Developing a prenatal nursing care International Classification for Nursing Practice catalogue

ICNP® terminological subset for preventing falls in the elderly in primary care

OBJECTIVE

Build and validate a terminological subset of ICNP® for the prevention of falls in the elderly in the context of primary health care, in light of the Self-Care Deficit Theory.

METHOD

Methodological study developed in accordance with ICN recommendations and the Brazilian method for constructing terminological subsets, in two stages: 1) construction of ICNP® statements of nursing diagnoses, outcomes, and interventions; 2) content validation of statements by specialist nurses.

RESULTS

A total of 182 diagnoses/outcomes and 321 nursing interventions were constructed, which were subjected to content validation by 28 experts, being validated with a Content Validity Index ≥ 0.80. After validation, the statements were organized according to self-care requirements and the majority of diagnoses/outcomes (51.6%) and interventions (52.7%) were classified under health deviation requirements.

CONCLUSION

It was possible to construct and validate a terminological subset of ICNP® with a predominance of statements related to health deviation requirements, standing out for being the first terminological subset for the prevention of falls in the elderly in the context of primary care.

Creating Subsets of International Classification for Nursing Practice Precoordinated Concepts: Diagnoses/Outcomes and Interventions Categorized Into Areas of Nursing Practice

The International Classification for Nursing Practice is a comprehensive terminology representing the domain of nursing practice. A categorization of the diagnoses/outcomes and interventions may further increase the usefulness of the terminology in clinical practice. The aim of this study was to categorize the precoordinated concepts of the International Classification for Nursing Practice into subsets for nursing diagnoses/outcomes and interventions using the structure of an established documentation model. The aim was also to investigate the distribution of the precoordinated concepts of the International Classification for Nursing Practice across the different areas of nursing practice. The method was a descriptive content analysis using a deductive approach. The VIPS model was used as a theoretical framework for categorization. The results showed that all the precoordinated concepts of the International Classification for Nursing Practice could be categorized according to the keywords in the VIPS model. It also revealed the parts of nursing practice covered by the concepts of the International Classification for Nursing Practice as well as the parts that needed to be added to the International Classification for Nursing Practice. This has not been identified in earlier subsets as they covered only one specific area of nursing.

Nursing Care Plan for a Newborn with the Defect of Congenital Gastroschisis in the Postoperative Period Using ICNPTM and the Dedicated Software

Background: Congenital defect gastroschisis manifests as a defect in the sheath in the intestine of the newborn, which is not covered by the hernia sac. In this case, the priority task of the neonatal nurse is to diagnose patient care problems quickly and accurately. Choosing the correct care plan elements has a significant impact on shortening the duration of hospitalization, reducing the number and severity of complications, and preventing their recurrence. The purpose of this study was to formulate a care plan for a newborn with diagnosed congenital defect gastroschisis in the postoperative period, using the International Classification for Nursing Practice (ICNP^TM) within the nursing documentation and decision support system, the “ADPIECare Dorothea” software. Methods: After a review of the relevant literature and nursing documentation, a case study of a newborn with the congenital defect gastroschisis was described. A care plan was prepared using ICNP and the “ADPIECare” software. Results: It was possible to organize and standardize care plans to provide consistent and comprehensive professional nursing care. The system supporting nursing decisions suggested interventions personalized for the nursing diagnoses and to the patient needs. Conclusions: Our findings can help to optimize the nurse’s work organization to improve health care quality, outcomes, and effectiveness.

ICNP® terminology subset to infants in Primary Health Care

OBJECTIVES

to describe the development of an ICNP® terminology subset for Nursing Consultation to infants in Primary Health Care.

METHODS

a methodological study, described in five stages, carried out from May to September 2018 with 15 nurses who identified diagnoses, results, interventions, and validated the subset content.

RESULTS

the subset developed consists of 86 nursing diagnoses and results and 178 interventions, organized in the fields of Theory of Basic Human Needs.

FINAL CONSIDERATIONS

the subset contributed to implement the systematized Nursing Consultation, assisting nurses in decision making. Construction and validation consolidate evidence-based practice, bringing the subset closer to practical reality, in addition to contributing to infant health care qualification.

Nursing Process Addressing the Focus "Anxiety": A Scoping Review

The aim of this review was to map the body of literature on data, diagnoses and interventions addressing the nursing focus "anxiety." A scoping review methodology was employed. The Joanna Briggs guidelines for scoping reviews and PRISMA checklist for scoping reviews were followed. Electronic database searches (MEDLINE, CINAHL and Web of Science) located 829 articles. From the total of articles located, 165 were included. The nursing diagnosis "anxiety" can be considered a parent diagnosis, from which other children diagnoses are derived. Data that lead to nursing diagnoses in the anxiety domain can be divided into cognitive and somatic data. Some interventions, such as educational and music-based interventions, seem to be useful to address nursing diagnoses in the anxiety domain. The findings of this review can add substantial value for systematising the nursing process related to the focus "anxiety." Therefore, reaching consensus regarding this nursing process seems highly relevant.

