Identification of Nursing Outcomes and Quality Indicators for Home Health Care in Older Adults with End-Stage Cancer.

OBJECTIVE: This study aimed to identify nursing outcomes and quality indicators for older adults with end-stage cancer receiving home health care. METHODS: Nineteen experts and professional caregivers, including palliative doctors, nursing faculty, advanced practice nurses, and registered nurses, participated in the Delphi technique. Final medians and interquartile ranges were calculated. RESULT: Seven components with 43 nursing outcomes and quality indicators for older adults with end-stage cancer were developed, encompassing physical pain relief, symptom management, physical well-being, complication prevention, psychosocial support, caregiver and family roles in end-of-life care, and advance care planning. CONCLUSION: The caregiver and family's role in end-of-life care had the most indicators, reflecting the significance of family involvement in Thailand's cultural context. Consistent implementation of these indicators is crucial, and correlational analysis of indicator scores can enhance their validity.

Examining Nurse and Patient Factors Before and After Implementing an Oncology Acuity Tool: A Mixed Methods Study.

Background and Purpose: To evaluate the nurse documentation compliance, pressure injury compliance, and fall prevention compliance before and after implementing an oncology acuity tool (OAT) at a specialized cancer center in Jordan. Methods: A mixed methods design was used. A qualitative approach was employed using a semistructured interview with 15 nurses selected by purposive sampling. In contrast, the quantitative approach included pre- and postdata obtained to identify the role of adopting the OAT in improving nursing documentation and applying fall and pressure injury-prevention precaution measures. Results: The thematic analysis developed seven themes, including oncology acuity score (OAS) and assignment processes, OAS and patient outcomes, OAS and nurse outcomes, limitations of the OAT, driving forces, restraining forces, and recommendations or suggestions. The results showed significant improvements in nursing documentation (p =.0385), application of pressure injury (p ≤ .00001), and falling precaution measures (p ≤ .00001). Conclusion: Nurse assignment, nursing compliance, and patients' and nurses' outcomes improved after utilizing the OAT.

Outcome-oriented integrated zero-defect nursing combined with respiratory functional exercise in the perioperative period of patients with heart bypass.

OBJECTIVE: This study aimed to explore the perioperative application of outcome-oriented integrated zero-defect nursing combined with respirational function exercise in patients undergoing cardiac bypass grafting. METHODS: In this retrospective study, the clinical data of 90 patients with bypass surgery in the General Ward of Cardiac Surgery, Beijing Anzhen Hospital Capital Medical University were collected. The patients were assigned into groups A (n=30), B (n=30), and C (n=30) according to different nursing methods. Group A received outcome-oriented integrated zero-defect nursing in combination with respiratory functional exercise administration, group B received outcome-oriented integrated zero-defect nursing, and group C received routine nursing. The postoperative recovery was detected. Left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVDD), left ventricular end-systolic diameter (LVSD), and interventricular septal thickness (IVST) were assessed among the three groups pre- and post-intervention. The forced expiratory volume in one second (FEV1), forced vital capacity (FVC), arterial partial pressure of oxygen (PaO2), and arterial partial pressure of carbon dioxide (PaCO2), and blood gas indices were measured before operation and three days after extubation. The occurrence of complications was compared. The quality of life among groups pre- and post-administration was evaluated by the Generic Quality of Life Inventory (GQOLI-74). RESULTS: The length of hospital stay, first exhaust time, first excretion interval, and intestine sound improvement time in groups A and B were markedly decreased compared with those in group C, and these markers in group A were markedly decreased compared with those in group B (all P<0.05). After the intervention, the levels of LVEF, LVDD, LVSD, IVST and FVC in group A were more improved compared with those in groups B and C, and the levels of FEV1, PaO2 and PaCO2 were more improved compared to those in group C (all P<0.05). The incidences of hypotension, subcutaneous hyperemia, pericardial tamponade, short-burst ventricular tachycardia, subacute stent thrombosis and pulmonary complications in group A and group B (13.33%, 23.33%) were significantly lower than those in group C (50.00%) (all P<0.05). After the intervention, the results of social function, physical, psychological function, and material lifecycle status in group A and B were significantly enhanced compared with those in group C, and the indicators in group A were appreciably better compared with those in group B (all P<0.05). CONCLUSION: Outcome-oriented zero-defect integrated nursing in combination with respirational function exercise can efficiently promote the postoperative revival of patients undergoing heart bypass operation, improve their cardiopulmonary function, diminish the occurrence of complications, and improve their life quality.

