes. The list of NANDA nursing diagnosis can be applied to individuals, families or communities. Included with the list of NANDA nursing diagnosis is an array of commonly applied interventions from which the caregiver can choose to implement to the given patient. Standardized nursing language is a body of terms used in the profession that is considered to be understood in common. The use of common terms promotes patient safety by allowing nurses to quickly and efficiently understand the aspects of a patient’s needs. The use of standardized terms allows nursing staff to avoid sifting through long narratives in order to determine a particular patient’s needs and planned course of care.
Critical Need to Address Accuracy of Nurses’ Diagnoses^ m d Bookmark and Share
Margaret Lunney, RN, PhD
Studies published from 1966 to 2006 describe how nurses’ interpretations of clinical data vary widely, thus significant percentages of nurses’ diagnoses may be of low accuracy. This is important because data interpretations, or diagnoses, serve as the basis for selection of interventions and the subsequent achievement of patient outcomes. Accuracy of nurses’ diagnoses is defined as a rater’s judgment of the match between a diagnostic statement and patient data. Low accuracy can lead to wasted time and energy, harm to patients, absence of positive outcomes, and patient and family dissatisfaction. The purpose of this article is to appeal to nurses in both practice and education to address the accuracy of nurses’ diagnoses. This appeal is based on three factors: (a) research evidence indicates the need for greater consistency among nurses in making nurses diagnoses, (b) accuracy of nurses’ diagnoses will always be an issue of concern because diagnosis in nursing is complex, and (c) with implementation of electronic health records, the degree of accuracy of nurses’ diagnoses will have broad-based implications. In this article, the need for nurses to be accountable for addressing diagnostic accuracy is explained and strategies to improve accuracy related to the diagnostician, the diagnostic task, and the situational context are recommended. Some of these strategies include a greater focus on educational methods and content for development of nurses as diagnosticians, adoption of partnership models of nurse-patient relationships, an increase in opportunities for critical thinking and clinical decision making, selection of software with appropriate structures and content libraries, and a change in health care policies.
Citation: Lunney, M., (Jan. 31, 2008) "Critical Need to Address Accuracy of Nurses’ Diagnoses" OJIN: The Online Journal of Issues in Nursing. Vol. 13 No. 1.
Nursing Diagnoses in Psychiatric
Nursing: Care Plans and Psychotropic Medications
Mary C. Townsend, DSN, PMHCNS-BC
Clinical Specialist/Nurse Consultant
Adult Psychiatric Mental Health Nursing
Former Assistant Professor and
Coordinator, Mental Health Nursing
Kramer School of Nursing
Oklahoma City University
Oklahoma City, OK
A nursing diagnosis is “a clinical judgment about individual, family, or community responses to actual or potential health problems / life processes. Nursing diagnosis provides the basis for selection of nursing interventions to achieve outcomes for which the nurse has accountability.” (Carpenito-Moyet, 2010, p.10). There are five types of nursing diagnoses recognized – actual, risk,
possible, wellness, and syndrome. And, one COLLABORATIVE diagnosis which nurses intervene either as a primary provider or in collaboration with medicine.
Sheila Sparks Ralph, RN, PhD, FAAN
Professor, Division of Nursing
Member of NANDA-I Foundation
Cynthia M. Taylor, RN, MS
Coordinator, Parish Nurse Program
St. Michael’s Church
Kailua Kona, HI
Critical Thinking in Nursing Process and Education
Belgin YILDIRIM PhD, RN, Research assistant Aydın School of Health Adnan Menderes University Aydın, Turkey Şükran ÖZKAHRAMAN PhD RN, Assistant Professor Faculty of Health Science, Süleyman Demirel University Isparta, Turkey, 2011
ABSTRACT Critical thinking is the process of searching, obtaining, evaluating, analyzing, synthesizing and conceptualizing information as a guide for developing one’s thinking with self-awareness, and the ability to use this information by adding creativity and taking risks. The nursing process has been important to nursing practice for a long time. The nursing process has been used as a problem-solving activity to think about a plan of care as the foundation for professional practice in everyday nursing practice. The nursing process may describe a nursing care plan that provides students with a learning experience that helps them practice critical thinking and decision making skills. The nursing process is seen as a decision making approach that promotes critical thinking in nursing. This process consists of five phases namely: assessment, diagnosis, planning, implementation and evaluation. Key Words: Critical Thinking, Nursing Process, Critical Thinking in Nursing Process.
