Frequency of Respiratory Nursing Diagnoses and Accuracy of Clinical Indicators in Preterm Infants

• Published in: International journal of nursing knowledge Vol. 30; no. 2; pp. 73 - 80
• Main Authors: Avena, Marta José, Pedreira, Mavilde da Luz Gonçalves, Bassolli de Oliveira Alves, Lucas, Herdman, T. Heather, Gutiérrez, Maria Gaby Rivero
• Format: Journal Article
• Language: English
• Published: United States 01.04.2019
• Subjects: Cross-Sectional Studies; Female; Humans; Infant; Infant, Newborn; Infant, Premature; Male; neonatal nursing; newborn; nursing care; Nursing Diagnosis; patient care planning; Respiration; Respiration Disorders - diagnosis; Respiration Disorders - nursing; respiratory signs and symptoms; Vital Signs; neonatal nursing; patient care planning; nursing diagnosis; Infant; newborn; nursing care; respiratory signs and symptoms
• ISSN: 2047-3087; 2047-3095; 2047-3095
• DOI: 10.1111/2047-3095.12205

PURPOSE To identify the frequency of the nursing diagnoses, ineffective breathing pattern, impaired gas exchange and impaired spontaneous ventilation in newborns; and, to analyze the accuracy of diagnostic indicators identified for each of these diagnoses. METHODS This was a cross‐sectional study conducted with a nonprobability sample of 92 infants. Data collected were represented by demographic and clinical variables, clinical indicators of the three respiratory nursing diagnoses from NANDA International, and were analyzed according to frequency and agreement between pairs of expert nurses (Kappa). FINDINGS Ineffective breathing pattern was identified in 74.5% of infants; impaired gas exchange was noted in 31.5%; impaired spontaneous ventilation was found in 16.8% of subjects. Use of accessory muscles to breathe showed the highest sensitivity for ineffective breathing pattern; abnormal blood gases had the best predictive value for impaired gas exchange. Use of accessory muscles to breathe had the highest sensitivity for impaired spontaneous ventilation. CONCLUSIONS Ineffective breathing pattern was the most frequently identified; use of accessory muscles, alteration in depth of breathing, abnormal breathing, and dyspnea were the most representative signs/symptoms. IMPLICATION FOR NURSING PRACTICE Early recognition of respiratory conditions can support safe interventions to ensure appropriate outcomes.