Specht J, Drey K
Iowa Veterans Home, Marshalltown.
Nurs Clin North Am. 1987 Dec;22(4):917-33.
This article has reviewed the process of implementing nursing diagnoses in one long-term care agency. Nursing diagnoses improved nursing process skills, made problem identification more accurate, and aided the identification of nursing interventions and desired outcomes. Nursing diagnoses have become the organizing framework for quality assurance, staff development, specialization and consultation, and computer applications. The presence of a professional model of nursing practice facilitated the use of nursing diagnoses. Prior to implementing nursing diagnoses, IVH nurses had defined the scope of nursing practice and formed a committee structure for decision-making by all RNs. The structure included mechanisms for collective and individual accountability. All nurses participated in the decision to use nursing diagnoses in their practice. Each nurse had the opportunity to influence the process of change. The process of implementing nursing diagnoses at IVH continues. Nurses recognize the need to establish the validity of each diagnostic statement. Skill with the diagnostic process is expected to improve. Nurses also recognize the need to test interventions for specific diagnoses. The standard nomenclature will continue to be used for the improvement of nursing practice and for nursing department programming. The use of nursing diagnoses is the basis of the continued development of a professional model of nursing practice.
本文回顾了一家长期护理机构实施护理诊断的过程。护理诊断提高了护理流程技能，使问题识别更加准确，并有助于确定护理干预措施和预期结果。护理诊断已成为质量保证、员工发展、专业化与咨询以及计算机应用的组织框架。专业护理实践模式的存在促进了护理诊断的使用。在实施护理诊断之前，IVH医院的护士确定了护理实践范围，并组建了一个由所有注册护士参与决策的委员会结构。该结构包括集体和个人问责机制。所有护士都参与了在实践中使用护理诊断的决策。每位护士都有机会影响变革过程。IVH医院实施护理诊断的过程仍在继续。护士们认识到需要确立每个诊断声明的有效性。预计诊断过程的技能将会提高。护士们还认识到需要针对特定诊断测试干预措施。标准术语将继续用于改善护理实践和护理部门规划。护理诊断的使用是护理专业实践模式持续发展的基础。
