NURSING DIAGNOSIS AND NURSING INTERVENTION

As Nursing Care Plans
Nursing Diagnosis and Inter­vention continues to mature and reflect the changing times and needs of its readers, as well as the needs of those for whom care is provided, nursing diagnoses continue to evolve. The body of research to support diagnoses, their definitions, related and risk factors, and defining characteristics is ever increasing and gaining momen­tum; nurses continue to study both independent and collaborative interventions for effectiveness and desir­able outcomes.
The taxonomy as a whole continues to be refined, its use as an international tool for practice, education, and research is testament to its importance as an organizing framework for the body of knowledge that is uniquely nursing. As a taxonomy, nursing diagnosis and all its components are standardized. Nurses must remember that plans of care developed for each diagnosis or cluster of diagnoses for particular patients must be individual­ized. The tailoring of the plan of care is the hallmark of nursing practice.
Nursing Interventions Classification (NIC) presents an additional opportunity for clarifying and organizing what nurses do. With NIC, nursing interventions have been systematically organized to help nurses identify and select interventions. NIC informa­tion continues to be presented along with each nursing diagnosis within each care plan, giving the user added ability to use NIC taxonomy in planning for individual­ized patient care. According to the deyelopers of NIC, nursing interventions are "any treatment, based on clin­ical judgment and knowledge, that a nurse performs to enhance patient/client outcomes" (McCloskey, Bulechek, 2000). These interventions may include direct or indirect care and may be initiated by a nurse, a physi­cian, or another care provider. Student nurses, practic­ing nurses, advanced-practice nurses, and nurse execu­tives can use nursing diagnoses and NIC as tools for learning, organizing, and delivering care; managing care within the framework of redesigned health care and within financial constraints through the development of critical paths; identifying res6atch questions; and moni­toring the outcomes of nursing care both at an individual level and at the level of service provision to large popu­lations of patients.
Nurse investigators at the University of Iowa have de­veloped Nursing Outcomes Classification (NOC), a tax­onomy of patient outcomes that are sensitive to nursing interventions. The authors of this outcomes taxonomy state, "For nurses to work effectively with managed care organizations to improve quality and reduce costs, nurses must be able to measure and document patient outcomes influenced by nursing care (Johnson, Maas, & Moorhead, 2000,).