bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Conceptual Development of Dependence, Independence, and Interdependence as Potential Nursing Diagnoses
Authors: Anderson Whiting Sylvia M. , Whiting Judith A. 
Published: August 2004

BACKGROUNDA Delphi study was completed in 1992. In the interim, sample statements were used to begin development of a questionnaire for ultimate testing of the concepts of dependence, independence, and interdependence. The statements have been used over several years in questionnaires given to students, adults in church groups, and individuals from a clinical cohort who have been in therapy with one of the authors. Certain statements are being considered for deletion because they may not be mutually exclusive; they will remain part of the questionnaire, however, until testing is completed.MAIN CONTENT POINTSDependency is well described as a disorder in psychiatric literature; however, the concept should be considered for inclusion in the nursing nomenclature. No attention has been given to independence as a disordered state of being, and interdependence has not been included in the nomenclature even though the term is frequently used in nursing literature to describe interactions between people.Nurses have long taken care of clients with problems of dependency or independence; however, while dependency has constituted a major focus of caregivers, independence has been ignored since it has traditionally been conceived of as a healthy behavior only. Clients often present with what is being termed defensive independence as opposed to dysfunctional independence. Interdependence is considered to be a healthy state of being and may be a way of defining strengths, depending on the degree to which it is demonstrated in given individuals. Recognizing that people tend to lack objectivity about themselves, a companion questionnaire is in development for use with spouses, partners, or any who have a close relationship with the client. The items are matched but are written as “My spouse/friend….”CONCLUSIONSThe client questionnaire will lend itself to research by clinical nurse specialists or nurse practitioners who work with clients having relationship problems.
Describing Professional Nursing Through a Universal Record in Perioperative Settings
Authors: Beyea Suzanne C. 
Published: August 2004

PURPOSETo establish professional nursing practice standards for perioperative documentation in order to provide clinicians and software developers with a national model for perioperative documentation.METHODSThe sample consisted of paper and computerized records representing clinical practice settings from for‐profit, nonprofit, and government agencies. Facilities ranged in size from 45–>900 beds and performed, on average, 500 surgeries each month. Intraoperative records ranged from 1–7 pages.A national sample of more than 150 perioperative records representing both inpatient and ambulatory settings were collected and analyzed to identify common data elements. Data elements that represented the intraoperative period were noted, using a structured format. Two expert nurses conducted the analysis and achieved a high level of interrater reliability when coding the clinical records.FINDINGSThis analysis uncovered a disappointing reality about the current status of intraoperative nursing documentation. One major finding included the marginal consistency in the collection of structural data elements (e.g., start time, stop time, anesthesia type, wound classification). Also, nursing diagnoses, interventions, and patient outcomes were documented in fewer than 22% of the records.CONCLUSIONSIn surgical settings, the professional aspects of intraoperative nursing care are embedded in the care delivered and not accurately or fully represented in clinical documentation. To understand the contributions of perioperative nurses to surgical outcomes, the framework for documentation must be structured in a manner that includes nursing diagnoses, interventions, and outcomes. The benefits of structured vocabulary can only be fully realized when national documentation standards are established and implemented within and across settings. This effort resulted in the development of a best practice model for a nursing preoperative assessment and intraoperative documentation that has been adopted by clinicians and software developers.Professional nurses must document the care they provide in a manner that represents the professional aspect of their care. Nursing contributions cannot be fully evaluated unless they are represented and documented in clinical records. The use of structured vocabulary may assist nurses to accept and utilize standardized terms, but the most important factor is a nursing record that fully represents and describes professional nursing practice. The ability to computerize clinical records will not help in evaluating the effectiveness of nursing practice unless assessments, identified problems, interventions, and outcomes are consistently and appropriately documented.
Integrating Nursing Acuity, NANDA, NIC, and NOC Into an Automated Nursing Documentation System
Authors: Frederick Julie , Watters Mary 
Published: August 2004

BACKGROUNDThe goal of this project was to have nursing documentation drive acuity in a seamless fashion. The success we have encountered was building our framework with standardized nursing language, integrating our stable patient classification system into the framework, and enclosing them online in the computer documentation system.MAIN CONTENT POINTSNursing documentation with NIC and NOC drives the acuity system. Acuity mapping is integrated into the automated nursing documentation system.CONCLUSIONSOur success in integrating nursing acuity, NANDA, NIC, and NOC into an online nursing documentation system has been monumental. The healthcare team's documentation can truly identify the patient's needs and provide the necessary acuity to make appropriate assignments, staff according to skill level requirements, and charge patients accurately. The journey from online documentation to integrating NANDA, NIC, and NOC into an online acuity system is just a start in identifying nursing best practices and efficient and effective patient outcomes. Continued research will prove exciting and lead the institution into the next step of patient outcome successes.
Nursing Care Documentation Using NANDA, NIC, and NOC
Authors: Johnson Carole 
Published: August 2004

