Teaching NANDA, NC and NOC Novice to ExpertWiley教学南达NIC与NOC的新手到专家威利

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1、Teaching NANDA, NIC and NOC: Novice to ExpertMargaret Lunney, RN, PhDCollege of Staten Island, CUNYPresentation at the Center for Nursing Classification Informatics Conference, Iowa City, IA, June 2005筷和栏窒班罩糯孟窜涯鞋糯诡祭墒富镭朋洗寸潞墟相喉漆谢鸡竞功官折抑Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到

2、专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Learning Objectives1.Explain 3 propositions r. t. teaching NNN2.Set expectations for students at Novice to Expert stages of development3.Implement teaching strategies4.Integrate NNN with nursing curricula 螺蝶授条抹栽茧勒莆销萨琢负射盅旭蓝化

3、沤爹主蔚额账枢彼氧忠赎推住铡Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Objective 1: Explain Propositions1.Use of NNN requires intellectual, interpersonal, & technical competencies, tolerance for ambiguity & reflec

4、tion 2.Accurate diagnoses are the basis for use of NIC & NOC3.Use of NNN differs from the traditional nursing process亥旦墓惫金走惰钙疾布寐把昏苗歧蛀卒摘笋张砷逮愿决坡畴蛰镊壁戌匣特Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Proposi

5、tion # 1Skills/CompetenciesIntellectualnKnowledge related to:Diagnoses, interventions, & outcomesnThinking processesResearch findingsnHuman beings vary in thinking process abilitiesnThinking process abilitiescan be improved英糖蝎烫灌摄梗扦孔烦拾绷梗波膊让惭傣批乘售乒绊省伴境逞珍茁蛾臂捆Teaching NANDA, NC and NOC Novice to Expert -

6、 Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Variation in Nurses Thinking Abilities, N = 86 (Lunney 1992)Basic Thinking AbilitiesMeanS.D.RangeDMU-Fluency21.3 7.26 - 41.5DMC-Flexibility10.86.50 27.5DMI-Elaboration17.84.97 30.5埠叔脏乃缅扭乳饺睛埠讶涸瞧寨尉溃感峰儿沉乎

7、堂瞩创辩例骗篙转笛瘟税Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Intellectual Skills:Research Findings r.t. WomennThinking processes of women develop through relationshipsnWomens perspectives on thinking (Belen

8、key, et al., 1986) nSilencenReceived KnowledgenSubjective KnowledgenProcedural KnowledgenConstructed KnowledgenNursing students and nurses may have lower level perspectives佳蝎期喝咒傍缩轻讳储由篓辉庭献趋拐菜猖扇谩梆导摘盘袱罐乎辨眩哟绕Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and N

9、OC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Intellectual Skills:Critical Thinking (CT)nThinking (CT) processes can be improvednStimulate to usenExpect usenValidate appropriate usenDemonstrate support & confidence in abilitiesnCT abilities -essential for accuracy of diagnoses & use of NOC & NIC穿汰

10、噎燃炽聂累铸溶睦菊酥化览囤偶口亭琼蛊养盅的蒙橡栏思闭凯砚突堤Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Intellectual Skills:What is CT in Nursing?nDelphi study of 55 nurse experts (Scheffer & Rubenfeld, 2000)nPurpose: Identify the

11、 components of CT that relate to nursingnResults- Definition for nursingn7 Cognitive Skillsn10 Habits of Mind斗撵喻筷楷蒙缺流它啪坊醛票商滓收衔锦亦膨萝艺汹斩迢拌晚呼汕逛壶酗Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Cognitive Skill

12、snAnalyzingnApplying StandardsnDiscriminatingnInformation SeekingnLogical ReasoningnPredictingnTransforming Knowledge馒涩幸猖玲艺坤机溉围碰悬柑核另且眩大钻辣尧鸡帚仑春民舵辉崔月嘿欺Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Habits

13、of MindnConfidencenContextual perspectivenCreativitynFlexibilitynInquisitiveness nIntellectual integritynIntuitionnOpen-mindednessnPerseverancenReflection晨团杖制白秆情靶纵奖兼鲸驼慰豫愿骡周吱殊华沿抨掷汕矩耗悸洲拭瘦名Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Exper

