Meanings of the nursing diagnosis implementation process for nurses at a university hospital

Abstract

This qualitative study aims to understand the meanings nurses at a university hospital attribute to the implementation process of the Nursing Diagnosis Classification System (DEn) as a phase in the Nursing Care System (NCS). Data were collected through interviews with eight nurses from the Medical Clinical Unit, who participated in the creation of an instrument to implement the DEn in the NCS. In their reports, the respondents expressed a positive change in their feelings, from initial discomfort and adverse perception of the changeproposal. The stepwise appropriation of the process stages allowed them, besides the sharing of feelings, decisions and responsibilities for the results, to develop the belief that they would able to overcome the difficulties. DESCRIPTORS: nursing diagnosis; organizational innovation; resources management SIGNIFICADOS DEL PROCESO DE IMPLEMENTACIÓN DEL DIAGNÓSTICO DE ENFERMERIA PARA ENFERMERAS DE UN HOSPITAL UNIVERSITARIO Este estudio cualitativo busca comprender los significados atribuidos por enfermeras de un hospital universitario al proceso de implementación del diagnóstico de enfermería (DEn) como etapa del Sistema de Atención de Enfermería (NCS). THE EXPERIENCEInitially, the nurses from the MC received a list of all nursing diagnoses contained in the database, distributed according to the domains established by NANDA's (4) Taxonomy II, together with a letter that asked them to individually choose the diagnoses they found most significant, i.e. that represented the clients they attended, and informing that they could add other diagnoses they considered necessary. The same letter contained an invitation for them to participate in a meeting, at the MC, to be held a few days after the material had been handed in, when the obtained results would be presented and discussed. Hence, decisions should be made through group consensus, with the participants' maximum involvement and commitment (6) .Next, seven two-hour workshops were held, on days and times chosen by the participants, during which they thoroughly discussed the 14 selected Despite the doubts and uncertainties that emerged during the workshops, the nurses constantly demonstrated their motivation to participate in a preliminary study that could be a landmark for the implementation of the nursing diagnosis as a phase of the NCS. We decided to carry out this study to understand the meanings the MC nurses attributed to this process of implementing the nursing diagnosis classification system at the NCS of the HU-USP. THE METHODOLOGICAL TRAJECTORYWe used the qualitative case study as a methodological reference framework. The case study is a qualitative methodological approach that represents a research moment, guided by an interpretative epistemology, where the subject, considered as the study object, is conceived as an individual and concrete being, unique in his/her existence, develops his/her activities creatively, in a determined space and time, within a structured sociocultural system (7) .Initially, the research project was s...

Assessment of Factors Affecting Implementation of Nursing Process Among Nurses in Selected Governmental Hospitals, Addis Ababa, Ethiopia; Cross Sectional Study

“…Similar results were also shown in a study published in 2006 during the implementation of the nursing diagnosis, in which the research subjects indicated difficulties in developing the nursing process at all stages, and the need for changes to speed up the work process and optimize the quality of actions in care and education [5]. This research was done in University hospital where students are doing clinical practice.…”

“…However, the existence of failures was shown among the nursing diagnoses in the patients' history, as well as the implementation of nursing prescriptions without recording the evaluation of the expected results [4].…”

Sistematização Da Assistência De Enfermagem Em Unidade Neonatal

“…A padronização dos cuidados norteada pelo conhecimento das fases do processo de enfermagem possibilita prestar cuidado de qualidade, principalmente quando aliado a recursos tecnológicos para atender as necessidades individuais do recém-nascido (14) . Assim, para que a ação do profissional de enfermagem seja feita a partir de condutas e atitudes seguras que embasem a tomada de decisões relacionadas ao cliente, o conhecimento constitui-se um dos valores de grande importância para que o enfermeiro tenha a certeza de estar agindo de maneira correta e adequada (6) .…”

“…Ocorre, também, o repasse de informações fragmentadas, o que evidencia a necessidade de planejamento e promoção de estratégias assistenciais envolvendo não somente a equipe da unidade neonatal, mas também os demais profissionais. O sucesso ou insucesso na implantação da SAE depende de fatores--chave como apoio, colaboração e interesse das chefias de enfermagem, além do preparo rigoroso, constante e sistemático dos enfermeiros (6,15) . Contudo, a falta de recursos humanos e sobrecarga de trabalho foram apontados pelos participantes como prejudiciais à implatação da SAE Estudo sobre SAE em Unidade de Terapia Intensiva, sustentado pela teoria de Wanda Horta (16) , em unidade de reabilitação (3) , constatou que apesar da existência de diversos formulários com a finalidade de facilitar a implementação da SAE, há dificuldade de enfermeiros para sua operacionalização.…”

“…A utilização da Sistematização no cuidado ao recém-nascido garante a qualidade e a organização da assistência, o que promove maior sobrevida e menor tempo de permanência da criança na UTIN. Assim, a aplicação da SAE nas instituições de saúde apresenta como aspectos positivos: segurança no planejamento, execução e avaliação das condutas de enfermagem, individualização da assistência, visibilidade e autonomia para o enfermeiro (6) .…”