MAJOR COMPONENTS OF NURSES: EVALUATION OF NURSING ...efccna.org/downloads/Presentations/Session...

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Samancioglu S.*, Unlu D.**, Akcicek F.**

*Internal Medicine Nursing Department , Ege University, Izmir, Turkey

** Ege University Hospital , Izmir, Turkey

Copenhagen 20114th EfCCNa Congress &FSAIO Spring

Congress 24. - 26. March 2011 Copenhagen, Denmark

MAJOR COMPONENTS OF NURSES:

EVALUATION OF NURSING DIAGNOSIS ACCORDING

TO NANDA AND NURSING CARE IN THE INTERNAL

MEDICINE INTENSIVE CARE UNIT

Nursing practice is a major component of health care in ICU

Nursing diagnosis and activities classification systems are

necessary for representing important aspects of

“what nurses do”

Carefully implementing classifications led to enhanced,

accurately stated nursing diagnoses, more effective nursing

interventions, and better patient outcomes

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Lack of motivation

Lack of information about nursing diagnoses, time

limitations, resistance of older nurses

Lack of ability or power to make changes

Resistance from physicians and assistants

The classification not being usable comprehensible

for the nurse

Hakverdioğlu Yönt et al 2009 3

Insufficient number of nurses

Burden of paper-work

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Determine Nursing interventions

Identify the prevalent Nursing Diagnoses (ND) in

the medical intensive care unit

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The study, which was carried out retrospective

Data was obtained in a university hospital Internal

Medicine Intensive Care Unit (ICU) in the period of three

years (2007-2009)

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Totally 431 patients

53.4% male

46.6% female

Mean age was 61.8

Median length of stay 6 days

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RESULTS

NURSING DIAGNOSIS %

Bathing/hygiene self-care deficit 100

Fluid Volume Deficit/Fluid Volume Excess

58.1

Ineffective Breathing Patterns 43.9

Risk for Infection 34.2

Acute pain

28.7

Imbalanced Nutrition 25.2

Altered Thought Processes 24.1

Risk for impaired skin integrity 22.3

Constipation

18.3

Uriner Incontinanse

13.1

Others 11.4 9

Average of 16 different interventions are applying

by nurses each patient in the internal medicine

ICU

Individual care deficit was 100% in the ICU

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Hand- Face care

Mouth care and mouthwash

Eye care

Nail care

Perineum care

Foot care

Hair and body bath

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NURSING

INTERVENTIONS

%

Intravenous interventions 96.2

Taking blood culture 87.3

Urinery catater care 81.4

Hyperthermia care 78.9

Oxygen therapy 76.3

Pain management 59.3

Giving position 57.2

Nausea follow up 44.6

Hypothermia therapy 18.9

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In relation to the most frequent nursing diagnoses

identified in the ICU,

they are also described in the literature as being the

most common,

which would likely indicate that they are common to

the clinical nursing practice as a whole and therefore

deserve greater attention and knowledge about them

Lucena 2006;

Canero, Carvalho, & Galdeano, 2004;

Galdeano,Rossi, Nobre, & Ignácio, 2003;

Guerriero, et al., 2000;

Ventura, 2001 13

It is important to reinforce the idea that to know

them and identify them correctly is fundamental to

precise clinical judgment that forms the basis for

choosing the best intervention and activities to

help the patient with a certain diagnosis and

eventually reach the expected outcome.

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However, other care could have been established as a

priority

The elevated frequency of these nursing diagnoses is

similar to those found in literature, which confirms that

they are common to clinical practice and, therefore, it is

essential that they be explored through studies and

practices that increase our understanding

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TAG DANMARK…

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20.03.2011 The Alps