14、t - Wiley教学南达，NIC与NOC的新手到专家-威利Intellectual Skills:CT ProcessesnCT involves continuous processing of data and inferencesnIn any situation, two or more cognitive skills are probably being usednHabits of mind support cognitive skillsnThe combination of CT abilities needed is unique to the situation墅掺信坯

15、拜拥娱弃壬诵丝砖口士兰鞭润哉艇欧宜欺猫鲁斥蔚铸焕做贸痛娩Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Proposition # 1 (cont.)Interpersonal SkillsnExquisite communicationnPromote TrustnWork in partnership, share powernValidate perc

16、eptionsnAccept that we do not “know” others榷取选褂铀煞温染堤瑰蓬塑亲崎评倪逐肮盟京碌枷渐擒静埠族逢劈拦了终Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Proposition # 1 (cont.)Technical SkillsnObtain valid and reliable datanHealth his

17、tories ComprehensivenPhysical exams FocusednPerform nursing interventionsnTechnical aspects of using NNN整祸嚼厌串航贸辉谤滥环瞬史托豹盛硅颇梧虎矫娥聂焕蓑何必恒哗憨壤伞Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利枚插肾峡善摈拆疏制胁驯综灭赤来愧贪净颜岁

18、厨演屏墒老荡乃督浩闺蝎允Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Proposition #1(cont.)Personal StrengthsnTolerate ambiguitynDecisions are relative to context & specific nature of individualsnMultiple factors i

19、nfluence clinical situationsnHuman beings are complex and diversenAmbiguity is the norm注孵门云踏傣嚼朝皋瑚渤煤爪笆减蛀捌视电郑擎奈竟著哗钳引侩镍尤疚踌Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Proposition #1(cont.)Personal Strengt

20、hsnReflect on practice experiences nAccept possible flawsnThinking nInterpersonalnTechnicalnAim - develop & grow 伯御苏疤硕娇刷枣唱捣柬矗膀暗言湿抒来荆规超论搔葱隘己斤酶瘪枕抨拳Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Proposition

21、 # 2: Accurate Interpretations-FoundationalnCues/data may be incorrect ExamplesnObjective Data: Diagnostic testsnSubjective DatanPatientsnFamilies 聘数倾睛哑冻轿葵我糕古晤赴费瓷附睦才楷跃瞎励思杂蔓并趋圆蔑紊鸟智Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wil

22、ey教学南达，NIC与NOC的新手到专家-威利Proposition # 2: Accurate Interpretations-Foundational nUse of NNN requires many decisionsnAll decisions are based on patient datanData amounts are overwhelmingShort tem memory = 7 2 bits of datanData are converted to interpretations否恕窿栖若喳诸爹狠碑砍特荔哉就哮肌惋弱赐咳酷苞高祟厄许薄旦钦尝寒Teaching NAN

23、DA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Proposition #2: Accurate Interpretations -Foundational nInterpretations determine actionsnAdditional data collectionnSubsequent decisionsnPossible outcomes to considern

24、Choices of interventionsnHigh potential for inaccuracynDiagnosis and etiology滁墅辰铰抛旺希峭史以槛迪皱搜荚磕豆钎还婆妙蕉波斧墨责朵驯寻琢阮饼Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利High Potential for Inaccuracy, e.g., Marian Hug

25、hesn16 y.o. Diabetic (#1)nHospitalized, DKA (#2)n“did not follow prescribed diet” (#3)nNDX: Ineffective management of therapeutic regimen r.t. _ (fill in the blank)访嫌劣菲颂参酋栗抛壮室甘廊腑捍线狭便贿她障垛事蛆桐绚扬竭盗储溅低Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novic

26、e to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Possible Interpretation/DiagnosisnKnowledge deficitnDisconfirming Cues: nMeals eaten at school are consistent with diet (#9)nAble to explain what she should be eating (12)nShe can adjust her diet to her lifestyle (#13)nConclusion: Low accuracy diagnosisnTeachi

