Nursing diagnoses as factors associated with delirium among intensive care unit patients with sepsis: A retrospective correlational study.

AIMS: To examine whether nursing diagnoses were associated with delirium in patients with sepsis. BACKGROUND: Nursing diagnosis is a nurse's clinical judgement about clients' current or potential health conditions. Delirium is regarded as an important nurse-sensitive outcome. Nonetheless, nursing diagnoses associated with delirium have not yet been identified. DESIGN: Retrospective correlational study. METHODS: This study was carried out from December 2021 to January 2023. We analysed electronic health records of patients with sepsis admitted to the intensive care units (ICUs) of a tertiary hospital in Seoul, South Korea. Delirium was defined based on the Intensive Care Delirium Screening Checklist score. Nursing diagnoses established within 24 h of admission to the ICU were included and were based on the North American Nursing Diagnosis Association diagnostic classification. The data were analysed using logistic regression. Demographics, comorbidities, procedures and physiological measures were adjusted. Regression model was evaluated via receiver operating characteristic curve, Nagelkerke R2, accuracy and F1 score. RESULTS: The prevalence of delirium in patients with sepsis was 51.8%. Ineffective breathing patterns, decreased cardiac output and impaired skin integrity were significant nursing diagnoses related to delirium. Age ≥ 65 years, Acute Physiology and Chronic Health Evaluation II score, mechanical ventilation, continuous renal replacement therapy, physical restraint and comatose state were also associated with delirium in patients with sepsis. The area under the receiver operating characteristic curve was 0.806. CONCLUSION: Ineffective breathing patterns, decreased cardiac output and impaired skin integrity could manifest as prodromal symptoms of delirium among patients with sepsis. IMPACT: The prodromal symptoms of delirium revealed through nursing diagnoses can be efficiently used to identify high-risk groups for delirium. The use of nursing diagnosis system should be recommended in clinical practice caring for sepsis patients. REPORTING METHODS: STROBE checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public involvement.

Researchin NANDA-Ⅰ Nursing Diagnoses, NIC Interventions, NOC Outcomes, and NNN Linkages for elderly patients with abdominal external hernia surgery / 中国实用护理杂志

Objective The purpose of the study was to identify the most frequently used nursing diagnoses,interventions,outcomes and linkages using standardized nursing terminologies for elderly patients with abdominal external hernia surgery.Methods For this study a descriptive design was used.The frequently used NANDA-Ⅰ,NIC,NOC,and NNN linkages were identified through 38 elderly patients with abdominal external hernia surgery who were admitted in hospital from March to August in 2014.Data were analyzed by SPSS17.0.Results The finding showed the most frequently used 5 nursing diagnoses were activity intolerance,impaired tissue integrity,deficient knowledge,chronic pain,and risk for falls,the frequency were 15.51％(38/245),15.51％(38/245),15.10％(37/245),14.69％(36/245) and 14.69％(36/245),the most frequently used 5 nursing outcomes were activity tolerance,ambulation,tissue integrity (skin and mucous membranes),wound healing (primary intention) and knowledge (diet) the frequency were 10.05％(38/378),10.05％(38/378),10.05％(38/378),10.05％(38/378) and 9.79％(38/378); the most frequently used 5 nursing interventions were environmental management (comfort),positioning,exercise therapy (ambulation,) incision site care and environmental management the frequency was all 6.96％(38/546).The most frequently used top 10 NNN linkages were also identified in this study.Conclusions The most frequently used NANDA-Ⅰ,NIC,NOC,and NNN linkages for patients with abdominal external hernia surgery from this study not only offer new knowledge to nurses but also provide scope of evidence-based nursing research in abdominal external hernia clinics.

Diagnósticos de enfermagem de pacientes com insuficiência cardíaca: revisão integrativa / Diagnósticos de enfermería de pacientes con insuficiencia cardíaca: revisión integral / Nursing diagnoses of patients with heart failure: an integrative review

Aim: To identify the information produced and published in the Brazilian and international literature regarding the diagnoses of nurses in the case of hospitalized patients with heart failure. Method: This is an integrative review without a defined time frame, performed with regard to the consultation of the following databanks: CINAHL, MEDLINE, SCOPUS, LILACS, Web of Science, CAPES Thesis Bank, USP Thesis Bank and BIREME. Results: 24 studies were selected and analyzed. Decreased cardiac output, excessive fluid volume, activity intolerance, impaired skin integrity, impaired gas exchange, efficient knowledge, risk of falls and impaired physical mobility were the most frequently mentioned diagnoses in the studies that were analyzed. Discussion: The results match the progression of heart failure, which limits the tolerance of the individual to physical exercise and causes water retention. Conclusion: This evidence will contribute to guiding nursing care and to the development of caring protocols...

