Nursing Care Plans Based Editorial

on NANDA, Nursing
Interventions Classification, and and
Titles Nursing
Abstracts: Brevity
Outcomes Classification: The Investigation of
the Effectiveness of an Educational Intervention
Titles matter. They can either capture your attention or L
cause you to ignore an article entirely. They can capture the be a
essence of the work or lose you in some lengthy ramble of is re

in Greece words. And they can either be to the point or catchy, irrever-
ent and tangential. Your work says a lot about who you are as
peo
title
a scholar. The title that seems topical and catchy today may imp
Elisabeth Patiraki, RN, PhD, Stylianos Katsaragakis, RN, MSc, lack PhD,aAngeliki
scholastic level ofRN,
Dreliozi, seriousness
MSc, PhD, or and
worse be outright the
Panagiotis Prezerakos RN, MSc, PhD embarrassing in years to come. I ca
When I speak on writing for publication, I provide de- 500
Elisabeth Patiraki, RN, PhD, is a Professor at Department of Nursing, Nationalexamples
identified and Kapodistrian University
of titles that do not of Athens, the work
represent By t
Athens, Greece, Stylianos Katsaragakis, RN, MSc, PhD, is a LecturerorattheFaculty of Nursing, University of Peloponnese,
author well. I have no idea why but references to gled
Sparta, Greece, Angeliki Dreliozi, RN, MSc, PhD, is Head of Continuing
someEducation
popular Department
songs and/oratmovies
2nd Regional
seem to Health
be rampant in can
Authority of Piraeus and Aegean Islands, Piraeus, Greece, and Panagiotis Prezerakos
manuscript titles I RN,
see. MSc, PhD, is an
For example, Associate
I often see references tual
Professor at Faculty of Nursing, University of Peloponnese, Sparta,to Greece.
“The Wizard of Oz” in a title of a scholarly paper. I love that
the movie and as a child, treasured our family’s annual nee
Search terms: PURPOSE: The aim of viewing around
this study wasHalloween each year.
to investigate But the namesofofan
the effectiveness the the
educational interventioncharacters
on home – the Cowardly
nursing care Lion,
plans Wizard,
based on Dorothy Nursing
NANDA, or Toto – tle a
Home nursing care, NNN, nursing
do not
Interventions Classification, andbelong
Nursing in Outcomes
the title ofClassification
serious scholarship. A more
for registered cite
care plan common problem is the long rambling title that is more
nurses working at primary healthcare settings in Greece. S
of an opening sentence
METHODS: This is a quasi-experimental studythan a title.
without a Short,
controlsuccinct
group. andTheto man
Author contact:
sample consisted of 19 the point isnurses.
registered far preferable.
The study Thetool
reader
was quickly should be
a questionnaire edit
prezerpot@gmail.com, with a copy able to quickly denote an article is about such as clinical I am
administered pre- and post-educational intervention.
to the Editor: journal@nanda.org decision making, or diagnostic accuracy,
FINDINGS: The intervention improved their skills on nursing diagnoses’ nomina- or the defining wor
tion, proper formulation,characteristics,
and individualizationor meaningful
of defininguse of nursing diagnosis
characteristics, but it did in sch
Authors’ Contribution: Professor E. the electronic
not improve them in desired outcomeshealth record.
formulation. ture
Patiraki and Assistant Professor P. You will become
CONCLUSIONS: A significant effect of an educational known and intervention
be remembered for your
on nursing to w
Prezerakos were responsible for work.
care plans was demonstrated. It should capture your scholarly effort. I caution you sch
the scientific supervision of the IMPLICATIONS FOR to think
NURSING about the
PRACTICE: title you choose
Nurses’ for
knowledgeyour article.
and It should
attitudes
concisely state
are important for understanding andwhat the work is
integrating about. Generally,
documentation this should
within the
project, the study’s design, and the
nursing process. be done in as few words as possible and all jargon should be
manuscript’s critical review. avoided.
Lecturer S. Katsaragakis was
responsible for data collection and
statistical analysis. Dr. A. Dreliozi
was responsible for the
manuscript’s preparation (writing).

Comparative evaluation (benchmarking) of the health-
care “outcome” is a key issue in the health sector. Still,
health services’ outcome is hard to define mainly because
of the inhomogeneity and complexity of health care.
Despite the significant progress made in the last decades,
the results of the enhanced efforts to measure health ser-
vices’ outcome remain fuzzy, miscellaneous, tautological,
and ephemeral (Berki, 1972). Nursing outcome is even more
difficult to define. Its underlying cause is the limited time
available for nurses to record purely nursing dimensions of
care, compared with the considerable time spent on record-
ing issues associated with medical treatment (Hansebo,
Kihlgren, & Ljunggren, 1999; Kärkkäinen, Bondas, &
Eriksson, 2005; Kirrane, 2001). This acts as a brake in pro-
moting autonomy given to the Nursing Science, as opposed
to documentation, which is the vehicle for its autonomy,
because only in thus, exchange of information and bench-
marking becomes possible.
This requires the establishment of a common language
for describing nursing work. The “Professional Nursing

