Nursing Students' Self-Assessments and Opinions About Using Nursing Diagnosis in Clinical Practice

PURPOSE

To determine student opinions about using nursing diagnosis in their future clinical practice.

METHODS

The course described in this study was an 11-credit hours course for third-year students, which included theory and clinical practice 22 hours/week. Theoretical content covered fundamental concepts such as crisis, child and family development, current developments in nursing process and nursing diagnosis, descriptions of the disease process and its effects on child and family, NANDA diagnoses, functional health patterns, and collaborative problems possibly associated with the disease/situations. Simulated case studies were discussed by student groups. Practice areas were pediatric-neonatal care units and pediatric outpatient clinics. Students care for hospitalized children, infants, and their families under the instructors' supervision. Students are assigned to patients and expected to identify relevant nursing diagnoses, design care plans, and discuss the care plans with instructors during the daily conferences. The sample was 57 students who had attended the course in full.

To evaluate students' opinions about using nursing diagnoses in clinical practice and perceived confidence in formulating/identifying nursing diagnoses, a two-part self-assessment tool was developed. Part 1 (5 items) was for self-assessment of the knowledge and skills related to identifying and formulating nursing diagnosis; part 2 had 5 items related to opinions about using nursing diagnoses in nursing practice in general. Items were reviewed by four nursing experts. Test-retest reliability of items was evaluated. The criterion used to decide whether to retain an item was at least 50% agreement in response over time.

After the final examination of the course, the purpose of the study was explained to students and all students were asked to participate. Self-assessment instruments were distributed to all students. Completed forms were left in a box for collection by a research assistant. Data analysis involved calculating percentages.

FINDINGS

All 57 students completed and turned in the self-assessment instruments. The majority of the students (85%) agreed/strongly agreed that they had a good understanding of nursing diagnosis and diagnostic reasoning, 64% did not have much difficulty with the expression of patient care needs as nursing diagnoses, and 87% said the course gave them a proper preparation on nursing diagnosis and diagnostic reasoning at a basic level.

Most of the students had a positive tendency toward using nursing diagnosis in their future practice; 80% agreed/strongly agreed that, after graduation, if they were asked to teach clinical nurses the formulation of nursing diagnosis they would accept this responsibility with pleasure; if nursing administration asked them to use nursing diagnoses, 78% of students would. If a course was offered in utilization of nursing diagnosis, 75% of students indicated they would attend such a course.

CONCLUSIONS

This study provided insight into the effects of knowledge on tendency of the students toward utilization of nursing diagnoses. Findings also indicated there might be a very effective potential if the undergraduate programs were revised by considering the utilization of nursing classification systems.