Paper
Friday, July 15, 2005
Unveiling the use of NANDA, NIC, and NOC Language With Clinical Reasoning Activities Using the Outcome Present State Test Model
RuthAnne Kuiper, PhD, RN, CCRN1, Donald D. Kautz, PhD2, and Randy L. Williams, BSN2. (1) Nursing, University of North Carolina, Wilmington, Wilmington, NC, USA, (2) Nursing, University of North Carolina Greensboro, Greensboro, NC, USA
| Learning Objective #1: Describe the integration of NNN standardized nursing language with a clinical reasoning model |
| Learning Objective #2: Compare the benefits and limitations of using standardized nursing language for educational interventions |
Purpose: The purpose of this project was to evaluate student's use of NANDA, NIC, NOC (NNN) language during clinical reasoning activities with the Outcome-Present State Test Model (OPT). Methods: A quasi-experimental design evaluated the use of the OPT model as a teaching-learning tool over a 10 week period of clinical experiences on acute care units with junior level nursing students. Secondary analysis was conducted on OPT model worksheets from 10 students using a “NNN Scoring Grid”. Findings: Extracted from a larger sample, 100 OPT models were evaluated using NANDA diagnoses, NOC outcomes, NOC indicators, NIC interventions, and NIC activities from the official resources of the Iowa Intervention and Outcomes Projects. The investigators determined that NOC outcomes were implied rather than stated the majority of the time. The interventions listed on the OPT worksheets were identified as linked to NIC interventions and activities associated with a NOC. Additional activities were listed but unrelated to NIC and connected to multiple health problems. Inter-rater agreement was determined to be 60% for NOC and 50% for NIC, reflecting the different views of the investigators. Discussion: Group analysis revealed students were efficient in using the OPT model worksheets in the first few weeks and chose case specific outcomes and interventions using some NNN language from a variety of resources. The findings reveal the challenges in identifying and teaching holistic care planning to students for patients with multiple health problems. Conclusions: Frequent faculty feedback is crucial for successful use of the OPT model of clinical reasoning and nursing language. Cognitive training of student thinking with the use of the OPT model and official nursing language could expand a repertoire of outcomes, interventions and activities based on research.