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Establish linkages between components of the Self- and Family Management Framework and outcomes of the Nursing Outcomes Classification to evaluate the comprehensiveness of outcomes addressing self- and family management in the Nursing Outcomes Classification.Descriptive study.Experts conducted a six-step process to establish linkages: (1) preliminary mapping of all relevant nursing outcomes to the framework; (2) development of checklists for team members serving as 'identifiers' and 'reviewers'; (3) mapping all relevant nursing outcomes to the framework; (4) final agreement on mapped outcomes; (5) establishment of inter-rater reliability; and (6) discussion of findings with authors of the Self- and Family Management Framework.Three hundred and sixty-three nursing outcomes were identified as related to the management of chronic disease across all components of the framework: outcomes related to patient self-management (n = 336), family functioning (n = 16) and family caregivers (n = 11).The Nursing Outcomes Classification outcomes comprehensively address self-management, and, less so, family functioning, and caregivers.Established linkages can be used by nurses to track and support patient and family management outcomes across the care continuum.Linking standardized nursing outcomes to the Self- and Family Management Framework can assist in goal setting and measurement of nursing care during chronic disease management. This work can help describe to funders, policy makers and others invested in health care reform the specific contributions of nurses to self- and family management of chronic disease.This paper demonstrates the linkages between components of the Self- and Family Management Framework and Nursing Outcomes Classification outcomes. The results of this study offer the opportunity to quantify the impact of nursing care and enhance nursing practice for patients with chronic conditions as well as contribute to developing Nursing Outcomes Classification outcomes that consider self-management processes.

Chaplains must document their ministry of care in electronic health records that primarily focus on the physical dimension of care. Creating chaplain documentation that reflects the spiritual dimension of care requires chaplains to participate in the screen design. This article describes how chaplain documentation was designed and refined using psychometric methods. The resulting system successfully supported chaplain workflow, provided an ability to aggregate chaplain workload, and integrated the chaplain into the interprofessional team by structuring, linking, and sharing both the chaplain and nursing assessment of spiritual distress in the electronic health record. Documentation used 5-point Likert scales to measure different dimensions of patient spirituality. Reliability and validity were further evaluated as part of a workshop at an Association of Professional Chaplains annual meeting. Findings supported interrater reliability and the ability to predict and discriminate change pre and post encounter. Documentation screen content is presented.

PURPOSE: To provide guidance to nurses caring for families with COVID-19, we developed linkages using interoperable standardized nursing terminologies: NANDA International (NANDA-I) nursing diagnoses, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC). In addition, we wanted to identify gaps in the terminologies and potential new nursing diagnoses, outcomes, and interventions for future development related to nurse roles in family care during a pandemic. METHODS: Using a consensus process, seven nurse experts created the linkages focused on families during the COVID-19 pandemic using the following steps: (1) creating an initial list of potential nursing diagnoses, (2) selecting and categorizing outcomes that aligned with all components of each nursing diagnosis selected, and (3) identifying relevant nursing interventions. FINDINGS: We identified a total of seven NANDA-I nursing diagnoses as the basis for the linkage work. These are distributed in three NANDA-I Domains and based in the psychosocial dimension of the Nursing Care in Response to Pandemics model. Eighty-nine different NOC outcomes were identified to guide care based on the nursing diagnoses, and 54 different NIC interventions were suggested as possible interventions. Fifteen new proposed concepts were identified for future development across the three classifications. CONCLUSIONS: The linkages of nursing diagnoses, outcomes, and interventions provide a guide to enhance nursing practice and care documentation that could quantify the impact of nursing care to patient outcomes for families at risk for or infected by COVID-19. IMPLICATIONS FOR NURSING PRACTICE: NANDA-I, NOC, and NIC linkages identified in this paper provide resources to support clinical decisions and guide critical thinking for nurses encountering care needs of families with COVID-19. Documentation of these linkages provides data that can create new knowledge to enhance the care of families impacted by COVID-19.

The purpose of this integrative review is to identify literature describing (a) subgrouping patients with cancer based on symptom experiences and their patterns of symptom changes over time and (b) methodologies of subgrouping patients with cancer based on symptom experiences.PubMed®, CINAHL®, and PsycINFO® were searched through January 2019.Studies were appraised for patterns of symptom change over time and methodologic approach using the QualSyst quality rating scale.11 studies met inclusion criteria. Clinical variables that influence symptom patterns were diverse. The most common clustering method was latent variable analysis (73%), and all studies collected symptom data prospectively using survey analysis to assess symptoms.The majority of studies (91%) observed that the symptom experience within the group of patients with cancer changed over time. Identifying groups of patients with similar symptom experiences is useful to determine which patients need more intensive symptom management over the trajectory of cancer treatment, which is essential to improve symptoms and quality of life.

