Academic literature on the topic 'Nursing Diagnosis methods'
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Journal articles on the topic "Nursing Diagnosis methods"
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SÖNMEZ, Münevver, and Öznur GÜRLEK KISACIK. "Perceptions of Turkish Nursing Students on Nursing Diagnose." Clinical and Experimental Health Sciences 12, no. 4 (December 30, 2022): 885–91. http://dx.doi.org/10.33808/clinexphealthsci.951967.
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Objective: This study aimed to determine how Turkish nursing students’ perceived nursing diagnosis. Methods: This descriptive and cross-sectional study was carried out with 655 nursing students in the Departments of Nursing in the Health Sciences Faculties of two universities, in the Aegean and western Black Sea Region, between 15 February and 5 April 2020. The Students Information Form and Perceptions of Nursing Diagnosis Scale were used for data collection. The independent samples t-test, one-way ANOVA test, and the Mann-Whitney U-test with Bonferroni-correction were used to determine the differences between the groups. Pearson correlation analysis was used to determine the effects of independent variables Results: The mean age of the nursing students was 21.12±1.39; 76.6% of them were female and 36.8% were in the second-year. 53.7% of the nursing students reported that they had difficulty in making nursing diagnoses. The overall Perceptions of Nursing Diagnosis Survey score of the nursing students was found to be 2.46±051. Statistically significant difference was found between Perceptions of Nursing Diagnosis Survey scores in terms of gender (p=0.012), the necessity of nursing diagnosis (p<0.001), and having sufficient knowledge about nursing diagnosis (p=0.019). Conclusions: The findings of this study have revealed that Turkish nursing students’ perceptions of nursing diagnoses are positive. It is important that use effective teaching methods in teaching nursing diagnoses in fundamental nursing education, to give more importance to nursing diagnoses. It is recommended to plan qualitative studies to in-depth examine students’ perceptions with randomized controlled studies involving innovative educational interventions in the future
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Cavalcante, K. M. H., M. L. Botelho, P. P. Cavalcanti, and F. M. P. Garcia. "Discussing nursing diagnosis applied by nursing students." Scientific Electronic Archives 9, no. 3 (July 15, 2016): 87. http://dx.doi.org/10.36560/932016238.
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Aimed to identify and discuss nursing diagnosis present in 50 Case Studies developed by students of graduation nursing of Federal University of Mato Grosso - Campus of Sinop, in a unit of clinical medical. Documentary research that addressed quantitatively the nursing diagnosis proposed using the Taxonomy II of NANDA-I (2009-2011). It was documented 82 different diagnosis, and covered all the 13 domains. The involvement of all the domains and the large variability of diagnoses identified suggested a possible holistic view of patient care and emphasized the individuality of the care plan. However, it may indicate an immaturity of these students, because often different diagnosis are related, and interventions set to one of these can solve the other, so opting for one avoids large health plans. Researchers and professors should conduct investigations and discussions to be identified teaching methods best suited to the teaching of the diagnostic process.
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Parreira, Pedro, Paulo Santos-Costa, Manoel Neri, António Marques, Paulo Queirós, and Anabela Salgueiro-Oliveira. "Work Methods for Nursing Care Delivery." International Journal of Environmental Research and Public Health 18, no. 4 (February 21, 2021): 2088. http://dx.doi.org/10.3390/ijerph18042088.
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This article analyzes the work methods based on care design, identification of needs, care organization, planning, delivery, evaluation, continuity, safety, and complexity of care, and discharge preparation. It describes the diagnosis of the situation, goal setting, strategy selection, implementation, and outcome evaluation that contribute to adopting a given work conception and/or method for nursing care delivery. Later, the concepts underlying the several methods—management theories and theoretical nursing concepts—are presented, with reference to relevant authors. The process of analysis and selection of the method is explained, highlighting the importance of diagnosis of the situation, goal setting, strategy selection, implementation, and outcome evaluation. The importance of various elements is highlighted, such as structural aspects, nature of care, target population, resources, and philosophy of the institution, which may condition the adoption of a method. The importance of care conceptualization is also underlined. The work methods are presented with a description of the key characteristics, advantages, and disadvantages of the task-oriented method (functional nursing) and patient-centered methods: individual, team nursing, and primary nursing. A critical and comparative analysis of the methods is then performed, alluding to the combination of person-centered methods.
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Hidayatun, Nur, and Abdul Aziz. "Overview of the Covid-19 Patient Nursing Diagnosis." JIKO (Jurnal Ilmiah Keperawatan Orthopedi) 4, no. 2 (December 31, 2020): 54–59. http://dx.doi.org/10.46749/jiko.v4i2.42.
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Covid-19 is a pneumonia caused by coronavirus, very fast transmission. This study aims to descriptions nursing diagnosis in covid-19 patients. This is a descriptive study uses quantitative methods. The sampling technique used is consecutive sampling with total samples are 240 medical records of covid-19 patients undergoing treatment at Fatmawati Hospital, both suspected, probable, and confirmed cases. The results showed that nursing diagnoses that often appeared in Covid-19 patients were the risk of infection (spread), ineffective airway, acut pain, anxiety, and the risk of nutritional deficits. The results of this study can be used for the hospital in making Covid-19 Nursing Care Guidelines, and for nurses in increasing their competences in care covid-19 patients.
Keywords: Nursing diagnoses, Covid-19
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Melo, Pedro, Dário Miranda, Sandra Santos, Sérgio Sousa, Teresa Cardoso, and Alexandra Pereira. "Nursing Epidemiological Approach of Hypertension Management in a Public Health Service from the Northern Region of Portugal." Healthcare 9, no. 1 (January 8, 2021): 59. http://dx.doi.org/10.3390/healthcare9010059.
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Background: Epidemiological surveillance of a nursing diagnosis is an approach anchored in a post-modern epidemiology focused on a person’s health disease responses. Regarding public health priorities, the population where our study occurred had as a priority problem arterial hypertension. Related to this chronic disease, nursing diagnoses about health disease responses in primary healthcare has, as a major focus, Therapeutic Regimen Management. Our aim was to study the nursing diagnosis in this issue from an epidemiological approach. Methods: A descriptive study from an epidemiological approach was developed, analyzing nursing diagnoses in hypertensive patients. Results: We found 17.7% of undiagnosed patients and better diagnoses in patients with complications than in those without complications. Conclusions: Nursing records need to be improved in order to promote more robust studies in the post-modern epidemiology for the future.
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Melo, Pedro, Dário Miranda, Sandra Santos, Sérgio Sousa, Teresa Cardoso, and Alexandra Pereira. "Nursing Epidemiological Approach of Hypertension Management in a Public Health Service from the Northern Region of Portugal." Healthcare 9, no. 1 (January 8, 2021): 59. http://dx.doi.org/10.3390/healthcare9010059.
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Background: Epidemiological surveillance of a nursing diagnosis is an approach anchored in a post-modern epidemiology focused on a person’s health disease responses. Regarding public health priorities, the population where our study occurred had as a priority problem arterial hypertension. Related to this chronic disease, nursing diagnoses about health disease responses in primary healthcare has, as a major focus, Therapeutic Regimen Management. Our aim was to study the nursing diagnosis in this issue from an epidemiological approach. Methods: A descriptive study from an epidemiological approach was developed, analyzing nursing diagnoses in hypertensive patients. Results: We found 17.7% of undiagnosed patients and better diagnoses in patients with complications than in those without complications. Conclusions: Nursing records need to be improved in order to promote more robust studies in the post-modern epidemiology for the future.