88 © 2015 The Authors International Journal of Nursing Knowledge published by Wiley Periodicals, Inc. on behalf of NANDA International
© 2015 NANDA International, Inc. 1
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and
International Journal of Nursing Knowledge Volume ••, No. ••, •• 2015
distribution in any medium, provided the original work is properly cited, the use isNANDA
C 2017
 non-commercial andInc.
International, no modifications or adaptations are made.
International Journal of Nursing Knowledge Volume 28, No. 2, April 2017
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E. Patiraki
Nursing et al.
Care Plans Nursing Care Plans
E. Patiraki et al.
scenario
Language” patients’
shouldhealth capture problems
the full and to nominate
range and variety nursingof tudes, knowledge,
the nursing processand within
skills ofstandardized
nurses. Nursing diagnoses,
language. The
diagnoses
individualized,before and nursing
holistic after the care educational
and ensureintervention
the distinct interventions,
most commonand outcomes
barriers should not be taught
to implementation sepa-
also include
(p > .050).
role of nurses at the local, national, European, and interna- rately,
limited but they should
ongoing be integrated
education, as in the to
lack of motivation case of the
learn, or
Moreover
tional levels. Thethe development
participants’ of responses
that language regarding their
surpasses present
the nurses’intervention
difficulties(Muller-Staub
in adjusting to et al., 2007).
its use Knowl-
(Whitley &
attitudes
standardized care, consolidating “expression patterns”for
for the use of nursing process and care plans of edge, attitudes,
Gulanick, and
1996). It hasskill
beenlevel of nurses
argued areimplementation
that the important for
documentation
Nursing (Sheerin, were strongly
Sermeus, negatively2015).
& Ehrenberg, correlated with understanding
of NANDA, Nursing and integrating documentation
Interventions to nursing
Classification, and
theAcknowledging
number of scenario the above patients’
need,health
in some problems recog-
of the states- process
Nursing inOutcomes
daily practice and hence to ensure positive
Classification—shortened to NNN— out-
nized
members(rho of= −0.48, p = .037, Union,
the European n = 19) nurses
but not develop
with the number
primary comes
nursingfor patients.interventions,
diagnoses, Although nurses and seem
outcomesto have a posi-
are related
of nursing
nursing diagnoses recognized
terminology, whereas in (rho other = −0.28, p = .909, and
cases translate n= tive attitude
to better towards
quality documentation
of nursing diagnosisand the nursing
documentation,
19)
adaptbefore
foreign theterminology
educationaldevelopedintervention. After the
by nurses, educa-
especially, process, a significant
etiology-specific gap in knowledge
nursing and skills
interventions, and innursing-
regard
tional
of Northintervention,
America. Such participants’
efforts includeresponses regardingClassi-
International their to planning
sensitive and documentation
patient of nursing et
outcomes (Muller-Staub care
al.,still remains.
2007). Also,
attitude
fication of forFunctioning
the use of (ECF), nursing process andClassification
International care plans for of teaching and clinical strategies should be developed to
documentation
Nursing Practice were not correlated
(ICNP), and International with theNursing
numberDiagno-of sce- guide students to focused learningKnowledge
on nursingand/or
diagnosis and
Implications for Nursing
nario patients’ health
ses Classification (NANDA-I). problems recognized.
International Nursing Moreover,
Diagno- utilization of standardized care plans (Carpenito-Moyet,
Language Development
nurses’ responses regarding
ses Classification their attitude=forNANDA-I)
(NANDA-International the use of is 2010). Aspects that should be taken into account to improve
nursing process andmostcare plans for documentation
innovative, andwere not theAlthough
introduction and usetoofhavetheanursing
considered as the updated, applied nurses seem positive process include
attitude toward
associated with the skills
globally (Muller-Staub, Needham,regarding nursingLavin,
Odenbreit, diagnoses’
& van specific protocols development, review of data record,
documentation and the nursing process, an important gap
nomination
Achterberg,before 2007).and after educational intervention. empowerment of nurses to implement the nursing process
in knowledge, planning, and documentation of nursing care
The aforementioned classifications authorize the use of a moreremains.
still effectively
The (De Moraes
present Lopes, Higa,
intervention Dos Reis, De
has demonstrated
Conclusions
common language among nurses and determine the nursing Oliveira, & Christóforo, 2010) and peer reviewing (Florin,
positive results in improving knowledge and attitudes to
knowledge through the development of nursing evidence- Ehrenberg, & Ehnfors,
documentation 2005).process and could serve as a
and nursing
The protocols,
based majority of participants
which guide thereporteddevelopment little knowledge
of nursing basis for education in clinical practice.
and
care experience
plans, tailored in the implementation
to specific environments of nursing process
and directed at
Purpose of the Study
and care plans
individual patient before
casesand and/orafterhealthy
the educational
citizens. Care interven-
plans
tion, and there were
may constitute no statistical
guidelines of care and differences
integrated between their
into clinical Knowledge Translation
responses. The purpose of this study was to investigate the effec-
practice forItthe is worth
evaluationnoting andthat none of the participants
documentation of the care
reported tiveness of an educational programinonhome
homecare
nursing care
provided excellent
to patients knowledge
(Doenges,orMoorhouse,experience&inMurr, the imple-
2008; Introduction of new practices nursing
mentation plans based on NNN for registered nurses involvement
working at
Hildman & of the nursing
Ferguson, 1991;process
Lee, 2006; and Shea,
