[4Gammy]

Hi,
I am currently enrolled in my masters in nursing and need some help from my peers. My capstone project is to develop a tool to help students cluster data for their careplans. My question is, has anyone used something that helped you cluster your data that made sense and wasn't too difficult to understand? Any information would be greatly appreciated.

[vickynurse]

Are you thinking of care mapping? Data clustering is a key component. Pam Schuster has a very useful book about them.

[4Gammy]

Vicky,
Yes, like care mapping. I am just trying to develop a tool that will make it easier for the students to collect data. Do you know the name of the book by chance?

[rpv_rn]

Originally Posted by 4Gammy

Vicky,
Yes, like care mapping. I am just trying to develop a tool that will make it easier for the students to collect data. Do you know the name of the book by chance?

Students could perform a history & assessment based on systems review. Based on the ineffective behaviors (signs/ symptoms), the data could easily be clustered and narrow the nursing diagnosis based on oxygenation, nutrition, rest & activity/ mobility, fluid balance, comfort, elimination, etc.
I use a local hospital's nurses' daily flow record where the patient either fits the criteria of "within normal limits" or not. When not WNL, the nurse can check the box for specific sign / symptoms.
This suggestion may sound simplistic. I teach in an ADN program, 1st semester, where I have to impart the concept of clustering data in order to lead them to a nursing diagnosis. The lightbulb turns on for the majority of the students.

[4Gammy]

Originally Posted by rpv_rn

Students could perform a history & assessment based on systems review. Based on the ineffective behaviors (signs/ symptoms), the data could easily be clustered and narrow the nursing diagnosis based on oxygenation, nutrition, rest & activity/ mobility, fluid balance, comfort, elimination, etc.
I use a local hospital's nurses' daily flow record where the patient either fits the criteria of "within normal limits" or not. When not WNL, the nurse can check the box for specific sign / symptoms.
This suggestion may sound simplistic. I teach in an ADN program, 1st semester, where I have to impart the concept of clustering data in order to lead them to a nursing diagnosis. The lightbulb turns on for the majority of the students.

Is there anyway that you could send me a copy of the daily flow sheet? I'm a visual learner. Thanks for the insight.

[4Gammy]

Is there anyway you could send me a copy of the daily flow sheet you mentioned? I'm a visual learner.
Thanks

[Daytonite]

I would be interested in knowing what you come up with. I decided to work on a project like this over the summer and realized very quickly that I was running into problems . I answer a lot of student questions on the student forums regarding care plans and they almost always are having problems getting to the nursing diagnosis. The ones who are having trouble don't get the concept of grouping the abnormal data. I stumbled onto a site http://servercc.oakton.edu/~mikey/nursingnewer/homecareplan.html which I thought might be an attempt by an informatics nurse to help in this process, but it looks to be only partially completed. Then, again, it may be an attempt to create their own care plan constructor. How are medical students taught diagnosis?

[rpv_rn]

Originally Posted by Daytonite

I would be interested in knowing what you come up with. I decided to work on a project like this over the summer and realized very quickly that I was running into problems . I answer a lot of student questions on the student forums regarding care plans and they almost always are having problems getting to the nursing diagnosis. The ones who are having trouble don't get the concept of grouping the abnormal data. I stumbled onto a site http://servercc.oakton.edu/~mikey/nursingnewer/homecareplan.html which I thought might be an attempt by an informatics nurse to help in this process, but it looks to be only partially completed. Then, again, it may be an attempt to create their own care plan constructor. How are medical students taught diagnosis?

I teach students about how physicians determine their medical diagnoses. There are specific signs/ symptoms and diagnostic criteria for each diagnosis.

It's same for nursing diagnoses. Many of the Nursing Diagnoses texts work well. My favorite is "Nursing Diagnosis Handbook by Judith M. Wilkinson."

Students need to first focus (specific problelm) on a specific system, e.g. respiratory system.
(1) Collect the subjective & objective data within that system. Examples: respiratory rate, rhythm & quality, prod or non-prod cough, c/o SOB or dyspnea, skin & mucous membranes status (color, hydration, etc), equipment (oxygen therapy), LOC, etc.
(2) Cluster data & utilize ND text. Possible ND: Ineffective Airway clearance; Ineffective Breathing Pattern.
(3) Students have problems with pt outcomes being measurable. Lots of tutoring needed here.
(4) ND text can be utilized for specific nsg interventions, based on pt data.
(5) Students must evaluate the outcome, NOT the interventions. In other words, if students evaluate interventions, then it is the nurse that is being evaluated --> wrong focus.
(6) Patient centered --> evaluate whether the patient met the delineated outcome.

Please excuse me if I am being too simplistic here. As stated previously, I teach 1st semester & must "culturize" the students to the language of "nursingalese."

[rpv_rn]

Originally Posted by 4Gammy

Is there anyway you could send me a copy of the daily flow sheet you mentioned? I'm a visual learner.
Thanks

Most acute facilities now use check charting, ie focus charting or charting by exception. (Hard copies.)
One clinical facility has a systems format. There is column of "normals" for each system. If pt does not meet the normals, the second column states the ineffective behaviors or signs / symptoms that may be assessed for each particular system.

The clinical facilities have been transitioning to computerized documentation. I am on a learning curve here & therefore, cannot provide input. Sorry.

[Daytonite]

Originally Posted by rpv_rn

Most acute facilities now use check charting, ie focus charting or charting by exception. (Hard copies.)
One clinical facility has a systems format. There is column of "normals" for each system. If pt does not meet the normals, the second column states the ineffective behaviors or signs / symptoms that may be assessed for each particular system.

The clinical facilities have been transitioning to computerized documentation. I am on a learning curve here & therefore, cannot provide input. Sorry.

That makes sense to me. Once the informatics people get into this, they will be able to write programs to turn that second column of symptoms into nursing diagnoses. I have no doubt that is where this will all go. I've been studying health information management and medical coding and immediately saw the connection with the NANDA diagnoses, NOC outcomes and NIC interventions. Especially, once I saw a listing of them with code numbers attached. A big task, of course, is to teach nurses how to use the terminology correctly!