V&VN heeft in het kader van 'Normen voor indiceren en organiseren van verpleging en verzorging in de eigen omgeving' (V&VN, 2014 juli) informatie verzameld over het indiceren en organiseren van zorg. Uit deze inventarisatie blijkt dat talloze instrumenten, richtlijnen, classificaties, gedragsregels, protocollen en zorgstandaarden (in het vervolg hulpmiddelen genoemd) beschikbaar zijn. Vanwege de grote diversiteit aan hulpmiddelen, heeft V&VN deze geordend en beschreven. Vervolgens is gekeken of een hulpmiddel aan de volgende criteria voldoet:
o Het hulpmiddel kan gebruikt worden ter ondersteuning van het indiceren en organiseren van
o Het hulpmiddel kijkt naar de gehele situatie van cliënt
o Het hulpmiddel wordt gebruikt in de praktijk
o Bij het hulpmiddel zit een handleiding hoe te gebruiken
o Het hulpmiddel kan gevonden worden op internet
Het doel van dit document is wijkverpleegkundigen te informeren over de verschillende hulpmiddelen. Daarnaast heeft dit document als doel de wijkverpleegkundigen voorbeelden te geven van hulpmiddelen die er zijn op het gebied van indiceren en organiseren van zorg.
Leeswijzer Allereerst worden in hoofdstuk 1 verschillende hulpmiddelen gedefinieerd en begrippen verhelderd. Bij de verschillende begrippen wordt een overzicht gegeven met voorbeelden voor de
wijkverpleegkundigen. Bij de voorbeelden staat door wie het desbetreffende hulpmiddel is ontwikkeld.
In hoofdstuk 2 wordt een overzicht gegeven van meetinstrumenten die bij de verschillende stappen
van het verpleegkundig proces gebruikt kunnen worden.
Agueda Maria Ruiz Zimmer CavalcanteI, Evelise Helena Fadini Reis BrunoriI,
Camila Takáo LopesII, Andréa Braz Vendramini SilvaI, T. Heather HerdmanIII
I Instituto Dante Pazzanese de Cardiologia. São Paulo-SP, Brasil.
II Hospital Universitário, Unidade de Terapia Intensiva Adulto. São Paulo-SP, Brasil.
III University of Wisconsin-Green Bay. Green Bay-WI, United State of America.
Submissão: 05-12-2014 Aprovação: 09-12-2014
T. Heather Herdman, PhD, RN
The Diagnosis Development Committee (DDC) of NANDA International frequently receives proposed “physiologic” and “surveillance diagnosis” submissions that may not meet the current definition of nursing diagnosis (NANDA, 2007, p. 332). There has been a request for a vote on newly proposed definitions of nursing diagnosis, risk diagnosis, and syndromes. The purpose of
this article is to provide information which enables members and interested nurses to continue the dialogue and to share their thoughts and also to consider the thoughts and information generated by the participants in the NANDA-I interest survey on the definition of nursing diagnoses.
An electronic survey of the current NANDA-I definitions, and potential changes to those definitions, was distributed via the NANDA-I Web site. This article summarizes the overall findings of that survey and provides an overview of commentary received from the 269 participants.
It is necessary to continue the dialogue on this important decision and to provide a mechanism for
input from members and interested nurses before reaching any conclusions on this subject.
NANDA-I has been recognized as the leader in the development and implementation of nursing diagnoses and must act responsibly in assessing the changing and emerging trends in nursing practice and in responding to these trends.
