Análise de AtividAdes não reAlizAdAs pelA equipe de enfermAgem pArA o
diAgnóstico pAdrão respirAtório ineficAz em idosos
Original article
The analysis of activities not performed by
the nursing team regarding the diagnosis of
ineffective breathing pattern in the elderly*
Análisis de ActividAdes no reAlizAdAs por el equipo de enfermeríA pArA
el diAgnóstico pAtrón respirAtorio ineficAz en AnciAnos
Agueda maria Ruiz Zimmer cavalcante1, Adélia Yaeko Kyosen nakatani2,
maria márcia bachion3, Telma Ribeiro Garcia4, daniella Pires nunes5, Patrícia Silva nunes6
AbSTRAcT
RESUmo
RESUmEn
The objective of this cross-sectional, descriptive study was to identify the activities
of the Nursing Intervention Classification
considered as priorities for an Ineffective
Breathing Pattern and not performed for elderly inpatients of a teaching hospital in the
state of Goiás. The study participants were
43 nursing professionals, and data collection was performed in the period spanning
October to December 2008, after receiving
approval from the Ethics Committee. It was
observed that among the 67 activities considered to be priorities for the referred diagnosis, only seven were performed by all of
the participants; the other activities, with a
varied frequency, were not performed, with
the main reason cited being that a professional from a different area completed the
activity. It is understood that the fact that
the nursing staff does not perform these activities can cause lack of complete coverage
in nursing care; therefore there is a need for
a legal apparatus to describe the activities
that comprise professional practice exclusive to nursing personnel and those activities that have an interdisciplinary nature.
Estudo transversal, descritivo, que objetivou identificar as atividades da Classificação de Intervenções de Enfermagem
consideradas prioritárias para Padrão Respiratório Ineficaz e não realizadas para pacientes idosos, internados em um hospital
escola do estado de Goiás. Participaram do
estudo 43 profissionais de enfermagem e a
coleta de dados foi realizada no período de
outubro a dezembro de 2008, após aprovação pelo Comitê de Ética. Observou-se que,
dentre as 67 atividades consideradas prioritárias para o referido diagnóstico, sete
eram realizadas por todos os participantes;
as demais, com frequência percentual variada, não eram realizadas, sendo o motivo
principal para isto sua execução por profissional de outra área. Entende-se que a não
realização destas atividades pela enfermagem pode resultar em alterações no campo
de abrangência da assistência de enfermagem; que há necessidade de aparato legal
na descrição das atividades que compõem
a prática profissional exclusiva da enfermagem e a de natureza interdisciplinar.
Estudio transversal, descriptivo, que objetivó identificar las actividades de Clasificación de Intervenciones de Enfermería consideradas prioritarias para Patrón Respiratorio Ineficaz no realizadas para pacientes
ancianos internados en hospital escuela
de Goiás. Participaron 43 profesionales de
enfermería, recolección de datos realizada
entre octubre y diciembre de 2008, previa
aprobación por Comité de Ética. Se observó que de las 67 actividades consideradas
prioritarias para el referido diagnóstico,
siete eran efectuadas por todos los participantes; las demás, con frecuencia porcentual variada, no eren ejecutadas, siendo
que el motivo principal para ello era la ejecución por parte de profesionales de otras
áreas. Se entiende que la no realización de
tales actividades por la enfermería puede
resultar en una alteración del campo abarcado por la atención de enfermería; que
existe necesidad de aparato legal en la descripción de las actividades que componen
la práctica profesional exclusiva de la enfermería y la de naturaleza interdisciplinaria.