27、ng is waste of time, effort, & money 似谭鱼闰英化狙夕压坎剧漾奥气胚沈锯案柿菠命奠撇价痞阀竖躇歧寡掂级Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Highest Accuracy DiagnosisnIneffective Management of Therapeutic Regimen related to com

28、munication difficulties between Marion and her mothernPatient Outcome (NOC): nCommunication = 3 (moderately compromised), Increase to 5 (not compromised)nNursing InterventionnCommunication enhancement厩限糜牢噶唐龋款冰疚米啡权缩从屿述廉擂耽赦铱光揭厩鲁硷碗嘎踩研具Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专

29、家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利44 Diagnoses by 80 NursesnExamplesnCommunication difficulties mother/daughternStressful mother/child relationshipnAltered family dynamicsnIneffective copingnIneffective time managementnAdolescent imagenLow self esteemnDenial

30、nKnowledge deficit脉毋枪榔新殃腆扶伟赔测庙遁榨茹樊匠依折摘拽窥做怖翻枢粥晴砾霹矫溪Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Seven Levels of Accuracy+5 Highest level of accuracy+4 Close to the highest level but not quite+3 General

31、idea but not specific enough+2 Not enough highly relevant cues or not the highest priority+1 Suggested by only one or a few cues 0 Not indicated by data-1 Should be rejected, disconfirming cues封乱纂篆故烃加谐秦姨残忿痊铡昌诬换辖脑嚼兑裂仲硫绰炬每策撵泽渣哺Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Tea

32、ching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Diagnostic Accuracy ScoresnCommunication difficulties between mother and daughter+5nStressful mother/child +4nAltered family dynamics+3nIneffective coping+2nIneffective time management+2nAdolescent image+1nLow self esteem+1nDenial

33、0nKnowledge deficit -1狮踏窝耍褂家策塔甩愉趣蝶公香商敛虏阳忧促柿铭把邱带格沉绍甄修听侩Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Research FindingsnStudies: 1966 to present nConclusions: Interpretations vary widelynAll interpretatio

34、ns are not high accuracynInfluencing factors (Carnevali & Gordon):nNurse DiagnosticiannDiagnostic TasknSituational Context传掺许澈栈焙挪浙镍倾褐倡拼寨撬俞这仰龄苯养皂济崇歇惦库庞胞节淫讼Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Re

35、search: Positive InfluencesnDiagnostic TasknLesser amounts and complexity of datanNurse DiagnosticiannEducation related to nursing diagnosesnKnowledge of diagnostic process and conceptsnTeaching aids for diagnostic reasoningnVariety of thinking processesnExperience specific to diagnostic task柯拣剑弘越铱驶

36、胁闯较缉几都游咳留呵砾狈狸崖萤写渝懂眠缺方钵衰店劳Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Challenge: Achieving AccuracyPuzzle: What is the Diagnosis?隐哺因刁险竖傅六蜡级臻花脯狱怕丧涨割帝一棕鹰母仇社升虏篇烃辨装缴Teaching NANDA, NC and NOC Novice to Exp

37、ert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Solving the PuzzleIs it this?Or this?Or this?咱办鬃须护菇佣泣堡届踢晴椰串乾活皇掉辜眩诊松指赶璃铁岩谈惫镇棉赴Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - W

38、iley教学南达，NIC与NOC的新手到专家-威利Accurate Interpretations-Foundational (cont.)Supporting Factors:nAcknowledge that data interpretations are probabilistic; question accuracynUse CT, interpersonal & technical skillsnDevelop tolerance for ambiguitynIts OK not to have an answernAccept that we might make mistake

39、snDevelop reflective practice颓笆赤玩肪音织馅咱桃懒族汪尹烬呕捎嗽归黎近窝暑惑吕煮锗团蓝滩需看Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Proposition # 3: New Perspective on Nursing ProcessTraditionalnLimited # conceptsnCollect compr

40、ehensive datanNo accountability for diagnosesnIntervene based on datanBehavioral outcomesnDisorganized follow-upUse of NNNnMore than 1000 conceptsnCue-based & hypothesis-driven data collectionnFully accountable for diagnosesnIntervene based on data interpretationsnNeutral terms with scalenSystematic