care planning.
1986). These involves challenging changes. The successful
results suggest primary
nurseshealthcare settings
as aninimportant
Peloponnese, Greece.
Nursing carethat plansnurses
are may have for
vehicles overestimated
communication, their of is considered success factor. All
knowledge
records for the andprovided
experience care, and for constitute
the implementationessential tools of of the above imply knowledge translation, evidence-based
nursing process
for everyday and The
care. nursingcarecare plans
plans’ before the
structure educa-
is formed interventions, and a strong commitment to quality. Educa-
Method
tional intervention.
according to the nursing Although caretaking
system part in the and
applied, educational
for this tional interventions on nursing documentation and nursing
intervention
reason, it canprovided
take a varietythem of with knowledge
forms (Björvell,on2002; the content
Mason, diagnoses
Setting and lead to more systematic and standardized docu-
Sample
of the nursing
1999). The basic process
meansand forcare plans, their and
understanding responses
using thefor mentation.
overall knowledge
abovementioned were care
nursing not plans
significantly
is systematicimproved, but
training, This is a quasi-experimental study without a control
remained
through which almost the same.
nurses’ knowledge,The preservation
attitudes, and ofskills
theircan mod-
be Acknowledgments.
group. The sample consistedThe abovementioned
of 19 registered nurses educational
(N = 19)
erate
improved attitude for documentation
(Chatzopoulou, Katsaragakis, of care Karlou, by &using the
Patiraki, intervention
working at primarywas part of a project
healthcare co-funded
settings by the Greek
in Peloponnese. The
nursing
2012). process is possibly due to their original false beliefs Government
participants and wereEuropean
randomlyUnion in terms
selected by theof National
6th RegionalStra-
on the use of standards. Consequently, the results revealed tegic
HealthReference
AuthorityFramework
of Greece. (NSRF) titled “Development
The selection criteria were: of
that the participants reported Background what they wish to use for Home Nursing Care Plans Based on Nursing Diagnoses.”
nursing care documentation rather than what they actually 1. to be registered nurses (graduates from nursing depart-
use.Despite the rich international research activity in this ments of universities and/or technological educational
Regarding thesuch clinical scenario References
field, in Greece, efforts remain instead
fragmented. of nominating
The over- institutes),
nursing diagnoses according the NANDA-I
riding problem is the fragmented or completely absent use classification, the 2. to have at least 5 years of work experience in primary
Berki, S. E. (1972). Hospital economics. Lexington/New York: Lexington
participants
of the nursing nominated medical diagnoses,
process. Although all undergraduate nursing courses
assess- healthcare
Books. settings, and
ments,
in nursingoutcomes,
departments and mostly
of both interventions
universities before the edu-
and technologi- 3. to have
Björvell, proficiency
C. (2002). in the Greekinlanguage.
Nursing documentation clinical practice, instrument
cational intervention, but after development and evaluation of a comprehensive intervention programme
cal educational institutes teachthat,the participants’
specific way responsesof provid- (Thesis). Department of Nursing, Karolinska Institutet, Stockholm.
were improved
ing nursing care, itstatistically
is not applied significantly.
in everyday practice. Despite This the The above L.
Carpenito-Moyet, nurses attended
J. (2010). an educational
Invited paper: Teaching nursingintervention
diagnosis to
decreased number
fact is attributed toof thepatients’
nurses’ health
shortage. problems basedthis
If we accept on that was part
increase of a after
utilization project co-funded
graduation. by theJournal
International Greek ofGovern-
Nursing
the scenario,asthe participants nominated Terminologies and Classifications, 21, 124–133. doi:10.1111/j.1744-618X.2010
assumption true, then we end up back only at thenursing
point of diag-
the ment and
.01158.x
the European Union in terms of National Strategic
noses,
definitionchosen
of the from the short
specific issuecatalog
because ofthereby,
the totalthe 36 taught
nurses Reference Framework
Chatzopoulou, (NSRF) the
M. (2010). Investigating titled “Development
impact of an educationalofprogram
Home
nursing
working diagnoses
in Greek health during sector
the educational
become unable intervention.
to demon- for nursing
Nursing Carecare documentation
Plans Based on onNursing
Greek nurses (PhD Thesis)The
Diagnoses.” (in Greek).
edu-
Chatzopoulou, M., Katsaragakis, S., Karlou, C., & Patiraki, E. (2012). Explora-
Participants’
strate this shortage, responses regardingwhen
and ultimately selection
they are andaskedproperto cational intervention was in the form of a clinical
tion of the effectiveness of an educational programme for nurses on seminar
formulation
argue for theofneed defining characteristics
for a prompt resolution were statistically
to this problem, that had care
nursing a duration of 60
documentation. hr, equally
NOSILEFTIKI, 51(4),spaced
396–408in(in10 days,
Greek).
significantly
they measure improved after the using
their workload educationalindicatorsintervention.
based on De Moraes
during theLopes,
period M. H. B., Higa,
from R., Dos12,
January Reis,
2015M. J.,
toDe Oliveira,
March 10,N.2015.
R., &
Christóforo, F. F. M. (2010). Evaluation of the nursing process used at a
In conclusion,
medical and not the study revealed
on nursing diagnoses. thatThus,
a well-organized
it becomes TheBrazilian
chosen method of clinical seminars included
teaching hospital. International Journal of Nursing Terminolo- the
and structured
imperative educational
to look for effective intervention could improve
ways to introduce the use atti-
of following direct and21, 116–123.
gies and Classifications, indirect teaching and learning
doi:10.1111/j.1744-618X.2010.01157.x

