Tips for teaching nursing diagnosis and the use of nanda international terminology
This presentation is the property of its rightful owner.
Sponsored Links
1 / 20

Tips for Teaching Nursing Diagnosis and the Use of NANDA International Terminology PowerPoint PPT Presentation


  • 52 Views
  • Uploaded on
  • Presentation posted in: General

Tips for Teaching Nursing Diagnosis and the Use of NANDA International Terminology. Nursing Diagnosis: Definition. The NANDA-I definition of a nursing diagnosis was adapted from a national, Delphi study by Dr. Joyce Shoemaker (1984)

Download Presentation

Tips for Teaching Nursing Diagnosis and the Use of NANDA International Terminology

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Tips for teaching nursing diagnosis and the use of nanda international terminology

Tips for Teaching Nursing Diagnosis and the Use of NANDA International Terminology


Nursing diagnosis definition

Nursing Diagnosis: Definition

  • The NANDA-I definition of a nursing diagnosis was adapted from a national, Delphi study by Dr. Joyce Shoemaker (1984)

    • Nursing diagnosis is a clinical judgment about individual, family, or community responses to actual or potential health problems/life processes. Nursing diagnoses provide the basis for selection of nursing interventions to achieve outcomes for which the nurse is accountable (NANDA, 1997).


The diagnoses

The Diagnoses

  • 206 NANDA-approved nursing diagnoses will be present in the Definitions & Classifications book for 2009 - 2011

  • Level of Evidence (LOE) Criteria Established for All New and Revised Diagnoses

    • Entry into the Taxonomy requires various levels of clinical evidence


Clinical decision making

Clinical Decision Making

Health care professionals face complex decisions daily regarding patient care— and must do so with decreased resources

What is the area of concern that nurses can treat/prevent/monitor? (Diagnosis)

What is an appropriate goal for this patient? (Outcome)

What treatment is most effective? (Intervention)


Critical thinking

Critical Thinking

  • Nurses need knowledge of diagnoses, definitions and defining characteristics, especially those common to the populations with which they work and the diagnostic processes that are used to interpret patient data

  • Skills of analyzing, logical reasoning, and applying standards are thinking processes required for accurate diagnosis in nursing

  • These skills are developed through:

    • Discussions of how data should be clustered to generate accurate diagnoses

    • Relation of data clusters to diagnoses

    • Comparisons of existing data to expected data based on research findings.

      Lunney (2009)


Diagnosis requires assessment

Diagnosis Requires Assessment

Identifying human responses that are related to medical diagnosis without a complete assessment to determine the presence of defining characteristics

Lack of instruction on clustering assessment data to derive a list of potential diagnoses

Lack of hypothesis testing to determine best diagnoses for each patient


Nurses are diagnosticians

Nurses Are Diagnosticians

  • Diagnosticians interpret data within their fields of expertise in order to provide needed services

  • A key element of data interpretations is that they are subject to error.

    • A good diagnostician must realize that there are always risks to the accuracy of data interpretations

  • Becoming a nurse diagnostician requires development of professional and personal skills and characteristics

    • Competencies in intellectual, interpersonal, and technical domains

    • Personal strengths of tolerance for ambiguity and use of reflective practice


Teaching methods

Teaching Methods

Review proper method to complete patient assessment to determine the presence of defining characteristics

Clustering of defining characteristics is often misunderstood : presence of one defining characteristic does not necessarily require a diagnosis

All nursing interventions do not require a nursing diagnosis

Medication administration for a condition that is not a primary focus of nursing care is related more to a medical diagnosis

Need to test hypotheses

Need to evaluate success of plan of care and reassess continually


Diagnostic process

Diagnostic Process

Assessment

Cluster cues / defining characteristics

Generatelist of potential diagnoses

Collect additional data to narrow list of potential diagnoses

Determine diagnosis/diagnoses to be treated

Implement plan of care based on identified diagnoses

Evaluate success of plan of care


Cue generation and nursing diagnosis

Cue Generation and Nursing Diagnosis

  • Cues are analyzed in relation to possible diagnoses

  • Existing cues are matched with the expected cues for the diagnoses being considered

  • During the evaluation of cues and related diagnoses, nurses may decide that there are not enough data to make a diagnostic decision or that there is enough evidence for one or more likely diagnoses

    • If there are not enough data to make a diagnosis, then the next step involves a focused search for additional cues

    • If there is enough supporting evidence, a diagnosis is made and then validated


Quality nursing care

Quality Nursing Care

Accurate Assessment and Diagnosis

Defining characteristics

Related factors

Risk factors

Identify Attainable Patient Outcomes

Efficiency

Utilize Proven Interventions

Effective

Least resource-intensive


Quality nursing care1

Quality Nursing Care

Accurate Assessment and Diagnosis

Defining characteristics

Related factors

Risk factors

Identify Attainable Patient Outcomes

Efficiency

Utilize Proven Interventions

Effective

Least resource-intensive


Incorrect diagnostic process

Incorrect Diagnostic Process

Assessment OR Identify Medical Diagnosis

Cluster cues / defining characteristics

Generatelist of potential diagnoses

Collect additional data to narrow list of potential diagnoses

Determine nursing diagnosis/diagnoses to be treated

Implement plan of care based on identified diagnoses

Evaluate success of plan of care


Teaching methods1

Teaching Methods

Requiring students to develop and detail care plans with “every possible diagnosis” creates resistance

Sets up situation that is not realistic

Cannot address every possible diagnosis in a short hospital stay

Becomes a “thing to do” rather than truly understanding and applying diagnostic reasoning and differential diagnosis

Students learn to “just pick a diagnosis” rather than making decisions about the best explanation(s) for patient responses


Teaching methods2

Teaching Methods

  • Use of case studies can assist students in identifying cues in patient situations that may be defining characteristics of one or more nursing diagnoses

  • Hypothesis generation and differential diagnosis skills can be developed through case studies, clinical conference discussions and in skills lab scenarios


The list

“The List”

Automating the electronic record to populate the plan of care with nursing diagnoses when a particular medical diagnosis is used

Becomes a documentation tool rather than an individualized plan of care to direct nursing interventions to meet important patient outcomes

Puts patients at risk / Negligence

May ignore or miss important diagnoses for patients

Plan of care does not address critical outcomes for patients


Reportable quality measures where is nursing

Reportable Quality Measures: Where is Nursing?

Management of diabetes:

Percent of adults with diabetes who had a foot examination in past year

Percent of adults with diabetes who had an influenza immunization in past year

Percent of adults with diagnosed diabetes with HbA1c level > 9.0% (poor control); < 7.0% (optimal)

Hospital admissions for short-term complications of diabetes per 100,000 population


The role of nursing in patient quality

The Role of Nursing in Patient Quality

Percent of adults with diagnosed diabetes with HbA1c < 7.0% (optimal)

Readiness for enhanced family coping

Health-seeking behaviors

Readiness for Enhanced Self Health Management


The role of nursing in patient quality1

The Role of Nursing in Patient Quality

Management of diabetes:

Hospital admissions for short-term complications of diabetes per 100,000 population

Anxiety

Ineffective coping

Ineffective health maintenance

Risk for injury

Deficient knowledge

Ineffective Self Health Management


Diagnostic difficulties

Diagnostic Difficulties

  • Significant overlap of cues (Defining Characteristics) to diagnoses

  • Contextual factors such as culture can change the perspective on diagnosis

  • Many studies have verified that interpretations of clinical cases have the potential to be less accurate than indicated by the data

    • (Lunney, 2007).


  • Login