Practicing nurses: improving attitude & accuracy of nursing diagnosis

NANDA International 2012 Conference Abstract
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Session 1.4
Clinical Judgement Track

Anita B.Collins

The purpose of this study, which used a quasi-experimental two-group design, was to test the intervention of educating nurses about nursing diagnosis & accuracy of nursing diagnosis. Does an educational course related to critical thinking and clincal reas0ning improve the attitude and accuracy in nursing diagnosis of nurses.

Results / Findings

In comparing the control & experimental group on attitude toward nursing diagnosis before intervention, the mean scores were not significant.  In the post test, however, the mean score of attitude of the experimental group was significantly higher than the control group, 131.1(SD=12.31) compared with 106.7(SD=22.58, t test 6.741; p<=0.05). The interrater reliability of scoring case studies, using Cohen’s Kappa, was substantial.  Statistical analyses of scores of the 3 case studies showed that there were no significant differences in accuracy of nursing diagnosis before the intervention and after the intervention there were significant improvements in accuracy of nursing diagnosis of the experimental group with the 3 case studies (unpaired t test 3.916, 6.884 & 2.162 df 98; p<=.05).

Discussion / Conclusion
Diagnostic education is needed for implementing SNL (Muller-Stuab et al 2006) & to meet this challenge educational courses are planned that include case discussion methods which are claimed to facilitate the development of diagnostic reasoning (Greenwood 2000, Lunney 2001). Empirical studies are needed to test these claims by evaluating the effects of learning methods on nurses’ ability to state nursing diagnosis (Muller Stauab et al 2008). A study (one group pre/posttest) conducted on nursing students & faculty in India has shown significant improvement in their attitude to & accuracy in diagnosing (Collins A 2010 unpublished). This study using a control group has helped increase the claim that an educational course related to critical thinking & clinical reasoning will improve the practicing nurses’ accuracy in nursing diagnosis & their attitude towards it.

The sample was 100 practicing medical-surgical nurses, 50 in each of two groups, who worked in two hospitals of two cities of India. The experimental group completed a 12 hour Continuing Nursing Education related to Critical Thinking & Clinical Reasoning; the control group received no education. A valid & reliable tool to measure attitude was used with both groups at two time periods, before & after the intervention. Valid & reliable medical-surgical case studies were used to test for accuracy of nursing diagnosis of both groups. The control group from two hospitals was administered the same tools twice with a 12 hour interval between them.

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