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Hariyati, Rr Tutik Sri, Hanny Handiyani, Laode Abdul Rahman, and Tuti Afriani. "Description and Validation of Nursing Diagnosis Using Electronic Documentation: Study Cases in Mother and Child Hospital Indonesia." Open Nursing Journal 14, no. 1 (December 31, 2020): 300–308. http://dx.doi.org/10.2174/1874434602014010300.
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Background: A nursing diagnosis is a clinical judgment concerning a human response to a health condition, vulnerability for that response, by an individual, family, group, or community. For the determination of the right nursing diagnosis, a system that guides nurses in implementing care professionally is needed. Objective: To describe the nursing diagnosis in mother and child cases validated by using a management nursing information system. Methods: This case study used secondary data from 5.294 medical records. Medical records were retrieved from the server, analyzed, and validated by using the mapping model in accordance with the most frequent cases in mothers and children in the hospital. Approximately ten million (10.021) nursing diagnoses were performed by nurses and validated by using a mapping model of medical cases and nursing assessment. The selected medical cases were the five most frequent cases, namely normal delivery, cesarean delivery, healthy newborn, fever, and dengue in children. Results: This study yielded the five most frequent nursing diagnoses, namely risk for infection (20.1%), pain (13.37%), anxiety (9.37%), the risk for imbalanced fluid volume (9.36%), and risk for bleeding (9.27%). Conclusion: The electronic nursing documentation could help to determine a nursing diagnosis and had been validated for its appropriateness with assessment and the most common cases in mothers and children. Information and system training development are required to carry out the nursing process comprehensively.
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Carlson-Catalano, Judy, and Margaret Lunney. "Quantitative Methods for Clinical Validation of Nursing Diagnoses." Clinical Nurse Specialist 9, no. 6 (November 1995): 306–10. http://dx.doi.org/10.1097/00002800-199511000-00007.
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Rofii, Muhamad, Bambang Edi Warsito, Agus Santoso, and Sarah Ulliya. "Nurse Trend in Writing Objectives and Outcome Criteria of Nursing Diagnosis in Patients With Pulmonary Tuberculosis at The Government Hospital in Salatiga Indonesia." Media Keperawatan Indonesia 2, no. 2 (June 26, 2019): 12. http://dx.doi.org/10.26714/mki.2.2.2019.12-18.
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Background. Writing nursing goals and outcome criteria found in nursing care documentation was very varied and not appropriately, it needs to be explored more deeply about the phenomenon. The Study objective was to determine the writing of nursing goals and the outcome criteria for nursing diagnoses. Methods. Research design was qualitative research with a direct observation approach. Data was taken in the MDR TB ward, samples were 100 documentation of pulmonary TB patients. Sampling technique was nonprobability sampling. Result. The goal of nursing diagnosis of ineffective airway clearance was airway clearance effectively again, the problem was resolved, the patient's airway returned to normal and coughing the patient returns to normal, etc. The goal of nursing diagnosis of ineffective breathing patterns was effective breathing patterns, ineffective breathing patterns resolved, etc. The outcome criteria of nursing diagnosis ineffective airway clearence was negative cough, normal respiratory rate, normal vital signs, negative sputum, shortness of breath, coughing resolved, comfortable patients, patients can demonstrate coughing effectively, sputum can come out, breath was relieved, sputum can come out, etc. The outcome criteria for nursing diagnosis ineffective breathing patterns are normal respiratory rate, normal vital signs, respiratory rate was 20 x/minute, it was not weakness, It was not nausea, etc. Recomendation. Nurses are advised to be given trainings, sosialisation, or workshops related to the goals and outcome criteria of nursing diagnoses, and are expected to use NANDA and NIC-NOC references.
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Gomes, Denilsen Carvalho, Nuno Abreu, Paulino Sousa, Claudia Moro, Deborah Ribeiro Carvalho, and Marcia Regina Cubas. "Representation of Diagnosis and Nursing Interventions in OpenEHR Archetypes." Applied Clinical Informatics 12, no. 02 (March 2021): 340–47. http://dx.doi.org/10.1055/s-0041-1728706.
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Abstract Objective The study aimed to represent the content of nursing diagnosis and interventions in the openEHR standard. Methods This is a developmental study with the models developed according to ISO 18104: 2014. The Ocean Archetype Editor tool from the openEHR Foundation was used. Results Two archetypes were created; one to represent the nursing diagnosis concept and the other the nursing intervention concept. Existing archetypes available in the Clinical Knowledge Manager were reused in modeling. Conclusion The representation of nursing diagnosis and interventions based on the openEHR standard contributes to representing nursing care phenomena and needs in health information systems.
Dissertations / Theses on the topic "Nursing Diagnosis methods"
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Welling, Anne. "A mixed methods study to explore the diagnostic accuracy and acceptability of the tuning fork test in the detection of ankle fractures." Thesis, University of Portsmouth, 2012. https://researchportal.port.ac.uk/portal/en/theses/a-mixed-methods-study-to-explore-the-diagnostic-accuracy-and-acceptability-of-the-tuning-fork-test-in-the-detection-of-ankle-fractures(dd65d1c3-8a41-42c1-98d3-5b9a74a3d9de).html.
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Aim and methodology: Ankle injuries account for 8% of all minor injuries attending emergency departments in the United Kingdom and the Ottawa ankle rules were introduced to assess the need for x-ray in the early 1990s (Stiell et al 1992). Although the rules are said to have reduced the number of ankle x-rays requested the frequency of fractures in the population still receiving x-rays is only 15% nationally. This study aims to assess whether the tuning fork can increase the diagnostic accuracy of the Ottawa ankle rules when used on twisting ankle injuries by multiple operators in multiple emergency care settings. A mixed methods study conducted in two phases was undertaken. Phase one consisted of a diagnostic test study using the Ottawa ankle rules in conjunction with the tuning fork test on patients already screened as being Ottawa positive to the ‘malleolar’ zone and requiring an x-ray of their ankle. Patients aged 12 years or over who had sustained an ankle injury by a twisting mechanism were eligible to take part. Patient age, gender, ethnicity, and previous history of injury or presence of distracting injuries, degree of swelling, and role of operator were all considered potential variables for an accurate tuning fork test, and these were analyzed individually and in a multiple logistical regression model to assess for predictor variables of a correct tuning fork test. Phase two of the study included a series of focus group discussions to explore participant and clinician experiences of the tuning fork test. Data was analyzed using thematic analysis. Results Data was collected for 2-years and 1313 patients were included in the final analysis. 56% of the study participants were male. Mean age was 34 years (range 12-91). 98% were of white ethnic origin. 210 (16%) were diagnosed with fractures, of which 38 were deemed to be not clinically significant. The tuning fork had a diagnostic accuracy of 56% (95% CI 53-58), NPV 96% (95% CI 94-97), sensitivity 84% (95% CI 78-89) and specificity 51% (95% CI 48-54). X-rays could have been reduced by 47% but this was at the expense of missing 29 ‘clinically significant’ fractures. However, seven of these were managed as soft tissue injuries and in nine the initial assessment of tenderness did not match the site of the fracture. A total of 113 clinicians (nurses & doctors) were involved in performing the tuning fork test independently. Patient age (adjusted OR 1.021, p. <0.001) and role of the operator (adjusted OR 1.595, p. 0.003 for nurse) were the only predictors of an accurate test. Ten patients and ten clinicians attended the focus group discussions in phase two of the study. Patients and clinicians appeared to accept the tuning fork as a method for assessment provided adequate explanation was given. Patients claimed the tuning fork test was not painful but had a similar sensation to that of a ‘Tens’ machine. There were differences in opinion between the two groups as to whether the tuning fork was accurate or not and clinicians held the perception that patients expect an x-ray when they present with an ankle injury, whereas patients disagreed with this. Patients were fully aware of the dangers of x-rays and stated that a reduction in x-rays was one of the main potential benefits of the study. Conclusions This is the largest study to investigate the accuracy of the tuning fork to detect fractures, not only in the size of the study population but the number of clinicians involved. It is also the first to report inconclusive Ottawa ankle rule and tuning fork test results. It is unlikely that the lower sensitivity will be accepted by patients and clinicians. Further research to assess inter-operator reliability is recommended before implementing the tuning fork test into clinical practice.
