Nursing diagnoses, outcomes and interventions identified in multimorbidity aged patients after discharge
Luis Villarejo Aguilar, Pedro L. Pancorbo-Hidalgo.

SUMMARY

Objectives: a) To identify nursing diagnoses, outcomes (NOC) and interventions (NIC) recorded in the nursing discharge report for aged patients with multimorbity. b) To determine if the number of diagnoses, outcomes and interventions are related with patients´ socio-demographic characteristics; c) To identify groups of nursing diagnoses, outcomes and interventions recorded together in the reports of these patients.

Methods: retrospective observational study on a sample of Nursing Discharge Reports for multimorbity patients. Patients were discharged from Hospital San Agustín (Linares, Jaén) between January 1^st 2009 and March 1^st 2010. The electronic health-history in community care system was the source of the data. Data extracted were: nursing diagnoses NANDA, outcomes NOC and interventions NIC and socio-demographic variables as age, sex, cause of admission, hospital unit and level of autonomy. A descriptive analysis was performed reporting frequencies and percentages, and a bivariate analysis to explore for possible correlations.

Results: 151 Nursing Discharge Reports were studied. Patients were aged 77 years as mean and a high percentage of dependent patients (40%) was found. These reports had recorded 30 different nursing diagnoses, 49 different outcomes and 59 different interventions; with a mean per patient of 3.85, 3.91 and 6.69, respectively. Among the most common diagnoses were: Impaired physical mobility (50.3%), Anxiety (50.3%), Risk of falls (43%), Risk for impaired skin integrity (36.4%) and Intolerance activity. The most frequent outcomes recorded were: Level of mobility (45%), Control of anxiety (32.5%), Safety behavior: fall prevention (24.5%), Risk control (23.8%) and Activity tolerance (19.9%). The most frequent interventions were: Energy management (58.3%), Prevention of falls (44.4%), 153 Support to family caregivers (42.4%), Prevention of pressure ulcers (34.4%) and Advice (30.5%). There are a positive correlation between the Index of Barthel and the number of diagnoses (R = 0.56), Outcomes (R = 0.35) and Interventions (R = 0.37). Several groups of diagnoses, outcomes and interventions jointly reported have been identified.

Conclusions: the group of patients with multiple co-morbidities required a lot of care at discharge. The use of nursing NNN languages in Nursing Discharge Reports allows an efficient communication amongst professionals, although it use still need more research.

KEY WORDS

Multimorbidity, nursing diagnosis, nursing taxonomies, nursing discharge report, hospitalization.

Vol. 22 nº4-2011