dEScRiPToRS
dEScRiToRES
dEScRiPToRES
Aged
Respiratory system
Nursing diagnosis
Nursing care
Classification
Idoso
Sistema respiratório
Diagnóstico de enfermagem
Cuidados de enfermagem
Classificação
Anciano
Sistema respiratorio
Diagnóstico de enfermería
Atención de enfermería
Clasificación
*taken from the thesis “nursing interventions for “ineffective breathing pattern” in elderly patients”, graduate nursing program, universidade federal de goiás,
2009. 1m.sc. in nursing, school of nursing, universidade federal de goiás. ph.d. student, graduate nursing program, escola paulista de enfermagem,
universidade federal de são paulo. nurse, Hospital das clínicas, universidade federal de goiás. goiânia, go, Brazil. enf_agueda@yahoo.com.br 2rn.
ph.d. in nursing. Associate professor, school of nursing, universidade federal de goiás. goiânia, go, Brazil. adeliafen@gmail.com 3rn. ph.d. in nursing.
full professor, school of nursing, universidade federal de goiás. goiânia, go, Brazil. mbachion@fen.ufg.br 4rn.ph.d. in nursing. Adjunct professor
iv, public Health nursing and psychiatry department, graduate nursing program, centro de ciências da saúde, universidade federal da paraíba. João
pessoa, pB, Brazil. telmagarciapb@gmail.com 5rn. ph.d. student in public Health, university of são paulo. são paulo, sp, Brazil. dpiresnunes@yahoo.
com.br 6undergraduate nursing student, universidade federal de goiás. goiânia, go, Brazil. patriciasn_gyn@hotmail.com
The analysis of activities
not performed
português
/ inglês by the nursing team
regarding the diagnosis
of ineffective breathing pattern in the elderly
www.scielo.br/reeusp
Cavalcante AMRZ, Nakatani AYK, Bachion MM, Garcia TR, Nunes DP, Nunes PS
received: 11/26/2010
Approved: 11/06/2011
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2012; 46(3):601-8
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inTRodUcTion
In recent years, studies have been developed that use
classification systems for Nursing practices, observing a
trend towards the use of those systems that reflect clinical
diagnoses, interventions and outcomes(1-4).
In this context, the Nursing Intervention Classification
– NIC stands out, because it comprises broad interventions
of nursing practice, can be associated with the NANDAI taxonomy and including different aspects of practice. It
is applicable in hospital and outpatient practice, in home
care, at primary health care units, in the individual, family
and group context, permitting its use during the full range
of nursing care(5).
professionals’ performance(2). In another study, the same
authors observed that nurses remain unable to prioritize
essential nursing activities, performing actions they can
and should delegate to others(8). This fact is concerning
as, when people present conditions that demand nursing
interventions and these are not performed, this puts the
users’ health at risk.
The population groups nursing attends include elderly
patients. Literature calls attention to the need for health
professionals to prepare themselves to see to this segment’s health needs(4,9-11).
Studies indicate that Ineffective Breathing Pattern is
one of the most prevalent nursing diagnoses among elderly patients in the hospital context(10,12).
The nurses can start these interventions in response
to a nursing diagnosis, or another professional can start
them, after which the nurse and/or nursing team puts
them in practice. Hence, they are defined as interventions
that are independent, interdependent and
dependent on other professionals(6).
Among the main activities nursing performs concerning elderly patients with breathing problems, the following stand out: assessment of breathing depth, pattern and
sounds, skin color, cough and pulmonary secretion reflexes;
pulmonary flow monitoring and measurement, assessing the quantity of air that is
inspired and expired, and the effectiveness
In the health work process, it is recom- nursing interventions of bronchodilators and nebulizers used. It is
mendable for professionals to work interde- for elderly patients with highlighted that patient education and orienpendently and complementarily, permitting ineffective Breathing tation represent important nursing care(13).
activity adjustments that will improve the pattern are relevant
One study(14) observed that patients with
clinical conditions of the clients under their for the problem-solving
breathing alterations always present Ineffeccare. Thus, the activities the nurses prescribe
ability of nursing
tive Breathing Pattern and considered that
should be significant for the established theractivities, so as to
this diagnosis precedes the development of
apy and benefit who receives them(7).