Purpose To describe a new method of validating nursing outcomes and indicators that incorporates nurses' and patients' perspectives. Methods The Nurse-Patient Outcome Content Validation Method was developed in light of the experience of conducting the content validation of the nursing outcome Knowledge: Heart Failure Management (1835). It was developed based on Fehring's content validation model used for the validation of NANDA International nursing diagnoses. It expands the concept of who is an expert in the validation of nursing outcomes. Findings The Nurse-Patient Outcome Content Validation Method is a new method in which the concept of experts is expanded to gather patients' as well as healthcare professionals' perspectives on the importance of indicators to measure an outcome. Based on the importance ratios, the indicators are grouped into three categories: critical, supplemental, or unnecessary. To validate the outcome, importance ratios of critical and supplemental indicators are summed and divided by the total number of the indicators to calculate the outcome content validity (OCV) score of the nursing outcome. Conclusion The Nurse-Patient Outcome Content Validation Method is a new method of content validation of nursing outcome and indicators that incorporates the patient perspective. Implications for nursing practice The Nurse-Patient Outcome Content Validation Method provides a mechanism to include nurses' and patients' perspectives to content validity research of nursing outcomes. It supports patient empowerment since the patient is viewed as an expert regarding the experience of living and managing his/her clinical condition.

Purpose To clinically validate indicators of the nursing outcomes "Breastfeeding establishment: Infant (1000)" and "Breastfeeding establishment: maternal (1001)", and their conceptual and operational definitions in infants admitted to a neonatal unit and their mothers. Method This study utilized several methods in a stepwise approach including an integrative review of the literature, content validation, and clinical validation. The content validity index was performed by eight experts, who evaluated revised content of the studied nursing outcomes. In the clinical validation, 61 mother-infant dyads were evaluated by two pairs of nurses: one pair used an instrument with developed definitions, whereas the other used an instrument without definitions. The evaluations were compared using Fleiss' kappa and weighted kappa. Results The agreement between all evaluators was considered excellent for almost all nursing outcome indicators related to the mothers. The pair of evaluators using the definitions had an agreement greater than 0.80 for most indicators. For the pair that did not use the definitions, agreement was poor. Conclusion There was an increase in uniformity and accuracy between the assessments when using the conceptual and operational definitions for the nursing outcome indicators related to Breastfeeding establishment. Implications for nursing practice This study contributed to the development of terms within the Nursing Outcomes Classification, and enriched the body of nursing knowledge.

Purpose To analyze the concept of adverse reaction to medications and to develop the new nursing diagnosis Risk for Adverse Reactions to Medications. Methods Concept analysis using Walker and Avant's eight step method. Findings Thirty-three articles indexed in four databases were included. The components of the new nursing diagnosis were determined, including possible nursing outcomes and interventions. Conclusions The concept analysis supported the development of the new nursing diagnosis Risk for Adverse Reactions to Medications, which may help nurses to evaluate and identify patients susceptible to adverse reactions. Implications for nursing practice The establishment of this nursing diagnosis will provide nurses an opportunity to implement interventions to anticipate and effectively intervene with patients at risk for this condition.

This article focuses on the critical need for nursing data to be used in the care process provided by nurses. It offers 10 potential paths nurse leaders can use to increase their use of data using nursing terminology such as the Nursing Outcomes Classification and the Nursing Interventions Classification. The paths highlight the need for data about both the nurse and the patient in the care environment. These paths support the use of the nursing process in care planning for patients and highlight the critical need for outcome measurement to determine the effectiveness of nursing interventions. Nurses are important care providers in our current healthcare system and need to have accurate data to make care decisions with the patient and their family. Nurse leaders are instrumental in making this happen.

Background An innovation scholarly interest group used the Jobs to Be Done Theory from the business literature to provide insight into the solution-focused progress that nurses are trying to make in challenging situations. Purpose This article presents a theoretical framework for understanding the progress nurses are trying to make through health care innovations across both practice and academic environments. Method This was a qualitative descriptive study using directed content analysis. We used the Jobs to Be Done Theory to guide the development of the semistructured questionnaire and the interpretation of findings. Findings A theoretical framework of nursing innovations was derived to summarize and visually display the pathways and linkages of challenges, innovations, and impact domains of nursing innovations. Situations and opportunities arise within the context of interconnectedness and can lead to health care innovations in care delivery, patient care interventions, role transitions, research and translational methods, communication and collaboration, technology and data, teaching methods, and processes to improve care. Discussion This theoretical framework offers insight into the dynamic interactions of academic-practice partnerships for innovation. Workplace situations are interconnected and can result in needed innovations designed to impact care delivery.

