Supporting Breast‐feeding When a Woman Is Homeless

PURPOSE. This case study demonstrates use of standardized nursing languages in the care of new mothers in community settings. DATA SOURCES. The author collected data from clinical practice as an instructor in a baccalaureate nursing program and from the research literature. DATA SYNTHESIS. The appropriate nursing diagnoses, outcomes, and interventions were identified in partnership with the new mother. CONCLUSIONS. This case shows that NANDA International (NANDA‐I), the Nursing Outcomes Classification (NOC), and the Nursing Interventions Classification (NIC) are useful to direct nursing care in community settings. IMPLICATIONS FOR NURSING. When teaching nursing students in a baccalaureate program, nurse faculty can use NANDA‐I, NOC, and NIC classifications to guide the growing practice of nursing students in community settings.     

Case study: a young male with auditory hallucinations in paranoid schizophrenia

PURPOSE. The purpose of this case study is to demonstrate use of the nursing process and the standardized nursing languages of NANDA International (NANDA‐I), the Nursing Outcomes Classification (NOC), and the Nursing Interventions Classification (NIC) to assist a young male with paranoid schizophrenia to deal with auditory hallucinations. DATA SOURCES. Data were obtained from the experience and expertise of the author and published literature. DATA SYNTHESIS. This case study demonstrates nurses' clinical decision making in providing care for an adolescent with mental illness. CONCLUSION. This case study provides the pertinent nursing diagnosis, patient outcomes, and nursing interventions for a young male with auditory hallucinations in paranoid schizophrenia. IMPLICATIONS FOR NURSING. The use of NANDA‐I, NOC, and NIC can provide the necessary framework for enhancing and improving the management of care with patients who experience auditory hallucinations in paranoid schizophrenia.     

My First Patient as a Nurse Practitioner: A Man With Low Literacy

PURPOSE: The purpose of this case study is to demonstrate the use of the nursing process and the standardized nursing languages of NANDA‐I, the Nursing Outcomes Classification (NOC), and the Nursing Interventions Classification (NIC) to assist a man with low literacy to self‐manage his medication regimen. DATA SOURCES: The data sources for this article are clinical nursing practice, research evidence related to helping people with low literacy, and the books that explain NANDA‐I, NOC, and NIC. DATA SYNTHESIS: This case study demonstrates nurses’ clinical decision making in providing care for a person with low health literacy. CONCLUSIONS: Low health literacy should be considered when nurses identify the nursing diagnosis of Ineffective Self‐Health Management. After trust is established, a screening tool should be used to evaluate the person's literacy level. Active partnership of the nurse and the person supports interventions to assist the person implement the medication regimen. IMPLICATIONS FOR NURSING: Inadequate evaluation of health literacy may result in mislabeling a person as “nonadherent” or “noncompliant” to a medication or treatment regimen. Low literacy is often an unrecognized barrier to effective self‐health management.     

Consensus‐Validation Study Identifies Relevant Nursing Diagnoses,Nursing Interventions,and Health Outcomes for People with Traumatic Brain Injuries

A consensus‐validation study used action research methods to identify relevant nursing diagnoses, nursing interventions, and patient outcomes for a population of adults with traumatic brain injury (TBI) in long‐term care. In meetings totaling 159 hours to reach 100% consensus through group discussions, the three classifications of NANDA International's (NANDA‐I's) approved nursing diagnoses, the Nursing Interventions Classification (NIC), and the Nursing Outcomes Classification (NOC) were used as the basis for three nurses experienced in working with adults with TBI to select the elements of nursing care. Among almost 200 NANDA‐I nursing diagnoses, 29 were identified as relevant for comprehensive nursing care of this population. Each nursing diagnosis was associated with 3–11 of the more than 500 NIC interventions and 1–13 of more than 300 NOC outcomes. The nurses became aware of the complexity and the need for critical thinking. The findings were used to refine the facility's nursing standards of care, which were to be combined with the interdisciplinary plan of care and included in future electronic health records.     

A Case Study of Teen Parenting

PURPOSE: The purpose of this case study is to demonstrate how the use of the standard nursing languages of NANDA International (NANDA‐I), the Nursing Interventions Classification (NIC), and the Nursing Outcomes Classification (NOC) help a teen mother provide safe care for her newborn. In addition, this study aims to demonstrate how important standardized nursing languages are in documenting the care provided. DATA SOURCES: The data sources for this article are clinical nursing practice, research evidence in the form of care directives from the American Academy of Pediatrics regarding newborn safety and feeding, and the books that provide directions for the use of NANDA‐I, NIC, and NOC. DATA SYNTHESIS: This case demonstrates the use of the nursing process in providing care for a teen mother and a newborn. CONCLUSIONS: Many new mothers, especially teens, are poorly informed regarding normal newborn care and safety upon hospital discharge. For this reason, teen mothers should be referred for nursing assessments in the home environment after discharge. IMPLICATIONS FOR NURSING: This case demonstrates the need for education of all parents prior to hospital discharge and supports the need for home‐based evaluations to ensure the safety of the infant. This case also supports the use of standardized nursing language to document the care provided.     