NANDA International, Nursing
diagnosis definition, physiologic nursing diagnoses,
surveillance nursing diagnoses
Tatiane Ramos Canero1, Rachel de Carvalho2, Luzia Elaine Galdeano
Hye Jin Park
University of Iowa
Copyright 2010 Hye Jin Park
This dissertation is available at Iowa Research Online: http://ir.uiowa.edu/etd/570
Follow this and additional works at: http://ir.uiowa.edu/etd
Implementation of Free Text Format Nursing Diagnoses at a University Hospital’s Medical Department. Exploring Nurses’ and Nursing Students’ Experiences on Use and Usefulness. A Qualitative Study
Sigrun Aasen Frigstad,1 Torunn Hatlen Nøst,2 and Beate André1
1Faculty of Nursing, Sør-Trøndelag University College (HiST), Postboks 2320, 7004 Trondheim, Norway
2St. Olav’s Hospital, Trondheim University Hospital, Postboks 3250, 7006 Trondheim, Norway
Received 20 January 2015; Accepted 23 April 2015
Academic Editor: Patrick Callaghan
Copyright © 2015 Sigrun Aasen Frigstad et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background. Nursing documentation has long traditions and represents core element of nursing, but the documentation is often criticized of being incomplete. Nursing diagnoses are an important research topic in nursing in terms of quality of nursing assessment, interventions, and outcome in addition to facilitating communication and continuity. Aim. The aim of this study was to explore the nurses’ and nursing students’ experiences after implementing free text format nursing diagnoses in a medical department. Method. The study design included educational intervention of free text nursing diagnoses. Data was collected through five focus group interviews with 18 nurses and 6 students as informants. The data was analyzed using qualitative content analysis. Results. The informants describe positive experiences concerning free text format nursing diagnoses’ use and usefulness; it promotes reflection and discussion and is described as a useful tool in the diagnostic process, though it was challenging to find the diagnosis’ appropriate formulation. Conclusion. Our findings indicate a valid usability of free text format nursing diagnoses as it promotes the diagnostic process. The use seems to enhance critical thinking and may serve as valuable preparation towards an implementation of standardized nursing diagnoses. Use and support of key personnel seem valuable in an implementation process.
NUR 133 NURSING DIAGNOSES PREP WORKBOOK
Diagnostic accuracy is as important to safety and quality care as dosage calculation. A recent study revealed that nursing students were having difficulty making good clinical judgments, and this learning activity was developed to aid students in mastering the diagnoses reviewed in Fundamentals of Nursing. Additional will be provided throughout the semester to master clinical judgments in the adult health nursing setting. The purpose of this booklet is to improve the student’s understanding of nursing diagnoses and PES format studied in Fundamentals of Nursing in order to improve diagnostic accuracy and information literacy. Students will use on the
Carpenito-Moyet nursing diagnoses text to complete these exercises, Nursing diagnoses identified in this learning activity will be tested at the start of the NUR 133 course next semester. It would be beneficial to read the preface of the Carpenito-Moyet text and the diagnoses indentified in your book first. After you complete these activities, you will need to complete the jeopardy game on the Evolve website that will be available to you after January 16, 2012. Do not attempt complete the Jeopardy game until you have mastered these diagnoses.
The ability to develop a NCP requires in-depth knowledge of the patient, the reason for admission, the main health complaints/concerns, the goals to be aimed for, the selection of appropriate nursing interventions, and strategies to evaluate the effectiveness of the interventions. Even if NCPs are no longer used as frequently as in the past, for educational/learning purposes they are still a very useful tool. For this reason, Massey University requires students to complete NCPs during a variety of clinical placements. NCPs will be adapted to the level the student is at and even the name and format might change slightly i.e. Patient Health Plan. While students are expected to complete the bulk of the writing outside of clinical practice, there is a need to interview patients as well as have access to the patients’ file in order to obtain the required data. NCP are checked by CTAs but your support and feedback will at all times be truly appreciated.