avoid the emergence overlapping diagnoses due to clinical worsIt is important for nurses to accurately of other diagnoses and ening. In elderly patients, the presence of
identify the clinical signs that will guide the minimize the number this diagnosis becomes more concerning,
choice of NIC interventions in advance, which
as total organic functioning capacity in this
of hospitalizations,
can be selected based on the specificity level
population decreases. Nursing interventions
criterion(3). That is, in view of a nursing diag- frequently observed in for elderly patients with Ineffective Breathing
this age range.
nosis, three different intervention groups can
Pattern are relevant for the problem-solving
be selected; essential or priority interventions
ability of nursing activities, so as to avoid the
for the modification and/or minimization of
emergence of other diagnoses and minimize
the human response (interventions in line with the defining the number of hospitalizations, frequently observed in this
characteristics and related factors); suggested interventions age range. It is believed that the identification of this diag(necessary, but less relevant for the identified diagnosis); and nosis in this population, as well as the implementation of
additional or optional (applied to specific patients only)(5).
interventions that modify this response, can avoid the need
In a study that identified that interventions nurses to use health services that comprise greater complexity levpracticed at a Pediatric Intensive Care Center (PICC) for els, which can solve problems even at the primary care level.
the nursing diagnosis “Ineffective airway clearance related
to the presence of an artificial airway”, it was considered
that the activities performed for the interventions the
NIC proposes are applicable and picture what the nursing
team has practiced(1).
In practice, however, it is observed that the nursing
team does not practice many of these activities. A study
developed at a hospitalization unit to identify the interventions nurses practiced revealed that direct care is sporadically performed and characterizes more complex procedures, as most actions these professionals develop are
related to bureaucratic activities or necessary for other
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It is in this context that the interest in studying priority NIC activities for this nursing diagnosis emerged. In a
study, those activities were identified which nursing professionals identified as NIC priorities for this diagnosis in
the hospital context, which permitted knowledge about
the reach and range of the actions and responsibilities
Nursing develops in this context. It was perceived in that
research that nursing indicates activities it finds important, but which are not performed(15).
Thus, we justify this study, which focuses on the activities the nursing team does not perform for the nursing
diagnosis Ineffective Breathing Pattern in care for the elThe analysis of activities not performed by the nursing team
regarding the diagnosis of ineffective breathing pattern in the elderly
Cavalcante AMRZ, Nakatani AYK, Bachion MM, Garcia TR, Nunes DP, Nunes PS
derly. Knowing what actions are absent from nursing practice in care delivery to this diagnosis in elderly patients
can contribute to reflect on clinical nursing practice in elderly care, and on the quality and problem-solving ability
of care delivery.
objEcTivE
To identify priority NIC activities for the nursing diagnosis Ineffective Breathing Pattern the nursing team does
not perform in care delivery to elderly patients and to analyze the reasons for their non-accomplishment.
mETHod
A descriptive study was developed at the Medical Clinic of a large teaching hospital in the State of Goiás. The
sample comprised nursing professionals who worked at
the sector. Inclusion was based on having worked at the
Medical Clinic for more than six months. This period was
determined because it is considered the minimum period
for professionals to experience care at the sector for elderly people with the diagnosis of interest to the study.
After clarifications about the research, the professionals
were invited to participate through the signing of the informed consent term. The study received approval (Protocol No. 007/09) from the Institutional Review Board of
the Hospital das Clínicas at Universidade Federal de Goiás.
Data collection took place between October and December 2008 through the application of a checklist questionnaire. All activities that corresponded to priority interventions for Ineffective Breathing Pattern – Asthma
Control, Breathing Monitoring and Airway Control – were
listed. The participant answered whether the activity was
accomplished or not in care delivery to elderly patients
with the diagnosis under analysis and, when proper, justified the reason for its non-accomplishment, marking one
of the alternatives: activity performed by another profes-
sional, the service does not have means for its accomplishment and I don’t know what this is about.
