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Educational diagnoses of nursing staff and their practical use
NOVÁČKOVÁ, Klára
This bachelor thesis is focused on the use of educational nursing diagnoses. These often diagnoses often named health improving, educational or wellness are aimed to improve and strengthen health of individual or community and is tailored for the need of a client in question to improve in a certain area (1, 2). Although many nurses are interested in wellness diagnoses and use them, there is an ongoing contradiction regarding their real clinical usefulness (3). The aim of the research part of this thesis was to identify which educational nursing diagnoses are most often used at internal medicine wards for patients medically diagnosed with Type 2 diabetes mellitus or hypertension. Two research questions were posed: Which educational nursing diagnoses are most often used for patients with medically diagnosed Type 2 diabetes mellitus? Second question: Which educational nursing diagnoses are most often used for patients with medically diagnosed hypertension? Qualitative form of research was chosen using the method of secondary data analysis. In this case this involved studying nursing documentation of patients with diagnosed Type 2 diabetes mellitus or hypertension. Studied data was transcribed into answer sheets (see Appendix 1), consequently analysed by coding method and divided into the following categories: Written report on education, Educational diagnosis designation of the problem, Educational plan, Progress of education, Evaluation of education. Studied research group consisted of ten nursing documentation files that belonged to patients then hospitalised at internal medicine wards of hospital Nemocnice Písek a.s. Six clients were diagnosed with Type 2 diabetes mellitus, four with hypertension, with one patient suffering from both. This research showed that educational nursing diagnoses or designation of the patient's educational needs are used by the nurses working at the wards. Educational diagnoses were present in each of the studied files. All were concerned with insufficient knowledge about the illness. In the file containing medical diagnosis of Type 2 diabetes mellitus educational diagnoses were concerned with areas normally defined in literature as desirable for the patient. Similar results were found for patients with hypertension. Interestingly, educational diagnoses were often in discord with educational themes, probably due to education not being always recorded as performed. Further information on the reporting quality about the education was also found, where nurses often omit to report individual components of the educational plan, such as the aim, type or environment. Also, proper evaluation of the education by a nurse is often absent from the report and instead only a short note on the fact that education of the patient was conducted in a certain area is given. On the other hand, evaluation conducted by the client is often reported, although very curtly. Results of this research show that educational nursing diagnoses are in use for patients with both Type 2 diabetes mellitus and hypertension, and are always targeted towards increased knowledge of the patient about the illness. Areas that the diagnoses focus at are in concordance with the medical diagnoses. Educational diagnoses that are concerned with other individually specific areas are also present in some of the education documentation files. With respect to the targeted diagnoses educational plan concerned with insufficient dexterity should also be used. The overall educational reporting is not flawless and its improvement is necessary. The output of this work therefore consists of a model of documentation reporting educational activity. (Appendix 3). This documentation model was evaluated by head nurse Zdeňka Matušicová as well-arranged and practical.
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