Case Study: The Challenges of Self‐Management of Exacerbation of Pulmonary Symptoms

PURPOSE. This case study demonstrates the signs and symptoms of pulmonary exacerbation and the challenges of self‐management for a female veteran. DATA SOURCES. Data were obtained through the author's clinical practice in primary care nursing and research literature sources. DATA SYNTHESIS. The appropriate nursing diagnosis, nursing interventions, and patient outcomes were identified through the use of NANDA‐International, the Nursing Interventions Classification, and the Nursing Outcomes Classification. CONCLUSIONS. This case study illustrates the appropriate nursing diagnosis, interventions, and outcomes pertinent to an individual with pulmonary exacerbations. It provides a framework for nurses in primary care when caring for individuals with pulmonary exacerbations. IMPLICATIONS FOR NURSING PRACTICE. Employing the NANDA‐International standardized nursing diagnoses, the Nursing Interventions Classification and the Nursing Outcomes Classification provided the needed constructs for improving care for a patient that had pulmonary issues in a primary care setting.     

Application of Orem''s Self-Care Deficit Theory and Standardized Nursing Languages in a Case Study of a Woman with Diabetes

PURPOSE: This paper aims to illustrate the process of theory-based nursing practice by presenting a case study of a clinical nurse specialist's assessment and care of a woman with type 2 diabetes. DESIGN: Orem's self-care deficit theory and standardized nursing language, NANDA, NIC (Nursing Interventions Classification), and NOC (Nursing Outcomes Classification), guided assessment and the identification of outcomes and interventions related to the client's management of diabetes. FINDINGS: Theory-based nursing care and standardized nursing language enhanced the client's ability to self-manage the chronic illness: diabetes. CONCLUSION: Nursing theory and standardized nursing language enhance communication among nurses and support a client's ability to self-manage a chronic illness.     

Case Study: A Woman Who Hemorrhages 24 Hours Post Tonsillectomy

PURPOSE. This case study focused on the emergency nursing care of a 32‐year‐old female, less than 24 hours post operatively from a tonsillectomy. The purpose is to identify the priority nursing diagnoses, patient outcomes, and nursing interventions that guided nursing care during this emergency. DATA SOURCES. Data were obtained through the author's clinical practice in emergency nursing and literature sources. DATA SYNTHESIS. NANDA International Classification, the Nursing Outcomes Classification, and the Nursing Interventions Classification were used to identify the appropriate nursing diagnosis, patient outcomes, and nursing interventions of an adult with a postoperative hemorrhage. CONCLUSIONS. This case study provides emergency nurses and students with the pertinent nursing diagnoses, patient outcomes, and nursing interventions for persons with post‐op hemorrhage after tonsillectomy.     

Using Standardized Nursing Languages in End‐of‐Life Care Plans

PURPOSE: This case study demonstrates the challenges to achieve dignified life closure and a comfortable death for a middle‐aged woman with terminal cancer and her family. DATA SOURCES: Data were obtained from a patient known through the author's clinical experiences, personal family experiences, and published sources. DATA SYNTHESIS: The appropriate nursing diagnosis, patient outcomes, and nursing interventions were identified through the use of NANDA‐International, the Nursing Outcomes Classification, and the Nursing Interventions Classification. CONCLUSIONS: This case study illustrates the appropriate nursing diagnosis, interventions, and outcomes pertinent to an individual with emotional distress at the end of life. IMPLICATIONS FOR NURSING PRACTICE: Employing the NANDA‐International standardized nursing diagnosis, the Nursing Interventions Classification and the Nursing Outcomes Classification provided the needed constructs for considering and improving a dying patient's care in a primary and home setting.     

Sexually Transmitted Disease in a Female Young Adult

PURPOSE. This case study demonstrates the sexual health challenges experienced by a woman newly married and recently migrated to the United States. DATA SOURCES. Data were obtained through the author's clinical experiences in primary healthcare nursing and published sources. DATA SYNTHESIS. The nursing diagnoses, nursing interventions, and patient outcomes for this woman were identified using the classifications of NANDA‐International, the Nursing Interventions Classification, and the Nursing Outcomes Classification. CONCLUSION. This case study demonstrates the appropriate nursing diagnoses, interventions, and outcomes that are relevant for an individual with a sexually transmitted infection. It provides a framework for nurse practitioners in primary health care when caring for individuals with sexually transmitted infections. IMPLICATIONS FOR NURSING PRACTICE. Based on the NANDA‐International standardized nursing diagnoses, the Nursing Interventions Classification, and the Nursing Outcomes Classification provided the needed structure to improve the care of a woman with issues involving sexual health.     