Objective The purposes of this project were to identify innovations conceived from nurse faculty at a college of nursing and nurses in an academic medical center, examine their characteristics, and create a typology of nursing innovations. Background Innovation is a crucial component for progress in healthcare. Jobs to Be Done Theory suggests that to make progress in nursing, workers must be solution focused to answer problems. Methods This qualitative study used directed content analysis to evaluate survey responses of nurses in 1 university's academic and practice setting about solutions or innovations to achieve progress in their jobs. Results Fifty-seven examples of situations needing an innovative solution were coded and categorized by challenges to yield an 8 characteristic typology in nursing innovation. Conclusions These findings serve as a guide for nurse executives to understand and leverage how innovations are conceptualized and translated in academia and practice.

To develop a nursing outcome, consistent with the standardized format of outcomes within the nursing Outcomes Classification (NOC). This outcome will include an outcome label, an outcome definition, and clinical indicators. The proposed use for this outcome is to evaluate the access site of a percutaneous procedure.Concept analysis with a scoping review. Initially, content experts were recruited to validate the indicators of the proposed outcome in order to complete a consensus validation. After consensus validation, a review of the proposed outcome and its indicators was completed by two of the editors of the NOC team to confirm that the outcome label, definition, and indicators were consistent with the NOC taxonomy. During this review, edits were made on the label name and definition.After a series of reviews, the initial outcome of Vascular Status: Percutaneous Procedure Access was changed to Tissue Injury Severity: Percutaneous Procedure. In addition, the original definition of the condition of an access site for percutaneous procedure by venous or arterial puncture and health of surrounding tissues was edited to: Severity of complications from a needle-puncture access through the skin and into deeper tissues. The outcome has 11 indicators to be used to formulate a target rating for use in the clinical setting. The indicators were not edited over the course of the reviews.The proposed outcome will assist nurses in evaluating the access site of percutaneous procedures and in identifying possible complications.This research contributes to the refinement of the NOC taxonomy by having a new outcome that meets clinical practice needs.Desenvolver um resultado de enfermagem, consistente com o formato padronizado de resultados da Classificação dos Resultados de Enfermagem (NOC). Este resultado incluirá um título de resultado, uma definição de resultado e indicadores clínicos. O uso proposto para esse resultado é avaliar o local de acesso de um procedimento percutâneo. MÉTODOS: Análise de conceito com revisão de escopo. Inicialmente, especialistas de conteúdo foram utilizados para validar os indicadores do resultado proposto em uma validação por consenso. Após a validação por consenso, uma revisão do resultado proposto e de seus indicadores foi realizada por dois editores da equipe da Classificação dos Resultados de Enfermagem para confirmar o título do resultado, definição e indicadores para serem consistentes com a taxonomia NOC. Durante esta revisão, foram feitas edições no título e na definição.Após uma série de revisões, o resultado denominado inicialmente de Estado Vascular: Acesso Procedimento Percutâneo foi alterado para Gravidade da Lesão Tecidual: Procedimento Percutâneo. Além disso, a definição original de condição de um local de acesso de procedimento percutâneo por punção venosa ou arterial e saúde dos tecidos adjacentes foi editada para - Gravidade das complicações de um acesso por punção com agulha através da pele e em tecidos mais profundos. O resultado tem 11 indicadores a serem usados para formular uma classificação-alvo para uso no ambiente clínico. Os indicadores não foram editados ao longo das revisões. CONCLUSÃO: O resultado proposto auxiliará o enfermeiro a avaliar o local de acesso dos procedimentos percutâneos e identificar possíveis complicações. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: Esta pesquisa contribui para o refinamento da taxonomia NOC por ter um novo resultado que atende às necessidades da prática clínica.

