Hemodialysis nurses rate nursing diagnoses relevant to clinical practice

This was a descriptive cross-sectional study conducted from August to September 2014 in the city of Goiânia, Goiás, Brazil. A questionnaire and a Likert scale (score 0-7) were given to participants to assess the relevance of diagnoses. Scores were obtained by calculating the ratio of the total score obtained to the highest score possible. Diagnoses that scored ≥0.75 were considered relevant.

Results

Forty nurses participated in the study, 80% had been working in the field for over 24 months, 42.5% were nephrology experts. The participants indicated 44 relevant nursing diagnoses, discussed in the context of hemodialysis nursing.

Conclusion

The diagnoses identified show the human responses valued by hemodialysis nurses.

Nursing diagnosis; Nursing; practical; Nursing process; Hemodialysis; Nephrology nursing

Variables	Time working with hemodialysis (in months)
	≥3 to <6	≥6 to 24	≥24	Total
	n(%)	n(%)	n(%)	n(%)
Gender
Male	-	1(2.5)	3(7.5)	4(10.0)
Female	1(2.5)	6(15)	29(72.5)	36(90.0)
Age group (in years)
<30	1(2.5)	4(10)	5(12.5)	10(25.0)
30 to 40	-	3(7.5)	14(35)	17(42.5)
>40	-	-	13(32.5)	13(32.5)
Time since obtained undergraduate degree (in years)
<10	1(2.5)	7(17.5)	21(52.5)	29(72.5)
10 to 20	-	-	6(15.0)	6(15.0)
>20	-	-	5(12.5)	5(12.5)
Qualification
Undergraduate	1(2.5)	7(17.5)	14(35)	22(55.0)
Specialization	-	-	17(42.5)	17(42.5)
Specialization underway	1(2.5)	3(7.5)	11(27.5)	15(37.5)
Master’s	-	-	1(2.5)	1(2.5)
Doctorate underway	-	-	1(2.5)	1(2.5)
Undergraduate training in nursing process	1(2.5)	7(17.5)	29(72.5)	37(92.5)
Currently studies nursing process	2(5.0)	3(7.5)	9(22.5)	14(35.0)
Promotes ongoing education in nursing process	1(2.5)	4(10.0)	17(42.5)	22(55.0)
Refresher training in nephrology*
Books	1(2.5)	7(17.5)	32(80)	40(100)
Articles	1(2.5)	5(12.5)	22(55.0)	28(70.0)
Events	-	-	14(35.0)	14(35.0)
Knowledge about NANDA-I**	-	1(2.5)	8(20.0)	9(22.5)

Nursing diagnoses	RI ^†
Safety/protection
Risk for infection	0.91
Risk for bleeding	0.89
Risk for falls	0.81
Risk for shock	0.81
Risk for allergy response	0.80
Nutrition
Excess fluid volume	0.90
Risk for imbalanced fluid volume	0.88
Risk for unstable blood glucose level	0.88
Risk for electrolyte imbalance	0.85
Imbalanced nutrition: less than body requirements	0.81
Activity/rest
Risk for ineffective renal perfusion	0.85
Risk for decreased cardiac tissue perfusion	0.82
Comfort
Chronic pain	0.83
Nausea	0.82
Acute pain	0.80
Health promotion
Risk-prone health behavior	0.81
Ineffective family therapeutic regimen management	0.80

Nursing diagnoses	RI^†
Safety/protection
Risk for vascular trauma	0.79
Risk for impaired skin integrity	0.79
Impaired skin integrity	0.79
Impaired tissue integrity	0.76
Risk for contamination	0.75
Health promotion
Readiness for enhanced immunization status	0.79
Ineffective self-health management	0.79
Coping/Stress tolerance
Fear	0.78
Death anxiety	0.78
Anxiety	0.76
Chronic sadness	0.75
Powerlessness	0.75
Life principles
Noncompliance	0.77
Activity/rest
Decreased cardiac output	0.77
Risk for ineffective cerebral tissue perfusion	0.76
Activity intolerance	0.76
Risk for ineffective peripheral tissue perfusion	0.75
Ineffective peripheral tissue perfusion	0.75
Disturbed sleep pattern	0.75
Insomnia	0.75
Elimination and exchange
Impaired urinary elimination	0.77
Constipation	0.76
Self-perception
Hopelessness	0.77
Risk for loneliness	0.76
Sexuality
Sexual dysfunction	0.76
Ineffective sexuality pattern	0.75
Nutrition
Risk for imbalanced nutrition: more than body requirements	0.75

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
E-mail: actapaulista@unifesp.br

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[1] Corresponding author. Maria Madalena Del Duqui Lemes. Universitária Avenue, 440, 74605-010, Goiânia, Goiás, Brazil. mdelduqui@gmail.com