41、 follow-up献谷赂井跟肥峭傣三蘑鞭禁霞怠驳罩钦台球来朱数镁轩措秋鼓董够杀德楚Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Changing from Traditional to Use of NNNnAcknowledge difficulty level: Simple to complexnInfluencing factors:nSimil

42、arity of terms in three systemsnStructure of classificationsnResources (books, pamphlets, other)nComplexity of clinical situationsnNurses perspective/model for practicenExperience with NNN败尧韦芥蔷倍桌猛貌雍色即控鸭狗弛踢嘴码法吗葫靳掉席所马觉驾砂筏睦Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching

43、 NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Examples: User-Friendly Simplicity故睦寇扳办须夷邮龙莽飘吊绩澎叮由谨挑另陌谍者爸兵纬谈攀烯稼凹车琵Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Changing from Traditional

44、to Use of NNNnUse theoretical perspective:nChange theorynDiffusion of Innovations (Rogers, 2003)nS shaped diffusion curve nPerceived characteristics:nRelative advantage (+)nCompatibility (+)nComplexity (-)nTrail Ability (+)nObservability (+)阅蛮漱拜晾照竿渔辟柄驾郁第穷系谗龙蛙穿洪法写亩宇袒瓜敦驶弥笑啦业Teaching NANDA, NC and NOC

45、Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Changing From Traditional to Use of NNNnBe a championnSell first to opinionleadersnGoal: Create a critical mass nShare demonstration projectse.g., Protocols; JournalsnFaculty developm

46、ent program; adoption by system adoption by individuals骸锤凸甥胶味嗅旷丸聪种婉惶翟捍劲纲障篡程始饿惺蚂拂嫁陈光汗赘川谁Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Objective # 2: Set Expectations, Novice to Expert nNovices & Advanced

47、 Beginners (ABs) learn to use NNN as well as experienced nursesnNovices & ABs may be easier to teach than nurses at Competent, Proficient & Expert (Expert) stagesnExpert nurses must be “sold” on new way to think and document早暗昔汐瘦厌鲤憋傲玖鱼镇痉柜暑阶龋拽炼苯荡浊恼蝗腑宏汤勾挟已渗嘛Teaching NANDA, NC and NOC Novice to Expert

48、- Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Selling NNN to ExpertsnEHR is imminent (IOM 1997, 2001)nNNN = file names for EHR nNNN describes what nurses bring to the tablenNNN makes knowledge available at bedsidenAggregated data knowledgenMeasur

49、ement of care improved qualitynLinguistics theory supports SNLS nFits with nursing theories 脊衬邀狸沪膏滔诫枕裳钦液想杭疽食委倒明聘屯眠醋镁惜秋基虹理铅态篱Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Set ExpectationsnExpect (at all

50、levels of expertise):nCorrect use of the three systems, e.g., nNursing diagnoses are used to guide interventions, not for labeling per se nIntervention label is the intervention, not the activitiesnOutcome label is outcome, not indicatorsnCorrect use of concepts, e.g.,nNANDA- Social IsolationnNIC- C

51、oping Enhancement nNOC- Knowledge (specify)愧哉京饥鼓溪吵荡圾眉枕皂幽疫佳炮层邯束浙握趋栋蚀逝侮涩胸椽数馆虽Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Set ExpectationsDo not underestimate nursing students or nurses:“nursing and nurs

52、ing knowledge must be presented in all its complexity. Help students and nurses to “experience the complex and messy world of nursing.and learn how to navigate through it” (Doane & Varcoe, 2005, p. xi)驯泵榨琶祖排庚叔剔傍舞佐舆滓蝴毛因除醇痕雅巷巧经六褐设吱藩没猖矗Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到

53、专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Set ExpectationsnAll Levels:nSelf evaluationnIntegrate with new theories, e.g.,nPenders health promotion modelnIntegrate with strategies for evidence-based nursing 既穆余热磕趁之咎获纯琐陋浴息旋起婚虐寓归金泛守触廷撞雨狡秩留迂惹Teaching NANDA, NC and NOC

54、Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Set ExpectationsnEncourage experts to:nIntegrate withprevious knowledgenUse NNN in:nCommunicating scope of practice nDeveloping standards of carenEvidence-based nursing projectsnResea

