A qualitative study to explain the criteria of nursing managers in selecting effective nursing diagnosis

Objective:This study aimed to explain the criteria of managers at different levels of nursing in selecting effective nursing diagnosis.Methods:In conventional content analysis,10 nursing managers at different levels including head nurse,supervisor,and nursing manager were interviewed.Data was collected with semi-structured interviews and a narrative approach.Data analysis was performed using the Zhang–Wildemuth method simultaneously with sampling.Results:Four head nurses,four supervisors(educational,clinical),and two nursing managers were interviewed.The results of the a nalysis led to the extraction of two main categories:centrality of the nursing profession,with the sub-categories compatibility with nursing p ractices and compliance with organizational and professional principles of nursing,and covering the patient care aspect,with s ub-categories of having potential to facilitate and adapting to patient care conditions.Conclusions:The analysis of the views of nursing managers shows that health managers should consider various management aspects such as functional and organizational to increase the efficiency of nursing interventions in the selection of nursing diagnostic systems.From the point of view of health managers,nursing diagnoses should cover the considerations of patients,nurses,and work environments.

Analysis of the evidence of related factors,associated conditions and at-risk populations of the NANDA-I nursing diagnosis insomnia

Objectives:To summarize evidence in the literature on the predictors of insomnia in adults and to determine correspondences with diagnostic indicators of the NANDA-I diagnosis Insomnia.Methods:An integrative review performed in Pubmed,Virtual Health Library and CINAHL.Forty-eight articles published in Portuguese,English or Spanish from 2011 to 2018 were included.An analysis of correspondence between the predictors and the NANDA-I related factors and associated conditions for Insomnia was performed.Results:There was a correspondence of the predictors found in this review with NANDA-I related factors and associated conditions,except for grieving and frequent naps during the day.Smoking,caffeine intake,dysfunctional sleep beliefs,obesity and caregiver role strain are possible new related factors;chronic illness is a possible new associated condition and individuals going through changes in marital status,economically disadvantaged,female gender,increasing age and night shift worker are possible new at-risk populations.Conclusion:The predictors of insomnia that had a correspondence with the NANDA-I elements can support the evidence base of the nursing diagnosis.The predictors found without a correspondence with the diagnosis can be considered for inclusion in the NANDA-I classification,thereby supporting the clinical reasoning of nurses and students.

Prevalence of the Nursing Diagnosis Lack of Adherence in People Living with AIDS

Introduction: In the 1990s, the development of highly active combination antiretroviral therapy in the treatment of AIDS was highlighted. The great benefit generated by the use of this treatment was the prolongation of survival of the people who got this disease, since it is no longer considered fatal, becoming a chronic condition. Objective: To identify the prevalence of the nursing diagnosis Lack of Adherence, its defining characteristics and related factors in people living with AIDS, to investigate the association between them and the prevalence rates. Methods: Cross-sectional study with 113 patients in a hospital in northeastern Brazil. For data analysis, the test of Pearson chi-square and Fisher’s exact test were used, and also calculated the prevalence rates. Results: Lack of Adherence diagnosis was present in 69% of the sample investigated. The defining characteristics and related factors that are statistically associated with that diagnosis were: lack of adherence behavior, missing scheduled appointments, complications related to development, insufficient skills to implement the system and complex treatment system. The first two characteristics had the highest chances for the development of this diagnosis. Conclusion: The study showed that the diagnostic studied was prevalent in these patients and 3 characteristics and 2 factors showed significant association.

Nursing Diagnosis in Patients with Liver Cirrhosis in Use of Feeding Tube

The objective was to identify the most frequent nursing diagnoses labels in patients with liver cirrhosis in use of feeding tube. A descriptive research was carried out in a Brazilian Hospital with 20 adult patients. Systematic data collection utilized the Conceptual Model of Wanda Horta, the first nurse to introduce the concept of Nursing Process in Brazil. The six phases of the nursing diagnostic reasoning proposed by Risner were used;nursing diagnoses were described according to NANDA-I taxonomy II. Patients were mainly male;half of them were middle age adults;they had an average of 12.8 nursing diagnoses labels;and the most frequent were: risk for aspiration and risk for infection. Nurses needed to develop effective skills to properly diagnose in order to provide safe care and improve patient outcomes.

Nursing Diagnoses of the Domain Safety/Protection and Socioeconomic and Clinical Aspects of Critical Patients

Objective: The objective is to correlate the nursing diagnoses of the domain Safety/Protection of NANDA-I in critically ill patients with sociodemographic and clinical data. Method: A cross-sectional study with 86 individuals was conducted, from October 2013 to May 2014 in the Intensive Care Unit of a university hospital in northeastern Brazil, through a formal interview and physical examination. Results: It was possible to identify a total of 20 significant statistical associations, and 15 were clinically justified by the literature, namely: risk for aspiration and reason for admission;impaired dentition and age;risk for peripheral neurovascular dysfunction and sex and comorbidity;skin integrity and comorbidity;risk for impaired skin integrity and gender and reason for admission;impaired tissue integrity and gender and reason for admission;risk for perioperative positioning injury and reason for admission;risk for thermal injury and age and comorbidity;delayed surgical recovery and reason for admission;risk for poisoning and years of schooling;and risk for imbalanced body temperature and age. Conclusions: By understanding the relationship between customers’ answers and the sociodemographic and clinical profile, positive health outcomes can be achieved in particular in the prevention of risks facing vulnerability characteristics, providing greater safety and protection for the critical customer.