Objetivo: Identificar o conhecimento produzido e publicado na literatura nacional e internacional sobre diagnósticos de enfermagem em pacientes hospitalizados com insuficiência cardíaca. Método: Revisão integrativa sem corte temporal definido, realizada nas bases de dados CINAHL, MEDLINE, SCOPUS, LILACS, Web of science, Banco de teses da CAPES, Banco de Teses da USP e BIREME. Resultados: Foram selecionadas e analisadas 24 produções. Débito cardíaco diminuído, volume excessivo de líquidos, intolerância à atividade, integridade da pele prejudicada, troca de gases prejudicada, conhecimento deficiente, risco de quedas e mobilidade física prejudicada foram os diagnósticos mais citados nos estudos. Discussão: Os resultados vão de encontro com a progressão da insuficiência cardíaca, que limita a tolerância do indivíduo ao exercício e causa retenção hídrica. Conclusão: Estas evidências contribuirão para o direcionamento do cuidado de enfermagem e elaboração de protocolos de assistência...

Objetivo: Identificar los conocimientos producidos y publicados en la literatura nacional e internacional sobre los diagnósticos de enfermería dados a pacientes hospitalizados con insuficiencia cardíaca. Método: Revisión integral sin corte temporal definido, realizada en las bases de datos CINAHL, MEDLINE, SCOPUS, LILACS, Web of science, Banco de tesis de la CAPES, Banco de Tesis de la USP y BIREME. Resultados: Fueron seleccionadas y analizadas 24 producciones. Débito cardíaco disminuido, volumen excesivo de líquidos, intolerancia a la actividad, integridad de la piel perjudicada, intercambio de gases perjudicado, conocimiento deficiente, riesgo de caídas y movilidad física perjudicada fueron los diagnósticos más citados en los estudios. Discusión: Los resultados están de acuerdo con la progresión de la insuficiencia cardíaca, que limita la tolerancia del individuo al ejercicio y causa retención hídrica. Conclusión: Estas evidencias contribuirán para direccionar el cuidado de la enfermería y la elaboración de protocolos de asistencia...

O processo de envelhecimento da pele do idoso: diagnósticos e intervenções de enfermagem / The elderly skin aging process: nursing diagnoses and interventions

As alterações próprias do avançar dos anos sobre o organismo humano,ou seja, as modificações fisiológicas são diversas e atingemvários órgãos e funções. Este estudo teve como objetivo identificardiagnósticos e intervenções de enfermagem, relacionados com asalterações de pele do idoso próprias do processo de envelhecimento.Utilizou-se o método da Revisão Integrativa (RI). A buscade artigos científicos foi realizada nas bases de dados CINAHL, LILACS,MEDLINE e SCIELO a partir dos descritores (Decs) diagnósticosde enfermagem, idoso e pele. Selecionaram-se 16 artigos, nosquais foram identificados 22 diagnósticos de enfermagem, 36 intervençõese 15 alterações da pele relacionadas ao envelhecimentocutâneo. Os diagnósticos prevalentes nos achados da RI foram:mobilidade física prejudicada (62,50%); integridade tissular prejudicada(50%); nutrição desequilibrada: menos do que as necessidadescorporais (43,75%) e risco de infecção (43,75%). Foramidentificadas intervenções de enfermagem como: promover/estimulara mobilização (37,5%); inspecionar a pele (31,25%) e observarsinais de infecção (25%). As alterações de pele prevalentes identificadasforam: pele rompida (50%), diminuição da perfusão tissularperiférica (25%) e pele ressecada (37,50%). A formulação de diagnósticosde enfermagem, seguida pela proposição de intervençõesrelacio nadas com alterações cutâneas foi verificada em 50% dosartigos selecionados. Nos demais artigos (50%), não se observoua determinação desses passos do processo de enfermagem. Osresultados da RI permitiram considerar que as alterações fisiológicasda pele do idoso devem ser observadas na formulação de diagnósticose intervenções de enfermagem e que o processo de enfermagemdeve ser utilizado como ferramenta na avaliação de saúde doidoso, pois possibilita o adequado planejamento do cuidado.