2 5
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 20473095, 2017, 2, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/2047-3095.12120 by INASP - TANZANIA, Wiley Online Library on [01/11/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
E. Patiraki
Nursing et al.
Care Plans E. Patiraki
Nursing et al.
Care Plans

methods:
Doenges, (a)Moorhouse,
M. E., lectures;M.(b) F., &bidirectional questions—replies;
Murr, A. C. (2008). Nursing diagnosis released
Lee, 2012;Nurses’
T. T. (2006). IBM SPSS Statistics
perceptions of their for Windows,experiences
documentation IBM Corp., in
(c)manual: Planning, individualizing, and documenting client care. Philadel-
groupworking;
phia, PA: F. A. Davis.
and (d) case studies, allowing in this way a computerized nursing care planning system. Journal of Clinical
Armonk, NY, USA).
Nursing, 15, 1376–1382.
Control of the variables’ normality was
the application
Florin, J., Ehrenberg, ofA., &theoretical knowledge
Ehnfors, M. (2005). in nursing
Quality of real-life situa-
diagnoses: performed
Mason, with
C. (1999). theto Kolmogorov–Smirnov
Guide practice or “load of rubbish”? test.
The The mean
influence of
Evaluation
tions, through of antheeducational intervention.
reinforcement of theInternational
trainees Journal
to make of care and
value plans standard
on nursing practice
deviationin five clinical
(SD) areasused
were in Northern Ireland.
to describe
Nursing Terminologies and Classifications, 16, 33–43. doi:10.1111/j.1744- Journal of Advanced Nursing, 29, 380–387.
correct clinical decisions based on the theoretical frame-
618X.2005.00008.x the quantitative
Muller-Staub, variables
M., Needham, and M.,
I., Odenbreit, the frequency
Lavin, M. A., & van(N) and 100
Achterberg, T.
work ofG.,
Hansebo, Doenges
Kihlgren, et M., al. (2008). To
& Ljunggren, evaluate
G. (1999). Reviewtheof educational
nursing docu- percent
(2007).rate (%) quality
Improved for the of description of qualitative
nursing documentation: variables.
Results of a nursing
mentation in nursing
intervention, home wards changes
a questionnaire after intervention
developed for individu-
and standardized Thediagnoses,
comparisoninterventions
between and outcomes
normal implementation
regular variables study. before
Interna-
alized care. Journal of Advanced Nursing, 29, 1462–1473. tional Journal of Nursing Terminologies and Classifications, 18, 5–17.
in the context
Hildman, of Chatzopoulou’s
T. B., & Ferguson, (2010) nurses’
G. H. (1991). Registered doctoral thesis
attitudes was
toward and H.
Shea, after the educational
L. (1986). intervention
A conceptual framework to studywas done
the use by paired
of nursing care
usedthe after
nursingher graded
process permission.
and written The questionnaire
/ printed nursing care plans. Journal con-
of statistical control Z
plans. International of Wilcoxon
Journal of Nursing(Z, p) and
Studies, 23, between
147–157. qualita-
Nursing Administration, 21(10), 20, 33, 45. Sheerin, F., Sermeus, W., & Ehrenberg, A. (Eds). (2015). Proceedings from 10th
sists of 22 items related to the evaluation of the trainees’
Kärkkäinen, O., Bondas, T., & Eriksson, K. (2005). Documentation of individu-
tive variables with paired statistical control Mac Nemar (p).
European Conference of ACENDIO: E-health and Nursing-Knowledge for
attitude towards
alized patient care:the documentation
A qualitative of nursing
metasynthesis. Nursingcare
Ethics,and the
12, 123– The two-tailed
Patient significance
Care. Dublin, level was set at ≤.05.
Ireland: ACENDIO.
132.
application of the nursing process. The Cronbach’s alpha Whitley, G. G., & Gulanick, M. (1996). Barriers to the use of nursing diagnosis
Kirrane, C. (2001). An audit of care planning on a neurology unit. Nursing
coefficient for36–39.
these items was 0.79, suggesting that these Findings
language in clinical settings. Nursing Diagnosis, 7, 25–32. doi:10.1111/
Standard, 15, j.1744-618X.1996.tb00506.x
have an acceptable internal consistency. The responses to
these items were Likert scale type on a 5-point scale (1 = I Most of the participants were female (N = 16, 84.2%), and
agree strongly, 5 = I disagree strongly). their mean age was 42 years (SD = 5.8) and married (N = 13,
Items about the participants’ demographic and educa- 68.4%). The majority of them (N = 16, 84.2%) were gradu-
tional characteristics as well as their previous teaching and ates from technological educational institutes, and 36.8%
clinical experience on the nursing process and documenta- had a postgraduate diploma or specialty. The mean years
tion were added at the end of the questionnaire. after their graduation were 17.8 (SD = 8.3), and their work
Lastly, one clinical scenario was used in order to evaluate experience was 18.2 years (SD = 7.1). Of the participants,
the trainees’ knowledge and skills on the nursing process. 52.6% had a previous education and experience in nursing
The questionnaire was completed at the beginning and process, mostly in a basis of continuing nursing education
after the end of the educational intervention. All the train- and only two of them (10.5%) during their basic nursing
ees were informed about the purpose of the study. It was education.
explained to them that their participation was voluntary and Participants were asked to report their knowledge
their answers were confidential. Out of the 20 trainees, 19 (Table 1) and experience (Table 2) in the implementation
participated in the study (response rate 95%). of the nursing process before and after the educational
intervention.
Data Analysis Seven (36.8%) and five (26.3%) participants answered
that they do not apply at all or at a minimum-level nursing
Data statistical analysis was performed by the use of IBM process in clinical practice. Following the educational inter-
Statistical Package for Social Sciences (version 21.0, vention and after understanding the content of the plans,

Table 1. Comparison of Trainees’ Responses Regarding Knowledge in Nursing Process Before and After Educational
Interventions

Pre-educational intervention Posteducational intervention p (paired)

Knowledge N % N %

None 3 15.8 2 10.5 .180

Little 10 52.6 6 31.6
Moderate 4 21.1 4 21.1
Good 2 10.5 5 26.3
Excellent 0 0.0 0 0.0

Table 2. Comparison of Trainees’ Responses Regarding Experience in Nursing Process Before and After Educational
Interventions

Pre-educational intervention Posteducational intervention p (paired)

Experience N % N %

None 7 36.8 12 63.2 .128

Little 5 26.3 2 10.5
Moderate 5 26.3 3 15.8
Good 2 10.5 1 5.3
Excellent 0 0.0 0 0.0