At the time, the nursing team at the Medical Clinic of
the study hospital consisted of 55 professionals. One professional in this group had been working at the sector for
less than six months, and ten were not contacted during
three consecutive visits because they were on holiday, on
leave or had repeatedly switched shifts. Thus, out of 44
invited professionals, 43 accepted (78.18% of the population), with seven nurses and 36 nursing technicians.
The collected data were inserted in Statistical Package
for the Social Sciences for Windows®, version 16.0, and
analyzed according to simple and percentage frequencies.
RESUlTS
The female gender predominated, with the group between 31 and 40 years as the most frequent age range and
finished secondary education as the main education level,
which is a minimum requirement for nursing technicians. It
is highlighted though, that part of them were taking a higher
education program or had already obtained an undergraduate degree and were even taking a specialization program.
All participants reported experience in adult and elderly care
delivery, including respiratory problems. Most (58.2%) of
these professionals had been working in the sector for more
than one year and 25.6% for more than 10 years.
As for the 67 activities present in the NIC priority interventions for Ineffective Breathing Pattern, which the participants analyzed, all of them indicated that seven of these
were performed. These correspond to activities that are
commonly present in medical prescriptions, such as bronchodilating medication administration, aerosol treatment,
oxygen therapy and positioning, i.e. dependent or basic activities, which both technicians and nurses perform.
The participants also agree that ten activities are not
performed, as displayed in Table 1.
Table 1 – Activities the nursing team does not perform, with 100% frequency, and distribution according to reason for non-performance - Goiânia, 2009
Activities not performed
Reasons for non-performance
Reason 1
Reason 2
Reason 3
4.Obtain spirometry measures (FEV1*, FVC*, FEV1/FVC ratio) before and
after the use of short-acting bronchodilators.
9.3%
76.7%
14.0%
5. Monitor peak expiratory flow (PEF), if adequate.
6. Educate patient about use of peak expiratory flow meter at home.
30. Insert artificial airway into oro/nasopharynx, as adequate.
31. Perform thorax physiotherapy, as adequate.
35. Help with incentive spirometer, as appropriate.
40. Administer treatment using an ultrasonic nebulizer.
42. Remove foreign bodies with McGill Forceps when adequate.
54. Monitor pulmonary function test results, particularly vital capacity, maximum inspiratory
volume, forced expiratory volume in one second, forced expiratory volume/forced vital capacity,
as available.
67. Prescribe and/or renew asthma medication.
7.0%
9.3%
---39.5%
14.0%
7.0%
67.4%
65.1%
100.0%
100.0%
79.0%
21.0%
67.4%
83.7%
25.6%
25.6%
--21.0%
39.5%
18.6%
9.3%
--
100.0%
--
* fev1 (forced expiratory volume in one second); * fvc (forced vital capacity).
reason 1- the service does not have the resources needed for its accomplishment.
reason 2 – Activity performed by another professional.
reason 3 - i do not know what this activity is about.
The analysis of activities not performed by the nursing team
regarding the diagnosis of ineffective breathing pattern in the elderly
Cavalcante AMRZ, Nakatani AYK, Bachion MM, Garcia TR, Nunes DP, Nunes PS
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It is observed that they considered the fact that another professional performed this activity as the main
reasons for non-performance of these activities, except
for activity 40 “Administer treatment using an ultrasonic
nebulizer”, justified by the non-availability of material for
its accomplishment in the sector (39.5%) or by not knowing what this activity was about (39.5%).
Non-performance frequencies for the other fifty activities under analysis varied. Due to the large number of activities, only those scoring ≥ 60% were presented.
Activities were divided by professional category to
identify professionals’ activities and the reasons for nonperformance.
Figure 1 – Distribution of activities the nursing technicians did not perform, with frequencies ≥ 60%, according to the reason for non-accomplishment - Goiânia, 2009
The predominant reason for the nursing technician’s
non-performance of these activities was their practice by
another professional.