BACKGROUNDProfessional nurses worldwide are concerned as we struggle to communicate and document what a nurse actually does, and how nursing decisions and actions contribute to the care component of health care. Nurses are confident that their actions affect patient care quality through improved patient outcomes, but data collection is the only way to defend this position. To enable nurses to contribute to these data, we need to expose them to the new languages in a pragmatic rather than theoretical format. Nurse‐friendly documents must be made available to assist the practitioner to assimilate the new languages into the daily practice of nurses who work with and care for real clients.MAIN CONTENT POINTSThis tool, organized according to the NIC taxonomy, begins appropriately with patient assessment and guides the nurse to courses of action that increase the probability of producing effective outcomes. As suggested interventions reflect current nursing practice gathered from expert clinicians in most specialties, the learning curve is not overwhelming.CONCLUSIONSWhile this document focused on the elderly, the format can be adapted for any patient population by a facility's expert clinicians, who would choose the most appropriate interventions and outcomes for the population served.
Applying Standardized Nursing Language to Three Cardiac and Pulmonary Rehabilitation Programs in a Rural Setting
Authors: Ahern Cathleen K. 
Published: August 2004

BACKGROUNDThe need for travel between rural and tertiary hospitals for cardiopulmonary services is a reality many patients experience. Communication between hospitals is essential in providing the most effective and efficient patient care. This work involved incorporating NANDA, NIC, and NOC into standard care plans and the ongoing documentation expansion for the care of an outpatient cardiopulmonary population.MAIN CONTENT POINTSThis regional project involved cardiopulmonary rehabilitation programs from three Mayo Health System affiliates. Acute care had begun to use NANDA, NIC, and NOC for computerized documentation. Cardiopulmonary services realized the benefits of following acute care's lead in applying standardized nursing language to outpatients. The project was undertaken to enhance communication across the care continuum.Pertinent NANDA nursing diagnoses, NIC interventions, and NOC outcomes were identified, a process that invoked the discussion of the commonalities and differences among the three taxonomies. This became beneficial in benchmarking the different program structures and gleaning best practices. Through much discussion the care plans were developed with subsequent revisions as necessary.Issues surrounding the project included getting used to the terminology and computerization, getting bogged down in the details, trusting each other with information about programs, building a group cohesiveness, seeing timely results of our efforts, and communication among sites.CONCLUSIONSBenefits realized through this project were strengthening the comprehensiveness of the plan of care for cardiopulmonary patients and computerizing the patient record. Through this process the interdisciplinary cardiopulmonary practice was better defined. Communication was strengthened because standardized nursing language took the “fuzz” out of communication between providers and across the care continuum. Another outcome included establishing trust and collegiality among the three sites for future networking and problem solving. Outcomes data can be used to test the effectiveness of nursing interventions for the improvement of patient care. This research should encompass studying the effectiveness of care provided within the programs as well as across the care continuum.
Estimated Time and Educational Requirements to Perform NIC Interventions
Authors: Bulechek Gloria M. , Dochterman Joanne McCloskey 
Published: August 2004

PURPOSETo estimate the time to perform and type of personnel to deliver each of the 486 interventions listed and described in the third edition of NIC.METHODSSmall groups of research team members rated selected interventions in their area of expertise on education and time needed for each intervention. Education needed was defined as the minimal educational level necessary to perform the intervention in most cases in most states. Rating categories were (a) nursing assistant (NA/LPN/LVN/technician), (b) RN (basic education whether baccalaureate, associate degree, or diploma), or (c) RN with post‐basic education or certification. Time needed was defined as the average time needed to perform the intervention. Raters selected one of five possible time estimates: (a) <15 minutes, (b) 16–30 minutes, (c) 31–45 minutes, (d) 46–60 minutes, or (e) >1 hour. All ratings were reviewed across groups to ensure overall consistency.FINDINGSResults of this exercise provide beginning estimates of the time and education needed for 486 NIC interventions. Twenty percent required <15 minutes, 30% required 16–30 minutes, 17% required 31–45 minutes, 12% required 46–60 minutes, and 21% required >1 hour. More than 70% of the interventions were judged as needing basic RN education to perform. Raters judged RN post‐basic education to be required to performi 16% of the interventions, and 14% were deemed appropriate for personnel with NA/LPN education to perform. A monograph, Estimated Time and Educational Requirements to Perform 486 Nursing Interventions, available from http://www.nursing@uiowa.ed/cnc, includes lists of interventions appropriate for each time and education category, as well as time and education ratings according to NIC domains and classes.DISCUSSIONThe estimates of time and education provided by expert ratings provide a good beginning for cost estimates, resource planning, and reimbursement. The results of this study add to the small but growing body of literature that demonstrates that estimates of time to perform interventions by nurses who are familiar with the interventions is an accurate and efficient method to determine time values. A description of how this information can be used in a costing model is in the July/August 2001 issue of Nursing Economics.CONCLUSIONSNIC has identified the interventions that nurses perform. This study of time to perform and type of personnel to deliver each of the NIC interventions can help nurse leaders make better‐informed decisions about cost‐effective nursing care.
Use of NANDA, NIC, and NOC in a Baccalaureate Curriculum
Authors: Finesilver Cynthia , Metzler Debbie 
Published: August 2004