690 3
 20473095, 2017, 2, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/2047-3095.12120 by INASP - TANZANIA, Wiley Online Library on [01/11/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
E. Patiraki
Nursing et al.
Care Plans Nursing Care Plans
E. Patiraki et al.
scenario
more nurses patients’
(n = health
12 [63.2%] problemsand nand = 2to[10.5%])
nominate nursing
answered tudes,
cational knowledge,
intervention. andAdditionally,
skills of nurses. Nursing diagnoses,
10 participants (52.6%)
diagnoses
that they do before
not apply and at after the
all or at educational
a minimum-level intervention
nursing interventions,
before the educational and outcomes should versus
intervention not be4taught sepa-
participants
(p > .050).
process and care plans. rately,
(21.1%) butafter they
the should
educational be integrated
intervention as in
(p the case=of
[paired] the
.034)
Moreover
Moreover, the the participants’
majority of the responses
participantsregarding
beforetheirand present
properly intervention
individualized (Muller-Staub
the relatedet factors
al., 2007). basedKnowl-on
attitudes
after the for the use ofintervention
educational nursing process reportedand no careuse plans for
of any edge,
patients’attitudes, and skill level of nurses are important for
pain characteristics.
documentation
nursing taxonomy were for strongly
documentation negatively
in everycorrelated
day practice with understanding
Participants’and integrating
responses documentation
regarding to nursing
the selection and
the
(prenumber
15 [78.9]ofvs.scenario patients’
post 15 [78.9], health problems
p [paired] recog-
= 1.000). Before process in daily practice
proper formulation of theand hencecharacteristics
defining to ensure positive were out-sta-
nized (rho = −0.48,
the educational p = .037, nonly
intervention, = 19)fivebut participants
not with the (26.3%)number comes
tistically forsignificantly
patients. Although improved nurses seem to<.0001
(p [paired] have aand posi-p
of nursing diagnoses recognized
reported that they use NANDA Taxonomy for documenta- (rho = −0.28, p = .909, n = tive
[paired]attitude
<.0001, towards
respectively).documentation and the nursing
19)
tionbefore
nursingthe care.educational intervention.intervention,
After the educational After the educa- a sta- process,
Although a significant
only 4 (21%) gap in participants
knowledge and hadskills in regard
chosen both
tional
tisticallyintervention,
significant participants’
number of 15 responses
participants regarding
(78.9%) their(p to planning
defining and documentation
characteristics of nursing
for acute pain care still remains.
patients’ nursing
attitude
[paired] for the use
= .013) of nursing
reported the use process
of NANDAand care plans for
Taxonomy in diagnosis before the educational intervention, 15 (78.9%)
documentation
everyday practice. wereOnly not correlated
few participants with the numberthe
reported of sce-
use participants chose both definingKnowledge
characteristics after the
Implications for Nursing and/or
nario
of other patients’
nursinghealth taxonomies problems recognized. Moreover,
for documentation pre- and educational intervention. On the other hand, 15 (78.9%)
Language Development
nurses’ responses
posteducational regarding such
intervention theirasattitude
Nursingfor the use
Outcome of
Tax- participants have not chosen any defining characteristics
nursing
onomy (pre process and care
2 [10.5%] vs.plans
post for documentation
1[5.3%], p [paired] were not
= 1.000), before the educational intervention, but only 2 participants
Although nurses seem to have a positive attitude toward
associated with the Taxonomy
Nursing Intervention skills regarding (pre 2nursing
[10.5%]diagnoses’
vs. post 1 (10.5%) did it after the intervention.
documentation and the nursing process, an important gap
nomination
[5.3%], p [paired] before and after ICNP
= 1.000), educational intervention.
(pre 1 [5.3%] vs. post 2 Similar results were and found for the individualization of
in knowledge, planning, documentation of nursing care
[10.5%], p [paired] = 1.000). defining characteristics. Almost all
still remains. The present intervention has demonstrated participants (N = 16,
Conclusions 84.2%) did not inindividualize defining characteristics
Additionally, before and after educational intervention, positive results improving knowledge and attitudes for to
all the participants (N = 19, 100%) reported that they would scenario patient’s
documentation andpain nursingcharacteristics
process andbeforecould theserve educa-
as a
likeThe majorityand
to provide of document
participants reported
nursing care by little knowledge
using nursing tionalfor
basis intervention,
education inand onlypractice.
clinical three participants (15.8%)
and
processexperience
and care in plans
the implementation
in everyday practice. of nursing Despiteprocess
this after. On the other hand, 1 (5.3%) participant before versus
and
result,caretheyplans before
reported and after attitude
a moderate the educational
regarding interven-
the use 14 (73.7%) participants after the educational intervention
tion, and there
of nursing process wereand no care
statistical
plans differences
for documentation between(mean their had properly formulated Knowledge theTranslation
defining characteristics (p
responses.
± SD: pre 74.1 It is worth
± 7.4 noting
vs. post that
75.1 none
± 6.1). of the
Their participants
responses were [paired] <.0001). Contrary, the participants did not improve
reported excellent
not statistically knowledgedifferent
significantly or experience
between in before
the imple-and Introduction