Alterations pertaining to the aging process of the human organism,that is, physiological changes, are diverse and act upon several organsand functions. This paper aims to identify nursing diagnosesand interventions related to the elderly skin pertaining to the agingprocess. We used the Integrated Revision (RI) method. The researchto find relevant scientific papers was made in the CINAH, LILACS,MEDLINE and SCIELO databases, using the descriptors (Decs) nursingdiagnoses, elder and skin. We selected 16 papers, in which 22nursing diagnoses, 36 interventions and 15 skin alterations relatedto cutaneous aging were identified. Prevalent diagnoses in the researchedpapers were: impaired physical mobility (62.5%); impairedtissue integrity (50%); imbalanced nutrition: less than body requirements(43.75%) and risk of infection (43.75%). Nursing interventionswere identified, such as: promoting/stimulating mobility (37.5%); inspectingthe skin (31.25%) and observing for signs of infection (25%).Prevailing skin alterations identified were: broken skin (50%), decreasein peripheral tissue infusion (25%) and dry skin (37.5%). Formulationof nursing diagnoses, followed by the proposal of interventionsrelated to skin changes were found in 50% of the selected papers. Inthe others (50%), we did not find these steps of the nursing process.The results of the RI allowed us to consider that physiological alterationsof the elder’s skin must be taken into account when makingnursing diagnoses and interventions and that the nursing processmust be used as a tool when evaluating the elder’s health, as longas it makes possible the adequate planning of care.

O processo de envelhecimento da pele do idoso: diagnósticos e intervenções de enfermagem / The elderly skin aging process: nursing diagnoses and interventions

As alterações próprias do avançar dos anos sobre o organismo humano,ou seja, as modificações fisiológicas são diversas e atingemvários órgãos e funções. Este estudo teve como objetivo identificardiagnósticos e intervenções de enfermagem, relacionados com asalterações de pele do idoso próprias do processo de envelhecimento.Utilizou-se o método da Revisão Integrativa (RI). A buscade artigos científicos foi realizada nas bases de dados CINAHL, LILACS,MEDLINE e SCIELO a partir dos descritores (Decs) diagnósticosde enfermagem, idoso e pele. Selecionaram-se 16 artigos, nosquais foram identificados 22 diagnósticos de enfermagem, 36 intervençõese 15 alterações da pele relacionadas ao envelhecimentocutâneo. Os diagnósticos prevalentes nos achados da RI foram:mobilidade física prejudicada (62,50%); integridade tissular prejudicada(50%); nutrição desequilibrada: menos do que as necessidadescorporais (43,75%) e risco de infecção (43,75%). Foramidentificadas intervenções de enfermagem como: promover/estimulara mobilização (37,5%); inspecionar a pele (31,25%) e observarsinais de infecção (25%). As alterações de pele prevalentes identificadasforam: pele rompida (50%), diminuição da perfusão tissularperiférica (25%) e pele ressecada (37,50%). A formulação de diagnósticosde enfermagem, seguida pela proposição de intervençõesrelacio nadas com alterações cutâneas foi verificada em 50% dosartigos selecionados. Nos demais artigos (50%), não se observoua determinação desses passos do processo de enfermagem. Osresultados da RI permitiram considerar que as alterações fisiológicasda pele do idoso devem ser observadas na formulação de diagnósticose intervenções de enfermagem e que o processo de enfermagemdeve ser utilizado como ferramenta na avaliação de saúde doidoso, pois possibilita o adequado planejamento do cuidado.(AU)

Alterations pertaining to the aging process of the human organism,that is, physiological changes, are diverse and act upon several organsand functions. This paper aims to identify nursing diagnosesand interventions related to the elderly skin pertaining to the agingprocess. We used the Integrated Revision (RI) method. The researchto find relevant scientific papers was made in the CINAH, LILACS,MEDLINE and SCIELO databases, using the descriptors (Decs) nursingdiagnoses, elder and skin. We selected 16 papers, in which 22nursing diagnoses, 36 interventions and 15 skin alterations relatedto cutaneous aging were identified. Prevalent diagnoses in the researchedpapers were: impaired physical mobility (62.5%); impairedtissue integrity (50%); imbalanced nutrition: less than body requirements(43.75%) and risk of infection (43.75%). Nursing interventionswere identified, such as: promoting/stimulating mobility (37.5%); inspectingthe skin (31.25%) and observing for signs of infection (25%).Prevailing skin alterations identified were: broken skin (50%), decreasein peripheral tissue infusion (25%) and dry skin (37.5%). Formulationof nursing diagnoses, followed by the proposal of interventionsrelated to skin changes were found in 50% of the selected papers. Inthe others (50%), we did not find these steps of the nursing process.The results of the RI allowed us to consider that physiological alterationsof the elder’s skin must be taken into account when makingnursing diagnoses and interventions and that the nursing processmust be used as a tool when evaluating the elder’s health, as longas it makes possible the adequate planning of care.(AU)