Margaret Lunney, RN, PhD
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Transcript of Margaret Lunney, RN, PhD
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Margaret Lunney, RN, PhD
Crista MinthornLoraine SkeahanDorothy VanDerWiele
Participant Action Research with Nurses to Identify NANDA, NIC and NOC Categories for Care of People with Diabetes and Women in Labor
Mary Beth MaciagAlda Savite
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This paper focuses on use of action research methods with nurse leaders
and staff.
Action Research Methodology
Findings: People with Diabetes,
Women in Labor
Advantages of Using Action Research Methods
problemproblem
Action
Research Plan
Action
Research Plan
DataData
ResultsResults
Action Research
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Action Research using NNN educates staff nurses on the
relevance of terms.NANDA
NICNOC
Local Studiesneeded
1,041 terms
determined by
experts
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With action research methods, the stakeholders or clinical nurses are
the researchers.
Level Playing Field
Engagement
Community-Based
Nurses’ Experience
Reflection
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The PI facilitates a process with stakeholders to achieve 100%
consensus. Develop Informed Consents & IRB submission
Train nurse leaders to conduct group sessions
Ensure trustworthiness of research products
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Informed consent and IRB review is necessary.
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Each group of nurses focused on their specific population of
patients.
Adults with Diabetesadmitted to HRMC
Women in Labor including the first hour after delivery
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Consensus validation was used to make the linkages with the terms.
Initial: Define the population
Reflect on Diagnoses
Consensus on
Interventions
Reflect on Intervention
s
Consensus on
Diagnoses
Reflect on Dx Interventions &
Outcomes
Consensus on
Dx/Interventions
Reflect on Outcomes
Consensus on Outcomes
Reflect on Dx/Interventi
ons
Consensus on Dx
Interventions & Outcomes
Final: Validation
Dx Intervention
s & Outcomes
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Date: November 22, 2005 1 nurse 2 nurses 3 nurses 4 nursesDiagnosis Relevance
Activity intolerance XActivity intolerance, risk for XAdjustment, impaired XAirway clearance, ineffectiveAllergy response, latexAllergy response, latex, risk forAnxietyAnxiety, deathAspiration, risk forAttachment, impaired parent/infant/child, risk forAutonomic dysreflexiaAutonomic dysreflexia, risk forBody image, disturbedBody temperature, imbalanced, risk forBowel incontinenceBreastfeeding, effectiveBreastfeeding, ineffectiveBreastfeeding, interruptedBreathing pattern, ineffectiveCardiac output, decreasedCaregiver role strain XCaregiver role strain, risk for XComfort, impairedCommunication, verbal, impairedCommunication, readiness for enhancedConflict, decisional (specify)Conflict, parental roleConfusion, acuteConfusion, chronicConstipationConstipation, perceivedConstipation, risk forCoping, ineffective XCoping, readiness for enhancedCoping, community, ineffectiveCoping, community, readiness for enhancedCoping, defensiveCoping, family, compromised XCoping, family, disabledCoping, family, readiness for enhanced
12/14/2005 Final List Med Surg: Patient with DM
ineffective
Tissue integrity, impaired
Tissue perfusion, ineffective
Therapeutic regimen management, ineffective
Therapeutic regimen management, readiness
for enhanced
Therapeutic regimen management, family,
Sedentary lifestyle
Sensory perception, disturbed
Skin integrity, impaired, risk for
Surgical recovery, delayed
Nutrition, readiness for enhanced
Peripheral neurovascular dysfunction, risk for
Powerlessness, risk for
Role performance, ineffective
Knowledge, deficient
Knowledge of Diabetes Mellitus, readiness
for enhanced
Noncompliance
Denial, ineffective
Falls, risk for
Infection, risk for
Injury, risk for
Caregiver role strain
Coping, ineffective
Caregiver role strain, risk for
Coping, family, compromised
Diagnosis
Activity intolerance
Activity intolerance, risk for
Adjustment, impaired
Final List Diagnoses 12/05
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Final Diagnoses-Interventions-Outcomes for “Activity Intolerance, Risk
For”
Interventions
Activity TherapyAnalgesic AdministrationEmbolus PrecautionsEnergy ManagementExercise ManagementPain ManagementSelf Care Assistance
10/26/06 Diagnosis-Interventions-Outcomes FINALActivity intolerance, risk for
Outcomes
Adults with Diabetes admitted to HRMC
Self Care Activities of Daily Living
Energy ConservationPain Control and Pain Level
Client Satisfaction: Functional AssistanceActivity Tolerance
Comfort LevelEndurance
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Defined as patient care provided from
inpatient admission to L&D through one hour recovery period
after delivery via NSD. Recovery period included
couplet care (mother and baby).
Women in Labor Group
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Diagnosis-Interventions-Outcomes for Anxiety
Interventions
Admission CareActive ListeningElectronic Fetal Monitoring: AntepartumHumorPresenceSimple Relaxation TherapyTruth Telling
Family Support During Treatment
CommunicationAnxiety Self-Control
Comfort Level
Diagnosis-Interventions-Outcomes FINALAnxiety
Outcomes
Women in Labor
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Challenges included
“getting off process” and
assuming incorrect
definitions of terms. People with Diabetes Group
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Many of us are
beginning the
Magnet Journey
for excellenc
e in nursing.
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Collaborating with university faculty and graduate students
seeking clinical sites is advantageous.
Scholarly research is brought to the bedside, a
Magnet journey requirement.
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Financial support
necessary, but only for books and RN time
for consensus sessions.
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Our study cost approximately
Nurses’ time
DM Group Nurses 30 Hours X 4 RNs $5,344.82
Labor Group Nurses 10 Hours X 3 RNs $803.40
Nursing Diagnosis Book -10 $239.40
Nursing Interventions Book -10 $383.63
Nursing Outcomes Book -10 $121.38
Grand Total $6893.63
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Action Research
allows RNs to “reflect”
on their practice.
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Nurses have a developed product to place in a new electronic health record.
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Action research
using NNN with
practicing nurses have innumerable benefits for staff nurses
and the agency.Comments/
Questions?
Women in Labor Group