BACKGROUNDFor the last 8 years, NANDA, NIC, and NOC have been successfully introduced to students in fundamentals courses at Bellin College of Nursing. As students progress through the curriculum, the classifications are expanded and applied to various client populations in all settings. The faculty expect students to use NANDA, NIC, and NOC in a variety of ways: during preparation for care of clients, documentation of client care, discussion of clients in postconference; in formal nursing process papers; and in the college laboratory setting.MAIN CONTENT POINTSThrough the use of standardized languages, which address all steps of the nursing process, students have been able to plan, implement, and evaluate nursing care in all settings, from primary care to specialty care areas. Application of the NANDA, NOC, and NIC frameworks into a baccalaureate curriculum is desirable because the classifications are research based, comprehensive, and based on current nursing practice. NOC and NIC include physiologic, psychosocial, illness prevention and treatment, health promotion, and alternative therapies. Because of the universal and clinically meaningful language, students are able to communicate and document nursing activities in diverse settings and better define the unique actions and value of nursing.Feedback from students and faculty has been positive. Faculty members are encouraged to refine and alter course expectations related to NANDA, NOC, and NIC as needed. Students in the fundamentals courses adapt easily to NANDA, NOC and NIC during small group work and during discussion of common client problems, such as constipation.CONCLUSIONSAlthough the frameworks are not used as part of the organizing framework, they are used to teach nursing process and increase students' critical thinking and problem‐solving capabilities.
Patient Response to the Fast‐Track Experience
Authors: Flanagan Jane , Jones Dorothy 
Published: August 2004

PURPOSETo describe patients' functional health, symptom distress, and recovery at home across a fasttrack perioperative experience.METHODSA nonexperimental, descriptive, correlational design using pre/post test measures and openended questions captured the fast‐tracking experience. A convenience sample included 77 patients entering the same‐day surgery unit to undergo arthroscopy with general anesthesia and planned fast‐track recovery. In the preadmission test area, patients were asked by a nurse to participate in the study. If they agreed and met selection criteria, a nurse completed a demographic sheet, the Foster and Jones Functional Health Pattern Assessment Screeing Tool (FHPAST), and the Symptom Distress Scale (SDS).On the evening of surgery, a nurse called the patient to review the SDS to be completed by phone. At 72 hours after surgery, the FHPAST, the SDS, and a 72‐hour open‐ended questionnaire were administered to understand the patient experience of fast‐tracking.FINDINGSAt 12 hours nurses reported patients were “euphoric” and it was difficult to imagine pain or other symptoms. Some patients complained of nausea and fatigue. Most patients had family present. At 72 hours patients described unmet expectations, fatigue, immobility, ineffective pain management, sleep disturbance, and nausea. Interventions included teaching, coaching, and reassurance. Some patients continued to have nursing problems at 72 hours and benefited from a telephone follow‐up call.CONCLUSIONSPreliminary results suggest that nursing diagnoses, interventions, and outcomes can be used to describe patient responses to the fast‐track experience. Results indicate a need for practice changes to include innovative models and further research to measure outcomes. Fast‐tracking can be effective, but requires clinical reasoning by nurses to guide the individual's healing. A coaching intervention seems to enhance patient satisfaction and a sense of being cared for.
Standardized Care Planning: Evaluation of ICNP Beta in the Areas of Nutrition and Skin Care in a Practice Setting
Authors: Florin Jan , Ehrenberg Anna , Ehnfors Margareta 
Published: August 2004

PURPOSETo evaluate completeness, granularity, multiple axial content, and clinical utility of the beta version of the International Classification of Nursing Practice (ICNP®).METHODSStandardized care plans were developed based on research in the areas of nutrition and skin care and clinically tested in a 35‐bed infectious disease unit at a Swedish university hospital. A convenience sample of 56 computerized and manual patient records were content analyzed and mapped to the terms in ICNP® beta.FINDINGSA total of 1,771 phrases were identified. Approximately 60% of the record content describing nursing phenomena and about one third of the nursing interventions in the areas of nutrition and skin care could be expressed satisfactorily using the terminology of ICNP® beta. For about 25% of the content describing both nursing phenomena and interventions, no corresponding term was found. The most common deficiencies were focus terms for stating patient perspective or collaboration, nonhuman focus, normal findings, more qualitative judgments, and different expressions for stating duration. Some terms are available in the ICNP beta as a whole, but the organization of axes impedes or restricts the use of terms beyond the ICNP categories. Terms needed to express nursing phenomena could sometimes be found in nursing actions axes.CONCLUSIONSThe ICNP® beta needs to be further developed to capture relevant data in nursing care. The axial structure needs to be evaluated, and completeness and granularity of terms need to be addressed further before ICNP beta can be used on a daily basis in the clinical setting. Terms need to be developed to express patient participation and preferences, normal conditions, qualitative dimensions and characteristics, nonhuman focuses as well as duration. Empirical studies covering the complexity of information in nursing care are needed.
Using NIC to Describe the Role of the Nurse Practitioner
Authors: Haugsdal Cindy S. , Scherb Cindy A. 
Published: August 2004