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Kristen, Haase. "Internet Cancer Information Use by Newly Diagnosed Individuals: A Mixed Methods Study of Interactions with Healthcare Professionals and the Health Care System." Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/37222.
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Background: People with cancer are increasingly turning to the internet to find information and support. However, little is known regarding the use of the internet and how this impacts patients’ cancer experiences and their interactions with, and within, the healthcare system.
Purpose and objectives: The overarching purpose of this dissertation is to explore the ways that patients newly diagnosed with cancer use cancer-related internet information (CRII) and the role it plays in interactions with the healthcare system. The specific objectives were to: (1) qualitatively explore the content of commonly searched websites from a critical nursing perspective; (2) explore patients’ prompts to use CRII and how CRII informs the ways in which patients interact with healthcare professionals and healthcare services, and (3) document what CRII is accessed and the patterns and frequency of use.
Methods: An embedded mixed methods study was conducted using interpretive description as the overarching methodology. Date sources included: (1) a qualitative review of 20 cancer websites; (2) 19 individuals newly diagnosed with cancer, who each took part in two in-depth interviews and a brief survey; and (3) 21 healthcare professionals who engaged in three focus groups (n=17) and in-depth individual interviews (n=4).
Results: The dominant discourse in the websites reviewed focused on empirical information about treatment, prognosis, and cure. A dearth of sociopolitical, ethical, personal, and esthetic information was noted. Thus, when seeking CRII, patients predominantly find empirical and biomedical information.
The qualitative interviews with patients revealed three key themes that characterize how patients used CRII: (1) person in context, (2) management of information, and (3) managing relationships with healthcare professionals. These themes explain how patients mobilized CRII to manage their patient experience. Patients described CRII as an important resource to process information, make decisions about their illness, and make sense of their disease. Patients also sought CRII to complement and reinforce information and support provided by healthcare professionals.
The interviews and focus groups with healthcare professionals revealed two key themes with respect to their views of CRII use. These themes relate to healthcare professionals’ perceptions of patient use of the internet to manage their pragmatic concerns and priorities as well as to navigate processes and practices of the healthcare system. Healthcare professionals found that CRII could modulate patients’ interactions with the healthcare system. Healthcare professionals also acknowledged key points in the cancer trajectory where information may be lacking or where patients may have less informational support; participants felt that CRII served as a beneficial resource to address these gaps. Although healthcare professionals were supportive of patient use of CRII to meet cancer information needs, they also described concerns regarding patients finding and using untrustworthy information.
Conclusions: Together, the findings from this dissertation research inform an understanding of how people with cancer use CRII to manage their cancer experience and interact with healthcare professionals and services. Findings highlight the importance of information diversity in the midst of a lack of holistic and varied information presently online. There is also a need for nurses and other healthcare professionals to be aware of the information that is available online and to understand what patients are accessing. Communication about CRII between patients and healthcare professionals may also strengthen areas of patient education that are lacking as well as encourage healthcare professionals to raise key topics of interest.
Implications for Practice: There is clearly a growing need for dialogue around pervasive technologies and the nursing role in assessing and directing patients to holistic information. Oncology nurses are well situated to take the lead in their multi-disciplinary care teams to engage patients about their CRII use and to explore the tensions experienced by clinicians surrounding CRII use. CRII use is a growing trend amongst patients across all healthcare settings, and nurses are well positioned to initiate discussions and be leaders in practice. Future research is warranted to expand on the link between CRII use and the utilization of health services, the role of CRII for those in rural areas compared to those in urban areas, and the role of the family in patients’ mobilization of CRII in their cancer experience.
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Defayette, Danielle. "Surveys of Women with HPV and Their Healthcare Experiences." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/honors/84.
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Genital human papillomavirus infection is the most common sexually transmitted virus in the United States, with almost 20 million Americans currently infected and an additional 6.2 million becoming newly infected each year. Women rely strongly on their health care providers to educate and comfort them regarding this distressing diagnosis. This study will use an online, self-completion questionnaire to obtain women’s opinions regarding their health care providers’ performances concerning the initial consultation after learning of their HPV diagnosis. Findings from this study provided insight as to how women prefer receiving information from their health care providers concerning their diagnosis of HPV. In addition, study findings provide suggestions for improving clinical practices regarding HPV consultations in the Tri-cities area of East Tennessee.
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Huang, Fan-Tz, and 黃芳子. "Comparison of Outcome Between Nursing Diagnosis of Problem Oriented Recording Method and Focus Charting Method." Thesis, 2003. http://ndltd.ncl.edu.tw/handle/78145695458169728637.
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碩士臺北醫學大學
護理學系
91
This study was a descriptive. The primary objective was to analyze and to compare the differences in outcomes between nursing diagnosis of problem oriented recording method (SOAPIE) and focus charting method (DART). The design was cross-sectional. Samples were nurses and from a district hospital in Taipei area. Nurses who work in this hospital had experiences in using both SOAPIE and DART recoding methods before. Instruments for data collection included a self-developed nursing record assessment tool and satisfaction questionnaire. The data collection period was from March to April of 2002. The response rate was 100%. Five charts were selected for each nurse and total 200 charts were reviewed for either SOAPIE or DART recording methods. Data were then analyzed by mean, percentage, standard deviation, and one-way ANOVA. The results were as follows. 1. The level of completeness for SOAPIE was 3.26 (total score was 6), but DART was 3.31. 2. The average satisfaction score was 2.71 (means satisfaction) for SOAPIE, but 2.91(means satisfaction) for DART. 3. A significant difference was found in satisfaction scores between SOAPIE and DART (p =0.011). But, no significant difference was found for the level of completeness between these two recoding methods (p >0.05). 4. The average nurse's time spending on nursing record was 88.5 minutes for SOAPIE and 73 minutes for DART every day. For asking about what method would choice in the future, about 80% of nurses selected , DART only 20% selected SOAPIE. 5. Satisfaction was affected by years of unit working experience, credential, and age, but other demographics did not. The level of completeness were affected by hospital working experience, unit working experience, and credentials. To sum up, the findings of this study can be used to assist clinical nursing managers to select nursing recording methods and to simplify the contents of nursing recording methods.
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VRZALOVÁ, Monika. "Role sestry ve screeningu deprese u seniorů." Master's thesis, 2016. http://www.nusl.cz/ntk/nusl-260905.