their of new practices
skills in formulating the desired in outcomes.
home careAlthough nursing
mentation of the nursing
after the educational process and
intervention care planning.
(p [paired] = .406).These involves challenging
less participants (prechanges.
n = 10 [52.6%]The successful
vs. post ninvolvement
= 4 (21.1%),
results
Based suggest
on thethat nurses
clinical may have
scenario, overestimated
before the educational their of nurses is= considered
p [paired] .109) gave as an important
a totally success factor.
wrong formulation All
of the
knowledge
intervention,and experience
participants for the almost
recognized implementation
10 different of of the above
desired outcomes implyafterknowledge translation,
the educational evidence-based
intervention, a sig-
nursing
patients’process and nursing
health problems, butcare
onlyplans before
2 of them the nursing
were educa- interventions,
nificant number and of a strong
15 (79%) commitment to quality.
participants Educa-
(vs. post 9
tional intervention. Although taking
diagnoses according to the NANDA Taxonomy (Table 3). part in the educational tional
[47.4%]) interventions
did not include on nursing documentation
the necessary criteriaandmainly
nursing in
intervention
Trainees improvedprovided their them skills
with knowledge
on nursing on the content
diagnoses’ for- diagnoses
timeframe.lead to more systematic and standardized docu-
of the nursing
mulation. Theirprocessskills wereand care plans, their
evaluated responses
regarding the: for
(a) mentation.
None of the participants’ demographic or professional
overall
choice of knowledge
the right-related were not significantly
factors and defining improved,
character-but characteristics was statistically significant in relation to
remained
istics, andalmost (b) thethe same. The preservation
individualization of these of their mod-
according to Acknowledgments.
their responses regarding The the abovementioned
nursing diagnoses’ educational
nomina-
erate
patients’ attitude
nursing fordiagnosis
documentation
“acute pain of care
(00132).”by using the intervention
tion before and was partthe
after of intervention
a project co-funded
(p > .50).by the Greek
Additionally,
nursing
Almost process is possibly (N
all participants due=to 18,their original
94.7%) false beliefs
recognized the Government
participants’ and Europeanregarding
responses Union in terms
their of National Stra-
knowledge and
on the use of standards.
right-related factor after Consequently,
the educational the results revealed
intervention (p tegic Reference
experience on the Framework
implementation (NSRF)oftitled
nursing“Development
diagnoses and of
that
[paired]the =participants
.008) vs. 11 reported what they wish
(57.9%) participants before to the
useedu-for Home Nursing
care plans wereCare Plans Based
not associated on their
with Nursing Diagnoses.”
skills to recognize
nursing care documentation rather than what they actually
use.
Table 3. Comparison
Regarding the clinical of Trainees’
scenario Responses References
Regarding Recognition
instead of nominating of Nursing Diagnoses Before and After
Educational
nursing diagnosesInterventions
accordingbased on a Clinical
the NANDA-I Scenario
classification, the
Berki, S. E. (1972). Hospital economics. Lexington/New York: Lexington
participants nominated medical diagnoses, nursing assess- Books.
Type of patient problem Pre-educational intervention Posteducational intervention p (paired)
ments, outcomes, and mostly interventions before the edu- Björvell, C. (2002). Nursing documentation in clinical practice, instrument
Mean ± SD (range) Mean ± SD (range)
cational intervention, but after that, participants’ responses development and evaluation of a comprehensive intervention programme
(Thesis). Department of Nursing, Karolinska Institutet, Stockholm.
were
Patient’s improved
health problems statistically significantly.
9.6 ± 3.2 Despite the 6.4 ± 1.8 L. J. (2010). Invited paper: Teaching Z
Carpenito-Moyet, = −2.3diagnosis
nursing p = .003 to
decreased number of patients’ health (0–18)problems based on (4–10)
increase utilization after graduation. International Journal of Nursing
Nursing
the diagnoses
scenario, the (NANDA)
participants nominated 1.6 ± 1.6only nursing diag- 6.2 ± 2.1 and Classifications, 21, 124–133. doi:10.1111/j.1744-618X.2010
Terminologies Z = −3.7 p < .0001
(0–7) .01158.x
(1–10)
noses, chosen
Nursing assessment
from the short catalog of the
0.7 ± 0.7
total 36 taught Chatzopoulou,
0 M. (2010). Investigating the impact of an Z educational
= −2.7 p program
= .016
nursing diagnoses during the educational (0–4) intervention. for nursing care documentation on Greek nurses (PhD Thesis) (in Greek).
Chatzopoulou, M., Katsaragakis, S., Karlou, C., & Patiraki, E. (2012). Explora-
Participants’
Nursing outcomesresponses regarding 0.5 selection
± 0.5 and proper 0 Z = −1.3 p = .180
tion of the effectiveness of an educational programme for nurses on
formulation of defining characteristics were statistically(0–5) nursing care documentation. NOSILEFTIKI, 51(4), 396–408 (in Greek).
Nursing interventions
significantly improved after the educational 2.7 ± 2.7 intervention. De Moraes0 Lopes, M. H. B., Higa, R., Dos Reis, M. J., Z −2.7 p =N..007
De=Oliveira, R., &
(0–10) Christóforo, F. F. M. (2010). Evaluation of the nursing process used at a
In conclusion, the study revealed that a well-organized Brazilian teaching hospital. International Journal of Nursing Terminolo-
and structured
SD, standard educational intervention could improve atti-
deviation. gies and Classifications, 21, 116–123. doi:10.1111/j.1744-618X.2010.01157.x

