ICNP<sup>®</sup> terminological subset for preventing falls in the elderly in primary care

Santos, Paulo Henrique Fernandes dos; Stival, Marina Morato; Lima, Luciano Ramos de; Volpe, Cris Renata Grou; Funghetto, Silvana Schwerz

doi:10.1590/1980-220X-REEUSP-2022-0483en

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 57 • 2023 • https://doi.org/10.1590/1980-220X-REEUSP-2022-0483en copy

ICNP^® terminological subset for preventing falls in the elderly in primary care

Subconjunto terminológico CIPE^® para la prevención de caídas en ancianos en atención primaria

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

Build and validate a terminological subset of ICNP^® for the prevention of falls in the elderly in the context of primary health care, in light of the Self-Care Deficit Theory.

Method:

Methodological study developed in accordance with ICN recommendations and the Brazilian method for constructing terminological subsets, in two stages: 1) construction of ICNP^® statements of nursing diagnoses, outcomes, and interventions; 2) content validation of statements by specialist nurses.

Results:

A total of 182 diagnoses/outcomes and 321 nursing interventions were constructed, which were subjected to content validation by 28 experts, being validated with a Content Validity Index ≥ 0.80. After validation, the statements were organized according to self-care requirements and the majority of diagnoses/outcomes (51.6%) and interventions (52.7%) were classified under health deviation requirements.

Conclusion:

It was possible to construct and validate a terminological subset of ICNP^® with a predominance of statements related to health deviation requirements, standing out for being the first terminological subset for the prevention of falls in the elderly in the context of primary care.

DESCRIPTORS
Nursing; Standardized Nursing Terminology; Aged; Accidental Falls; Primary Health Care

