The effects of applying an assessment form based on the health functional patterns on nursing student's attitude and skills in developing the nursing process

Nursing Diagnosis Accuracy in Nursing Education: Clinical Decision Support System Compared With Paper-Based Documentation-A Before and After Study

Computer-based technologies have been widely used in nursing education, although the best educational modality to improve documentation and nursing diagnostic accuracy using electronic health records is still under investigation. It is important to address this gap and seek an effective way to address increased accuracy around nursing diagnoses identification. Nursing diagnoses are judgments that represent a synthesis of data collected by the nurse and used to guide interventions and to achieve desirable patients' outcomes. This current investigation is aimed at comparing the nursing diagnostic accuracy, satisfaction, and usability of a computerized system versus a traditional paper-based approach. A total of 66 nursing students solved three validated clinical scenarios using the NANDA-International terminologies traditional paper-based approach and then the computer-based Clinical Decision Support System. Study findings indicated a significantly higher nursing diagnostic accuracy ( P < .001) in solving cancer and stroke clinical scenarios, whereas there was no significant difference in acute myocardial infarction scenario. The use of the electronic system increased the number of correct diagnostic indicators ( P < .05); however, the level of students' satisfaction was similar. The usability scores highlighted the need to make the electronic documentation systems more user-friendly.

Web-based standardized patient simulation for taking anamnesis: an approach in nursing education during the pandemic

BACKGROUND

To address the challenges in nursing education brought about by the pandemic, this study aimed to evaluate the use of a web-based standardized patient practice in the development of nursing students' anamnesis taking skills and their views about its application.

METHOD

We conducted a descriptive intervention study with 39 s-year nursing students. The students completed anamnesis using the standardized patient practice in line with a scenario with real standardized patients in a web-based environment with audio and video.

RESULTS

The total scores of students' anamnesis skills were low. The agreement between the total scores, scores obtained from the health patterns, and each item in the control list was statistically significant (p < 0.05).

CONCLUSION

Web-based standardized patient practice is an alternative for clinical practice facilitating the gaining of competencies in making holistic nursing diagnoses under conditions that limit face-to-face interactions, such as pandemics.

Nursing knowledge captured in electronic health records

PURPOSE

The purpose of this study was to describe the extent to which nursing assessment data was present in the electronic health record and linked to NANDA-I, NIC, and NOC.

METHODS

This retrospective review used a descriptive approach to examine documentation in the electronic health records (EHR) of 10 hospitalized patients requiring cardiac surgery. A team of experts applied a Delphi consensus-building process to identify the supports and barriers for nursing documentation.

FINDINGS

Collection of the health history was organized using Gordon's Functional Health Pattern (FHP) Framework. Seventy-five fields were noted for the entry of nursing assessment data of which 65 focused on health history data and 30 documented physical findings and observations. There were no references to the defining characteristics or etiologies with any of the diagnostic labels used. Care plans included the nursing diagnoses, goals of care, and interventions, although there was a lack of clear alignment between the assessment, NANDA-I, NIC, and NOC and the care plan. Progress note documentation addressed significant events in the patient's clinical course; however, these were not nursing problem or diagnosis focused. Four expert reviewers arrived at consensus regarding the supports and challenges impacting nurses' ability to document data depicting nursing's contribution to care using a FHP and standardized nursing language in the EHR.

CONCLUSIONS

The EHR provides an opportunity to reflect nursing clinical judgment and make nursing care visible. These findings suggest there are challenges to capturing nurse focused data elements in the EHR.

IMPLICATIONS FOR NURSING PRACTICE

This work has important implications for clinicians, educators, and administrators alike. EHR systems must accurately capture nurses' contribution to patient care to plan for resource allocation and quality care delivery. Ultimately, the development of standardized data sources reflecting the outcomes of nursing care will expand the opportunities to advance nursing knowledge.

Nursing process application in Nepal teaching hospital

Relevance. Nursing process is a scientific method of organizing and providing nursing care. Due to imbalance of nurse patient ratio, application of nursing process in actual clinical setting is very limited which reduces the quality nursing care. Despite the importance of application of nursing process, there is no standard nursing process protocol available in the hospital where study was carried out. The governments set a standard nurse patient ratio in Nepal, UK and USA is 1:10, 1:8, and 1:5 respectively. However, global statistic has been revealed due to improper nurse patient ratio which cannot implement the nursing process for patient caring which are being for leading cause of mortality of patient in hospitals. Aim of the study. The study was conducted to assess the application of the nursing process among nurses working in teaching hospital. Additionally, this study explores the association between status of application of nursing process and selected variables. Materials and Methods. Based on a descriptive cross-sectional study design. A simple random sampling technique was applied for nurses working in tertiary hospital of Chitwan, Nepal. The data was collected using structured questionnaire among 182 nurses. The statistical analysis tool chi-square was used to find out the association and logistic bivariate to find out the odds ratio. Results and Discussion. The result indicates that only 23,1 % of nurses have moderate level of application of nursing process. Majority of nurses did not follow standard ways of nursing process. This study also explored the infl ncing variable for barriers related to nurses and profession. Age (p=0.001), professional qualification (p=0.001) and learning approach (p=0.022) were the significant influencing variable for barriers related to nurses whereas practical skill (p= 0.001), cooperation among nurses (p=0.008) and diffi in diagnosis characteristic (p=0.010) were the barrier related to profession. Conclusion. It was concluded that the majority of nurses working in teaching hospital of Nepal did not follow the standard ways of nursing process so that barriers for the application of nursing process are identifi The overall ratio of nurses to patients in the teaching hospital is 1:16, that is in the lower range than the standards set by the government. Therefore, special attention must be paid to adherence to a standardized nursing process protocol for quality medical care.