Among the activities the nurses did not perform, nonperformance frequencies for six were ≥ 60%.
Figure 2 - Distribution of activities the nurses did not perform, with frequencies ≥ 60%, according to the reason for non-accomplishment - Goiânia, 2009
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The analysis of activities not performed by the nursing team
regarding the diagnosis of ineffective breathing pattern in the elderly
Cavalcante AMRZ, Nakatani AYK, Bachion MM, Garcia TR, Nunes DP, Nunes PS
The predominant reasons for non-performance were
performance by other professionals and non-availability
of resources at the service/institution.
diScUSSion
Professionals should thoroughly study and improve
nursing interventions, working not only towards empowerment, but mainly to improve individual health.
In the elderly population, the situation is urgent, in
view of high rehospitalization levels within a period of up
to one year, which may be related with weak health conditions and with the problem-solving ability of the previously received care(9).
The NIC considers the activities under analysis as priorities. They are necessary and fundamental for people with
the diagnosis focused on. Thus, out of 67 NIC priority activities for Ineffective Breathing Pattern, the nursing technicians indicated that 16 were not performed, with frequency
levels ≥ 60%, while the nurses indicated 06 with the same
frequency levels. Both professional categories agreed that
10 activities were not performed in 100% of cases.
Most of these activities nursing did not perform were
indicated as actions another professional category performs. Some of the NIC activities describe actions uncommon to nursing practice in the study context, as evidenced
in participants’ reports, who are unfamiliar with activities
related to the use of spirometers and other equipment
(activities 4, 5, 6, 35, 40, 42 and 54).
Some of these activities refer to the accomplishment
of the respiratory function measure test. This activity is
important as, in elderly people, most pulmonary functional capacity levels have dropped. This fact can also be
observed in individuals who smoked or are smokers. Thus,
it is observed that pulmonary volumes vary according to
gender, age, accomplishment of physical exercise or not,
posture and weight. Therefore, knowledge about and early identification of pulmonary volumes and capacities can
prevent, diagnose and/or quantify pulmonary/ventilatory
problems and disorders, contributing to change habits
and select interventions to benefit these individuals(16).
Activities 30 and 67 refer to orotracheal intubation and
the prescription or renewal of asthma medication, respectively. In the Brazilian nursing context, legally, these are
exclusive medical activities, except in cases established by
law, like some public health problems or institutional protocols. Only the medical team performs these activities in
the study scenario, as expected. On the other hand, orotracheal intubation is not common in elderly patients with the
study diagnosis at the hospital sector under analysis.
The NIC activity Perform thorax physiotherapy, as
appropriate does not refer to specific physiotherapy activities, as various activities that enhance adequate ventilation, through special techniques, can be considered
The analysis of activities not performed by the nursing team
regarding the diagnosis of ineffective breathing pattern in the elderly
Cavalcante AMRZ, Nakatani AYK, Bachion MM, Garcia TR, Nunes DP, Nunes PS
as respiratory physiotherapy, including: position changes
to mobilize secretion, airway clearance, aspiration and
nebulization.
NIC includes a specific intervention called Respiratory
physiotherapy, defined as: help to the patient to move secretions from the peripheral to the more central airways
with a view to expectoration and/or aspiration(5). This
intervention refers to broader activities that, when described, are recognized in nursing practice. This fact is better perceived when analyzing activity 55 in Figures 1 and
2 start respiratory physiotherapy treatments (e.g. nebulization, if necessary). This reveals the need to adapt the
names of some activities in this classification with a view
to better use and understanding in Brazilian nursing.
In the work routine, the nursing team performs some
of these activities, as these are acknowledged as part of
nursing work and have been accomplished in the history
of the profession, like in the case of percussion. A study
emphasizes the need for nurses’ direct action in care delivery to patients with respiratory problems and who need
physiotherapy, spirometry, among other types of care(1). In
elderly patients, this need is maximized as, during pathological processes, individuals present related factors and
typical defining characteristics that compromise health
more, deriving from the organism’s association in response to biological aging and senility(13). Therefore, nursing should prescribe and perform the respiratory exercises
the NIC describes as respiratory physiotherapy with elderly patients, constantly assessing the improvements
produced.