Obstetric analgesia in labor and its association with neonatal outcomes

OBJETIVE

To investigate the association between analgesia during labor and occurrence of neonatal outcomes.

METHOD

Retrospective cohort study with medical records of 850 parturient. The exposure variable of interest was receiving pharmacological analgesia during labor and neonatal outcomes were: one- and five-minute Apgar, resuscitation maneuvers and referral of the newborn to Neonatal ICU. A logistic regression was carried out to obtain Odds Ratios and 95% confidence interval, with adjustment for confounding factors.

RESULTS

Among the women studied, 35% received analgesia and this use was associated with a greater chance of neonatal outcomes such as one-minute Apgar < 7 (p <0.0001), resuscitation maneuvers (p <0.001) and referral to the Neonatal ICU (p = 0.004), mostly were among low-risk pregnant women, even after adjustments.

CONCLUSION

The use of pharmacological analgesia during labor is associated with one-minute Apgar < 7, resuscitation maneuvers and referral to the Neonatal ICU.

Paths taken by Brazilian Nursing for the development of terminological subsets

OBJECTIVE

to discuss the paths taken by Brazilian Nursing in the development of terminological subsets of the International Classification for Nursing Practice.

METHOD

documentary research, carried out in master's dissertations and doctoral theses, which developed terminological subsets, available at the Bank of Doctoral Theses and Master's Dissertations of the Under-graduation Personnel Improvement Coordination. The variables were analyzed were institution, year; academic level, type of health service, methodological approach, clientele, theoretical reference, validation of terms, cross mapping, modeling of new concepts, validation of statements, method used for elaboration, term collection, finalization and dissemination.

RESULTS

124 doctoral theses and master's dissertations were found, 91 were excluded and 33 were included, 23 (69.70%) of which were master's dissertations, with the highest production in 2014 (n=10; 30.30%), with emphasis on the Northeast (36.36%); the 'Primary Care' scenario, with six studies (18.18%); and the predominant clientele was cancer patients. As for the methodological characteristics, in 96% of the studies, the quantitative approach was used; in 2%, a qualitative approach; and 2% associated the quantitative and qualitative approaches. As for the type of study, 60% were methodological and 24% descriptive-exploratory, with the Horta model being the most used (36%).

CONCLUSION

the paths are successful, yet still permeated by weaknesses in the validations and potentialities to standardize the language.

Terminological subsets of the International Classification for Nursing Practice: an integrative literature review

OBJECTIVE

To characterize the scientific production available in the literature on the construction of terminological subsets of ICNP® with emphasis on the clientele and/or health priority to which the subsets are intended, the theoretical reference used and the validation process of constructed statements.

METHOD

An integrative review of the literature with bibliometric approach of publications between 2008 and 2017.

RESULTS

Thirty-five (35) publications were included for analysis. Most of the studies were linked to postgraduate programs of universities in Northeast Brazil. Regarding the attended clientele, there was a trend towards the care of cancer, older adult and child/adolescent patients. For the theoretical reference for constructing the subset, there was a trend towards using the Basic Human Needs model. The validation process was not described in all studies.

CONCLUSION

The importance of constructing terminological subsets of ICNP® aimed at priority health clientele is reinforced in order to enhance the use of this terminology. The methodological course should be based on specific methodologies, and the construction process should be parallel to the validation process.

Born in Belo Horizonte: the trajectory of parturient women and their reproductive outcomes

OBJECTIVE

To analyze the trajectory taken by pregnant women for delivery care in Belo Horizonte and its relation with the reproductive outcomes.

METHOD

A cross-sectional study using a database from a study conducted in Belo Horizonte. The studied variables were referent to the trajectory of women seeking delivery care, to their social, demographic and health care characteristics, and to the reproductive outcomes. Odds Ratios were estimated with their 95% confidence intervals to evaluate the factors associated with unfavorable trajectory and outcomes.

RESULTS

A total of 1,087 cases were studied, of which 39.3% had an unfavorable trajectory. The chance of having an unfavorable trajectory was higher for women who were not Belo Horizonte residents, with lower education, non-white race/color, and who had undergone prenatal care in public healthcare service. The prevalence of reproductive outcomes was similar regardless of the trajectory status, except for vaginal delivery.

CONCLUSION

An unfavorable trajectory remains high, and shows weaknesses in the health care services network to guarantee timely and qualified access to pregnant women. However, the care received in the health services outweighs the risks of an unfavorable trajectory.