Clinical applicability of nursing outcomes in the evolution of orthopedic patients with Impaired Physical Mobility

Abstract

AIM: to evaluate the clinical applicability of outcomes, according to the Nursing Outcomes Classification (NOC) in the evolution of orthopedic patients with Impaired Physical Mobility METHOD: longitudinal study conducted in 2012 in a university hospital, with 21 patients undergoing Total Hip Arthroplasty, evaluated daily by pairs of trained data collectors. Data were collected using an instrument containing five Nursing Outcomes, 16 clinical indicators and a five point Likert scale, and statistically analyzed. RESULTS: The outcomes Body Positioning: self-initiated, Mobility, Knowledge: prescribed activity, and Fall Prevention Behavior presented significant increases in mean scores when comparing the first and final evaluations (p<0.001) and (p=0.035). CONCLUSION: the use of the NOC outcomes makes it possible to demonstrate the clinical progression of orthopedic patients with Impaired Physical Mobility, as well as its applicability in this context.

Quality of nursing documentation before and after the Hospital Accreditation in a university hospital

“…The evolution model adopted in the institution contains the items: subjective, objective, interpretation and practices, including those related to patient education. Since the system used is computerized and uses the terminology of the NANDA-I 8 , Questions 12, 13 and 14 did not reach the maximum score only when there was no daily Nursing Evolution, being dispensable in this assessment. The significant improvement in Question 15 is also due to the clinical judgment of nurses in choosing accurate etiologies.…”

“…However, this registration practice needs to be strengthened, since it corresponded to a representative portion of the category " partly documented ", with 58.9% in 2009 and 44.6% in 2013. The registration of nursing outcomes is not yet a reality in the institution, although its application in clinical practice have been investigated in the evolution of patients 8 .…”

“…Question 26 showed no significant changes, since the institution is still on a process of research for the effective implementation of NOC in its working method. Studies have shown the applicability of NOC, aiming at the improvement and significant progress not only in the quality of documentation but also in the nursing practices 8 - 16 . Based on these results, it is clear that the operationalization of NOC in the institution tends to benefit the quality of nursing documentation, facilitated by the articulation of standardized languages and computerised systems 15 .…”

“…The NP used as a working method has the ND stage based on the terminology of the NANDA International (NANDA-I) and the prescribed care based on the Nursing Interventions Classification (NIC) 8 .…”

Diagnósticos e intervenções de enfermagem ao neonato com Síndrome de Donohue (Leprechaunismo): estudo de caso [Nursing diagnoses and interventions for a neonate with Donohue Syndrome (Leprechaunism): a case study]

“…Deve-se considerar a descrição de cada componente do diagnóstico a ser testado com suas respectivas definições operacionais, indicando o que e como será avaliado. Esses procedimentos também se aplicam às intervenções e aos resultados de enfermagem 10 .…”