Understanding the use of standardized nursing terminology and classification systems in published research : a case study using the International Classification for Nursing Practice®

Background In the era of evidenced based healthcare, nursing is required to demonstrate that care provided by nurses is associated with optimal patient outcomes, and a high degree of quality and safety. The use of standardized nursing terminologies and classification systems are a way that nursing documentation can be leveraged to generate evidence related to nursing practice. Several widely-reported nursing specific terminologies and classifications systems currently exist including the Clinical Care Classification System, International Classification for Nursing Practice®, Nursing Intervention Classification, Nursing Outcome Classification, Omaha System, Perioperative Nursing Data Set and NANDA International. However, the influence of these systems on demonstrating the value of nursing and the professions’ impact on quality, safety and patient outcomes in published research is relatively unknown. Purpose This paper seeks to understand the use of standardized nursing terminology and classification systems in published research, using the International Classification for Nursing Practice® as a case study. Methods A systematic review of international published empirical studies on, or using, the International Classification for Nursing Practice® were completed using Medline and the Cumulative Index for Nursing and Allied Health Literature. Results Since 2006, 38 studies have been published on the International Classification for Nursing Practice®. The main objectives of the published studies have been to validate the appropriateness of the classification system for particular care areas or populations, further develop the classification system, or utilize it to support the generation of new nursing knowledge. To date, most studies have focused on the classification system itself, and a lesser number of studies have used the system to generate information about the outcomes of nursing practice. Conclusions Based on the published literature that features the International Classification for Nursing Practice, standardized nursing terminology and classification systems appear to be well developed for various populations, settings and to harmonize with other health-related terminology systems. However, the use of the systems to generate new nursing knowledge, and to validate nursing practice is still in its infancy. There is an opportunity now to utilize the well-developed systems in their current state to further what is know about nursing practice, and how best to demonstrate improvements in patient outcomes through nursing care

Delirium in a surgical context from a nursing perspective : A hybrid concept analysis

Publisher Copyright: © 2022Background: The term delirium has been defined in medical diagnosis criteria as a multidimensional disorder, and the term acute confusion is included in nursing classifications. Delirium can be a serious complication assessed in a patient after a surgical procedure. Still, the patient's delirium frequently remains unrecognised. Care of patients with delirium after surgical procedure is complex, and it challenges nursing expertise. From the nurses’ viewpoint, delirium is associated with ambiguity of concepts and lack of knowledge. Therefore, reseach on how nurses perceive patients with delirium in a surgical context is needed. Objective: The aim of this study was to describe the concepts of delirium and acute confusion, as well as the associated dimensions, in adult patients in a surgical context from the nursing perspective. Design: The study used Schwartz and Barcott's hybrid concept analysis with theoretical, fieldwork, and final analytical phases. Settings: Surgical wards, surgical intensive care units, and post-anaesthesia care units. Data sources: A systematic literature search was performed through Pubmed (Medline), Cinahl, PsycInfo, and Embase. Participants: Registered nurses and licensed practical nurses (n = 105) participated in the fieldwork phase. Methods: In the theoretical phase, the concepts’ working definitions were formulated based on a systematic literature search with the year limitations from 2000 until February 2021. At the fieldwork phase, the nurses’ descriptions of patients with delirium were analysed using the deductive content analysis method. At the final analytical phase, findings were combined and reported. Results: The concepts of delirium, subsyndromal delirium, and acute confusion are well defined in the literature. From the perspective of the nurses in the study, concepts were seen as a continuum not as individual diagnoses. Nurses described the continuum of delirium as a process with acute onset, duration, and recovery with the associated dimensions of symptoms, symptom severity, risk factors, and early signs. The acute phase of delirium was emphasised, and preoperative or prolonged disturbance did not seem to be relevant in the surgical care context. Patients’ compliance with care may be decreased with the continuum of delirium, which might challenge both patients’ recovery from surgery and the quality of nursing care. Conclusions: In clinical practice the nurses used term confusion inaccurately. The term acute confusion might be used when illustrating an early stage of delirium. Nurses could benefit from further education where the theoretical knowledge is combined with the clinical practice. The discussion about the delirium, which covers the time both before surgery and after the acute phase should be increased.Peer reviewe

Are comprehensive and individually designed care and service plans for older people's home care a vision or a reality in Finland?

The global population is ageing and many older people want to continue to live in their own homes, supported by home-care services. The basis for comprehensive care is real-time care and service plans, but more knowledge is needed about these plans to ensure that older people benefit from individual and comprehensive home care. Our aim was to describe the contents of older home-care clients' care and service plans by using the Finnish Care Classification (FinCC), version 3.0, which includes the Finnish classification of nursing diagnoses (FiCND) and the Finnish classification of nursing interventions (FiCNI). The data were collected during spring 2018 from 71 anonymised care and service plans provided by 47 registered and practical nurses who worked for one government-funded home-care organisation in an urban region of Finland. We analysed the data using descriptive statistical methods. The documentation focused on daily activities, but was based on a narrow view of individual needs and comprehensive care planning. In addition, we found a statistically significant association between documented clients' needs (FiCND) and nursing interventions (FiCNI) in secretions, fluid balance, respiration and skin integrity. The client's age, gender, how long they had been receiving home care and the number of home visits they received each week were all associated with certain documented needs and interventions. Our findings provide new knowledge about inconsistent documentation related to clients' needs and nursing interventions. Collaboration between technical and home-care professionals is needed to develop and test specific content in the FinCC related to home care. The contents should also take into account the views of older people on how they want their care and services needs to be planned and delivered so that they can lead independent and fulfilling lives