4 5
91
 20473095, 2017, 2, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/2047-3095.12120 by INASP - TANZANIA, Wiley Online Library on [01/11/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
E. Patiraki
Nursing et al.
Care Plans E. Patiraki
Nursing et al.
Care Plans

scenarioM.patients’
Doenges, health
E., Moorhouse, problems
M. F., & Murr, A.and to nominate
C. (2008). nursing
Nursing diagnosis tudes,
Lee, T. T. knowledge,
(2006). Nurses’and skills of
perceptions nurses.
of their Nursingexperiences
documentation diagnoses, in
manual: Planning, individualizing, and documenting client care. Philadel- a computerized nursing care planning system. Journal of Clinical
diagnoses before
phia, PA: F. A. Davis.
and after the educational intervention interventions, and
Nursing, 15, 1376–1382.
outcomes should not be taught sepa-
(p > .050).
Florin, J., Ehrenberg, A., & Ehnfors, M. (2005). Quality of nursing diagnoses: rately,C.but
Mason, they
(1999). should
Guide be integrated
to practice as in the
or “load of rubbish”? Thecase of the
influence of
Evaluation
Moreoverofthe an educational
participants’ intervention.
responses International
regardingJournal of
their care plans
present on nursing practice
intervention in five clinicalet
(Muller-Staub areas
al., in2007).
NorthernKnowl-
Ireland.
Nursing Terminologies and Classifications, 16, 33–43. doi:10.1111/j.1744- Journal of Advanced Nursing, 29, 380–387.
attitudes for the use of nursing process and care plans for
618X.2005.00008.x edge, attitudes,
Muller-Staub, and skill
M., Needham, level of
I., Odenbreit, nurses
M., Lavin, are
M. A., important
& van Achterberg,for
T.
documentation
Hansebo, G., Kihlgren,were strongly G.negatively
M., & Ljunggren, (1999). Reviewcorrelated with
of nursing docu- understanding
(2007). Improvedand integrating
quality documentation
of nursing documentation: Resultsto nursing
of a nursing
thementation
numberin nursing home wards
of scenario changes health
patients’ after intervention
problems for individu-
recog- diagnoses,
process interventions
in daily practice andand
outcomes
hence implementation
to ensure positivestudy. Interna-
out-
alized care. Journal of Advanced Nursing, 29, 1462–1473. tional Journal of Nursing Terminologies and Classifications, 18, 5–17.
nized (rho
Hildman, T. B.,=&−0.48, p=
Ferguson, G. .037, n =Registered
H. (1991). 19) but not with
nurses’ the number
attitudes toward comes
Shea, H. L.for patients.
(1986). Although
A conceptual nurses
framework seem
to study to have
the use a posi-
of nursing care
of the
nursing
nursingdiagnoses
process andrecognized (rho
written / printed = −0.28,
nursing p = .909,
care plans. Journalnof = tive attitude
plans. towards
International Journal of documentation
Nursing Studies, 23, and the nursing
147–157.
19)Nursing
before Administration, 21(10), 20, 33, 45.
the educational intervention. After the educa-
Kärkkäinen, O., Bondas, T., & Eriksson, K. (2005). Documentation of individu-
Sheerin, F., Sermeus, W., & Ehrenberg, A. (Eds). (2015). Proceedings from 10th
process, a significant gap in knowledge and skills in regard
European Conference of ACENDIO: E-health and Nursing-Knowledge for
tional
alizedintervention,
patient care: A participants’ responses
qualitative metasynthesis. regarding
Nursing Ethics, 12,their
123– to planning
Patient Care. and documentation
Dublin, Ireland: ACENDIO. of nursing care still remains.
132.
attitude for the use of nursing process and care plans for Whitley, G. G., & Gulanick, M. (1996). Barriers to the use of nursing diagnosis
Kirrane, C. (2001). An audit of care planning on a neurology unit. Nursing language in clinical settings. Nursing Diagnosis, 7, 25–32. doi:10.1111/
documentation were not correlated with the number of sce-
Standard, 15, 36–39. j.1744-618X.1996.tb00506.x
Implications for Nursing Knowledge and/or
nario patients’ health problems recognized. Moreover,
Language Development
nurses’ responses regarding their attitude for the use of
nursing process and care plans for documentation were not
Although nurses seem to have a positive attitude toward
associated with the skills regarding nursing diagnoses’
documentation and the nursing process, an important gap
nomination before and after educational intervention.
in knowledge, planning, and documentation of nursing care
still remains. The present intervention has demonstrated
Conclusions
positive results in improving knowledge and attitudes to
documentation and nursing process and could serve as a
The majority of participants reported little knowledge
basis for education in clinical practice.
and experience in the implementation of nursing process
and care plans before and after the educational interven-
tion, and there were no statistical differences between their Knowledge Translation
responses. It is worth noting that none of the participants
reported excellent knowledge or experience in the imple- Introduction of new practices in home care nursing
mentation of the nursing process and care planning. These involves challenging changes. The successful involvement
results suggest that nurses may have overestimated their of nurses is considered as an important success factor. All
knowledge and experience for the implementation of of the above imply knowledge translation, evidence-based
nursing process and nursing care plans before the educa- interventions, and a strong commitment to quality. Educa-
tional intervention. Although taking part in the educational tional interventions on nursing documentation and nursing
intervention provided them with knowledge on the content diagnoses lead to more systematic and standardized docu-
of the nursing process and care plans, their responses for mentation.
overall knowledge were not significantly improved, but
remained almost the same. The preservation of their mod- Acknowledgments. The abovementioned educational
erate attitude for documentation of care by using the intervention was part of a project co-funded by the Greek
nursing process is possibly due to their original false beliefs Government and European Union in terms of National Stra-
on the use of standards. Consequently, the results revealed tegic Reference Framework (NSRF) titled “Development of
that the participants reported what they wish to use for Home Nursing Care Plans Based on Nursing Diagnoses.”
nursing care documentation rather than what they actually
use.
Regarding the clinical scenario instead of nominating References
nursing diagnoses according the NANDA-I classification, the
Berki, S. E. (1972). Hospital economics. Lexington/New York: Lexington
participants nominated medical diagnoses, nursing assess- Books.
ments, outcomes, and mostly interventions before the edu- Björvell, C. (2002). Nursing documentation in clinical practice, instrument
cational intervention, but after that, participants’ responses development and evaluation of a comprehensive intervention programme
(Thesis). Department of Nursing, Karolinska Institutet, Stockholm.
were improved statistically significantly. Despite the Carpenito-Moyet, L. J. (2010). Invited paper: Teaching nursing diagnosis to
decreased number of patients’ health problems based on increase utilization after graduation. International Journal of Nursing
the scenario, the participants nominated only nursing diag- Terminologies and Classifications, 21, 124–133. doi:10.1111/j.1744-618X.2010
.01158.x
noses, chosen from the short catalog of the total 36 taught Chatzopoulou, M. (2010). Investigating the impact of an educational program
nursing diagnoses during the educational intervention. for nursing care documentation on Greek nurses (PhD Thesis) (in Greek).
Chatzopoulou, M., Katsaragakis, S., Karlou, C., & Patiraki, E. (2012). Explora-
Participants’ responses regarding selection and proper tion of the effectiveness of an educational programme for nurses on
formulation of defining characteristics were statistically nursing care documentation. NOSILEFTIKI, 51(4), 396–408 (in Greek).
significantly improved after the educational intervention. De Moraes Lopes, M. H. B., Higa, R., Dos Reis, M. J., De Oliveira, N. R., &
Christóforo, F. F. M. (2010). Evaluation of the nursing process used at a
In conclusion, the study revealed that a well-organized Brazilian teaching hospital. International Journal of Nursing Terminolo-
and structured educational intervention could improve atti- gies and Classifications, 21, 116–123. doi:10.1111/j.1744-618X.2010.01157.x