Nursing outcome quality indicators for patients with ischemic stroke receiving thrombectomy treatment: A Delphi study.

Background: Thrombectomy treatment is a critical procedure that emerged a few years ago, and nurses play a crucial role in the process, particularly in preventing complications and improving outcomes. Therefore, determining the quality of nursing care with best-fit quality indicators in patients with ischemic stroke receiving thrombectomy is necessary. However, no research has determined the nursing outcome quality indicators for these patients. Objective: This research aimed to identify the nursing outcome quality indicators for patients with ischemic stroke receiving thrombectomy treatment. Methods: Nineteen experts involved with patients with ischemic stroke receiving thrombectomy treatment were recruited. The Delphi method was implemented with three rounds between October 2021 to February 2022. Medians and interquartile ranges were analyzed. Results: Twenty-eight nursing outcome quality indicators were developed and grouped into three components, including 1) pre-procedure (five indicators), 2) intra-procedure (six indicators), and 3) post-procedure (17 indicators). Conclusion: This study revealed that the post-procedure of thrombectomy treatment had a greater number compared to pre and intra-procedures. The quality indicators developed in this research are practical and appropriate for nursing practice to enhance the quality of nursing care for patients with ischemic stroke receiving thrombectomy treatment.

Creation and Location-Specific Revision of a Core Nursing Outcomes Evaluation System Based on Nursing Outcomes Classification for Stroke Inpatients in China.

PURPOSE: To screen and create a core nursing outcomes evaluation index system based on NOC for stroke inpatients in China. METHODS: This study adopted the method of Delphi expert consultation, with the degree of consent >4.0 points and the coefficient of variation <0.25 as the standard for inclusion of indexes. RESULTS: The evaluation index system established in this study includes five first-grade indexes, 15 second-grade indexes, and 58 third-grade indexes. CONCLUSION: The evaluation index system of core nursing outcomes for stroke inpatients in China has good specificity and reliability. PRACTICE IMPLICATIONS: The evaluation index system of core nursing outcomes provides a standardized location-specific tool for clinical nurses to evaluate the nursing quality and intervention effect for stroke inpatients in China.

Clinical application of nursing diagnosis, nursing outcome clacication and nursing interventions clacica-tion in health education for hospitalized patients with coronary heart disease / 现代临床护理

Objective To validate the effect of nursing diagnosis, outcomes clacication and interventions clacication(NNN Link)on health education in hospitalized patients with coronary heart disease. Methods Ninety-six patients with coronary heart disease in our hospital during July 2016 to July 2017 were randomly divided into experimental group and control group equally. The control group was given the conventional health education, while the experimental group was given health education by NNN Link at days 1,2,3,7 and one day before discharge.The two groups were compared in terms of nursing outcome scores on admission day,the 5th day and discharge day. Result Day 5 after hospitalization and the day discharged,the scores of knowledge in the experimental group were significantly higher than those of the control group(all P＜0.05). Conclusion The linked nursing diagnosis, nursing outcome and nursing interventions can promote the knowledge of health knowledge and help to improve the quality of nursing service so as to promote research and application of standardized nursing language.

Nursing diagnoses, outcomes and interventions as measures of patient complexity and nursing care requirement in Intensive Care Unit.

AIMS: To describe the nursing diagnoses, outcomes and interventions for patients admitted to intensive care units and to assess their possible relation with classical outcomes like length of stay and mortality. BACKGROUND: The analysis of nursing diagnosis frequencies may help to estimate the patients' complexity and the need for nursing interventions and can predict hospital outcomes. Nonetheless, few studies were conducted on critical patients. DESIGN: Prospective cohort observational study. METHODS: Between 15 July-31 October 2013 we collected the above-described nursing parameters of 100 subjects throughout their stay in intensive care. We classified the parameters according to established taxonomies. The independent association between the number of nursing diagnoses and length of stay/mortality was investigated with multiple regressions. RESULTS: We found an average of 19 diagnoses, 24 outcomes and 60 interventions per patient. Most frequently, the plans of care involved support for self-care deficits or interrupted family processes. They also included strategies to prevent infection, disuse syndrome and impairment of skin integrity. Nineteen nursing diagnoses were significantly related with mortality or length of stay in bivariate analyses. In regression models, the number of such diagnoses explained 29·7% of the variance in length of stay and was an independent predictor of mortality. CONCLUSION: In critically ill patients, the analysis of nursing diagnoses, outcomes and interventions confirmed an intense activity in response to a broad spectrum of patient needs. The number of nursing diagnoses allowed to predict patient outcomes.

