Gümüşhane University Health Science Faculty Nursing Department, Turkey
Received date: December 19, 2016; Accepted date: January 03, 2017; Published date: January 10, 2017
Citation: Demir Doğan M (2017) Nursing Diagnoses Determined by Second Year Students. J Pat Care 3:125.
Copyright: © 2017 Demir Doğan M. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Objective: Nursing diagnoses used to determine existing or potential health problems in professional nursing care. The aim of this study to determine the skill of second year students in defining nursing diagnoses. Methods: A scenario which contain 15 nursing diagnoses was prepared by the teachers and were given a student characteristics form and 2011 NANDA nursing diagnosis with scenario. Findings: Students mean age was 19.93 ± 1.18 and most of students were female (71.2%). The students were determined 13 out of the 15 nursing diagnoses. Conclusion: Students were successful in half identified the majority of nursing diagnoses. Assess what stage we are at identifying nursing diagnoses will contribute to the development of nursing education.
The meaning of nursing is the protection, promotion, and optimization of health, prevention of illness and injury, and protected right of people, families and populations in the care . A nurse; while maintaining the care of the patient and family, uses the nursing diagnoses and nursing care plans. Preparing nursing care plans is a scientific problem solving method and includes assessment of patient, selecting nursing diagnosis, determining outcomes, planning, implementation and evaluation [1-3].
The first step of the nursing care plan is to find the right nursing diagnosis. Nursing diagnosis is determination to current or potential health problems of person, family or society. So that, proving the independent decision-making aspect of the profession, is the center of professional nursing care, nurses are important indicators of the health of individual and social responsibility [4-6]. Resolved the problem with the success of the individual, depends on the accurate determination of nursing diagnoses. The decisions that drive the nursing diagnosis involve cognitive and interpersonal skills, as well as professional attitudes . A true and valid nursing diagnosis will guide the selection of appropriate nursing care results and individual-specific nursing interventions .
Nursing diagnosis, the problems of patients who require nursing care and nursing interventions to solve the problems to be clearly defined and ensure documented. However, the use of nursing diagnoses in the health care field, and it is seen that the documentation is insufficient in systematic research and then nurses determined that the difficulty and lack to the patient’s condition with the correct nursing diagnose lack to determine the etiology, symptoms and signs about the nursing diagnosis [9-11]. So that, put the correct diagnosis nursing, brings success in the expected patient outcomes. Therefore, the aim of this study to determine the skill of second year students in defining nursing diagnoses.
This descriptive and cross-sectional study’s aim is determine the skill of second year students in defining nursing diagnoses. The population of the study are the second class students of health school department of nursing (n=100). The students who agreed to participate in the study without going to the sampling method were included in the study. The sample consisted of 59 students who agreed to participate in the study. All students had done 14 week clinical practical in nursing principles lesson in first year. Study was conducted at the beginning of the 14 week clinical practical in the internal medicine nursing lesson in 2014-2015 fall semesters. Using pre-prepared scenario and 2011 NANDA nursing diagnosis given to students and then were asked to identify appropriate nursing diagnosis .
A scenario which common problems experienced by people with diabetes was prepared by the teachers. The researchers (2 assistant professor, 3 master student) first of all described the nursing diagnoses relating to actual and possible problems in the case. And then we determined a total of 15 nursing diagnoses included in the scenario. The nursing diagnoses contained in the scenario were as follows: readiness for enhanced self-care, nutrition imbalanced-more than body requirements, risk for unstable blood glucose level, risk for impaired liver function, impaired skin integrity, ineffective health maintenance, ineffective family therapeutic regimen management, risk for infection, risk for Trauma, deficient Knowledge (specify), ineffective peripheral tissue perfusion, ineffective planning activity, risk for peripheral neurovascular dysfunction, activity intolerance, risk for injury.
All students were gathered in a class and were given a student characteristics form and 2011 NANDA nursing diagnosis with scenario . Student characteristics form contained student’s age, sex and school of graduation. 2011 NANDA nursing diagnosis form have an extra blank near the all nursing diagnosis. Student crossed laid to near the nursing diagnosis which they determined. Students were given a total of 1 h to complete the task. All students done the scenario at the same time and in same classroom.
The nursing diagnoses were grouped in accordance with Gordon’s Functional Health Patterns and the percentages of nursing diagnoses were calculated for descriptive data analysis.
The required permission was taken from the administration of health school nursing department. The students were informed, and verbal consent was obtained.
Students mean age was 19.93 ± 1.18 and most of students were female (71.2%). Almost half (91.5%) of the students were not working and graduates of high schools (57.6%). Only 13 students graduate of health high schools (22.0%).
