Models and instruments to evaluate the diagnostic accuracy
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NANDA International 2012 Conference Abstract
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Session 1.3
Clinical Judgement Track


Authors
Rodrigo Jensen
Maria Helena B.  Lopes
Fabiana  Gonçalves de Oliveira Azevedo
Diná de Almeida Lopes Monteiro da  Cruz

Question
The aim of this study was to know which models and instruments for diagnostic accuracy evaluation in nursing are available at the nursing scientific literature and discuss its application on practice. Which models and instruments for diagnostic accuracy evaluation in nursing are available at the nursing scientific literature?

Results / Findings
A total of 18 papers were identified in the databases. Of these, 16 were excluded because not introduce new methods to evaluate the diagnosis accuracy. One study not found in the databases was included because met the inclusion criteria. It was found two models and three instruments. The first model and instrument was proposed by Lunney (1). The second instrument was proposed by Matos and Cruz (2), based on the Lunney’ model (1). The third instrument was proposed by Jensen (3), based on the Lopes’ model (4).

Discussion / Conclusion
The Lunney Scoring Method for Rating Accuracy of Nursing (1) consists of a seven-point scale designed to assess the 'accuracy of the interpretation of clinical findings' of nurses. It is guided by the principle of sufficiency of data appropriateness of diagnosis and context in which they occur. The Nursing Diagnoses Accuracy Scale (NDAS) (2) was created based on the Lunney’s scale. It also aims to assess the 'accuracy of the interpretation of clinical findings' of nurses. It has four items that assess the presence, relevance, specificity and coherence of cues (defining characteristics) of the diagnosis. This scale was refined recently by its authors, and called NDAS - Version 2 (5). Jensen (3) developed an educational software that evaluates the diagnostic accuracy of the nursing students. The software uses the Fuzzy Sets Theory and was based on the model proposed by Lopes (4). The activity proposed in this software consists of four steps where the student establishes degrees of relation (degrees of membership) between the defining characteristics/risk factors (DC/RF), ND and clinical cases. The relations established by the student are compared to the relations determined by experts. The software shows to the student four scores.

Methods
A scientific literature review was made to find studies about models and instruments constructed for diagnostic accuracy evaluation in nursing. The search was carried out in the Scielo, PubMed and Medline databases, with no limitation on time of publication. The key-words used to find the studies was Nursing diagnosis [Subjects] AND Accuracy [Title].  Additionally, a manual search was performed. The abstract of studies were read in the selection process. Studies that introduced new models or instruments to evaluate the diagnosis accuracy in nursing, written in Portuguese and English, were included.

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