Strategies for nursing process implementation in a Brazilian university hospital
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NANDA International 2012 Conference Abstract
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Session 2.3
Education & Implementation Track

Authors
Salviano, Marcia E.

Question
This study aims to describe the implementation experience of the nursing care process model in an university hospital. Is it possible to design and to develop an educational program to implement the nursing process at a large hospital?

Results / Findings
The elements of critical thinking used and defined by the nurses to solve the clinical case were: clinical judgment, which is characterized by technical-scientific knowledge associated to clinical experience and clinical thinking, since through signs/symptoms the professional assesses importance/severity and determines conduct; clinical experience, which makes it possible for broadening the professional’s perspective through previous experiences that differ assessment ability from clinical thinking; ethics, which is characterized by respect and the individuality and value of a human being, fulfillment of a nurse’s activities; technical-scientific knowledge, which is the basis for nursing practice and for all the competence that a nurse must present, supported by theory/pathology knowledge; patient knowledge is characterized by understanding the health/disease process which makes it easier for decision-making with the objective of promoting clinical improvement; clinical thinking which is characterized by relating evidence and by thinking which is directed to a problem situation with the purpose of making the best decision.

Discussion / Conclusion
The educational program was also related to a social change in the nursing work process. The autonomy and self confidence perceived within the nursing team overcome the expectations inferred on a nursing care model implementation, which was a better quality of the care. The multidisciplinary team is acknowledging that the nursing work process changes and is seeking to improve dialogue, the care quality and better results.The use of a nursing process at most Brazilian hospital settings remains as a challenge. It has been recognized as a great contribution on the JCI accreditation process.

Method
Two hundred and fifty nurses were submitted to an four educational program for the nursing process training. The assessment, the nursing diagnosis, care plan and evaluation were implemented. It took two years to be implemented in 18 units.

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