Background and Project Content

Hypothermia is a medical term that describes a condition in which the body temperature decreases to a dangerously low level. When taking place before, during, and after operations, it is called perioperative hypothermia. It is defined as being susceptible to an inadvertent drop in core body temperature below 36°C that occurs from one hour before an operation to 24 hours after that (Herdman et al., 2021). There are several health hazards associated with hypothermia, and various risk factors increase the likelihood of being afflicted by it. The NANDA-International already provides a nursing diagnosis (ND) for identifying risk factors (RF), at-risk populations (ARP), and associated conditions (AC) for perioperative hypothermia and how to make provisions for those experiencing it. However, there is still room for development, which is where the current project comes in.

Goals

Refining and validating the NANDA-International ND Risk for perioperative hypothermia (RPH) (00254) (Herdman et al., 2021) is the primary goal of this project. This includes answering the following research questions:

•    What constitutes the NANDA International ND definition for RPH? What risk factors (RF), at-risk populations (ARP), and associated conditions (AC) does it include, what is its empirical foundation, and on which model cases is it based?
•    Using Fehring's diagnostic content validation (DCV) model (Fehring, 1987) and data from a questionnaire presented to a sample of selected nurse experts, what major and minor RF, ARP, and AC can be identified for perioperative hypothermia? 
•    How high is the consensus among nurse experts (using questionnaire data obtained) about the variables of interest (i.e., RF, ARP, and AC) using Fehring's clinical diagnostic validation (CDV) model?

Methods

Three studies make up the project: First, a concept analysis (CA) is carried out following the criteria given by Walker and Avant (2019). The CA can be divided into various parts, beginning with selecting a concept and progressing to establishing the aims of the analysis and constructing different types of cases, just to name a few. In addition to that the CA includes a literature review. Second, a DCV study uses using Fehring's model is conducted. For this, a panel of nurse experts is recruited who are asked to assess in what ways the RF, ARP, and AC presented in the ND RPH and identified in the CA are relevant for nursing diagnosis. Third, a CDV investigation using Fehring's model too is carried out. To that end, data from patients having surgery at an Austrian university hospital are gathered and analyzed.

Results

CA and validation studies are performed to further develop a risk nursing diagnosis in the context of perioperative hypothermia. This offers fresh perspectives on the topic and strengthens the NANDA International taxonomy's procedures' empirical base. As a result, nurses receive an evidence-based risk nursing diagnosis for identifying perioperative hypothermia RF, ARP, and AC and preventing related health problems.

References:

Herdman, T. H., Kamitsuru, S., & NANDA International. (2021). Nursing diagnoses: Definitions and classification, 2021-2023, 12th New edition. Thieme.

Fehring, R. (1987). Methods to Vaildate Nursing Diagnoses. Heart Lung, 16 (6), 625-629.

Walker, L. O., & Avant, K. C. (2019). Concept analysis. In L. O. Walker & K. C. Avant (Eds.), Strategies for theory construction in nursing (pp. 157–179). Pearson Prentice Hall.

Funding

This study is  supported by a grant from the NANDA International Foundation, by an ACENDIO research grant and by the Gesellschaft für Forschungsförderung (GFF). It received the Marjory Gordon Award as well as the ACENDIO Research Network Award.

The content does not necessarily represent the view of the state of Lower Austria or the funding agency. Neither the state of Lower Austria nor the funding agency can therefore be held responsible for the content.