Purpose To estimate the content validity of the outcome Knowledge: Heart Failure Management (1835) of the Nursing Outcomes Classification (NOC). Methods A methodological study conducted in Brazil with nurses with expertise in cardiovascular nursing and nursing process. The nurse experts evaluated the relevance of the indicators for the nursing outcome on a 5-point Likert scale. A total of 55 indicators were analyzed, including 50 NOC indicators, four indicators located from a scoping review, and one suggested by an expert during the content validation process. The relevance ratio supported the categorization of indicators as critical, supplemental, or unnecessary. Relevance ratios of critical and supplemental indicators were summed and divided by the total number of the indicators to calculate the outcome content validity (OCV) score of the nursing outcome. Findings Fifteen nurse experts, mostly females (n = 13) with a mean age of 36.0 ± 6.3 years, 13.9 ± 6.5 years of professional experience, and extensive use of the nursing process in their clinical practice (n = 10), teaching (n = 13), and research (n = 11), participated in this study. Regarding the content validation, 43 (78.2%) out of 55 indicators were categorized as critical (relevance ratio .80-.98), 11 (20%) as supplemental (relevance ratio .67-.79), and one indicator (1.8%) was categorized as unnecessary (relevance ratio .48). The OCV score of the nursing outcome was .87. Conclusion The study provided evidence of content validity of 49 indicators of the NOC outcome, Knowledge: Heart Failure Management, and five new indicators identified through the validation process based on nurse experts' opinions. Implications for the nursing practice These findings provide evidence-based indicators for the measurement of heart failure patients' knowledge about disease management. As a result, nurses can test the effectiveness of nursing interventions based on valid outcome indicators.

Purpose To provide guidance to nurses caring for individuals with COVID-19, we developed linkages using interoperable standardized nursing terminologies: NANDA International (NANDA-I) nursing diagnoses, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC). We also identified potential new NANDA-I nursing diagnoses, NOC outcomes, and NIC interventions for future development related to nurses' role during a pandemic. Methods Using a consensus process, seven nurse experts created the linkages for individuals during the COVID 19 pandemic using the following steps: (a) creating an initial list of potential nursing diagnoses, (b) selecting and categorizing outcomes that aligned with all components of each nursing diagnosis selected, and (c) identifying relevant nursing interventions. Findings A total of 16 NANDA-I nursing diagnoses were identified as the foundation for the linkage work, organized in two dimensions, physiological and psychosocial. A total of 171 different NOC outcomes were identified to guide care based on the nursing diagnoses and 96 NIC interventions were identified as suggested interventions. A total of 13 proposed concepts were identified for potential future development across the three classifications. Conclusions The linkages of nursing diagnoses, outcomes, and interventions developed in this article provide a guide to enhance nursing practice and determine the effectiveness of nurses' contribution to patient outcomes for individuals at risk for or infected by COVID-19. Implications for nursing practice NANDA-I, NOC, and NIC linkages identified in this paper are an important example of the value of using standardized nursing terminologies to guide and document nursing care. When included in electronic health record databases and used widely, the data generated from the care plans can be used to create new knowledge about how to better improve outcomes for patients with COVID-19.

PURPOSE We developed linkages using interoperable standardized nursing terminologies, NANDA International (NANDA‐I) nursing diagnoses, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC), to present initial guidance for the development of care plans focused on COVID‐19 for nurses practicing in community or public health roles. METHODS Seven nurse experts identified the linkages of NANDA‐I, NOC and NIC for our work related to the COVID‐19 pandemic. A model was developed to guide the project. The first step in creating linkages focused on the identification of nursing diagnoses. Then, for each nursing diagnosis, outcomes aligned with all components of the diagnosis were categorized and a list of nursing interventions was selected. The experts used their clinical judgment to make final decisions on the linkages selected in this study. FINDINGS Two community level nursing diagnoses were identified as key problems appropriate for a pandemic related to COVID‐19: Deficient Community Health and Ineffective Community Coping. For the nursing diagnosis Deficient Community Health, eight nursing outcomes and 12 nursing interventions were selected. In comparison for the nursing diagnosis, Ineffective Community Coping, nine nursing outcomes and 18 nursing interventions were identified. A total of40 concepts were identified for future development across the three classifications. CONCLUSIONS The nursing diagnoses, outcomes and interventions selected during this linkage process provide knowledge to support the community challenged with responding to the COVID‐19 pandemic, provide the opportunity to quantify the impact of nursing care, and enhance nursing practice by promoting the use of three standardized terminologies. IMPLICATIONS FOR NURSING PRACTICE NANDA‐I, NOC and NIC linkages identified in this manuscript provide resources to support clinical decisions and care plan development for nurses practicing in the community.

