Valéria Gonçalves Silva

Accuracy in inference of nursing diagnoses in heart failure patients

UNLABELLED Heart failure (HF) is a common cause of hospitalization and requires accuracy in clinical judgment and appropriate nursing diagnoses. OBJECTIVE to determine the accuracy of nursing diagnoses of fatigue, intolerance to activity and decreased cardiac output in hospitalized HF patients. METHOD descriptive study applied to nurses with experience in NANDA-I and/or HF nursing diagnoses. Evaluation and accuracy were determined by calculating efficacy (E), false negative (FN), false positive (FP) and trend (T) measures. Nurses who showed acceptable inspection for two diagnoses were selected. RESULTS the nursing diagnosis of fatigue was the most commonly mistaken diagnosis identified by the nursing evaluators. DISCUSSION the search for improving diagnostic accuracy reaffirms the need for continuous and specific training to improve the diagnosis capability of nurses. CONCLUSION the training allowed the exercise of clinical judgment and better accuracy of nurses.

Acurácia na inferência de diagnósticos de enfermagem de pacientes com insuficiência cardíaca

UNLABELLED Heart failure (HF) is a common cause of hospitalization and requires accuracy in clinical judgment and appropriate nursing diagnoses. OBJECTIVE to determine the accuracy of nursing diagnoses of fatigue, intolerance to activity and decreased cardiac output in hospitalized HF patients. METHOD descriptive study applied to nurses with experience in NANDA-I and/or HF nursing diagnoses. Evaluation and accuracy were determined by calculating efficacy (E), false negative (FN), false positive (FP) and trend (T) measures. Nurses who showed acceptable inspection for two diagnoses were selected. RESULTS the nursing diagnosis of fatigue was the most commonly mistaken diagnosis identified by the nursing evaluators. DISCUSSION the search for improving diagnostic accuracy reaffirms the need for continuous and specific training to improve the diagnosis capability of nurses. CONCLUSION the training allowed the exercise of clinical judgment and better accuracy of nurses.

La precisión en inferencia de diagnóstico de enfermería en pacientes con insuficiencia cardíaca

UNLABELLED Heart failure (HF) is a common cause of hospitalization and requires accuracy in clinical judgment and appropriate nursing diagnoses. OBJECTIVE to determine the accuracy of nursing diagnoses of fatigue, intolerance to activity and decreased cardiac output in hospitalized HF patients. METHOD descriptive study applied to nurses with experience in NANDA-I and/or HF nursing diagnoses. Evaluation and accuracy were determined by calculating efficacy (E), false negative (FN), false positive (FP) and trend (T) measures. Nurses who showed acceptable inspection for two diagnoses were selected. RESULTS the nursing diagnosis of fatigue was the most commonly mistaken diagnosis identified by the nursing evaluators. DISCUSSION the search for improving diagnostic accuracy reaffirms the need for continuous and specific training to improve the diagnosis capability of nurses. CONCLUSION the training allowed the exercise of clinical judgment and better accuracy of nurses.

Diagnósticos de Enfermagem em crianças com cardiopatias congênitas: mapeamento cruzado

Objective To identify the NANDA International nursing diagnoses from the terms found in the nursing records of hospitalized children with congenital heart defects, and verify the association between these terms and the mapped nursing diagnoses. Methods Observational and cross sectional study, developed by mapping of the terms in the nursing records of hospitalized children up to two years of age with congenital heart disease. The association between the terms and the most frequent nursing diagnoses were evaluated using the Student’s t-test or chi-square. Results The most frequent nursing diagnoses in the 82 records analyzed were: risk for infection (81.7%), impaired gas exchange (46.3%) and activity intolerance (36.6%). The terms “cyanotic” and “pallor” had significant associations with the diagnosis, impaired gas exchange. Conclusion The terms recorded in the records of children with congenital heart disease allowed for the identification of NANDA International nursing diagnoses, in addition to verification of associations.

Terms of nursing: human responses of children hospitalized with heart disease – a cross-sectional study

Objetivos: Descrever as caracteristicas demograficas e clinicas a partir dos termos encontrados nos registros de enfermagem dos prontuarios de criancas com cardiopatias congenitas hospitalizadas. Metodo: Trata-se de um estudo transversal, realizado em um hospital da rede publica. Foi realizado por duas especialistas, atraves da analise documental de 01 registro de enfermagem de cada prontuario para identificacao das principais caracteristicas clinicas dessas criancas. Resultados: Foram estudados 82 prontuarios, as criancas do estudo apresentaram um perfil majoritariamente do sexo masculino (54,9%), sao lactentes (91,5%) e maioria possui cardiopatia acianotica (58,5%). Os termos mais encontrados nos prontuarios das criancas com cardiopatias congenitas foram: “cianotico” (80,5%), seguido de “esforco respiratorio” (79,3%), “taquipneico” (72,3%) e “hipocorado” (65,9%). Conclusao: O reconhecimento precoce da cardiopatia congenita pelo enfermeiro, possibilita que os cuidados de enfermagem sejam estabelecidos e executados com prioridade. Evitando a rapida deterioracao clinica e mantendo a crianca em bom estado para realizacao dos procedimentos terapeuticos.

Nursing diagnoses identified in records of children with heart disease: a retrospective cohort

The dissertation for the Professional Master in Nursing degree, aims to: identify the nursing diagnoses of NANDA-I from the terms found in the nursing records of children with congenital heart disease; identify the results and nursing interventions for these diagnoses, and develop a standard nursing care instrument guided by the NANDA-NOC-NIC classifications. Method: A retrospective cohort consisting of a non-probabilistic sample of convenience limited to a time frame of 6 months was studied using cross mapping as a methodological tool. It was performed through the transcription and analysis of 3 nursing records, at admission, after 24 and 48 hours, in the medical records of children with heart disease, in a federal hospital in the city of Rio de Janeiro. Results: The data obtained from medical records were submitted to descriptive analysis and agreement between the researcher and expert nurses; it was measured using the Kappa coefficient