PURPOSETo have nurse practitioners (NPs) identify the 20 most prevalent NIC interventions describing their nursing practice; to determine if the NIC is applicable to the NP role.METHODSThe study used a descriptive survey design. NPs with prescriptive privileges in the state of Minnesota received a cover letter and survey that included a description of NIC and a list of the 486 intervention labels and their definitions from the NIC (3rd ed.). Each participant was asked to identify all interventions performed at least once per month in their practice and to provide basic demographic data, including identification of NP specialty.FINDINGSA total of 1,190 surveys were mailed with a return rate of 37%. NPs' average age was 45 years; the average number of years of NP practice was 9. Employment in a clinic represented the work setting of 72% of respondents followed by hospital practice (11%) and long‐term care (10%). Specialty (certified) areas were family practice (27%), pediatrics (21%), adult (19%), women's health (16%), geriatrics (11%), psychiatric (5%), and oncology (1%). The educational level was primarily master's degree (73%).NPs identified an average of 120 interventions they performed at least once per month. These interventions reflected areas of patient education and support, as well as documentation and physician collaboration. The 20 most frequently selected interventions were reported by 71%– 90% of respondents. Four core interventions —“documentation,”“telephone consultation,”“teaching: prescribed medication,” and “emotional support”— were used at least once per month by all specialties.DISCUSSIONThe level of consistency (70%) among responses validates the strong foundation that professional nursing, as described by NIC, provides NPs in their role. Four core interventions and the remaining 16 most frequently selected interventions that are more specific to each specialty practice indicates that NIC is comprehensive enough to meet the needs of a variety of NP practices.CONCLUSIONSNIC encompasses key areas of interventions (health screening, treatment and management, health promotion and education, psychosocial support, indirect activities) central to the role of NPs, but qualitative comments described the need for more language within NIC to characterize the NP role related to the prescribing of medications and treatments. Some respondents found the definitions to be unclear as to whether they were performing or ordering/prescribing the intervention. This lack of clarity could be addressed by further development of the NIC definitions and activities so the advanced role of the NP is more fully described.Development of documentation systems using the core interventions identified by the various NP specialties is needed. Using standardized nursing language for documentation will enable NPs to build clinical databases that reflect and describe the role. Future research needs to be focused by NP specialty and to go beyond the NIC definition and include analysis at the activity level.
NLINKS: Online Research and Web Site Development
Authors: Lavin Mary Ann , Fletcher Ben 
Published: August 2004

BACKGROUNDThe Network for Language in Nursing Knowledge Systems (NLINKS) was the product of a 1998 NANDA Board of Directors brainstorming session. As a project, it was approved by the membership at the NANDA conference in Orlando, Florida in 2000. It became an online reality in fall 2001, and a summary of its development was presented at the NNN 2002 conference in Chicago, IL.MAIN CONTENT POINTSNLINKS provides the infrastructure needed for Web development opportunities in the field of language development. At present, NLINKS consists of the following components: Information page, an “About NLINKS” page, a Concept Analysis Center, a Research Center, and a Membership/Donor page. While anyone is free to use the information provided on the site, a paid membership in NLINKS confers two privileges that are especially relevant to networking worldwide. NLINKS members may use the site to conduct online research, or use the domain name and infrastructure to develop a Special Interest Center.Research investigators may develop online surveys, diagnostic tests, online health promotion tools, as well as other applications for completion by visitors to the site or by subjects recruited by the investigators. Taxonomists, informaticists, international colleagues, and others may be interested in developing an NLINKS center for their own special interest purposes. The process from application through implementation is similar for researchers or special interest groups. It entails six steps: (a) designing a site map for the pages desired and accompanying business profile, (b) negotiating a price with NLINKS's coordinator and Web development firm, (c) submitting a research proposal with institutional review board approval if human research is to be conducted, (d) establishing formal contractual relationships among all parties, (e) raising funds or obtaining grant funds to cover the cost, and (f) constructing the research or special interest center pages with staff from the Web development firm.CONCLUSIONSDevelopment and use continues as we strive to expand the site.