Objectives: To evaluate the effectiveness of NIC interventions “Teaching: Disease Process”, “Health Education” and “Cardiac Care” in the improvement of NOC results in individuals with Heart Failure (HF), and the Nursing Diagnosis (ND) “Ineffective Health Control”. Methods: Retrospective cohort, conducted at a Health Education in Nursing outpatient clinic. Fourteen patients with HF had follow-up for one year in six bimonthly consultations. The effectiveness of interventions was verified through the change of the result scores through the Friedman’s Non-Parametric Test and Analysis of Non-Parametric Variance for repeated measures. The level of significance was 5%. Results: The interventions were implemented in consultations in a variety of activities. There was a significant improvement in the result scores until the fourth visit (p

Select and validate outcomes from Nursing Outcomes Classification and interventions from Nursing Interventions Classification for diagnoses Risk for Frail Elderly Syndrome and Frail Elderly Syndrome/NANDA International.A consensus study with 15 gerontological nursing specialists. Data were collected by a Google forms instrument developed by the research team and analyzed using descriptive statistics.For the risk diagnosis, 11 outcomes and seven interventions were validated. For the problem-focused diagnosis, 12 outcomes and eight interventions were validated.The outcomes and interventions showed up as important elements applicable in the health assistance to older adults care with risk or Frail Elderly Syndrome.Those outcomes and interventions are a linkages proposal with the diagnoses to be applied in the clinical practice.Selecionar e validar intervenções/NIC e resultados/NOC para os diagnósticos Risco de síndrome do idoso frágil e Síndrome do idoso frágil/NANDA-I. MÉTODOS: Estudo de consenso entre 15 especialistas em enfermagem gerontológica, com dados coletados em instrumento construído no Google forms® e analisados usando estatística descritiva.Para o diagnóstico de risco foram validadas sete intervenções e onze resultados. Para o diagnóstico com foco no problema foram validadas oito intervenções e doze resultados. CONCLUSÃO: Os resultados e as intervenções se apresentaram como importantes elementos aplicáveis para o cuidado ao idoso com risco ou síndrome do idoso frágil. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: As intervenções e resultados validados são uma proposta de ligação com os diagnósticos para qualificar a prática clínica.

OBJECTIVE To identify self-care behaviors, instruments, techniques, parameters for the assessment of self-care behaviors in people with heart failure, compare these behaviors with the indicators of the Nursing Outcomes Classification outcome, Self Management: Cardiac Disease. METHOD Integrative literature review performed in Lilacs, Medline, CINAHL, and Cochrane, including publications from 2009 to 2015. One thousand six hundred ninety-one articles were retrieved from the search, of which 165 were selected for analysis. RESULTS Ten self-care behaviors and several different assessment instruments, techniques, and parameters were identified. The addition and removal of some indicators are proposed, based on this review. The data provide substrate for the development of conceptual and operational definitions of the indicators, making the outcome more applicable for use in clinical practice.

The purpose of this integrative review is to synthesize recent literature that used NANDA International diagnoses, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC) to determine the effectiveness of nursing interventions and cost-analysis and to identify the direction for future effectiveness research using standardized nursing terminologies (SNTs). A search was performed using the Cumulative Index to Nursing and Allied Health Literature, Scopus, and KoreaMed, covering the period from 2003 to 2018. A total 267 articles were identified, and 24 articles were analyzed for this review. Eighteen studies evaluated the effectiveness of nursing interventions based on outcomes, and of those 18 studies, four examined the effectiveness based on the development of NNN linkages. Six studies analyzed the cost of nursing interventions. Integrating SNTs into electronic health records (EHRs), developing NNN linkages, and further effectiveness studies using SNTs are required to determine the value of nursing care to improve patient outcomes.

Resumo Objetivo Validar definições conceituais e operacionais para os indicadores do resultado NOC “Autocontrole da doença cardíaca”. Métodos Estudo metodológico de validação consensual desenvolvido em três etapas: revisão integrativa da literatura, elaboração de definições conceituais e operacionais para os indicadores do resultado NOC “Autocontrole da doença cardíaca” e validação das definições por consenso de 20 especialistas. Foi realizado teste binomial para análise da proporção de especialistas que concordaram que as definições elaboradas eram relevantes e claras. Valores de p inferiores a 0,05 indicavam diferença significativa na opinião dos especialistas quanto à relevância e a clareza das definições. Resultados Na avaliação dos especialistas, as definições conceituais de 43 indicadores apresentaram valores de p > 0,05 para clareza e 43 para relevância. Nas definições operacionais 36 indicadores apresentaram valor de p>0,05 para clareza e 43 para relevância. Para indicadores com o p0,05 respecto a la claridad y 43 a la relevancia. En las definiciones operativas, 36 indicadores presentaron valores de p>0,05 respecto a la claridad y 43 a la relevancia. Con relación a los indicadores con p0.05. Operational definitions of 36 indicators presented for clarity and 43 for relevance had a p-value >0.05. Indicators showing p