It is important to take into account care comprehensiveness, observing individuals as holistic beings with
multiple needs. Articulation with the patient’s singularity
shows to be fundamental in nursing care practice though.
Nurses increasingly need to put in practice and diversify direct actions oriented towards individuals’ observed
needs and which act as human response modifiers(3,17).
In Figure 1, it is observed that activities 18, 19, 21, 49,
50, 51, 53 and 62 are part of the physical examination.
Each of these activities is useful to identify complications
and/or new problems, permitting the implementation of
new nursing activities or interventions. These activities demand professionals with comprehensive knowledge about
inspection, palpation, percussion and auscultation techniques, which permit decision making when performed
correctly and associated with clinical knowledge(18).
Accompanied by the necessary skills, these activities
will contribute not only to the identification of relevant
clinical information, but also to the implementation of
nursing interventions and the identification of probable
causes, besides permitting stronger bonds between professionals and patients, enhancing credibility and trust
between nurses and patients and also permitting comparisons among patients’ clinical repercussions in view of
the disease(18). In that sense, nursing technicians are not
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expected to perform these activities, which need theoretical and practical knowledge, based on scientific foundation, specifically aiming to achieve safer activities in the
elaboration of patient care plans.
Most nursing technicians answered that another professional category performs that activitiy. The non-performance percentages for these procedures are as expected,
as these procedures are not part of these professionals’
competences and attributions.
The main physiological pulmonary function alterations aging entails are: impairment of gaseous exchange
efficiency, decreased pulmonary compliance and reduced
respiratory muscle strength, decreased oxygen transporation to tissues, accompanied by a reduced cardiac debit,
body muscle mass, alveolar volume and ventilation/perfusion ratio(19). Therefore, nurses are responsible for recognizing these changes during the physical examination and
selecting interventions to improve respiratory conditions
within the limits expected for this age.
In Figure 2, it is observed that frequency levels for activities 50 and 62 were also ≥ 60%. According to the nurses, the predominant reason for this was the unavailability
of resources needed for their performance. For those participants who indicated non-performance, the justification was lack of time, high levels of patient demands at
the institution in comparison with the small number of
available staff members, who limit themselves to fundamental activities to guarantee the service’s continuity.
A study developed at a teaching hospital to identify
prevalent nursing diagnoses in elderly patients and compare them with hospitalization time evidenced the presence of Ineffective Breathing Pattern as the fourth most
cited among sixty two identified diagnoses. For this diagnosis, the predominant prescription was to watch over
the breathing pattern(20).
Watching over means constant monitoring and observation of the patient’s health condition, and can happen
on the occasion of the physical examination. The NIC prioritizes similar activities for this diagnosis. It is observed
that activities number 63 (Monitor thorax x-ray reports)
and 58 (Observe changes in SaO2 and SvO2, in expired CO2
and in arterial gasometry levels as appropriate)(5) were associated with performance by another professional category in the nursing technicians’ answers. Both categories
mentioned the first activity, while only the technicians
mentioned the second.
Observations of changes in arterial gases can be accompanied by clinical alterations in the breathing patterns as well as systemic alterations, such as decreased
consciousness level caused by excess CO2, frequently observed in this age group(10,13,21).
Nurses generally perform these activities, which are
uncommon in nursing technicians’ education. In this
study, it was noticed that the nurses monitor the results
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of the patients’ laboratory tests, observing improvements
and worsening during the hospitalization process.
Authors emphasize the importance of recognizing interventions that reveal better results for a given problem, as
well as interventions that are usually performed in this professional’s activity areas or specialties. The possibility of identifying these nursing interventions allows them to modify the
human response when they are put in practice(22).
