目的:确定院前急救小组协助的患者中NANDA-International护理诊断的患病率和聚集性。
方法:电子记录回顾的回顾性描述性研究。
方法:2019年期间记录的事件,至少包括护理诊断,从西班牙公共应急机构的电子健康记录中恢复(N=28,847)。使用描述性统计来表征样本并确定患病率。采用两步聚类分析对护理诊断进行分组。进行了社会人口统计学和医学问题集群之间的比较。数据于2020年11月访问。
结果:跌倒风险(00155)(27.3%),焦虑(00146)(23.2%),急性疼痛(00132),恐惧(00148)和无效呼吸模式(00032)占所有记录诊断的96.1%。找到了六簇解决方案(n=26.788)。五个集群具有单一的高患病率诊断优势:集群1中的跌倒风险(00155),集群2中的焦虑(00146),集群3中的恐惧(00148),集群4中的急性疼痛(00132)和无效呼吸模式(00032)。第5类有几个高患病率诊断,这些诊断同时发生:血糖水平不稳定的风险(00179),应对不力(00069),无效健康管理(00078),舒适度受损(00214)和言语交流受损(00051)。
结论:5项护理诊断几乎占整个患病率。确定的聚类表明,院前患者存在六种护理诊断模式。五组以与患者安全相关的主要护理诊断为主导,应对,comfort,和活动/休息,分别。第六群集对适用于慢性病恶化的几种护理诊断进行了分组。
■了解护理诊断的患病率和聚集性,可以更好地了解院前急救团队护理患者的人类反应,并增加院前临床环境中个性化/标准化护理计划的证据。
结论:研究解决了什么问题?院前急救服务有不同的模式。院前设置中标准化护理语言的使用并不均匀。院前NANDA-I护理诊断的研究很少,这些都是在小样本上进行的。主要发现是什么?本文报告了在院前护理环境中发表的NANDA-I护理诊断中样本最多的研究。五项护理诊断占所有记录的96.1%。这些诊断与患者的安全性/保护和应对/压力耐受性有关。院前护理团队根据护理诊断将患者分为六组,这种分类与患者的医疗状况无关。研究将在何处以及对谁产生影响?了解护理诊断的普遍性可以更好地了解在院前环境中接受治疗的患者的人类反应,增加院前护理个性化和标准化护理计划的证据。
■STROBE检查表已用作报告方法。
■仅对患者的记录进行了审查,没有进一步的参与。
OBJECTIVE: To determine the prevalence and clustering of NANDA-International nursing diagnoses in patients assisted by pre-hospital emergency teams.
METHODS: Retrospective descriptive study of electronic record
review.
METHODS: Episodes recorded during 2019, including at least a nursing diagnosis, were recovered from the electronic health records of a Spanish public emergency agency (N = 28,847). Descriptive statistics were used to characterize the sample and determine prevalence. A two-step cluster analysis was used to group nursing diagnoses. A comparison between clusters in sociodemographic and medical problems was performed. Data were accessed in November 2020.
RESULTS: Risk for falls (00155) (27.3%), Anxiety (00146) (23.2%), Acute pain (00132), Fear (00148) and Ineffective breathing pattern (00032) represented 96.1% of all recorded diagnoses. A six-cluster solution (n = 26.788) was found. Five clusters had a single high-prevalence diagnosis predominance: Risk for falls (00155) in cluster 1, Anxiety (00146) in cluster 2, Fear (00148) in cluster 3, Acute pain (00132) in cluster 4 and Ineffective breathing pattern (00032) in cluster 6. Cluster 5 had several high prevalence diagnoses which co-occurred: Risk for unstable blood glucose level (00179), Ineffective coping (00069), Ineffective health management (00078), Impaired comfort (00214) and Impaired verbal communication (00051).
CONCLUSIONS: Five nursing diagnoses accounted for almost the entire prevalence. The identified clusters showed that pre-hospital patients present six patterns of nursing diagnoses. Five clusters were predominated by a predominant nursing diagnosis related to patient safety, coping, comfort, and activity/rest, respectively. The sixth cluster grouped several nursing diagnoses applicable to exacerbations of chronic diseases.
UNASSIGNED: Knowing the prevalence and clustering of nursing diagnoses allows a better understanding of the human responses of patients attended by pre-hospital emergency teams and increases the evidence of individualized/standardized care plans in the pre-hospital clinical setting.
CONCLUSIONS: What problem did the study address? There are different models of pre-hospital emergency care services. The use of standardized nursing languages in the pre-hospital setting is not homogeneous. Studies on NANDA-I nursing diagnoses in the pre-hospital context are scarce, and those available are conducted on small samples. What were the main findings? This paper reports the study with the largest sample among the few published on NANDA-I nursing diagnoses in the pre-hospital care setting. Five nursing diagnoses represented 96.1% of all recorded. These diagnoses were related to patients\' safety/protection and coping/stress tolerance. Patients attended by pre-hospital care teams are grouped into six clusters based on the nursing diagnoses, and this classification is independent of the medical conditions the patient suffers. Where and on whom will the research have an impact? Knowing the prevalence of nursing diagnoses allows a better understanding of the human responses of patients treated in the pre-hospital setting, increasing the evidence of individualized and standardized care plans for pre-hospital care.
UNASSIGNED: STROBE checklist has been used as a reporting method.
UNASSIGNED: Only patients\' records were reviewed without further involvement.