NURSING DIAGNOSES/OUTCOMES, AND INTERVENTIONS	CVI
UNIVERSAL SELF-CARE REQUIREMENTS
Nursing Diagnosis/Outcome Risk for Fall (10015122) Risk for Fall, Absent Nursing Intervention Demonstrating Falls Prevention (10040248) Recommend Environment with Adequate Lighting Recommend Anti-Slip Mat Remove Obstacles (Objects, Furniture) from the Floor Assessing Risk for Falls (10023520)	1.00 1.00 1.00 1.00 1.00 1.00 0.93
Nursing Diagnosis/Outcome Impaired Exercise Behavior (10022043) Physical Exercise Behavior, Effective Nursing Intervention Assess Adherence to the Physical Exercise Regimen Guidance on Sedentary Lifestyle Teaching about Exercise (10040125) Manage Exercise Regime (10023890) Get Physical Fitness Data	0.93 0.93 1.00 1.00 1.00 0.93 0.93
Nursing Diagnosis/Outcome Self-Care Deficit (10023410) Able to Perform Self Care (10025714) Nursing Intervention Teaching about Self Care (10045014) Promoting Self-Care (10026347) Assisting with Self-Care (10035763) Establish Self-Care Routine Identify Barriers to Self-Care in the Nursing Consultation	0.93 0.93 1.00 1.00 0.96 0.96 0.96
Nursing Diagnosis/Outcome Lack of Knowledge of Fall Prevention (10040230) Knowledge of Fall Prevention (10040276) Nursing Intervention Guide the Nursing Team on Fall Prevention Teaching Family about Fall Prevention (10040269) Promote Educational Action on Fall Prevention Assessing Readiness to Learn (10002781) Providing Instructional Material (10024493)	0.93 0.93 1.00 1.00 1.00 0.96 0.96
Nursing Diagnosis/Outcome Environmental Safety Problem (10029856) Effective Environmental Safety (10030233) Nursing Intervention Identify Stairs or Steps in the Home Implementing Safety Regime (10036565) Assessing Environment (10026064) Teaching About Safety Measures (10024687) Evaluating Home Before Home Care (10041038)	0.93 0.93 1.00 1.00 0.96 0.96 0.89
SELF-CARE REQUIREMENTS RELATED TO DEVELOPMENT
Nursing Diagnosis/Outcome Impaired Psychomotor Activity (10025087) Psychomotor Activity, Improved Nursing Intervention Facilitating Activity of Daily Living (10051125) Refer to Physiotherapy Monitoring Fall Risk (10037442)	0.96 0.96 0.96 0.93 0.93
Nursing Diagnosis/Outcome Impaired Balance (10047170) Improved Balance (10047348) Nursing Intervention Obtain Data on Proprioceptive Deficit Assessing Balance (10037457) Obtain Data on Postural Instability Advise on the Risk of Rapid Body Movements Promoting Adherence to Exercise Regime (10041628)	0.96 0.96 0.96 0.96 0.96 0.96 0.96
Nursing Diagnosis/Outcome Muscle Strength, Reduced Muscle Strength, Increased Nursing Intervention Assess Muscle Tone Assessing Nutrition Status (10030660) Promoting Exercise (10040834) Measure (or Check) Muscle Strength with a Dynamometer	0.96 0.96 1.00 0.96 0.96 0.93
Nursing Diagnosis/Outcome Impaired vision(10022748) Improved vision (10047353) Nursing Intervention Identifying Obstruction to Communication (10009683) Refer to Ophthalmologist Assessing Vision (10050138) Promoting Use of Glasses (10037643)	0.93 0.93 1.00 0.96 0.96 0.96
Nursing Diagnosis/Outcome Fear of Falling Fear of Falling, Reduced Nursing Intervention Advise on Fear of Falling Reassure Patient About Safety Facilitating Ability to Communicate Feelings (10026616) Assessing Fear of Falling	0.89 0.89 0.96 0.96 0.93 0.93
SELF-CARE REQUIREMENTS RELATED TO HEALTH DEVIATIONS
Nursing Diagnosis/Outcome Self-medication Self-medication, Absent Self-medication, Reduced Nursing Intervention Advise on Risk Behavior Warn about the risks of self-medication Obtain Data on Self-Medication Monitor Self-Medication	0.96 0.96 0.96 1.00 1.00 0.96 0.93
Nursing Diagnosis/Outcome Functional Deficit Functional Deficit, Decreased Nursing Intervention Encourage Independence Assess Degree of Disability (or Limitation) Facilitating Activities of Daily Living (10051125) Reinforcing Capabilities (10026436) Assess Need for Corrective Device	0.96 0.96 1.00 0.96 0.96 0.96 0.89
Nursing Diagnosis/Outcome Impaired Walking (10001046) Able to Walk (10002833) Nursing Intervention Assisting with Walking (10038986) Assessing Ability to Walk (10038917) Recommend Use of Appropriate Footwear Monitor Gait (Walk) Investigate Dysmetria	0.96 0.96 0.96 0.96 0.96 0.93 0.89
Nursing Diagnosis/Outcome Chronic, Pain (10000546) No Pain (10029008) Reduced Pain (10027917) Nursing Intervention Evaluating Response to Pain Management (10034053) Implementing Comfort Care (10039705) Assessing Pain (10026119) Teaching About managing Pain (Control) (10019489) Administering Medication (10025444)	0.93 0.93 0.93 0.96 0.96 0.96 0.96 0.89
Nursing Diagnosis/Outcome Fall (10029405) No Fall (10034704) Nursing Intervention Guide the Family on Recording the Date and Time of the Fall Teaching Abou Fall Prevention (10040253) Listen to Older People Self-Report about the Circumstance of the Fall Assessing Knowledge of Fall Prevention (10039780) Post-Fall Evaluation (10037540)	0.89 0.89 1.00 1.00 0.96 0.93 0.89

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Paulo Henrique Fernandes dos Santos, Campus Universitário Darcy Ribeiro, Asa Norte, 70910-900 – Brasília, DF, Brazil, paulofs@unb.br

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ICNP® terminological subset for preventing falls in the elderly in primary care

Subconjunto terminológico CIPE® para la prevención de caídas en ancianos en atención primaria

ABSTRACT

Objective:

Method:

Results:

Conclusion:

ICNP^® terminological subset for preventing falls in the elderly in primary care

Subconjunto terminológico CIPE^® para la prevención de caídas en ancianos en atención primaria