Purpose To determine nursing outcomes and interventions for problem-focused nursing diagnoses related to nutritional problems. Methods Judgment of linkages among nursing diagnoses, outcomes, and interventions using a multiple review process. Five nursing diagnoses were selected, and then outcomes and interventions were determined, based on clinical expertise and scientific literature. Findings Nursing outcomes and interventions were determined for the resolution or improvement of the nursing diagnoses, with selection of interventions that could influence the progression of the outcomes. Conclusions This study provides knowledge for developing care plans for patients with nutritional problems and evaluating the response to the interventions. Implications for nursing practice NANDA-I, Nursing Outcomes Classification (NOC), and Nursing Interventions Classification (NIC) linkages facilitate nurses' ability to select nursing outcomes and interventions for patients with nutritional problems.

PURPOSE To critically evaluate 2014 American Academy of Nursing (AAN) call-to-action plan for generating interoperable nursing data. DATA SOURCES Healthcare literature. DATA SYNTHESIS AAN's plan will not generate the nursing data needed to participate in big data science initiatives in the short term because Logical Observation Identifiers Names and Codes and Systematized Nomenclature of Medicine – Clinical Terms are not yet ripe for generating interoperable data. Well-tested viable alternatives exist. CONCLUSIONS Authors present recommendations for revisions to AAN's plan and an evidence-based alternative to generating interoperable nursing data in the near term. These revisions can ultimately lead to the proposed terminology goals of the AAN's plan in the long term.

PURPOSE The study aimed to validate clinically the indicators of the nursing outcome “Tissue Integrity: Skin and Mucous Membranes” and its conceptual and operational definitions in people with diabetes mellitus. METHODS A methodological study was conducted with an evaluation of 100 participants for two pairs: one of these pairs used the indicators without the definitions and the other used the indicators with their definitions. FINDINGS The pair who used the definitions presented greater concordance and similarity in the ratings. CONCLUSIONS The indicators and their definitions have been validated clinically. IMPLICATIONS FOR NURSING PRACTICE The use of indicators with definitions can contribute to reliable and accurate evaluation of the tissue integrity of the feet in people with diabetes mellitus and, thus, assist in the measurement of the effectiveness of the nursing care provided. OBJETIVO Validar clinicamente os indicadores do resultado de enfermagem “Integridade Tissular: pele e mucosas” e suas definicoes conceituais e operacionais em pessoas com diabetes mellitus. METODOS Estudo metodologico que consistiu na avaliacao de 100 participantes por duas duplas de avaliadores: uma dupla utilizou os indicadores sem as definicoes e, a outra dupla, os indicadores com suas definicoes. RESULTADOS A dupla que utilizou as definicoes apresentou maior concordância e similaridade nas avaliacoes. CONCLUSAO Os indicadores e suas definicoes foram validados clinicamente. IMPLICACOES PARA A PRATICA DE ENFERMAGEM A utilizacao de indicadores com suas respectivas definicoes pode contribuir para a avaliacao confiavel e precisa da integridade tissular dos pes de pessoas com diabetes mellitus e, assim, auxiliar na mensuracao da eficacia da assistencia de enfermagem.

People with diabetes have to self-manage their health conditions to promote, maintain, and restore their health. The Nursing Outcomes Classification provides two outcomes for people with diabetes to evaluate their knowledge and self-management behaviors. The purpose of this study was to validate these two Nursing Outcomes Classification outcomes for adults with diabetes. A descriptive exploratory design using the Delphi technique was used. Two groups of experts were invited for validation of the outcomes. Descriptive statistics were used to determine definition adequacy, clinical usefulness, and content similarity. The Outcome Content Validity method was used to evaluate each outcome and the indicators. A total of 16 nurse experts participated in this study. The definition adequacy of the two Nursing Outcomes Classification outcomes was rated higher than 4.0 out of 5. Clinical usefulness was rated higher than 4.0 out of 5. The range of content validity of the two Nursing Outcomes Classification outcomes was from 0.89 to 0.92 (perfect score is 1.0). The invited experts reported that the content of this outcome pair was very similar. By using validated Nursing Outcomes Classification outcomes, nurses who take care of patients with diabetes can evaluate patient outcomes effectively and determine the effect of nursing interventions accurately.

