What Do Public Health Nurses Really Do During Prenatal Home Appointments?

Abstract

This study describes the nursing interventions and activities utilized by public health nurses in home-based delivery of care to high-risk prenatal clients. Fourteen home appointments by nine public health nurses were audiotaped, transcribed, and coded using the Nursing Interventions Classification (NIC) as the coding frame. Seven interventions accounted for approximately 83% of the nursing care during these appointments. Weak relationships were found between the interventions projected in the client's written nursing care plan, the interventions identified in the coded transcriptions, and the chart documentation of the events of the home appointment. Practice, education, and research implications are discussed.

Análise da produção científica sobre a Classificação das Intervenções de Enfermagem (NIC) de 1980 a 2004

“…Outros estudos realizados referem-se: a) ao desenvolvimento de um formulário para documentar a prática de enfermagem em saúde pública, baseado nas linguagens de enfermagem padronizadas, entre elas, a NIC (16) ; b) à descrição da prática de enfermagem em paróquias* usando o NMDS (Nursing Minimum Data Set) e a NIC para codificar os elementos de cuidados de enfermagem (17) ; c) à identificação das intervenções e atividades de enfermagem empregadas por enfermeiras de saúde pública nos cuidados em domicílio à gestante de alto risco, no período pré-natal (18) ; d) à descrição do uso da NIC em uma unidade cardiovascular de cuidados intensivos e o papel do serviço de educação nesse sentido, tendo sido identificado, entre outros aspectos, que os profissionais que já trabalham com os diagnósticos de enfermagem foram mais aptos ao uso da NIC (19) ; e) à descrição e validação de diagnósticos de enfermagem e intervenções na prática, sendo que as intervenções foram submetidas ao projeto de Iowa para revisão e consideração para a segunda edição da NIC (20) .…”

Promoting Clinical Practice Knowledge in an Age of Taxonomies and Protocols

“…However, their recommendations for narrowing the practice–research chasm often overlook the practical know‐how and skillful acumen of clinicians who confront the messy details of everyday work. As the narratives of experts demonstrate, excellent practice escapes standardization and is misrepresented when filtered through taxonomic structures (see Twohy & Reif, 1997). Nurses do not adopt taxonomies of diagnosis and treatment to describe what they do or to guide their practice (Benner et al, 1996), nor do taxonomies inherently improve practice or lead to the development of new clinical knowledge precisely because the “logic” of practice is concerned with judgments regarding appropriate action for a given case, not with the discernment of universal relationships.…”

Implementing Nurse Home Visitation Programs

“…A review of the standards of public health nursing ( Wallinder, 1997; Council of Community Health Nurses, 1986; Harnish & Leeser, 1984), as well as descriptions of the content ( Byrd, 1997; Barnard et al, 1988; Twohy & Reif, 1997; Gulino & LaMonica, 1986), strategies ( Reutter & Ford, 1997; Zerwekh, 1991a; Hanks, Kitzman, & Milligan, 1995), and theory of nurse home visiting ( SmithBattle, Drake, & Diekemper, 1997; Zerwekh, 1991a, 1992), reveals that the intervention implemented in this case study does reflect the rich history of nursing practice and research.…”