International Journal of Nursing Knowledge

Until now the nursing diagnosis knowledge deficit has served as a label for all teaching/learning situations. This is inadequate and does not effectively give direction to correct intervention(s). The purpose of this article is to present the diagnostic concept, situational learning disability (SLD), a component of Alterations in Learning, which has been identified as an area to be devel-oped in the Knowing pattern of the NANDA taxonomy. A thorough review of the literature and empirical support involving 20 cardiology patients on a 27-bed telemetry step-down unit is provided. The data support the development of two nursing diagnoses: (1) situational learning disability: impaired ability to learn; and (2) situational learning disability: lack of motivation to learn. The proper identification of these diagnoses can assist nurses in discriminating between patients who can learn, those who cannot learn, and those who need adjustments made in order to facilitate their learning. With this information nurses will be able to make decisions concerning the timing and type of intervention that is most appropriate.

This correlational study of acutely ill geriatric patients examined (1) if psychosocial dysfunctioning is associated with hearing impairment, as popularly believed; (2) the utility of using psychosocial changes as cues for making the nursing diagnosis sensory/perceptual alterations: auditory; and (3) an alternative model of defining characteristics for predicting auditory perception using variables that have been reported in the literature as being associated with hearing loss but, to date, are not part of the approved diagnostic category. A random sample (n = 226) was drawn from daily admission lists of English-speaking patients 65 years of age or older, admitted to nonintensive care units of a medical center hospital. The major defining characteristics for sensory/perceptual alterations were operationalized as seven variables: depression, cognitive function, social contact with children, social contact with other relatives, social contact with friends, subject-reported hearing ability, and subject-reported overall health status. Auditory sensory perception was operationalized as number of tones heard on audiometric examination. Findings indicate that assessing psychosocial functions does not provide nurses with helpful cues for making the auditory alteration diagnosis. Rather results suggest that nurses can make a more accurate diagnosis merely by knowing the patient's age, self-rating of hearing, and checking ear canals for impacted cerumen.

The purpose of this descriptive study was to validate the nursing diagnosis, bathing/hygine self-care deficit. Defining characteristics and related factors were abstracted retrospectively from a computerized patient care planning database. Data were treated to descriptive statistics and chi-square analysis to determine frequencies and percentages. Major support was found for the defining characteristic “inability to wash body or body parts” (84%) and minor support was garnered for “inability to obtain/access water source” (77%). Related factors associated with the diagnosis were also examined for this acute-care patient population. The percentages of occurrence were decreased activity tolerance (40%); mobility impairment (24%). pain (19%), musculoskeletal impairment (19%), neuromuscular impairment (9%), and perceptual or cognitive impairment (4%). The diagnosis was found among 80 DRCs and across all age groups (range, 9–92 years).

In the early 1970s the need for a precise and computerizable language of nursing phenomena was identified. This need stimulated the formation of the National Conference Group for the Classification of Nursing Diagnoses The group began the work of identifying nursing diagnoses and developing a taxonomic structure for their classification. Based on the initial success with the development of nursing diagnoses, the conference group became the North American Nursing Diagnosis Association (NANDA). There are two benefits of taxonomic development within nursing: one is scientific in nature, while the other is applied or practical. The development of this taxonomy has occurred over a span of 17 years including nine national conferences. Details of this development have been abstracted from the proceedings of the nine conferences and the minutes of the Taxonomy Committee in order to explicate the taxonomic structure. The rules for the classification, developed by the committee, are presented. Future directions for taxonomic development and collaboration with other health care professions are proposed.

One-hundred medical/surgical nurses from two hospitals participated in a study designed to determine which defining characteristics professional nurses working in acute-care settings associated with each of the three respiratory nursing diagnoses identified by the North American Nursing Diagnosis Association (NANDA). All NANDA defining characteristics for impaired gas exchange and ineffective airway clearance were selected by at least 63% and 67% of the study participants, respectively. Thirteen of the 15 NANDA defining characteristics for ineffective breathing pattern were selected by at least 68% of the study participants. Two characteristics of ineffective breathing pattern identified by NANDA, cough and fremitus, were selected by only 47% and 45% of respondents. This study was the first in a series of studies intended to validate the respiratory nursing diagnoses.