Diagnosis adalah identifikasi sifat-sifat penyakit atau kondisi atau membedakan satu penyakit atau kondisi dari yang lainnya. Penilaian dapat dilakukan melalui pemeriksaan fisik, tes laboratorium, atau sejenisnya, dan dapat dibantu oleh program komputer yang dirancang untuk memperbaiki proses pengambilan keputusan.Diagnosa Keperawatan Nanda NIC NOC- Aplikasi Ringan dan Mudah- Lengkap dan Terpercaya- Tampa Koneksi Internet.
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DesignThis study was a Randomized Clinical Trial (RCT). Documented nursing reports were reviewed in terms of using the NNN system related to the NANDA‐I Safety/Protection domain. This study was approved by the Joint Committee of Ethics, of Nursing and Midwifery school with the School of Rehabilitation, Tehran University of Medical Sciences (TUMS) with IR.TUMS.FNM.REC.1396.2697 code. The permission for data collection was obtained from the School of Nursing and Midwifery education office and the Nursing Office of Roozbeh Hospital. According to the written commitment to the Roozbeh Hospital's nursing office, the patients’ personal information has not been collected, and only the nursing documented reports, in terms of using the NDs, NIC and NOC were gathered by the research team. The study was also registered at the Iranian Center for Clinical Trials (IRCT) with the code of; IRCT6237N2.
Participants and data collectionThe study participants were the nurses working in the Roozbeh Hospital. Eighty of them were selected and assigned into two, Control and Experimental, groups randomly, by permuted‐block randomization. With regard to the aims of the study, our goal was to examine the impact of training among the group that received the intervention (The Experimental group), with the group that did not receive any training (The Control Group).
All the nurses were asked for written informed consent regarding participation in the study.The data were collected by the researcher in a 9‐month period. The nursing reports were selected randomly, in a way that one nurse was chosen, and three documented reports of that nurse were assessed in respect to the frequency of the NNN system usage.
The time interval between the pre‐test and post‐test in this study was 12 weeks. Moreover, due to the similarity of the research site and the possibility of association between the two groups, the pre‐test and the post‐test were done in the Control Group at first, and then, these steps were done in the experimental group afterwards.The inclusion criteria involve the following: written and informed consent to participate in the research, having at least a bachelor's degree in Nursing and working in the psychiatric hospital as a clinical nurse. The exclusion criteria include the following: refuse to continue participating in the study, transfer from the psychiatric hospital to another centre during the study period. Data were collected with two questionnaires.
One questionnaire examines the demographic and occupational information, and another one examines the frequency of using NDs, NIC and NOC in the nursing documents. Intervention of the studyIntervention of the study was the training of NANDA‐I NDs, NIC and NOC related to the Safety/Protection domain, during the four sessions, each lasted for 4 hr and in a 2‐month period in the Roozbeh Hospital. This training was educated by the researcher.
Safety/Protection domain has NDs in six classes such as Infection, Physical harm, Violence, Environmental hazards, Defensive processes and Thermoregulation. With each ND, related NIC and NOC were also taught.
By reviewing the similar studies (Frauenfelder et al., ), one of the best ways to examine the diagnoses, interventions and nursing outcomes used by the nurses working in psychiatric setting is to review the nursing documents. Training of the NNN system in this study focused on training of the signs, symptoms and recognition of the nursing diagnoses aetiology. In this regard, the defining characteristics and risk factors of every NDs were included in the training to select the appropriate interventions and consequently, identification of short, medium and long‐term outcomes. Data analysisDescriptive statistics were applied to calculate the frequencies of identified NNN system use in the nursing documents. Statistical analysis was performed using IBM SPSS Statistics 23 software (IBM Corp., Armonk, NY, USA). The Pearson chi‐square, independent‐samples t test and paired‐sample t test were adapted to detect the frequency and absolute distribution of the participants age, work experience, gender, level of education, working department and comparison between the NDs, NIC and NOC used in two groups' nursing reports, before and after the intervention.
The level of significance was set at 0.05. Steps of the Methodology are summarized in the Figure. CONSORT flow diagram. 5. RESULTSMost of the research samples were.
Category% (N)Age. The findings from using NDs, NIC and NOC (NNN system) before the intervention indicate a low‐level use of this system, in both control and experimental groups.
In the Control Group, 20 ND and 14 NIC were used in different classes before the intervention, while after the intervention, 21 ND and 13 NIC were used. NOC were not used, before and after the intervention, nevertheless (Figure ).In the experimental group, the frequency of using the NNN system was increased considerably, so that the number of the NDs used increased from 22–202. The frequency of the used NIC reached from 4–144 times and NOC 0–88. After the intervention, the violence class received the highest number of NDs, NIC and NOC use.
Subsequently, classes of physical harm, infection, thermoregulation and environmental hazards were the most commonly used classes in the NNN system, respectively. Defensive process class was not used in any of the control and experimental groups, before and after the intervention.Comparing the mean amounts of the NNN system use, in the experimental group, before and after the intervention, all the classes in the Safety/Protection domain, showed a significant increase, except the “defensive processes” class. Paired‐sample t test showed a significant difference ( p. 7. CONCLUSIONNANDA‐I Nursing Diagnoses (NDs), NIC and NOC or the NNN system promote the nursing care related to the patient safety in psychiatric wards.
The NNN system training enhanced the frequency of using NDs, NIC and NOC, as well as the variety of used components. With regard to the high use of the violence class, it is recommended to focus on the nursing care related to the violence and the concepts connected to it. More studies could be conducted on the class of violence, as well as other NANDA‐I classification domains in psychiatric wards.
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NotesTaghavi Larijani T, Saatchi B. Training of NANDA-I Nursing Diagnoses (NDs), Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC), in Psychiatric Wards: A randomized controlled trial.
Nursing Open. 2019; 6:612–619. 10.1002/nop2.244 Funding informationThis research was done under the Master's degree thesis at the Tehran University of Medical Sciences (TUMS) and received no specific grant from any other funding agency in public, and commercial or not‐for‐profit sectors.