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The diploma thesis deals with problems of depression in older people. Mainly the work is focused on identifying and analyzing the role of nurses in screening for depression in older people in primary care, acute care, long-term care and home care. This thesis was focused on theoretical direction and was used the method of design and demonstration. In this thesis was set one main goals with five research questions. The main goal was to identify and analyze the role of nurses in screening for depression in the elderly. RQ 1: What is the role of the nurse in screening for depression in the elderly? RQ 2: What is the role of the nurse in the primary care in screening for depression in the elderly? RQ 3: What is the role of the nurse in screening for depression in hospitalized patients in acute care? RQ 4: What is the role of the nurse in screening for depression in seniors in long-term and home care? RQ 5: What rating scales and methods are used in screening for depression in the elderly? The thesis introduce the concept of depression. The following are specified the causes of and the important factors that affect depression in the elderly. It also deals the differences in the clinical symptomatology of depression in old age. It explains possibilities and various barriers in the diagnosis of depression. Another chapter introduces complete geriatric examination, diagnostic classification systems, possible screening methods and scales for detection of depression in the elderly population. It also deals methods of pharmacological and non-pharmacological treatment and its possible complications associated with older age. By reason of increased suicide rate caused by depressive disorder the issue of suicidal behavior in the elderly is introduced. The next chapter deals with the nursing process, which is used by nurses in practice. It consists of the evaluation of the patient's health condition, making nursing diagnosis, creating nursing plan and subsequent implementation and evaluation. The nursing process is also needy for providing quality care. The nursing process in the stage of nursing diagnosis, introduces possible nursing diagnosis for a patient suffering from depression, which are based on the latest classification. Finally is described the role of nurses in screening for depression in the elderly in different health facilities and their contribution to the timely evaluation of depression in the elderly. This chapter introduces the role of nurses, nursing screening and collaboration with a physician. The role of nurses in screening for depression in different medical facilities is based on the first phase of the nursing process of assessment. On the basis of objective and subjective information, the nurse will assess the overall health and mental condition of the patient. Primarily, it was investigated what is the role of the nurse in screening for depression. On the basis of content analysis and synthesis it was necessary to used and processed domestic and foreign literature. A number of relevant sources are the results of various studies and Meta-analyzes, mostly from abroad, but also from the Czech Republic. The thesis can serve as a basis for nurses. The result of this thesis is to create e-learning material available for students in the Faculty of Health and Social Sciences of South Bohemia in Ceske Budejovice in the tutorial called Moodle.
Books on the topic "Nursing Diagnosis methods"
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Ladwig, Gail B. Mosby's guide to nursing diagnosis. 3rd ed. Maryland Heights, Mo: Mosby/Elsevier, 2011.
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1947-, Moorhouse Mary Frances, ed. Application of nursing process and nursing diagnosis: An interactive text for diagnostic reasoning. 6th ed. Philadelphia: F.A. Davis, 2013.
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J, Ackley Betty, ed. Mosby's guide to nursing diagnosis. 3rd ed. Maryland Heights, Mo: Mosby, 2011.
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Assessing for nursing diagnosis: A human needs approach. Philadelphia: Lippincott, 1992.
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E, Doenges Marilynn. Application of nursing process and nursing diagnosis: An interactive text for diagnostic reasoning. 2nd ed. Philadelphia, PA: Davis, 1995.
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1947-, Moorhouse Mary Frances, ed. Application of nursing process and nursing diagnosis: An interactive text for diagnostic reasoning. 5th ed. Philadelphia, PA: F.A. Davis, 2008.
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Diann, Urden Linda, Stacy Kathleen M, and Lough Mary E, eds. Critical care nursing: Diagnosis and management. 6th ed. St. Louis, Mo: Saunders/Elsevier, 2010.
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M, Taylor Cynthia, ed. Sparks and Taylor's nursing diagnosis pocket guide. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health, 2011.
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Downing, Philip. Emergencies in adult nursing. Oxford: Oxford University Press, 2009.
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Rapid nursing interventions--neurologic. Albany: Delmar Publishers, 1996.
Find full textBook chapters on the topic "Nursing Diagnosis methods"
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Mogli, GD. "Introduction to Medical History Taking, Physical Examination Methods and Techniques for Diagnosis." In Comprehensive Allied Health and Diagnostics Sciences for Nursing and Paramedics, 313. Jaypee Brothers Medical Publishers (P) Ltd., 2018. http://dx.doi.org/10.5005/jp/books/14181_24.
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"Inflammatory joint diseases." In Oxford Handbook of Musculoskeletal Nursing, edited by Susan M. Oliver and Susan M. Oliver, 61–126. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198831426.003.0004.
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Inflammatory joint diseases are conditions that have an underlying inflammatory component that may be driven by a faulty autoimmune response by the body, often resulting in the body’s tissues being attacked by the body’s own immune responses. This chapter covers a range of inflammatory joint diseases, which both target specific joints and/or surrounding tissues and have a genetic predisposition. For each condition, it covers methods of diagnosis, clinical features, methods of assessment and treatment, management, and frequently asked questions when presented with a patient experiencing the condition.
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Bernhard, Stefan, Kristine Al Zoukra, and Christof Schtte. "From Non-Invasive Hemodynamic Measurements towards Patient-Specific Cardiovascular Diagnosis." In Quality Assurance in Healthcare Service Delivery, Nursing and Personalized Medicine, 1–25. IGI Global, 2012. http://dx.doi.org/10.4018/978-1-61350-120-7.ch001.
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The past two decades have seen impressive success in medical technology, generating novel experimental data at an unexpected rate. However, current computational methods cannot sufficiently manage the data analysis for interpretation, so clinical application is hindered, and the benefit for the patient is still small. Even though numerous physiological models have been developed to describe complex dynamical mechanisms, their clinical application is limited, because parameterization is crucial, and most problems are ill-posed and do not have unique solutions. However, this information deficit is imminent to physiological data, because the measurement process always contains contamination like artifacts or noise and is limited by a finite measurement precision. The lack of information in hemodynamic data measured at the outlet of the left ventricle, for example, induces an infinite number of solutions to the hemodynamic inverse problem (possible vascular morphologies that can represent the hemodynamic conditions) (Quick, 2001). Within this work, we propose that, despite these problems, the assimilation of morphological constraints, and the usage of statistical prior knowledge from clinical observations, reveals diagnostically useful information. If the morphology of the vascular network, for example, is constrained by a set of time series measurements taken at specific places of the cardiovascular system, it is possible to solve the hemodynamic inverse problem by a carefully designed mathematical forward model in combination with a Bayesian inference technique. The proposed cardiovascular system identification procedure allows us to deduce patient-specific information that can be used to diagnose a variety of cardiovascular diseases in an early state. In contrast to traditional inversion approaches, the novel method produces a distribution of physiologically interpretable models (patient-specific parameters and model states) that allow the identification of disease specific patterns that correspond to clinical diagnoses, enabling a probabilistic assessment of human health condition on the basis of a broad patient population. In the ongoing work we use this technique to identify arterial stenosis and aneurisms from anomalous patterns in signal and parameter space. The novel data mining procedure provides useful clinical information about the location of vascular defects like aneurisms and stenosis. We conclude that the Bayesian inference approach is able to solve the cardiovascular inverse problem and to interpret clinical data to allow a patient-specific model-based diagnosis of cardiovascular diseases. We think that the information-based approach provides a useful link between mathematical physiology and clinical diagnoses and that it will become constituent in the medical decision process in near future.