Objective: to construct conceptual and operational definitions of Nursing Outcomes “Breastfeeding establishment: infant (1000)” and “Breastfeeding establishment: maternal (1001)”. Method: integrative literature review in the following databases: PUBMED (United States National Library of Medicine); LILACS (Latin American and Caribbean Health Sciences Literature); CINAHL (Cumulative Index to Nursing and Allied Health Literature); SciVerse SCOPUS; Web of Science; BDENF (Brazilian Nursing Database) and EMBASE (Excerpta Medica Database). The gray literature was explored to elucidate topics not covered by the articles. Of 3242 articles, 96 were selected to be read in full, and 43 were used for constructing the definitions. Five theses, three dissertations, three books and two manuals were selected. Results: all the results were reviewed. The definitions facilitated the improvement of the content proposed by the Nursing Outcomes Classification, favoring its application in clinical practice and supporting the development of research and teaching. Conclusion: it was proposed to change the definition of the two outcomes, as well as to change the title of one of them to “Breastfeeding establishment: newborn & infant” (1000), modifying seven of its indicators and excluding one. For the outcome related to the mother, it was proposed to modify two indicators and exclude one.

OBJECTIVE To identify predictors of red blood cell transfusion (RBCT) after cardiac surgery. METHOD A prospective cohort study performed with 323 adults after cardiac surgery, from April to December of 2013. A data collection instrument was constructed by the researchers containing factors associated with excessive bleeding after cardiac surgery, as found in the literature, for investigation in the immediate postoperative period. The relationship between risk factors and the outcome was assessed by univariate analysis and logistic regression. RESULTS The factors associated with RBCT in the immediate postoperative period included lower height and weight, decreased platelet count, lower hemoglobin level, higher prevalence of platelet count

Aims and objectives To integrate literature data on the predictors of excessive bleeding after cardiac surgery in adults. Background Perioperative nursing care requires awareness of the risk factors for excessive bleeding after cardiac surgery to assure vigilance prioritising and early correction of those that are modifiable. Design Integrative literature review. Methods Articles were searched in seven databases. Seventeen studies investigating predictive factors for excessive bleeding after open-heart surgery from 2004–2014 were included. Results Predictors of excessive bleeding after cardiac surgery were: Patient-related: male gender, higher preoperative haemoglobin levels, lower body mass index, diabetes mellitus, impaired left ventricular function, lower amount of prebypass thrombin generation, lower preoperative platelet counts, decreased preoperative platelet aggregation, preoperative platelet inhibition level >20%, preoperative thrombocytopenia and lower preoperative fibrinogen concentration. Procedure-related: the operating surgeon, coronary artery bypass surgery with three or more bypasses, use of the internal mammary artery, duration of surgery, increased cross-clamp time, increased cardiopulmonary bypass time, lower intraoperative core body temperature and bypass-induced haemostatic disorders. Postoperative: fibrinogen levels and metabolic acidosis. Conclusions Patient-related, procedure-related and postoperative predictors of excessive bleeding after cardiac surgery were identified. Relevance to clinical practice The predictors summarised in this review can be used for risk stratification of excessive bleeding after cardiac surgery. Assessment, documentation and case reporting can be guided by awareness of these factors, so that postoperative vigilance can be prioritised. Timely identification and correction of the modifiable factors can be facilitated.

DOI : 10.26650/FNJN386150 Aim : The aim of this study was to review interventional studies conducted by nurses about elderly people with urinary incontinence in nursing homes and to match the results to standardized nursing terminology using the Nursing Interventions Classification and the Nursing Outcomes Classification Linkages to the NANDA-I diagnoses guidelines. Method : A systematic review of quantitative intervention studies was conducted using the PRISMA statement as a guide. The interventional research in English was scanned using the MEDLINE and CINAHL databases from January 2005 to May 2015. Fourteen studies that had at least one nurse researcher were conducted in nursing homes, excluding surgical and pharmacological interventions. The Nursing Outcome Classification and Nursing Intervention Classification Linkages to NANDA-I diagnoses and the Clinical Conditions Part II-U List were used as a guide to select North American Nursing Diagnosis Association International nursing diagnoses, Nursing Outcome Classification Scales, and Nursing Interventions from the data. Results : We found the frequency of use of various NANDA-I diagnoses, Nursing Interventions, and Nursing Outcomes based on the Nursing Outcomes Classification and Nursing Interventions Classification Linkages to NANDA-I diagnoses and the Clinical Conditions List for incontinence. Conclusion : Using the Nursing Outcomes Classification and Nursing Interventions Classification Linkages to NANDA-I diagnoses guide may provide new nursing perspectives on non-standardized research. In future studies, this may allow a comparison of data worldwide, enabling nurses to use the results in evidence-based practices. Cite this article as : Bebis, H., Moorhead, S., Gencbas, D., Ozdemir, S, Seven, M. (2019). NOC/NIC Linkages to NANDA-I for continence care in nursing homes. FNJN Florence Nightingale Journal of Nursing, 27(3), 284-303.