692 5
 20473095, 2017, 2, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/2047-3095.12120 by INASP - TANZANIA, Wiley Online Library on [01/11/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
E. Patiraki
Nursing et al.
Care Plans Nursing Care Plans
E. Patiraki et al.
scenario
Doenges, M.patients’ health
E., Moorhouse, M. problems
F., & Murr, A.and to nominate
C. (2008). Nursing nursing
diagnosis tudes,
Lee, T. T.knowledge,
(2006). Nurses’and skills of
perceptions nurses.
of their Nursing experiences
documentation diagnoses, in
manual: Planning,
diagnoses beforeindividualizing,
and after and thedocumenting
educational clientintervention
care. Philadel- a computerized
interventions, andnursing care planning
outcomes shouldsystem.
not be Journal
taught of Clinical
sepa-
phia, PA: F. A. Davis. Nursing, 15, 1376–1382.
(p > .050).
Florin, J., Ehrenberg, A., & Ehnfors, M. (2005). Quality of nursing diagnoses: rately,
Mason, C.but they
(1999). should
Guide be integrated
to practice as in theThe
or “load of rubbish”? case of the
influence of
Moreover
Evaluation ofthe an participants’ responses
educational intervention. regarding
International their
Journal of present
care plansintervention (Muller-Staub
on nursing practice in five clinicaletareas
al., in2007).
NorthernKnowl-
Ireland.
Nursing Terminologies and Classifications, 16, 33–43. doi:10.1111/j.1744- Journal of Advanced Nursing, 29, 380–387.
attitudes for the
618X.2005.00008.x
use of nursing process and care plans for edge, attitudes, and skill level of nurses are important for
Muller-Staub, M., Needham, I., Odenbreit, M., Lavin, M. A., & van Achterberg, T.
documentation
Hansebo, G., Kihlgren, were
M., & strongly
Ljunggren, negatively
G. (1999). Review correlated
of nursing with
docu- understanding
(2007). Improved and integrating
quality documentation
of nursing documentation: toofnursing
Results a nursing
thementation
numberin of scenario
nursing patients’
home wards changeshealth problems
after intervention recog-
for individu- process in daily
diagnoses, practice
interventions andand henceimplementation
outcomes to ensure positive out-
study. Interna-
alized care. Journal of Advanced Nursing, 29, 1462–1473. tional Journal of Nursing Terminologies and Classifications, 18, 5–17.
nized
Hildman, T. B.,=&−0.48,
(rho p =G..037,
Ferguson, n =Registered
H. (1991). 19) but not withattitudes
nurses’ the number
toward comes for
Shea, H. L. patients.
(1986). Although
A conceptual nurses
framework seem
to study the to
usehave a posi-
of nursing care
of nursing
the nursing diagnoses
process andrecognized (rho
written / printed = −0.28,
nursing p = .909,
care plans. Journaln of
= tiveplans.
attitude towards
International Journaldocumentation
of Nursing Studies, 23,and the nursing
147–157.
19) Nursing
beforeAdministration, 21(10), 20,
the educational 33, 45.
intervention. After the educa- Sheerin, F., a
process, Sermeus, W., & Ehrenberg,
significant A. (Eds). (2015).
gap in knowledge andProceedings
skills in from 10th
regard
Kärkkäinen, O., Bondas, T., & Eriksson, K. (2005). Documentation of individu- European Conference of ACENDIO: E-health and Nursing-Knowledge for
tional intervention,
alized patient care: Aparticipants’ responses
qualitative metasynthesis. regarding
Nursing their
Ethics, 12, 123– to planning
Patient Care. and documentation
Dublin, of nursing care still remains.
Ireland: ACENDIO.
attitude
132. for the use of nursing process and care plans for Whitley, G. G., & Gulanick, M. (1996). Barriers to the use of nursing diagnosis
Kirrane, C. (2001). An audit of care planning on a neurology unit. Nursing language in clinical settings. Nursing Diagnosis, 7, 25–32. doi:10.1111/
documentation were not correlated with the number of sce-
Standard, 15, 36–39. Implications for Nursing Knowledge and/or
j.1744-618X.1996.tb00506.x
nario patients’ health problems recognized. Moreover,
Language Development
nurses’ responses regarding their attitude for the use of
nursing process and care plans for documentation were not
Although nurses seem to have a positive attitude toward
associated with the skills regarding nursing diagnoses’
documentation and the nursing process, an important gap
nomination before and after educational intervention.
in knowledge, planning, and documentation of nursing care
still remains. The present intervention has demonstrated
Conclusions
positive results in improving knowledge and attitudes to
documentation and nursing process and could serve as a
The majority of participants reported little knowledge
basis for education in clinical practice.
and experience in the implementation of nursing process
and care plans before and after the educational interven-
tion, and there were no statistical differences between their Knowledge Translation
responses. It is worth noting that none of the participants
reported excellent knowledge or experience in the imple- Introduction of new practices in home care nursing
mentation of the nursing process and care planning. These involves challenging changes. The successful involvement
results suggest that nurses may have overestimated their of nurses is considered as an important success factor. All
knowledge and experience for the implementation of of the above imply knowledge translation, evidence-based
nursing process and nursing care plans before the educa- interventions, and a strong commitment to quality. Educa-
tional intervention. Although taking part in the educational tional interventions on nursing documentation and nursing
intervention provided them with knowledge on the content diagnoses lead to more systematic and standardized docu-
of the nursing process and care plans, their responses for mentation.
overall knowledge were not significantly improved, but
remained almost the same. The preservation of their mod- Acknowledgments. The abovementioned educational
erate attitude for documentation of care by using the intervention was part of a project co-funded by the Greek
nursing process is possibly due to their original false beliefs Government and European Union in terms of National Stra-
on the use of standards. Consequently, the results revealed tegic Reference Framework (NSRF) titled “Development of
that the participants reported what they wish to use for Home Nursing Care Plans Based on Nursing Diagnoses.”
nursing care documentation rather than what they actually
use.
Regarding the clinical scenario instead of nominating References
nursing diagnoses according the NANDA-I classification, the
Berki, S. E. (1972). Hospital economics. Lexington/New York: Lexington
participants nominated medical diagnoses, nursing assess- Books.
ments, outcomes, and mostly interventions before the edu- Björvell, C. (2002). Nursing documentation in clinical practice, instrument
cational intervention, but after that, participants’ responses development and evaluation of a comprehensive intervention programme
(Thesis). Department of Nursing, Karolinska Institutet, Stockholm.
were improved statistically significantly. Despite the Carpenito-Moyet, L. J. (2010). Invited paper: Teaching nursing diagnosis to
decreased number of patients’ health problems based on increase utilization after graduation. International Journal of Nursing
the scenario, the participants nominated only nursing diag- Terminologies and Classifications, 21, 124–133. doi:10.1111/j.1744-618X.2010
.01158.x
noses, chosen from the short catalog of the total 36 taught Chatzopoulou, M. (2010). Investigating the impact of an educational program
nursing diagnoses during the educational intervention. for nursing care documentation on Greek nurses (PhD Thesis) (in Greek).
Chatzopoulou, M., Katsaragakis, S., Karlou, C., & Patiraki, E. (2012). Explora-
Participants’ responses regarding selection and proper tion of the effectiveness of an educational programme for nurses on
formulation of defining characteristics were statistically nursing care documentation. NOSILEFTIKI, 51(4), 396–408 (in Greek).
significantly improved after the educational intervention. De Moraes Lopes, M. H. B., Higa, R., Dos Reis, M. J., De Oliveira, N. R., &
Christóforo, F. F. M. (2010). Evaluation of the nursing process used at a
In conclusion, the study revealed that a well-organized Brazilian teaching hospital. International Journal of Nursing Terminolo-
and structured educational intervention could improve atti- gies and Classifications, 21, 116–123. doi:10.1111/j.1744-618X.2010.01157.x

6 5
93