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Hughes, Cathy. "Gynaecological oncology." In Oxford Handbook of Women's Health Nursing, 321–56. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198842248.003.0011.
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This chapter concerns cancers that affect the female reproductive organs, including the ovaries, fallopian tubes, uterus, cervix, vagina, and vulva. For each type of cancer the chapter covers the epidemiology, incidence, associated risk factors, presenting complaints, methods of diagnosis, grades and staging, and treatment. Where possible, monitoring procedures for prevention are explained. The chapter also includes an overview of radiotherapy, including dose and duration and treatment planning. Indications for chemotherapy for specific cancers are also covered.
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Robinson, Terry, and Jane Scullion. "Palliative care." In Oxford Handbook of Respiratory Nursing, 507–14. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198831815.003.0023.
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Although there are respiratory diseases that are acute and respond well to treatments, many end in what could be viewed as an essentially palliative or terminal phase. Many respiratory disease processes are essentially chronic in nature and some patients should be considered palliative from diagnosis. There is increasing evidence that patients with end-stage lung disease experience declining heath, anxiety, depression, fatigue, coping difficulties, and somatic preoccupation, and if this is unrecognized then there is a potential for basic needs to remain unmet. This chapter describes the management of breathlessness, chest clearance, and relaxation during the palliative phase of care, methods for managing anxiety, depression, and pain, and the nurse’s role in care during end-of-life care.
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"Acute coronary syndromes." In Oxford Handbook of Cardiac Nursing, edited by Kate Olson, 119–36. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199651344.003.0007.
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Acute coronary syndromes (ACS) refers to a clinical spectrum of the same disease process, and includes unstable angina, non-ST-segment elevation MI (NSTEMI) and ST-segment elevation MI (STEMI). Treatment for this group of patients may be initiated and then continued across a variety of areas which include the pre-hospital/community setting, emergency department, coronary care unit, cardiac catheter laboratory, general ward, and chest pain unit. Nurses will encounter patients with both ST-segment elevation ACS and non-ST-segment elevation ACS at various points in their journey, thus clear and effective communication between healthcare providers across the different areas is imperative. The aim of this chapter is to outline the pathophysiology, methods for rapid diagnosis, and appropriate clinical management of ACS so that it may applied within any area and at any point in the patient’s journey.
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Chrastek, Joan “Jody”, and Camara van Breemen. "Symptom Management in Pediatric Palliative Care." In Oxford Textbook of Palliative Nursing, edited by Betty Rolling Ferrell and Judith A. Paice, 699–707. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190862374.003.0058.
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Pediatric symptom management can be complex and challenging, but, when done well, it improves quality of life significantly. Assessment of symptoms should be started at the diagnosis of a life-threatening condition and continued throughout the trajectory of the condition or disease. Treatment methods of each symptom depend on the reversibility of the symptom, disease trajectory, and family goals of care. Both nonpharmacological and pharmacological interventions should be employed. Decisions should be made jointly between the healthcare team and the parents/caregivers. Cultural norms and traditions need to be respected and adhered to when possible. Palliative care should be holistic, addressing not only the physical but also the spiritual, emotional, and social aspects. This chapter provides an overview of managing common symptoms of dyspnea, excessive secretions, nausea/vomiting, constipation, and neurological issues. A list of websites, guidelines, and sample algorithms are included for further information.
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"Acute coronary syndromes." In Oxford Handbook of Cardiac Nursing, edited by Kate Olson, 141–58. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198832447.003.0007.
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This chapter aims to outline the pathophysiology, methods for rapid diagnosis, and appropriate clinical management of acute coronary syndromes (ACS) so that it that may be applied within any area and at any point in the patient’s journey. The term ACS refers to a clinical spectrum of the same disease process, and includes unstable angina to non-ST-segment elevation MI (NSTEMI) and ST-segment elevation MI (STEMI). The common underlying cause results in the formation of a platelet-rich thrombus and reduced coronary arterial blood flow, which either partially or completely occludes the artery. When complete occlusion of a coronary artery occurs (STEMI) limitation of the infarct size is vital and thus rapid initiation of treatment is essential to obtain the greatest benefit. The development of services such as pre-hospital thrombolysis, direct delivery of patients from the ambulance to the catheter laboratory, and ↑ numbers of 24h 1° percutaneous coronary intervention (PPCI) facilities available (Heart Attack Centres) have been important government initiatives that have been implemented to manage heart disease. Treatment for this group of patients may be initiated and then continued across a variety of areas which include the pre-hospital/community setting, emergency department, Coronary Care Unit, cardiac catheter laboratory, general ward, and chest pain unit. Nurses will encounter patients with both ST-segment elevation ACS and non-ST-segment elevation ACS at various points in their journey, thus clear and effective communication between healthcare providers across these different areas is imperative.
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Burch, Jennie, and Brigitte Collins. "Endoscopy." In Oxford Handbook of Gastrointestinal Nursing, 233–78. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198833178.003.0011.
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The endoscopy chapter explains how the endoscope can be used as a diagnosis tool or a treatment modality. The endoscope can look at various part of the gastrointestinal tract, such as the stomach, that is a gastroscopy, also termed an oesophagogastroduodenoscopy, or the colon, that is a colonoscopy. An endoscope can be used as a diagnostic tool, such as a double balloon endoscopy or capsule endoscopy. An endoscope may be used to remove a polyp; this is termed a polypectomy. Endoscopy can also be used a method of treatment, such as an endoscopic retrograde cholangiopancreatography. Concise descriptions related to endoscopes as a treatment or investigative piece of equipment within this chapter can be referred to by the nurse when necessary within clinical practice.
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Mogli, GD. "Practical Summary of History Taking and Physical Examination Methods." In Comprehensive Allied Health and Diagnostics Sciences for Nursing and Paramedics, 356. Jaypee Brothers Medical Publishers (P) Ltd., 2018. http://dx.doi.org/10.5005/jp/books/14181_26.
Full textConference papers on the topic "Nursing Diagnosis methods"
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Santos, Deborah Ferreira, Marcele Pescuma Capeletti Padula, and Camila Waters. "Nursing diagnoses of patients with Ischemic Stroke: a bibliographic search." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.706.
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Introduction: Stroke causes cell injury and neurological damage that induce paralysis of a particular brain zone from which it has been left without proper circulation owing to thrombus, embolus or hemorrhage. Objective: Identify, through scientific articles, the nursing diagnoses of Stroke patients. Methods: Bibliographic and descriptive research held at Virtual Health Library, using the specific descriptors: Stroke and Brain Ischemia that were crossed with the general descriptor: Nursing Diagnosis, written in Portuguese and published from 2008 to 2018. Results: Eight articles were selected between 2008 and 2018 we found two publications in the following years: 2010, 2012, 2013 and 2015. The first publication was in 2010 and the last one in 2015, there is no evidence of research on nursing diagnoses in patients with stroke in the last four years. All studies were performed cross-sectionally, with data collected in the state of Ceará and with a sample ranging from 24 to 156 patients. The Nursing Diagnoses cited by the articles were: urinary incontinence; risk for aspiration; impaired verbal communication; intolerance and risk for activity intolerance; risk for disuse syndrome; risk for falls; fatigue; impaired physical mobility, impaired bed mobility, impaired wheelchair mobility; impaired transfer ability; impaired walking; sedentary lifestyle. Conclusion: Stroke results in disabilities that compromise the quality of life. The importance of preventing risk factors for stroke is clear, as well as the need for quick and effective care, emphasizing the individually, systematic and qualifies nursing care in order to decrease stroke sequels and guarantee quality of life.