OBJECTIVE:To report the experience of an outpatient nursing education clinic caring for people with chronic heart failure.EXPERIENCE REPORT:In this service, qualified “listening,” recreational educational actions about the disease and its treatment are conducted, based on the interventions from the

Purpose: To describe what electronic health record meaningful use requirements mean for nursing clinical information system (CIS) development. Conclusions: The nursing CIS in many, if not most hospitals, has a number of critical design inadequacies that constrain the meaningful use of nursing data to ensure quality outcomes for patients and data-based maturing of the nursing profession. Implications: It is the responsibility and obligation of nurses to ensure that CISs are designed for the meaningful use of nursing clinical data. To accomplish these ends, interoperable clinical nursing data must be documented in a properly integrated operational CIS, and must be retrievable and stored in data repositories for analysis and reports.

PURPOSE: To critically evaluate 2014 American Academy of Nursing (AAN) call-to-action plan for generating interoperable nursing data. DATA SOURCES: Healthcare literature. DATA SYNTHESIS: AAN’s plan will not generate the nursing data needed to participate in big data science initiatives in the short term because Logical Observation Identifiers Names and Codes and Systematized Nomenclature of Medicine – Clinical Terms are not yet ripe for generating interoperable data. Well-tested viable alternatives exist. CONCLUSIONS: Authors present recommendations for revisions to AAN’s plan and an evidence-based alternative to generating interoperable nursing data in the near term. These revisions can ultimately lead to the proposed terminology goals of the AAN’s plan in the long term.

The purpose of this study was to validate the Cardiac Health Behavior Scale for Korean adults (CHB-K) to determine its validity and reliability.Cardiovascular diseases (CVDs) are one of the most important chronic diseases due to their high prevalence and mortality rates. Patients with cardiovascular risks or diseases need to perform appropriate cardiac health behaviors that help to prevent the progression of the disease and improve their health status.This secondary analysis obtained data from two clinical trials of cardiac rehabilitation. Data from 298 patients with cardiovascular risks or diseases were analyzed for validation. Data analyses included correlation coefficients, t-tests, and exploratory and confirmatory factor analyses using SPSS (version WIN 22.0) and AMOS (version 20.0). The Self-Efficacy Scale was used to assess convergent validity, while reliability was assessed using Cronbach's alpha coefficients.Five main factors were verified: health responsibility, physical activity, diet habit (eating habit and food choice), stress management, and smoking cessation. A set of 21 items from the 25-item scale was verified after performing item analysis, factor analyses, and critical evaluation of the statistical results. The 21-item CHB-K (CHB-K21) exhibited acceptable validity, and the model of the CHB-K21 provided a good fit to the data. Most of the factors were found to be moderately correlated with SES scores (r=0.45-0.52, p0.001). The CHB-K21 also demonstrated acceptable reliability (Cronbach's alpha=0.83).The CHB-K21 demonstrates strong validity and reliability. It can be used to assess cardiac health behaviors in Korean adults with cardiovascular risks or diseases.

The study aimed to validate clinically the indicators of the nursing outcome "Tissue Integrity: Skin and Mucous Membranes" and its conceptual and operational definitions in people with diabetes mellitus.A methodological study was conducted with an evaluation of 100 participants for two pairs: one of these pairs used the indicators without the definitions and the other used the indicators with their definitions.The pair who used the definitions presented greater concordance and similarity in the ratings.The indicators and their definitions have been validated clinically.The use of indicators with definitions can contribute to reliable and accurate evaluation of the tissue integrity of the feet in people with diabetes mellitus and, thus, assist in the measurement of the effectiveness of the nursing care provided.Validar clinicamente os indicadores do resultado de enfermagem "Integridade Tissular: pele e mucosas" e suas definições conceituais e operacionais em pessoas com diabetes mellitus. MÉTODOS: Estudo metodológico que consistiu na avaliação de 100 participantes por duas duplas de avaliadores: uma dupla utilizou os indicadores sem as definições e, a outra dupla, os indicadores com suas definições.A dupla que utilizou as definições apresentou maior concordância e similaridade nas avaliações. CONCLUSÃO: Os indicadores e suas definições foram validados clinicamente. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: A utilização de indicadores com suas respectivas definições pode contribuir para a avaliação confiável e precisa da integridade tissular dos pés de pessoas com diabetes mellitus e, assim, auxiliar na mensuração da eficácia da assistência de enfermagem.