Nursing interventions for smoking cessation
Virginia Hill Rice1 , Lindsay F Stead2
1College of Nursing, Wayne State University, Detroit, Michigan, USA. 2Department of Primary Health Care, University of Oxford, Oxford, UK
Contact address: Virginia Hill Rice, College of Nursing, Wayne State University, 5557 Cass Avenue, Detroit, Michigan, 48202, USA. firstname.lastname@example.org. email@example.com .
Editorial group: Cochrane Tobacco Addiction Group.
Publication status and date: Edited (no change to conclusions), published in Issue 1, 2009.
Review content assessed as up-to-date: 20 October 2007.
A B S T R A C T
Healthcare professionals, including nurses, frequently advise patients to improve their health by stopping smoking. Such advice may be brief, or part of more intensive interventions.
To determine the effectiveness of nursing-delivered smoking cessation interventions.
Search strategy We searched the Cochrane Tobacco Addiction Group specialized register and CINAHL in July 2007.
Randomized trials of smoking cessation interventions delivered by nurses or health visitors with follow up of at least six months.
Data collection and analysis
Two authors extracted data independently. The main outcome measure was abstinence from smoking after at least six months of follow up. We used the most rigorous definition of abstinence for each trial, and biochemically validated rates if available. Where statistically
and clinically appropriate, we pooled studies using a Mantel-Haenszel fixed effect model and reported the outcome as a risk ratio (RR) with 95% confidence interval (CI).
Forty-two studies met the inclusion criteria. Thirty-one studies comparing a nursing intervention to a control or to usual care found the intervention to significantly increase the likelihood of quitting (RR 1.28, 95% CI 1.18 to 1.38). There was heterogeneity among the study results, but pooling using a random effects model did not alter the estimate of a statistically significant effect. In a subgroup
analysis there was weaker evidence that lower intensity interventions were effective (RR 1.27, 95% CI 0.99 to 1.62). There was limited indirect evidence that interventions were more effective for hospital inpatients with cardiovascular disease than for inpatients with other conditions. Interventions in non-hospitalized patients also showed evidence of benefit. Nine studies comparing different nursedelivered interventions failed to detect significant benefit from using additional components. Five studies of nurse counselling on smoking cessation during a screening health check, or as part of multifactorial secondary prevention in general practice (not included in the main meta-analysis) found nursing intervention to have less effect under these conditions.
Using the Nursing Interventions Classification as a Potential Measure of Nurse Workload
Pamela B. de Cordova, MSN, RN-BC, Robert J. Lucero, PhD, MPH, RN, Sookyung Hyun, DNSc, RN, Patricia Quinlan, MPA, RN, CPHQ, Kwanza Price, MPH, and Patricia W. Stone, PhD, FAAN
Nursing Outcomes Classification (NOC), 3rd ed. Outcome Labels and Definitions (330 Outcomes)
The National Database of Nursing Quality Indicators® (NDNQI®)
voorbeelden: Ineffective Breathing Pattern Debra Siela, PhD, RN, CCNS, ACNS-BC, CCRN, CNE, RRT NANDA-I Definition Inspiration and/or expiration that does not provide adequate ventilation
Defi ning Characteristics Alterations in depth of breathing; altered chest excursion; assumption of three-point position; bradypnea; decreased expiratory pressure; decreased inspiratory pressure; decreased minute ventilation; decreased vital capacity; dyspnea; increased anterior-posterior diameter; nasal fl aring; orthopnea; prolonged expiration phase; pursed-lip breathing; tachypnea; use of accessory muscles to breathe Related Factors (r/t) Anxiety; body position; bony deformity; chest wall deformity; cognitiveimpairment; fatigue; hyperventilation; hypoventilation syndrome; musculoskeletal impairment; neurological immaturity; neuromuscular dysfunction; obesity; pain; perception impairment; respiratory muscle fatigue; spinal cord injury NOC (Nursing Outcomes Classifi cation)