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Wu, Leyi, Jing Luo, and Huihui Guo. "An interactive design solution for prenatal emotional nursing of pregnant women." In 13th International Conference on Applied Human Factors and Ergonomics (AHFE 2022). AHFE International, 2022. http://dx.doi.org/10.54941/ahfe1001973.
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With the continuous development of interactive technology, informatization has begun to integrate into people's life[1].Having been neglected in history, postpartum depression reminds us that we need to pay attention to maternal emotional needs and prenatal care[2]. In the current situation, it is worth researching the interactive products for prenatal emotional care. According to the survey, it is not difficult to find that some speech emotion and facial expression recognition technologies in artificial intelligence are developing Which have large potential for extensive use.[3,4]. Therefore, it is necessary and feasible to design prenatal emotional diagnosis tools for pregnant women. This study has designed a product to care for pregnant women by identifying their emotional needs through AI recognition technologies. Appropriate prenatal intervention is conducive to the prevention of postpartum depression[5,6] . The use of artificial intelligence recognition technology can provide an appropriate emotional care plan. This can reduce the difficulty of training medical personnel and the difficulty of relatives caring for pregnant women. Therefore, the risk of postpartum depression can be reduced. QUESTIONCollecting opinions and information from previous studies is an important reference for this study. Therefore, this study needs to solve the following problems.1) How to design an artificial intelligence product that can accurately diagnose the emotion of pregnant women?2) How to integrate AI facial emotion recognition technology?3) How to help nurses and their families take care of users more professionally and easily through the information database?4) How to adapt the emotional care program provided by interactive products to different pregnant women? Methods:the research methods of this study are as follows:1) Observing the working process of artificial midwives and psychologists to find Which part can be assisted by machines[7].2) To understand the emotional needs of pregnant women through interview.3) To brainstorm according to the real data collected before and research findings, and then design interactive products that can practically solve the emotional care problems of pregnant women.4) Through the experiment of AI emotion recognition technologies, the feasibility of emotion recognition is verified. CONCLUSIONS:With the continuous development of artificial intelligence, more and more artificial intelligence products have entered our life [1]. This study is aimed to help pregnant women prevent prenatal and postpartum depression and maintain their health through artificial intelligence interaction technologies. This study is exploring the solution under the help of artificial intelligence after studying the problem that prenatal and postpartum emotion are neglected. This design is still in the conceptual design stage, but it seems only a matter of time before this design is applied in the future[8]. REFERENCES:[1]. Lee H S , Lee J . Applying Artificial Intelligence in Physical Education and Future Perspectives. 2021.[2]. Beck C T . Postpartum depression: it isn't just the blues.[J]. American Journal of Nursing, 2006, 106(5):40-50.[3].Ramakrishnan S , Emary I M M E . Speech emotion recognition approaches in human computer interaction[J]. Telecommunication Systems, 2013, 52(3):OnLine-First.[4]. Samara A , Galway L , Bond R , et al. Affective state detection via facial expression analysis within a human–computer interaction context[J]. Journal of Ambient Intelligence & Humanized Computing, 2017.[5]. Clatworthy J . The effectiveness of antenatal interventions to prevent postnatal depression in high-risk women[J]. Journal of Affective Disorders, 2012, 137(1-3):25-34.[6]. Ju C H , Hye K J , Jae L J . Antenatal Cognitive-behavioral Therapy for Prevention of Postpartum Depression: A Pilot Study[J]. Yonsei Medical Journal, 2008, 49(4):553-.[7]. Fletcher A , Murphy M , Leahy-Warren P . Midwives' experiences of caring for women's emotional and mental well-being during pregnancy[J]. Journal of Clinical Nursing, 2021.[8]. Jin X , Liu C , Xu T , et al. Artificial intelligence biosensors: Challenges and prospects[J]. Biosensors & Bioelectronics, 2020, 165:112412.
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Freitas, Alexandre Villela de, Arnaldo Pereira Cortez Junior, Marília Silva de Souza Takimoto, Vanessa Radavelli de Araujo, and Carolina Rosa de Araujo. "EFFECT OF THE COVID-19 PANDEMIC IN A MASTOLOGY SERVICE AT A TERTIARY HOSPITAL." In Scientifc papers of XXIII Brazilian Breast Congress - 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s1089.
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Introduction: The measures of social isolation and campaigns to combat the COVID-19 pandemic released after March 2020 and the risk of severe respiratory disease in the population older than 65 years determined a decrease in the performance of preventive tests and demand to outpatient clinics, as well as the removal of professionals in risk groups reducing the supply of care. The delay in diagnosis and initiation of treatment is considered a problem in health systems worldwide, directly impacting mortality from the disease. In force since 2012, Lawn. 12732 of the Brazilian Department of Health establishes that the first cancer treatment for SUS (Brazilian Unified Health System) patients must begin within a maximum of 60 days from the signature of the pathological report that confirms malignant neoplasia. Objectives: To evaluate the effects of the pandemic in a mastology service at a tertiary hospital of the Unified Health System (SUS) from the measurement of the interval between diagnosis and initiation of treatment, first proposed oncological, surgical (CT) or systemic (TS) treatment and the justifications pointed out when the beginning of treatment occurred in a period of more than sixty days. Methods: Cross-sectional cohort study of patients diagnosed with breast cancer between March 2019 and January 2021, divided into two groups – prepandemic and pandemic from the evaluation of data in the hospital management system (Stratec) and comparison of information between the two groups. Results: In group 1, prepandemic, from March 2019 to March 2020, 82 patients admitted, mean of 6.3 patients per month, 62 started treatment before 60 days (59TC and 3TS) and 20 after (13TC and 7TS). In group 2, pandemic, from April 2020 to January 2021, 65 patients, mean of 7.2 patients per month, 51 started treatment before 60 days (37TC and 14TS) and 14 after (11TC and 3TS), 32.3 and 27.5%, respectively. Regarding the indication of initial treatment, surgical treatment predominated in both groups, however there was an increase in the indication of systemic treatment in group 2 (17/65 vs 10/82). Among the main justifications for delay in the beginning of treatment, we identified clinical conditions of the patients, the need for a plastic surgery team and unavailability of a vacancy in the operating room in the first group, and clinical conditions of the patients and indecision to accept the therapeutic proposal in the second group. Conclusions: The reception by the nursing team to the patients at the time of diagnosis guiding the performance of preoperative examinations and consultations, availability of the operating room exclusively for emergencies, cardiac or oncological surgeries and replacement of professionals when the absence was necessary were effective measures in the maintenance of care and quality of service.
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Serigatti, Giulia, Marcele Pescuma Capeletti Padula, and Camila Waters. "Nursing care for patients diagnosed with epilepsy: bibliographic research." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.304.