The Application of Scales in the Diagnosis of Perceived Needs in the Elderly with Mild Cognitive Impairment

The study evaluated the use of the Mini-Mental State Examination scale (MMSE), Tinettiscale, and Motor Scale for the Elderly (EMTI) toassist in the diagnosis of potential needs observed in elderlies with Mild Cognitive Impairment. This was aquasi-experimental research, conducted in a Basic Health Unit in thecityof Rio de Janeiro in 2014. The sample population consisted of 22 elderlies aged 64 to 88 years and 86.36% females. The SAS statistical software (version 9.3.1) and Kruskal-Wallis test were used at a 95% confidence interval and a significance level of 0.05 and demonstrated significant differences in the evaluations performed before and after the intervention. The detected diagnoses were: impaired memory, the risk of falls, and willingness to improved relationships, among others. The evaluations showed MMSE results that were suggestive of cognitive impairment in 22.73% of the elderlies;the Tinetti scale showed a high risk of falls in 31.82% of theelderlies;and EMTI with 88.36 points, which was equivalent to the normal low classification. The intervention took place through ten weekly activity sessions after the initial evaluations. In the second evaluation, the Tinetti showed 59.09% of the elderlies with a moderate risk of falls and the EMTI as the normal average classification with 90.32 points. It was concluded that the scales offered diagnostic possibilities, which allowed for the implementation of necessary interventions according to the detected problems.

Development and Practice of Integrated Nursing Model NNN Link for Breastfeeding Clinical Nursing Model as a Whole

Objective: To establish breastfeeding clinical holistic nursing model used in clinical nursing and teaching, it is possible to improve nurses and nursing students to master knowledge of breastfeeding, analysis, judgment, decision-making and the ability to care-related issues, promoting pure improve breastfeeding rates. Method: 1) The North American Nursing Diagnosis Nursing Association (NANDA), Nursing Outcomes Classification (NOC) and Nursing Classification (NIC) link (NNN link) clinical clues reasoning to determine the contents of the questionnaire were used. Then, the Delphi method to care was used. 2) The survey questionnaire was designed. The content included the clinical holistic nursing care model in breastfeeding and the model’s use situation. 3) Questionnaire survey: in the national midwifery care industries, volunteers were collected who were willing to use the breastfeeding clinical holistic nursing care model in the nursing work. We issued 98 questionnaires and took back 76 valid questionnaires. Results: The construction of the breastfeeding clinical holistic nursing model includes 9 nursing diagnoses which contain the breastfeeding effective, the lack of knowledge, the decision conflicts, the risk of breast tenderness, the risk of cracked nipple, the invalid hazard occurring in breastfeeding, the risk of caregiver role strain, the risk of breast feeding jaundice and the ineffective community coping, 18 nursing outcomes and 64 nursing measures. In the composition of breastfeeding after clinical holistic nursing model in clinical practice, 100% of obstetric nurses think that the breastfeeding nursing model can promote the nursing staff to care patients according to the nursing process, can help nurses to analyze, evaluate, make decision, and care about breastfeeding related problems, as well as can promote the mother’s milk feeding rate. Conclusion: The establishment of the breastfeeding nursing model provides a learning material for obstetric breast-feeding. Moreover, nursing diagnosis, nursing outcomes and nursing measures correspond according to the form of chart, which are easy to use and find. The breastfeeding clinical holistic nursing model is practicing in clinical nursing, which can help nursing staff to improve the ability of nursing personnel according to evidence-based nursing patients, to improve the ability of nursing personnel analysis, evaluation, decision-making and nursing in breastfeeding problems and to promote the rate of breastfeeding.

Nursing Diagnostics of Nutrition Domain of NANDA International in Hemodialysis Patients

Introduction: The dialysis causes the loss of the nutrients and the elevation of catabolism, thus, patients in dialysis have at high risk for the loss of body reserves of protein and energy. Objective: To identify nursing diagnoses of nutrition domain of NANDA International in hemodialysis patients and to correlate them to the socioeconomic and clinical data. Design: Cross-sectional study. Setting: Performed in a large university hospital in northeastern Brazil. Participants: The first stage was carried out with 50 patients, selected with the following inclusion criteria: Being hospitalized and undergoing hemodialysis in that hospital;aged 18 years old or over;being conscious and oriented. Exclusion criteria were patients undergoing hemodialysis in that hospital with external service, pregnant women and patients being treated by plasmapheresis. In the second stage, participants were three nursing specialists in nephrology and nursing diagnoses. Methods: The defining characteristics of the nursing diagnoses inserted in the nutrition domain were observed in patients and then these data were judged by nurses, in order to identify diagnoses present in each patient. The Chi-square, Fisher’s exact and Mann-Whitney tests were used in the analysis of the relationship of socioeconomic and clinical data, with an adopted p value of p = 0.001), origin (p = 0.014), religion (p = 0.046) and income (p = 0.039), respectively. Conclusion: The variables that showed significant association were risk of impaired liver function and gender;imbalanced nutrition: More than body requirements and origin requirements;risk for deficient fluid volume and religion;and deficient fluid volume and income.