Application of Orem's Self‐Care Deficit Theory and Standardized Nursing Languages in a Case Study of a Woman with Diabetes

PURPOSE. This paper aims to illustrate the process of theory‐based nursing practice by presenting a case study of a clinical nurse specialist's assessment and care of a woman with type 2 diabetes. DESIGN. Orem's self‐care deficit theory and standardized nursing language, NANDA, NIC (Nursing Interventions Classification), and NOC (Nursing Outcomes Classification), guided assessment and the identification of outcomes and interventions related to the client's management of diabetes. FINDINGS. Theory‐based nursing care and standardized nursing language enhanced the client's ability to self‐manage the chronic illness: diabetes. CONCLUSION. Nursing theory and standardized nursing language enhance communication among nurses and support a client's ability to self‐manage a chronic illness.     

Case Study: Home Nursing Care for a 62‐Year‐Old Woman with Multiple Health Problems

PURPOSE. This case study illustrates the characteristics of, and challenges for, a woman in the United States with multiple health problems. DATA SOURCES. Data were obtained through the authors' experience and knowledge of community health nursing and from published literature. DATA SYNTHESIS. NANDA International, Nursing Interventions Classification, and Nursing Outcomes Classification were utilized to identify appropriate nursing diagnoses, interventions, and outcomes for the client. CONCLUSION. This case study illustrates and provides appropriate nursing diagnoses, interventions, and outcomes relevant to a woman with many health concerns. It provides guidance for nurses in community health settings when caring for patients with multiple health problems. IMPLICATIONS FOR NURSING PRACTICE. Utilizing the standardized nursing languages of NANDA International, Nursing Interventions Classification, and Nursing Outcomes Classification can provide the necessary framework for enhancing and improving the management of care for patients with many health concerns in the community setting.     

Case Study: Home Nursing Care for a 62-Year-Old Woman with Multiple Health Problems

PURPOSE.  This case study illustrates the characteristics of, and challenges for, a woman in the United States with multiple health problems.
DATA SOURCES.  Data were obtained through the authors' experience and knowledge of community health nursing and from published literature.
DATA SYNTHESIS.  NANDA International, Nursing Interventions Classification, and Nursing Outcomes Classification were utilized to identify appropriate nursing diagnoses, interventions, and outcomes for the client.
CONCLUSION.  This case study illustrates and provides appropriate nursing diagnoses, interventions, and outcomes relevant to a woman with many health concerns. It provides guidance for nurses in community health settings when caring for patients with multiple health problems.
IMPLICATIONS FOR NURSING PRACTICE.  Utilizing the standardized nursing languages of NANDA International, Nursing Interventions Classification, and Nursing Outcomes Classification can provide the necessary framework for enhancing and improving the management of care for patients with many health concerns in the community setting.     

Toward integrating a common nursing data set in home care to facilitate monitoring outcomes across settings

The purpose of our research is to identify a realistic subset of North American Nursing Diagnosis Association (NANDA), Nursing Outcome Classification (NOC), and Nursing Interventions Classification (NIC) terms specific to the home care (HC) setting. A subset of 89 NOC outcomes were identified for study in HC through a baseline survey. Three research assistants then observed the care of 258 patients to whom the 89 NOC outcomes applied and recorded the associated NANDA and NIC terms. Follow-up surveys and focus groups were conducted with the nurses and research assistants. There were 81 different NANDA and 226 NIC labels used to describe study patients' care. Only 36 of the 89 NOC labels studied were deemed clinically useful for HC. We found that expert opinion about terminology usage before actual experience under practice conditions is unreliable.     

An Exemplar of the Use of NNN Language in Developing Evidence‐Based Practice Guidelines

PURPOSE. To explore the use of standardized language, NNN, in the development of evidence‐based practice (EBP). DATA SOURCES. Published research and texts on family interventions, nursing diagnoses (NANDA‐I), nursing interventions (NIC), and nursing outcomes (NOC). DATA ANALYSIS. Research literature was summarized and synthesized to determine levels of evidence for the NIC intervention Family Integrity Promotion. CONCLUSIONS. The authors advocate that a “standards of practice” category of levels of evidence be adopted for interventions not amenable to randomized controlled trials or for which a body of research has not been developed. Priorities for nursing family intervention research are identified. IMPLICATIONS FOR NURSING PRACTICE. The use of NANDA‐I nursing diagnoses, NIC interventions, and NOC outcomes (NNN language) as research frameworks will facilitate the development of EBP guidelines and the use of appropriate outcome measures.     