In that sense, activity 22, observed in Figures 1 and 2,
is considered necessary for elderly patients with breathing problems. Aging reduces effectiveness in the removal
of residues and in airway humidification, thus contributing to the accumulation of secretion and decreased efficient ventilatory capacity. Hydration enhances the fluidification of secretions, contributing towards mobilization
and expectoration(21).
The professional categories manifested different reasons for not performing this activity. According to some
professionals, a category directly involved in nutrition
should perform this activity. At the study sector, the presence of professionals with nutritional assessment and
prescription skills for hospitalized patients is uncommon.
Concerning activity number 15, most reported that,
frequently, either the physician or Medical, Nursing, Nutrition and Psychology students performed this under the
teacher’s supervision. This fact should arouse nurses’ concern, as this is an important activity to put in practice care
in the development of the data collection, nursing diagnosis, care planning and implementation phases. This can reflect the absence of nursing care organization that is more
directed at each patient’s singularities, based on the Nursing process and in accordance with the law that regulates
professional practice. Based on the non-performance of
these activities, it is inferred that other actions, also important to modify the patient’s health condition, are not
performed either.
A study developed to identify the activities nurses
developed at a hospital institution considered that many
professionals have practiced actions based on the routine
established at the sector, disclosing little effort to innovate and/or improve their work(8).
The health actions put in practice during hospitalization should consider comprehensive elderly care, including curative and health promotion actions. Besides, the
reality the person lives in should be taken into account,
thus providing for care planning in accordance with his/
her needs, so that, after discharge, the elderly adopt
healthy measures learned during the hospitalization process and avoid rehospitalizations(11).
It is considered that the important activities nurses
perform include the assessment of the person’s health
and the implementation of interventions needed to
change the clinical situation. In general, many activities
are developed in partnership with other professional
The analysis of activities not performed by the nursing team
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Cavalcante AMRZ, Nakatani AYK, Bachion MM, Garcia TR, Nunes DP, Nunes PS
categories and reflect the complementariness and interdependence of different agents active in care delivery(7).
Absence from the performance of certain activities
distances the nursing team, including the nurse, from relevant and useful information to monitor and change nursing care planning, with a view to achieving results(8).
Another negative aspect observed refers to this professional’s distancing from discussions and clinical decision making together with other professionals, which
would contribute to gain visibility and noteworthiness in
the interprofessional team.
conclUSion
As a part of NIC priority activities for the diagnosis
Ineffective Breathing Pattern in elderly people, it is considered that nurses’ non-performance of certain activities
can result in important gaps in the problem-solving ability
of nursing care, as well as non-performance by other nursing team members, as it is the nurse who prescribes what
care the individual needs.
In all activity groups that were not performed, the performance of these actions by other professionals was the
predominant reason for not doing them. In the context,
however, imprecisions are perceived among participants
as to what activities other professionals legally can and
should practice. Hence, the need for legal support is highlighted in the description of nursing practice activities,
in view of the relevant need to describe them and better define nursing team members’ work, thus delimiting
the actions they perform. Also, the need emerges to assess, among priority nursing interventions for Ineffective
Breathing Pattern, which activities are truly fundamental
for care delivery to elderly patients with this diagnosis.
Interdisciplinarity should be taken into account, as
well as bonding with other professionals, which can contribute to the treatment patients receive and enhance
nurses’ credibility among professionals and patients with
regard to care prescription.
The activities nursing does not perform for elderly patients with Ineffective Breathing Pattern permit the emergence of other diagnoses that aggravate the patient’s
clinical condition, extend hospitalization and minimize the
patient’s health.
From another perspective, not using some actions
permits the strengthening of other professionals’ clinical
activities in areas Nursing has historically occupied, which
can entail changes in the range of nursing care. In the future, this can lead to changes in the scope of the profession’s domain.
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cep 02401-400 – são paulo, sp, Brazil