Agreement Between Experts Regarding Assessment of Postoperative Urinary Elimination Nursing Outcomes in Elderly Patients.

PURPOSE: This study aims to verify the interrater reliability for indicators of the Nursing Outcomes Classification of urinary elimination. METHODS: A total of 103 elderly postoperative patients were followed by two nurses with specialized training in medical-surgical and gerontological nursing. FINDINGS: The agreement of evaluators was based on interpretation of the Krippendorff's alpha coefficient, for complete emptying of the bladder (.928) and presence of leukocytes (.885). The amount of urine (.262), density (.425), and urinary frequency (.307) had the lowest rates of agreement. IMPLICATIONS FOR NURSING PRACTICE: Analysis of urinary elimination could help in clinical follow-up of elderly postoperative patients and selection of nursing interventions.

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.

Nurse-sensitive indicators suitable to reflect nursing care quality: a review and discussion of issues.

AIMS AND OBJECTIVES: To review nurse-sensitive indicators that may be suitable to assess nursing care quality. BACKGROUND: Patient safety concerns, fiscal pressures and patient expectation create a demand that healthcare providers demonstrate the quality of nursing care delivered. As a result, nurse managers are increasingly encouraged to provide evidence of nursing care quality. Nurse-sensitive indicators are being proposed as a means of meeting this need. DESIGN: Literature review. METHODS: A review of the literature was conducted using CINAHL and MEDLINE from 2002-2011. Key search terms were nurs* and sensitive indicators, outcome measures, indicators, metrics and patient outcomes. RESULTS: Most of the research has examined the relationship between nursing structural variables and patient outcomes in acute care settings and have explored potential indicators for specific patient groups and nursing roles. When using nurse-sensitive indicators, issues concerning the selection, reporting and sustained use are important for nurse managers to consider. CONCLUSION: Evidence for the nurse-sensitivity of some commonly used indicators is inconsistent due to the disparity in definitions used, data collection and analysis methods. Further research on the application and implementation of these indicators is required to assist nurse managers in attempting to quantify the quality of nursing care. Nurses need to continue to strive to achieve agreement on the definitions of indicators, gather strong consistent evidence of nurse-sensitivity, resolve issues of regular data collection and consider selection, reporting and sustainment when implementing nurse-sensitive indicators. RELEVANCE TO CLINICAL PRACTICE: Once identified, nurse-sensitive indicators can be applied for quality improvement purposes, but consensus is required to fully realise their potential. Nurse managers need to be aware of the factors that can influence the use of indicators at unit level. Strategies need to be implemented to promote these indicators becoming integrated with routine nursing care.

Helping a 10-year-old Haitian girl with vaginitis.

PURPOSE: The purpose of this case study is to demonstrate how nurses who work with Haitian children and families can use NANDA-I (diagnosis), the Nursing Outcomes Classification, and the Nursing Interventions Classification to assist a 10-year-old child with symptoms of vaginitis. DATA SOURCES: The case study derives from the author's experience and literature sources. DATA SYNTHESIS: This case study demonstrates a nurse's clinical decision making while providing care to a 10-year-old girl with symptoms of vaginitis. CONCLUSIONS: Increased knowledge and awareness about appropriate health behaviors can increase patients' power and enable them to freely act and adopt health behaviors to improve health outcomes. IMPLICATIONS FOR NURSING: Placing patients at the center of the nursing process and partnering with patients to plan and develop interventions enable them to take actions and improve health outcomes.

Validation of the mobility nursing outcome in stroke survivors.

PURPOSE: To validate the indicators of the mobility nursing outcome. METHODS: This is a methodological study carried out from February to April 2011. The instrument was assessed by 23 nurses, and the data were analyzed using SPSS version 16.0. FINDINGS: The title "physical mobility" was the most suitable. There was a statistical proportion of less than 85% of experts who agreed that the indicators running, crawling, jumping, and moves with ease were relevant to mobility nursing outcome (p < .05). However, these indicators were not associated with stroke patients. CONCLUSIONS: For stroke patients, some indicators are not adequate to their evaluation. IMPLICATIONS FOR NURSING PRACTICE: This work supports the tools' development to assess accurate outcome measurements in specific populations.