Older Adult Who Falls: A Case Study

PURPOSE. The purpose of this case study is to illustrate the nursing process by incorporating the standardized nursing languages of NANDA International, the Nursing Interventions Classification, and the Nursing Outcomes Classification to assist an older adult with a history of falls. DATA SOURCES. The data sources were the author's clinical nursing practice and research‐based evidence related to falls of older adults. DATA SYNTHESIS. The data were synthesized by using clinical reasoning to select the best possible nursing diagnoses, interventions, and patient outcomes. CONCLUSIONS. To provide a framework for nurses to achieve positive patient outcomes, standardized nursing languages should be incorporated into patients' clinical nursing databases. IMPLICATIONS FOR NURSING. In determining factors that relate to falls, nurses need to obtain baseline data, set goals with patients, and identify milestones, while encouraging patients to be active participants in plans of care.     

A Pilot Study to Validate the Priority Nursing Interventions Classification Interventions and Nursing Outcomes Classification Outcomes for the Nursing Diagnosis "Excess Fluid Volume" in Cardiac Patients

PURPOSE.  To validate the content of the priority Nursing Interventions Classification (NIC) interventions and Nursing Outcomes Classification (NOC)-suggested outcomes for cardiac patients with the nursing diagnosis excess fluid volume in the Brazilian context.
METHODS.  The content of the interventions and outcomes was scored by seven expert nurses using a Likert scale, using the Fehring model.
FINDINGS.  From the 83 activities of the priority NIC interventions, nine had scores lower than 0.5 (nonuseful) and 50 had scores higher than 0.8 (major); from the 53 indicators of the suggested NOC outcomes, eight scored lower than 0.5 and 26 had scores higher than 0.8.
CONCLUSIONS.  The majority of the NIC interventions and NOC outcomes were considered useful by the Brazilian Cardiology expert nurses.
IMPLICATIONS FOR PRACTICE.  Clinical studies are an important strategy for validation of the usefulness of North American Nursing Diagnosis Association, NIC, and NOC language in clinical protocols. Additional studies are necessary to confirm the findings of this pilot study.     

Establishing competency in the use of North American Nursing Diagnosis Association, Nursing Outcomes Classification, and Nursing Interventions Classification terminology

The purpose of this study was to evaluate a 16-hour intervention designed to build clinician competency in the use of North American Nursing Diagnosis Association (NANDA), Nursing Outcome Classification (NOC), and Nursing Interventions Classification (NIC) (hereinafter: N3) among nurses with limited N3 knowledge. Each of 19 pairs of nurses independently selected N3 terms and rated the outcomes applicable to an actual patient for a specified time. A pair-through discussion then created a single consensus patient profile of the applicable terms. Before discussion, pairs agreed on 46% of the NANDA diagnoses, 30% of the NOC outcomes, and 20% of the NIC interventions selected. Eighty-nine percent of NOC label pair ratings were within 1 point. Building competency in N3 requires consistent use in written and oral communication with peers across time. Inter-rater reliabilities (IRRs) for NOC label ratings support previous findings.     

Case Study: The Challenges of Self-Management of Exacerbation of Pulmonary Symptoms

PURPOSE.  This case study demonstrates the signs and symptoms of pulmonary exacerbation and the challenges of self-management for a female veteran.
DATA SOURCES.  Data were obtained through the author's clinical practice in primary care nursing and research literature sources.
DATA SYNTHESIS.  The appropriate nursing diagnosis, nursing interventions, and patient outcomes were identified through the use of NANDA-International, the Nursing Interventions Classification, and the Nursing Outcomes Classification.
CONCLUSIONS.  This case study illustrates the appropriate nursing diagnosis, interventions, and outcomes pertinent to an individual with pulmonary exacerbations. It provides a framework for nurses in primary care when caring for individuals with pulmonary exacerbations.
IMPLICATIONS FOR NURSING PRACTICE.  Employing the NANDA-International standardized nursing diagnoses, the Nursing Interventions Classification and the Nursing Outcomes Classification provided the needed constructs for improving care for a patient that had pulmonary issues in a primary care setting.     

La enfermera especialista en salud mental en la gestión del caso de una paciente con esquizofrenia grave

Community-based programmes for people with severe mental illness (SMI), with a case management methodology, have shown high treatment adherence and a decrease in psychiatric hospitalizations. There is a need for continuity of care through a good therapeutic relationship, maintained throughout the care process until reaching clinical stabilization. The proposed case shows the treatment of a woman with a diagnosis of schizophrenia who began treatment in a mental health centre and was later referred to a case managed SMI programme. A nursing assessment was carried out from the beginning and a care plan was made based on the NANDA (North American Nursing Diagnosis Association), NOC (Nursing Outcomes Classification), NIC (Nursing Interventions Classification) taxonomy. The outcomes over the years are remarkable, achieving among other objectives not only clinical stabilization but also a normal life.