Standardized terminologies represent a vital element of effective care provision in the current healthcare system. According to Lewis, Dirksen, Heitkemper, and Bucher (2013), they facilitate the provision and guarantee the continuity of nursing care. The existing nomenclatures empower nurse practitioners to bring together different aspects of nursing and develop a holistic picture of patients’ health needs. Their integration creates a more favorable environment for achieving greater quality and efficiency of nursing care. The focus of the present work is on applying the integration of standardized terminologies (NANDA-I, NOC, and NIC) to a patient with the lack of disease and treatment knowledge. The paper identifies the critical elements of NANDA, NOC, and NIC, followed by the analysis of the data-information-knowledge-wisdom hierarchy in the context of the given scenario.
As a nurse working on a surgical floor in a general hospital, I see patients with a variety of physical complaints. However, as a nurse who is pursuing a degree in the Family Nurse Practitioner track, I also seek to expand my knowledge of patients beyond their physiological problems. Two weeks ago, one of our patients came for a consultation to our department. He had previously undergone appendectomy in our unit. I could remember him quite well, since he had been one of the youngest patients admitted to our department in an acute condition. The young man said that he felt well, but he did not know if he could take a bath and restore his typical hygiene practices. He was told upon discharge that he had to follow the basic precautions, but he did not know for how long. Also, the patient confessed that he did not take the medications that were prescribed to him upon discharge because he was not sure they were needed. He did not have any complaints except that the surgery had severely impacted his quality of life – he abstained from sports, sexual activity, and other simple pleasures for the fear that they were not allowed to him.
While nurses seek to address the physiological needs of patients, their cognitive and emotional needs also should not be ignored.
According to Taxonomy II of NANDA, lack of knowledge about a specific health problem or procedure constitutes a distinct diagnostic category known as deficient knowledge, which can be defined as the absence or deficiency of cognitive information related to a specific topic. (Galdeano & Dantas, 2012, p. 101)
The situation described above is just one of the many examples of deficient knowledge encountered by nurses. The patient does not know how to achieve the desired health outcomes without disrupting his lifestyle routines. The task of a nurse is to develop a care plan that will expand the patient’s knowledge of the disease and improve his compliance with the prescribed treatment regimen.
In the context of the present scenario, the following NOC outcomes will be directly related to the NANDA-I diagnosis of deficient knowledge: disease process, health behavior, healthy diet, prescribed activity, and treatment regimen (Ackley, Ladwig, & Makic, 2016). More specifically, the client will acquire a more thorough understanding of the disease. He will understand the importance of the prescribed medications and their implications for his health (Ackley et al., 2016). He will also learn the nature and scope of prescribed activities and exercise within the limits imposed by the required treatment regimen.
Here, a variety of interventions can be used to achieve the abovementioned outcomes. Some of the recommended NIC interventions include learning facilitations and teaching the disease process (Ackley et al., 2016). Individual teaching could also be helpful in improving patient and nursing outcomes. Undoubtedly, the entire process should begin with a brief evaluation of the client’s health literacy and his readiness to enhance his knowledge of the disease process. The teaching strategy will have to be aligned to the unique needs, expectations, and literacy skills of the client. Any nurse working with this patient will greatly benefit from using the NANDA-NOC-NIC linkages that are relevant to the case. In the meantime, the analysis and subsequent interpretation of the primary patient data will gradually translate into knowledge and wisdom that will guide future practices in surgical and family nursing care.
The data-information-knowledge-wisdom (DIKW) hierarchy is a popular concept used in nursing informatics. It has also guided my decisions and observations in analyzing the above scenario. I began with data, which are defined as clusters or entities that are presented objectively, literally, and without interpretation (Ronquillo, Currie, & Rodney, 2016). The data came directly from the patient in the form of his complaints, concerns, and questions. It was interpreted in the context of the patient’s situation and the surgery he had undergone, creating information. The latter was also synthesized and related to the data he had previously received from other nurses and his health behaviors after being discharged from the hospital. This is how information was transformed into knowledge (Ronquillo et al., 2016). This knowledge guided the selection of the most appropriate diagnosis and the analysis of the NANDA-NOC-NIC linkages. Ultimately, wisdom came as the general understanding of how patients manage health information and what actions nurses should undertake to avoid similar information pitfalls in the future.
As a conclusion, standardized terminologies facilitate the delivery of quality nursing care. The conceptual linkages between NANDA, NOC, and NIC enable nurses to determine the needs of patients, confirm relevant nursing diagnoses, set comprehensive goals and priorities for nursing care, and propose interventions that will assist in achieving the desired goals and outcomes. The use of standardized terminologies illustrates the transformation of data through information and knowledge into wisdom. These terminologies create a general understanding of the most pressing nursing issues and allow for the use of standardized interventions in a variety of patient situations.
- Ackley, B.J., Ladwig, G.B., & Makic, M.B. (2016). Nursing diagnosis handbook: An evidence-based guide to planning care. NY: Elsevier Health Sciences.
- Galdeano, L.E., Rossi, L.A., & Dantas, R.A. (2010). Deficient knowledge nursing diagnosis: Identifying the learning needs of patients with cardiac disease. International Journal of Nursing Terminologies and Classifications, 21(3), 100-107.
- Lewis, S.L., Dirksen, S.D., Heitkemper, M.M., & Bucher, L. (2013). Medical-surgical nursing: Assessment and management of clinical problems. NY: Elsevier Health Sciences.
- Ronquillo, C., Currie, L.M., & Rodney, P. (2016). The evolution of data-information-knowledge-wisdom in nursing informatics. Advances in Nursing Science, 39(1), E1-E18.