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Background: Characterized as a seizure crisis, the transient occurrence of signs and/or symptoms resulting from brain electrical impulses, in an unorganized, excessive and repeated manner. It’s the responsibility of the health team, including nursing, to provide information to the population about the disease. Objective: Identify, through scientific articles, nursing care for patients diagnosed with epilepsy. Design and setting: Bibliographic and descriptive research on nursing care for patients diagnosed with epilepsy, a search for scientific articles was carried out in Latin American and Caribbean Health Sciences and Nursing Database, which are part of the Virtual Health Library Methods: Articles available, online, in Portuguese, Spanish and English, published from January 2008 to December 2018. Results: Five articles were analyzed, which identified the nursing care provided to patients diagnosed with epilepsy. The articles were categorized as: “training of nurses on epilepsy care” in four articles that describe the development and implantation of a plan to take care of epilepsy by nurses, the care for patients with specialist nurse in epilepsy and training of nurses to be specialist nurses; and “education and training of parents of children diagnosed with epilepsy” in an article that describes a tool development by nurses to help parents and family to take care of a child with epilepsy. Conclusions: The nurse with the health team is very important in the participation of explanatory processes of individual and family adaptation, as they can identify the limitations that must be worked on and they assist in the development of solutions.
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Nurjannah, Intansari, and Jane Mills. "The 4 Step Method and the 6 Step Method of Diagnostic Reasoning in Nursing: An Outcomes Comparison." In 1st Annual Worldwide Nursing Conference (WNC 2013). Global Science and Technology Forum Pte Ltd, 2013. http://dx.doi.org/10.5176/2315-4330_wnc13.48.
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Ricardo Castillo Salazar, David, Laura Lanzarini, Héctor Gómez Alvarado, and José Varela-Aldás. "Artificial vision system to detect the mood of an Alzheimer's patient." In 13th International Conference on Applied Human Factors and Ergonomics (AHFE 2022). AHFE International, 2022. http://dx.doi.org/10.54941/ahfe1001445.
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Dementia is a brain disorder that affects older individuals in their ability to carry out their daily activities, such as in the case of neurological diseases. The main objective of this study is to automatically classify the mood of an Alzheimer's patient into one of the following categories: wandering, nervous, depressed, disoriented, bored or normal i.e. in Alzheimer's patients from videos obtained in nursing homes for the elderly in the canton of Ambato, Ecuador. We worked with a population of 39 people from both sexes who were diagnosed with Alzheimer's and whose ages ranged between 75 and 89 years of age. The methods used are pose detection, feature extraction, and pose classification. This was achieved with the usage of neural networks, the walk classifier, and the Levenshtein Distance metric. As a result, a sequence of moods is generated, which determine a relationship between the software and the human expert for the expected effect. It is concluded that artificial vision software allows us to recognize the mood states of the Alzheimer patients during pose changes over time.
Reports on the topic "Nursing Diagnosis methods"
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Schnabel, Filipina, and Danielle Aldridge. Effectiveness of EHR-Depression Screening Among Adult Diabetics in an Urban Primary Care Clinic. University of Tennessee Health Science Center, April 2021. http://dx.doi.org/10.21007/con.dnp.2021.0003.
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Background Diabetes mellitus (DM) and depression are important comorbid conditions that can lead to more serious health outcomes. The American Diabetes Association (ADA) supports routine screening for depression as part of standard diabetes management. The PHQ2 and PHQ9 questionnaires are good diagnostic screening tools used for major depressive disorders in Type 2 diabetes mellitus (DM2). This quality improvement study aims to compare the rate of depression screening, treatment, and referral to behavioral health in adult patients with DM2 pre and post-integration of depression screening tools into the electronic health record (EHR). Methods We conducted a retrospective chart review on patients aged 18 years and above with a diagnosis of DM2 and no initial diagnosis of depression or other mental illnesses. Chart reviews included those from 2018 or prior for before integration data and 2020 to present for after integration. Sixty subjects were randomly selected from a pool of 33,695 patients in the clinic with DM2 from the year 2013-2021. Thirty of the patients were prior to the integration of depression screening tools PHQ2 and PHQ9 into the EHR, while the other half were post-integration. The study population ranged from 18-83 years old. Results All subjects (100%) were screened using PHQ2 before integration and after integration. Twenty percent of patients screened had a positive PHQ2 among subjects before integration, while 10% had a positive PHQ2 after integration. Twenty percent of patients were screened with a PHQ9 pre-integration which accounted for 100% of those subjects with a positive PHQ2. However, of the 10% of patients with a positive PHQ2 post-integration, only 6.7 % of subjects were screened, which means not all patients with a positive PHQ2 were adequately screened post-integration. Interestingly, 10% of patients were treated with antidepressants before integration, while none were treated with medications in the post-integration group. There were no referrals made to the behavior team in either group. Conclusion There is no difference between the prevalence of depression screening before or after integration of depression screening tools in the EHR. The study noted that there is a decrease in the treatment using antidepressants after integration. However, other undetermined conditions could have influenced this. Furthermore, not all patients with positive PHQ2 in the after-integration group were screened with PHQ9. The authors are unsure if the integration of the depression screens influenced this change. In both groups, there is no difference between referrals to the behavior team. Implications to Nursing Practice This quality improvement study shows that providers are good at screening their DM2 patients for depression whether the screening tools were incorporated in the EHR or not. However, future studies regarding providers, support staff, and patient convenience relating to accessibility and availability of the tool should be made. Additional issues to consider are documentation reliability, hours of work to scan documents in the chart, risk of documentation getting lost, and the use of paper that requires shredding to comply with privacy.
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Travis, Amanda, Margaret Harvey, and Michelle Rickard. Adverse Childhood Experiences and Urinary Incontinence in Elementary School Aged Children. University of Tennessee Health Science Center, October 2021. http://dx.doi.org/10.21007/con.dnp.2021.0012.
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Purpose/Background: Adverse Childhood Experiences (ACEs) have an impact on health throughout the lifespan (Filletti et al., 1999; Hughes et al., 2017). These experiences range from physical and mental abuse, substance abuse in the home, parental separation or loss, financial instability, acute illness or injury, witnessing violence in the home or community, and incarceration of family members (Hughes et al., 2017). Understanding and screening for ACEs in children with urinary incontinence can help practitioners identify psychological stress as a potentially modifiable risk factor. Methods: A 5-month chart review was performed identifying English speaking patients ages 6-11 years presenting to the outpatient urology office for an initial visit with a primary diagnosis of urinary incontinence. Charts were reviewed for documentation of individual or family risk factors for ACEs exposure, community risk factors for ACEs exposures, and records where no related documentation was included. Results: For the thirty-nine patients identified, no community risk factors were noted in the charts. Seventy-nine percent of patients had one or more individual or family risk factors documented. Implications for Nursing Practice This chart review indicates that a significant percentage of pediatric, school-aged patients presenting with urinary incontinence have exposure to ACEs. A formal assessment for ACEs at the time of initial presentation would be helpful to identify those at highest risk. References: Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the adverse childhood experiences (ACE) study. Am J Prev Med. 1998;14:245–258 Hughes, K., Bellis, M.A., Hardcastle, K.A., Sethi, D., Butchart, D., Mikton, C., Jones, L., Dunne, M.P. (2017) The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. Lancet Public Health, 2(8): e356–e366. Published online 2017 Jul 31.doi: 10.1016/S2468-2667(17)30118-4 Lai, H., Gardner, V., Vetter, J., & Andriole, G. L. (2015). Correlation between psychological stress levels and the severity of overactive bladder symptoms. BMC urology, 15, 14. doi:10.1186/s12894-015-0009-6
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Newman-Toker, David E., Susan M. Peterson, Shervin Badihian, Ahmed Hassoon, Najlla Nassery, Donna Parizadeh, Lisa M. Wilson, et al. Diagnostic Errors in the Emergency Department: A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), December 2022. http://dx.doi.org/10.23970/ahrqepccer258.
