Clinical indicators of nursing outcomes classification for patient with risk for perioperative positioning injury: A cohort study.

AIMS AND OBJECTIVES

To test the validity and reliability of Nursing Outcomes Classification outcomes and their clinical indicators for patients with the nursing diagnosis 'Risk for perioperative positioning injury'.

BACKGROUND

Surgical positioning is an essential part of perioperative nursing practice. The use of a standardised language values the clinical evaluation of the perioperative nurse, reinforcing its contribution to surgical patient care.

DESIGN

Longitudinal concept validation cohort study.

METHODS

Patients were selected based on the operating room surgical schedule. The sample included adult patients who underwent elective surgical procedures requiring anaesthesia, classified as surgical class 2, 3 or 4. Outcomes were measured with an instrument, which included 33 clinical indicators for eight outcomes. The patients were assessed at five distinct time points in the perioperative phases. This study followed the STROBE guidelines.

RESULTS

A total of 50 patients were included. Each underwent five clinical assessments, for a total of 250 documented assessments. Differences in evaluations were mostly related to reduced scores of clinical indicators in the immediate postsurgical time points, which recovered to the highest score at the end of the fifth (and last) evaluation. The results of factor analysis and Cronbach's alpha calculations suggested a new configuration for this nursing outcomes, consisting of five outcomes-Circulation Status, Tissue Perfusion: peripheral, Neurological Status: peripheral, Tissue Integrity: skin and mucous membranes and Thermoregulation-and 13 clinical indicators.

CONCLUSIONS

Nursing Outcomes Classification outcomes and clinical indicators for the nursing diagnosis at 'Risk for perioperative positioning injury' are sensitive to patient states during the perioperative period.

RELEVANCE TO CLINICAL PRACTICE

Use of nursing taxonomies during the perioperative period may contribute to the discussion on the role of perioperative nurses and their relevance in patient care.