A Study on Nursing Diagnoses, Interventions, Outcomes Frequently Used and Linkage to NANDA-NOC-NIC in Major Nursing Departments / 간호행정학회지

PURPOSE: The purpose of this study was to identify NANDA, NIC, and NOC frequently used and their linkages in major nursing departments for development of the nursing process and nursing management system. METHODS: This study was a descriptive study. Data were collected from 123 nurses who worked in medical, surgical, pediatric, gynecologic, and psychiatric department. The questionnaire was based on the NANDA, NOC, NIC, and NANDA-NOC-NIC linkage system. This research was analyzed by an EXCEL program and SPSS Pc+15.0. RESULTS: Nursing diagnoses frequently used were 'anxiety', 'disturbed sleep pattern', 'activity intolerance', 'social isolation', 'nausea', 'ineffective airway clearance', 'chronic pain', nursing outcomes frequently used were 'thermoregulation', 'bowel elimination', 'pain control', 'vital sign status', 'pain level', and nursing interventions frequently used were 'nausea management', 'airway suctioning', 'bowel elimination management', 'diarrhea management', 'medication management'. NANDA-NOC-NIC linkages in major nursing departments were recognized, and these results were similar to the results of other researches. CONCLUSION: The results of this study will be provided as a guideline to apply to the nursing process and development of the nursing process system with the NANDA-NOC-NIC linkage in major nursing department.

Surgery or Intervention for Intracranial Aneurysm in Elderly and Nursing Care: 67 Cases Report / 中国康复理论与实践

@#ObjectiveTo study the treatment and nursing care for intracranial aneurysm in elderly patients. Methods67 patients aged over 60 with intracranial aneurysm were reviewed. ResultsThe outcome was well (Glasgow Outcome Scale scores, 4～5) in 50 cases, and poor in 17 cases(Glasgow Outcome Scale scores, 1～3)．The median of time staying in hospital was 19 d in patients accepted surgery, and 11 d in the patients accepted intervention (P<0.05)． The preoperative Hunt-Hess grade was related with the outcome (P<0.05). ConclusionThe Hunt-Hess grades and the location of aneurysms are related with the outcome, but the treatment of surgery or intervention is not.

Analysis of Nursing Records of Cardiac Surgery Patients Based on Nursing Process Focusing on Nursing Outcome / 대한의료정보학회지

OBJECTIVES: The objective of this study is to find out what nurses wrote in narrative nursing notes. METHODS: Forty-six patients' nursing notes were analyzed based on the nursing process. Eight patterns were extracted depending on the different combinations of the nursing process components. RESULTS: Of the 8 patterns, assessment only pattern was the most frequent comprising 45.8% and assessment or diagnosis-intervention-outcome patterns accounted for 25.9% of the total nursing phrases. The content of nursing notes was also classified into 15 categories. Out of these 15 categories, nursing outcomes were recorded more frequently in nursing care mainly driven by doctor's order such as diseases related symptom management, insomnia care, respiratory care and pain control than in independent nursing care such as education and emotional care. According to the survey on nurses' attitude toward nursing record, nurses did not document nursing outcome as much as they reported they did. The main reasons for this discrepancy were insufficient time for recording and lack of knowledge about why, how and what to evaluate. CONCLUSION: Even though there is room for improvement, nursing notes can be used a source for nursing contribution to patient outcomes.

Perception of Nurse Experts on the Contribution of Nursing Interventions to NOC Nursing Outcomes in General Hospitals in Korea / 간호학회지

The purpose of this study was to identify the perception of nurse experts on the contribution of nursing interventions to Nursing Outcomes Classification NOC nursing outcomes. A nursing outcome is a nursing-sensitive patient outcome primarily affected by nursing interventions. As one of the standardized language systems of nursing outcomes, the NOC must be examined for applicability before it is used in Korea. Data were collected in February and March 2003 using a 5-point Likert scale. For data collection, 230 quality improvement (QI) or quality assurance (QA) nurses from general hospitals in Korea were asked to rate the extent that nursing interventions contribute to each of the NOC nursing outcomes (2000) in their hospitals. Ninety-six nurses from 63 hospitals responded and the response rate was 41.7%. Mean scores for perception of contribution of nursing interventions to each of the NOC nursing outcomes ranged from 2.18 to 4.54. Vital Signs Status had the highest score (M=4.54), and Abuse Recovery: Financial, the lowest score (M=2.18). Of the seven NOC domains, the mean score was highest for Physiologic Health (M=3.91) and lowest for Community Health (M=2.92). Of the 29 NOC classes, the mean score for perceived contribution was highest for Metabolic Regulation (M=4.32) and lowest for Community Well-Being (M=2.92). Participants perceived that nursing interventions in general hospitals in Korea contributed, at least to a certain extent, to most of the NOC nursing outcomes. Based on these results, NOC should have relatively good applicability in Korea.