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Objectives. Diagnostic errors are a known patient safety concern across all clinical settings, including the emergency department (ED). We conducted a systematic review to determine the most frequent diseases and clinical presentations associated with diagnostic errors (and resulting harms) in the ED, measure error and harm frequency, as well as assess causal factors. Methods. We searched PubMed®, Cumulative Index to Nursing and Allied Health Literature (CINAHL®), and Embase® from January 2000 through September 2021. We included research studies and targeted grey literature reporting diagnostic errors or misdiagnosis-related harms in EDs in the United States or other developed countries with ED care deemed comparable by a technical expert panel. We applied standard definitions for diagnostic errors, misdiagnosis-related harms (adverse events), and serious harms (permanent disability or death). Preventability was determined by original study authors or differences in harms across groups. Two reviewers independently screened search results for eligibility; serially extracted data regarding common diseases, error/harm rates, and causes/risk factors; and independently assessed risk of bias of included studies. We synthesized results for each question and extrapolated U.S. estimates. We present 95 percent confidence intervals (CIs) or plausible range (PR) bounds, as appropriate. Results. We identified 19,127 citations and included 279 studies. The top 15 clinical conditions associated with serious misdiagnosis-related harms (accounting for 68% [95% CI 66 to 71] of serious harms) were (1) stroke, (2) myocardial infarction, (3) aortic aneurysm and dissection, (4) spinal cord compression and injury, (5) venous thromboembolism, (6/7 – tie) meningitis and encephalitis, (6/7 – tie) sepsis, (8) lung cancer, (9) traumatic brain injury and traumatic intracranial hemorrhage, (10) arterial thromboembolism, (11) spinal and intracranial abscess, (12) cardiac arrhythmia, (13) pneumonia, (14) gastrointestinal perforation and rupture, and (15) intestinal obstruction. Average disease-specific error rates ranged from 1.5 percent (myocardial infarction) to 56 percent (spinal abscess), with additional variation by clinical presentation (e.g., missed stroke average 17%, but 4% for weakness and 40% for dizziness/vertigo). There was also wide, superimposed variation by hospital (e.g., missed myocardial infarction 0% to 29% across hospitals within a single study). An estimated 5.7 percent (95% CI 4.4 to 7.1) of all ED visits had at least one diagnostic error. Estimated preventable adverse event rates were as follows: any harm severity (2.0%, 95% CI 1.0 to 3.6), any serious harms (0.3%, PR 0.1 to 0.7), and deaths (0.2%, PR 0.1 to 0.4). While most disease-specific error rates derived from mainly U.S.-based studies, overall error and harm rates were derived from three prospective studies conducted outside the United States (in Canada, Spain, and Switzerland, with combined n=1,758). If overall rates are generalizable to all U.S. ED visits (130 million, 95% CI 116 to 144), this would translate to 7.4 million (PR 5.1 to 10.2) ED diagnostic errors annually; 2.6 million (PR 1.1 to 5.2) diagnostic adverse events with preventable harms; and 371,000 (PR 142,000 to 909,000) serious misdiagnosis-related harms, including more than 100,000 permanent, high-severity disabilities and 250,000 deaths. Although errors were often multifactorial, 89 percent (95% CI 88 to 90) of diagnostic error malpractice claims involved failures of clinical decision-making or judgment, regardless of the underlying disease present. Key process failures were errors in diagnostic assessment, test ordering, and test interpretation. Most often these were attributed to inadequate knowledge, skills, or reasoning, particularly in “atypical” or otherwise subtle case presentations. Limitations included use of malpractice claims and incident reports for distribution of diseases leading to serious harms, reliance on a small number of non-U.S. studies for overall (disease-agnostic) diagnostic error and harm rates, and methodologic variability across studies in measuring disease-specific rates, determining preventability, and assessing causal factors. Conclusions. Although estimated ED error rates are low (and comparable to those found in other clinical settings), the number of patients potentially impacted is large. Not all diagnostic errors or harms are preventable, but wide variability in diagnostic error rates across diseases, symptoms, and hospitals suggests improvement is possible. With 130 million U.S. ED visits, estimated rates for diagnostic error (5.7%), misdiagnosis-related harms (2.0%), and serious misdiagnosis-related harms (0.3%) could translate to more than 7 million errors, 2.5 million harms, and 350,000 patients suffering potentially preventable permanent disability or death. Over two-thirds of serious harms are attributable to just 15 diseases and linked to cognitive errors, particularly in cases with “atypical” manifestations. Scalable solutions to enhance bedside diagnostic processes are needed, and these should target the most commonly misdiagnosed clinical presentations of key diseases causing serious harms. New studies should confirm overall rates are representative of current U.S.-based ED practice and focus on identified evidence gaps (errors among common diseases with lower-severity harms, pediatric ED errors and harms, dynamic systems factors such as overcrowding, and false positives). Policy changes to consider based on this review include: (1) standardizing measurement and research results reporting to maximize comparability of measures of diagnostic error and misdiagnosis-related harms; (2) creating a National Diagnostic Performance Dashboard to track performance; and (3) using multiple policy levers (e.g., research funding, public accountability, payment reforms) to facilitate the rapid development and deployment of solutions to address this critically important patient safety concern.
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Brown, Candace, Chudney Williams, Ryan Stephens, Jacqueline Sharp, Bobby Bellflower, and Martinus Zeeman. Medicated-Assisted Treatment and 12-Step Programs: Evaluating the Referral Process. University of Tennessee Health Science Center, November 2021. http://dx.doi.org/10.21007/con.dnp.2021.0013.
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Purpose/Background Overdose deaths in the U.S. from opioids have dramatically increased since the COVID-19 pandemic. Although medicated-assisted treatment (MAT) programs are widely available for sufferers of opiate addiction, many drop out of treatment prematurely. Twelve-step programs are considered a valuable part of treatment, but few studies have examined the effect of combining these approaches. We aimed to compare abstinence rates among patients receiving MAT who were referred to 12-step programs to those only receiving MAT. Methods In this prospective study, a cohort of participants from a MAT clinic agreeing to attend a 12-step program was compared to 15 controls selected from a database before project implementation. Eligible participants were diagnosed with OUD, receiving buprenorphine (opiate agonist), and at least 18. Participants were provided with temporary sponsors to attend Narcotics Anonymous, Alcoholics Anonymous, and Medication-Assisted Recovery meetings together. The primary endpoint was the change in positive opiate urine drug screens over 6 months between participants and controls. Results Between March 29, 2021, and April 16, 2021, 166 patients were scheduled at the clinic. Of those scheduled, 146 were established patients, and 123 were scheduled for face-to-face visits. Of these, 64 appeared for the appointment, 6 were screened, and 3 were enrolled. None of the participants attended a 12-step meeting. Enrollment barriers included excluding new patients and those attending virtual visits, the high percentage of patients who missed appointments, and lack of staff referrals. The low incidence of referrals was due to time constraints by both staff and patients. Implications for Nursing Practice Low enrollment limited our ability to determine whether combining medication management with a 12-step program improves abstinence. Failure to keep appointments is common among patients with OUD, and virtual meetings are becoming more prevalent post-COVID. Although these factors are unlikely to be controllable, developing strategies to expedite the enrollment process for staff and patients could hasten recruitment.