Identified nursing diagnoses
The students were determined 13 out of the 15 nursing diagnoses (Table 1). The nursing diagnoses were as follows: readiness for enhanced self-care, nutrition imbalanced-more than body requirements, risk for unstable blood glucose level, risk for impaired liver function, impaired skin integrity, ineffective health maintenance, ineffective family therapeutic regimen management, risk for infection, risk for trauma, deficient knowledge (specify), ineffective planning activity, activity intolerance, risk for injury. The diagnoses ineffective peripheral tissue perfusion, risk for peripheral neurovascular dysfunction were identified by none of the students. But ineffective peripheral tissue perfusion risk was diagnosed instead of ineffective peripheral tissue perfusion. Incorrectly identified nursing diagnoses are shown in Table 1.
|Readiness For Enhanced Self-Care||10||16.9|
|Nutrition Imbalanced-More Than Body Requirements||22||37.3|
|Risk For Nutrition Imbalanced-More Than Body Requirements||31||52.5|
|Risk For Unstable Blood Glucose Level||34||57.6|
|Risk For Impaired Liver Function||12||20.3|
|Impaired Skin Integrity||35||59.3|
|Risk For Impaired Skin Integrity||17||28.8|
|Ineffective Health Maintenance||29||49.2|
|Ineffective Family Therapeutic Regimen Management||33||55.9|
|Risk For Infection||33||55.9|
|Risk For Trauma||6||10.2|
|Deficient Knowledge (Specify)||33||55.9|
|Risk For Ineffective Peripheral Tissue Perfusion||5||8.5|
|Ineffective Planning Activity||26||44.1|
|Impaired Body Image||26||44.1|
|Risk For Activity Intolerance||16||27.1|
|Nutrition Improvement Request||16||27.1|
|Risk For Falling||5||8.5|
|Ineffective Individual Health Management||25||42.4|
|Risk For Injury||15||25.4|
|Disruption Management Home||7||11.9|
|Risk For Deterioration In The Electrolyte Balance||19||32.2|
|Deterioration In Physical Movement||17||28.8|
Table 1: Distribution of nursing diagnoses determined by students according to Gordon’s functional health patterns.
Nurses determined that the difficulty and lack to the patient’s condition with the correct nursing diagnose, lack to determine the etiology, symptoms, signs about the nursing diagnosis [9,11]. Nursing language cannot be used for reasons such as insufficient information, the observation that rarely use the standardized nursing language in the application environment and limited critical thinking . So that, the aim of this study to determine the skill of first year students in defining nursing diagnoses. In our study, we gave to students a scenario which prepared in diabetes mellitus. In this scenario, 15 nursing diagnoses that may be available. The students were determined 13 out of the 15 nursing diagnoses. In another study showed that students were determined 15 out of the 18 nursing diagnoses . This result is consistent with the finding of our study. In our study, students identify the nursing diagnosis was found to be of moderate success. In a study reported that nursing students of determine the correct diagnosis rate is seen not even reached 50 % in Turkey . Another study showed that more than half of the nursing students determined nursing diagnoses (62.9%) successfully . This result is consistent with the finding of our study.
Our result showed that the diagnoses ineffective peripheral tissue perfusion, risk for peripheral neurovascular dysfunction were identified by none of the students. But ineffective peripheral tissue perfusion risk was diagnosed instead of ineffective peripheral tissue perfusion. In a study, which was done to determination of nursing diagnoses based on patient data, reported that nursing students were found to be lower than the success of the nursing diagnosing . In our study showed that as a similar results. And than we found that the highest percentages of diagnoses identified by the students were “Self-Neglect” (69.5%), “Impaired Skin Integrity” (59.3%), “Risk for Unstable Blood Glucose Level” (57.6%), “Ineffective Family Therapeutic Regimen Management” (55.9%), “Risk For Infection” (55.9%) and “Deficient Knowledge (Specify)” (55.9%), “Risk For Nutrition Imbalanced-More Than Body Requirements” (52.5%). A study reported that students’ most often used nursing diagnoses in clinical practice were anxiety and pain [9,16]. Nursing diagnosis which were “The risk of aspiration”, “excess fluid volume,” “deterioration in social interaction”, “change in parental role”, “aggression potential for others,” “ineffective to individual head”, “lack of fluid volume,” “corruption in maintaining of the health” were found to be little or no accurate number of responses. The number of correct responses of the highest level of nursing diagnosis were found to be “disruption of sleep patterns,” “social isolation’’ and “Risk for Infection” . In another study reported that most frequently used diagnoses were risk for infection, pain, activity intolerance, anxiety, nutrition: imbalanced, less than body requirements, constipation, oral mucous membrane impaired, knowledge deficit, impaired skin integrity .
Consequently, students identify the nursing diagnosis was found to be of moderate success. Students who have yet to begin the nursing course in internal medicine in this scenario about diabetes mellitus can be considered as a good indicator of their performance. When they receive the nursing course in internal medicine, students will increase in determining the success of the nursing diagnoses.