Distinguishing Risk and Problem-Focused Diagnosis in Adult Pressure Injury: A Critical Discussion to Enhance Nursing Diagnoses Linkages

Abstract

Portuguese

Purpose

To critically analyze the NANDA-I nursing diagnoses “Adult pressure injury” (00312) and “Risk for adult pressure injury” (00304) regarding the expected outcomes and recommended interventions. This contributes to strengthening the linkages between NANDA-I Diagnoses, Nursing Outcomes Classification, and Nursing Interventions Classification taxonomies in clinical practice, education, and nursing research.

Methods

This study adopts a consensus-based approach, with descriptive and analytical components, grounded in clinical reasoning of experts in nursing diagnosis, outcomes and interventions taxonomies and supported by a narrative review of the literature. A structured consensus process was used to reach agreement.

Findings

A total of 51 linkages were mapped for the nursing diagnosis “Risk for adult pressure injury” (00304). Additionally, 37 linkages were identified for the nursing diagnosis “Adult pressure injury” (00312). From this analysis, 88 linkages were identified.

Conclusions

The established linkages allow for the distinction between preventive and treatment-oriented outcomes and interventions, enabling a more effective approach to caring for patients with pressure injury. In addition, ongoing efforts to validate and disseminate these linkages are crucial for advancing nursing practice, ensuring high-quality patient care, and creating reliable records that reflect nursing practice.

Implications for nursing practice

This work can assist nurses in their clinical reasoning and decision-making by providing a standardized nursing language in the development of nursing care plans with adjusted diagnoses, outcomes, and interventions appropriate for addressing the needs of patients with pressure injury.

Keywords

clinical reasoning delivery of health care nursing nursing diagnosis pressure ulcer standardized nursing terminology

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