Effects of a Closed Endotracheal Suction System on Oxygen Saturation, Ventilator-Associated Pneumonia, and Nursing Efficacy / 간호학회지

PURPOSE: The purpose of this study was to examine the effects of a closed endotracheal suction system(CES) on oxygen saturation, ventilator associated pneumonia(VAP), and nursing efficacy in mechanically ventilated patients. METHOD: This study was conducted in the intensive care unit of a University Hospital in Gwangju City. Data was collected from July to October, 2003. Seventy mechanically ventilated patients were randomly divided into two groups; 32 for CES and 38 for open endotracheal suction system(OES) protocol. Twenty one nurses were also involved to examine the nurses' attitude of usefulness about CES. RESULT: SaO2 was significantly different between CES and OES. The incidence of VAP in CES was lower than that of OES. Nursing efficacy was related to time, cost, and usefulness of the suction system. Time of suctioning in CES was shorter than that of OES. CES also contributed significantly to lower the cost of treatment than OES. The usefulness score of CES increased after 6 months of use. CONCLUSION: CES prevented VAP, was cost effective, and a safe suctioning system. CES ncan be used with patients with sensitivity to hypoxygenation and with a high risk of VAP.

A Development of Nursing Outcome Indicators for Stroke Patients / 성인간호학회지

PUPPOSE: This study was conducted to develop nursing outcome indicators based on nursing activities done for stroke patients. METHOD: focus group meeting and delphi technique, which consisted of clinical nurse experts, neurologist, and nursing professors. CVI(Index of Content Validity) and user validity test was performed. RESULT: 12 nursing diagnoses, 29 nursing interventions and nursing outcomes were identified. The former were from NIC and the latter were developed according to nursing interventions. They were verified by experts in focus group. 199 nursing activities were identified, 133 nursing outcome indicators were developed. In user validity, usefulness and usability were tested. CONCLUSION: This systemic approach of measuring nursing outcomes verified nurses' positive effects in changing patients health status and nursing contributions in the health care system as a profession.

Analysis of Nursing Interventions and Nursing Outcomes of the Patients with Liver Transplantation / 성인간호학회지

PURPOSE: This study was designed to investigate the survey of analyzing nursing interventions and nursing outcomes of the patients with liver transplantation. METHOD: The subjects of this study consisted of 83 patients and fifteen nurses who took care of them. The methods of this study were retrospective and descriptive survey. RESULT: The mean age of patients was 42.7 years and the subjects were 62.7% males. 56.7% of these patients were diagnosed with liver cirrhosis of B type. The mean duration of hospitalization was 48.6 days. Ninety-five nursing interventions were performed at least daily. The most frequent used interventions were "environmental management: comfort", "medication administration: parenteral", "cough enhancement", and " oxygen therapy". Even though SGOT level to identify nursing outcomes was decreased, SGOT was not within normal limits. Therefore, even after discharge of patients, There is a need to take care of them carefully. CONCLUSION: Conclusion: These findings revealed the significance and need of nurse practitioners who performed professional nursing intervention for the patients with liver transplantation. Especially, it is necessary needs to develop the nursing intervention programs for comfort.

A System for Nursing Diagnosis and Intervention Management using the Nursing Outcome Indicators / 대한의료정보학회지

This paper proposes a system for nursing diagnosis and intervention management that is using nursing outcome indicators to guide the nursing intervention. In Korea, it has been studied on computerization of nursing process, but most of the studies are on the management of nursing records and not on the databases of nursing intervention. So far, the actual nursing processes have been performed by individual nurses' judgement without any supporting programs. Therefore, we provide the system with standardized database for nursing diagnosis and interventions so that nurses can make more accurate diagnoses and perform more adequate interventions. For that purpose, we have developed an algorithm that links nursing outcome indicators to nursing diagnoses and interventions. As a result, we expect the system can be used in many hospitals efficiently in the future after pilot operations.