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Do nursing diagnoses affect functional status?

J S Harrell, E S McConnell, D S Wildman

    Journal of Gerontological Nursing
    |October 1, 1989
    PubMed
    Summary
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    Accurate nursing diagnoses and comprehensive patient assessments, particularly using the Katz ADL scale, are crucial for improving patient function and predicting discharge outcomes. Enhanced diagnostic reasoning training for nurses is recommended.

    Area of Science:

    • Nursing
    • Healthcare Management
    • Patient Outcomes

    Background:

    • Nursing diagnoses are fundamental to clinical practice and patient care planning.
    • Accurate diagnostic reasoning is essential for effective nursing interventions.
    • Patient functional status is a key indicator of care effectiveness and discharge needs.

    Purpose of the Study:

    • To evaluate the accuracy of nursing diagnoses in clinical practice.
    • To determine the relationship between the number of nursing diagnoses and patient functional improvement.
    • To identify predictors of functional status at discharge and institutionalization.

    Main Methods:

    • Analysis of nursing diagnoses recorded for hospitalized patients.
    • Correlation of nursing diagnoses with patient functional status improvements.

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  • Utilizing the Katz ADL scale to measure functional status at admission and discharge.

    • Main Results:

    • Nursing diagnoses often focused on physiological rather than psychosocial issues, with "impaired home maintenance management" frequently misapplied.
    • A higher number of nursing diagnoses correlated with greater functional improvements during hospitalization.
    • Katz ADL scores at admission were the strongest predictors of discharge functional status and institutionalization.

    Conclusions:

    • Improved clinical training in diagnostic reasoning is needed for nursing staff.
    • The number of nursing diagnoses may influence nursing actions and patient functional gains.
    • The Katz ADL scale is a valuable tool for assessing patient function and guiding discharge planning.