Relevance of NANDA and health promotion diagnoses to school nursing. National Association of School Nurses

NANDA Diagnoses, NIC Interventions, and NOC Outcomes used in an Electronic Health Record with Elementary School Children

This is a report of a secondary analysis of data from a published quasi-experimental feasibility study of the effects of implementing diagnoses from North American Nursing Diagnosis Association International, interventions from the Nursing Interventions Classification, and outcomes from the Nursing Outcomes Classification (referred to as NNN) on nurses’ power and children's health outcomes. For this study, the NNN terms that were frequently used by nurses in the original study were identified through the nurses’ printed reports of health-related visits (N = 766) with 103 New York City children in the 4th and 5th grades in six schools. The findings indicate that a large majority of nurses’ efforts were focused on health promotion and management of risk states. Health problems such as pain and ineffective airway clearance were identified and were treated when present. Findings from this study can be combined with findings from previous studies to identify the diagnoses, interventions, and outcomes that are relevant for school settings. Use of the relevant NNN terms will provide data to support evidenced-based school nursing practice, education of school nurses, development of policies, and communication of the value of school nursing practice to stakeholders.

Feasibility of Studying the Effects of Using NANDA, NIC, and NOC on Nursesʼ Power and Childrenʼs Outcomes

This was a pilot study with a pretest and posttest design to test the feasibility of conducting large-scale studies of the effects of using computer-based terms from NANDA, NIC, and NOC on nurses' power to help children and children's health outcomes. Four hypotheses were tested with data from 12 public health nurses in school settings and 220 schoolchildren. Group A comprised six nurses who used SNAP Health Center (SNAP 98) software to record health visits with 117 children. Group B comprised six nurses who used the same software and NANDA, NIC, and NOC with 103 children. After use of the software, the power of the 12 nurses to help children significantly increased. For the 220 children, the number of coping strategies significantly increased but there were no changes in the other health outcomes. The hypotheses indicating that Group B nurses and children would have more positive changes than Group A were not supported. Positive and negative elements for large-scale studies were identified.

The use of standardized language to describe abdominal pain

The assessment, diagnosis, and management of abdominal pain (AP) in children is a complex and challenging process. The factors that contribute to this complexity are the varied etiologies of AP in children that may be biological and/or psychological, nurses' perceptions of AP, manifestations of AP in children, and the lack of a standardized language to describe AP. In this descriptive study, 64 school nurses completed an investigator-developed survey to determine the usefulness of standardized language in describing AP. This study identified the most frequently used assessments to document complaints of AP; activities from the Nursing Interventions Classification "pain management" intervention used to treat AP; and relevant indicators used by school nurses from the Nursing Outcomes Classification "pain level" and "symptom severity" outcomes. Use of standardized language to document nursing care will make nursing's contribution to the care of children with AP more visible and provide data that will identify and monitor trends of AP in the school setting.

The nursing outcomes classification: its relevance to school nursing

Two surveys were conducted to determine school nurses' perceptions of the relevance of 190 outcomes developed by the Nursing Outcomes Classification (NOC) research team to school nursing practice. First, a national random survey of members of the National Association of School Nurses was conducted. Participants were asked to identify the percentage of children and families for whom school nurses affect health outcomes. Usable responses were returned from 227 school nurses (22% response rate). Ninety outcomes were perceived as relevant for 30% or more of children and families; 8 outcomes were perceived as relevant for 50% or more of children and families. A second survey--targeting state representatives attending a school nursing leadership meeting--was conducted using a revised version of the instrument. The legend was changed to degree of relevance to school nursing practice, with a response scale of 0 to 10. Usable responses were returned from 31 state representatives (41% response rate). The means of 172 of 190 outcomes were above 5 (median point on the 10-point scale of relevance). The findings of both surveys indicate that a large number of NOC outcomes are useful for documentation of the effectiveness of nursing interventions in school settings.

Health promotion and the role of the school nurse: a systematic review

This paper describes findings from a systematic review of the literature on the effectiveness of school nurses in promoting the health of school children. The paper gives a brief account of the background to the study and the search strategy adopted. Some key findings are presented and discussed. The brief for the review was to seek evidence of effectiveness in the practice of school nurses. The results of the review were disappointing, in that little research of acceptable quality was found and little could be said about effectiveness. The result is therefore a more diffuse review that gives a summary of descriptive research and current views and opinions, although it does also present some pointers for future research. The study was funded by Health Promotion Wales.