Nursing process application in Nepal teaching hospital

Relevance. Nursing process is a scientific method of organizing and providing nursing care. Due to imbalance of nurse patient ratio, application of nursing process in actual clinical setting is very limited which reduces the quality nursing care. Despite the importance of application of nursing process, there is no standard nursing process protocol available in the hospital where study was carried out. The governments set a standard nurse patient ratio in Nepal, UK and USA is 1:10, 1:8, and 1:5 respectively. However, global statistic has been revealed due to improper nurse patient ratio which cannot implement the nursing process for patient caring which are being for leading cause of mortality of patient in hospitals. Aim of the study. The study was conducted to assess the application of the nursing process among nurses working in teaching hospital. Additionally, this study explores the association between status of application of nursing process and selected variables. Materials and Methods. Based on a descriptive cross-sectional study design. A simple random sampling technique was applied for nurses working in tertiary hospital of Chitwan, Nepal. The data was collected using structured questionnaire among 182 nurses. The statistical analysis tool chi-square was used to find out the association and logistic bivariate to find out the odds ratio. Results and Discussion. The result indicates that only 23.1 % of nurses have moderate level of application of nursing process. Majority of nurses did not follow standard ways of nursing process. This study also explored the influencing variable for barriers related to nurses and profession. Age (p=0.001), professional qualification (p=0.001) and learning approach (p=0.022) were the significant influencing variable for barriers related to nurses whereas practical skill (p= 0.001), cooperation among nurses (p=0.008) and difficulty in diagnosis characteristic (p=0.010) were the barrier related to profession. Conclusion. It was concluded that the majority of nurses working in teaching hospital of Nepal did not follow the standard ways of nursing process so that barriers for the application of nursing process are identified. The overall ratio of nurses to patients in the teaching hospital is 1:16, that is in the lower range than the standards set by the government. Therefore, special attention must be paid to adherence to a standardized nursing process protocol for quality medical care.

Consensus on the health education of home-based negative pressure wound therapy for patients with chronic wounds: a modified Delphi study

Background

The study aimed to develop consensus on the components of health education of home-based negative pressure wound therapy (NPWT) for patients with chronic wounds.

Methods

A Delphi method was used to achieve consensus on the components of health education and 75% agreement and coefficient of variation (CV) <0.25 were used as cutoff. Sixteen experts were recruited purposefully to finish this study.

Results

Two rounds of consultation were implemented. Consensus was achieved on 36 of the 42 statements. The final agreed list of statements represented three domains: health education before carrying out home-based NPWT, health education for the treatment day of NPWT at hospital and health education for NPWT at home.

Conclusions

This study was the first attempt to develop consensus on the comprehensive components of health education of home-based NPWT for patients with chronic wounds. According to the established framework and components of health education, wound professionals can safely and effectively implement health education of home-based NPWT for patients with chronic wounds and improve their self-care ability and treatment experience at home.

End-of-life: An urgent update in nursing terminology

Although nursing terminologies and classifications represent nursing knowledge across diverse clinical areas, end-of-life care seems under represented in many aspects of these instruments. NANDA- I is an international nursing diagnostic classification widely used in nursing education and research. This taxonomy is based on seven axes, including the axis of time. In this commentary we bring discussion to the need to update nursing terminology by including the term end-of-life in the time axis of NANDA-I. After describing the epidemiologic aspects of end-of-life care and discussing the relevant nursing role, we discuss patients' and family's human responses towards the end-of-life time and circumstance, which are central to defining nursing diagnoses. End-of-life care is one priority in health care, and nursing diagnoses should represent that situation as well. This paper focuses on a specific and international nursing diagnosis classification, NANDA-I, which lacks an end-of-life component to its time axis for defining labels of nursing diagnoses. Attending to the importance of classifications in clinical reasoning, nursing diagnoses could better represent responses towards this health condition, opening new opportunities for increasing nursing roles in clinical practice, and also for new studies aiming to validate nursing diagnoses, and promoting an evidence-based practice by including end-of-life in the axis time.