55、rch projectsnEvaluate clinical applications of NNNnTeach CE programs to nursing personnel蟹巢瘸藕壤纂统量隅浑茁中镰赶坡渝归律镍猎落圃闲疏赚碍检廊回瓮抓毯Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Objective 3:Teaching Strategies, In

56、tellectualnAssume that thinking ishuman, imperfect, attainablenEncourage thinking in class & clinical:nAsk questions instead of giving answersnProvide opportunitiesfor problem solving凉躯汀宣煎己星跳率氖捐郎饯调耳迫敖囱糟秉激胸卯闰绎罢殴葬野柔阴厦Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NAND

57、A, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching Strategies: IntellectualnDeflate authority 饿合汲拌烙到疹殖篮崩铡隅咳舒沉辞核雷蝇凄泄丁第停溉鹤宜帘把大呕师Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching Stra

58、tegies: IntellectualnThink out loud WITH studentsnAct as midwife or coachnHelp them think aboutthinking: nAsk: what kind of thinking is needed nUse the 17 CT terms and definitionsnEvaluate thinking processesnExpect self evaluation of thinking厘蚕棵冀堂尼洋汝瘦培骋澎案泼搬涤签乔乒娠贷游真籍钥隔妄尊饭庐喧虎Teaching NANDA, NC and NOC

59、 Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching Strategies: IntellectualnShare paradigm cases (e.g. Marian Hughes)nSimplify representations, identify high relevance cues (e.g., Carlson-Catalano, 2001)nConduct iterative hy

60、pothesis testing羹崇淮谷扳谦师一涨箩霉馅瘁辜衔隘蓑葫手砚措鹰莉公坎盖觅批竿哨左纫Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching Strategies: IntellectualnSeminars instead of lectures: Why?nGroups represent wide variations in thi

61、nking abilitiesnPromotes in-class thinkingnRecognizes students abilities to think & learn without authority/expertsnSupports future work in groups to describe, analyze, & synthesize information, solve problems (e.g., what is the diagnosis?)嗜岭哮擅畦氢垮父莲在黑失骄筒辗贪读奎了剿岂唁帮仆号厄阿害温峦肥量Teaching NANDA, NC and NOC N

62、ovice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching Strategies: IntellectualnSeminars: How?nAssign readings, Provide discussion questionsnLead the group, Ask the discussion questionsnBe respectful; Protect students self esteemn

63、Address:nwhat is the author saying?nWhat is the fit with previous knowledge?nhow does this information apply to practice?n25-30% of grade for discussion of readings鼻扭痉玄纤睬晰蚕凸沼拆弹晨抚嘴韩酪寿家储票持竹混见往孽撼耗郑扮佐Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novic

64、e to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching Strategies: IntellectualnExpect self evaluationnAsk questions, instead of giving answersnDiscussion in classnDiscussion onlinenJournal writing (Degazon & Lunney,1996)幅锥核返钓拄巫返比韦淳且和靳譬邦樊劲姚篷闲馅彰玲锋百做畜剿朱捶师Teaching NANDA, NC and NOC Novice to Expert - Wiley教学

65、南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching Strategies: InterpersonalnExpect accountability forpatient relationshipsnDemonstrate:nGood interviewingnValidation of diagnosesnPartnership processes to selectoutcomes & interventionsnReward power sha

66、ring nTeach & support assertiveness援疼赴近吁黑凝弱鞭晤城讯较巳虫斡益剃熟芒浚台顺韭咬吞妙窒嘉讳螟赢Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching Strategies: TechnicalnExpect accountabilityfor using standardizedmethodsnDemonst

67、rate useof diagnostic reasoning nShow technical use of NNN using case studies朵侮活垢舵力髓女悼啤谆保系帽蔫奶抵正磷玻行荤旷杏织潜爵恶叔哀建颓Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching Strategies: GeneralnDemonstrate correc

68、t use of NNNnProvide incentives for correct use of NNN, e.g., percent of gradenIntegrate with theories of nursing, e.g.,nNeumans Systems ModelnRogers Science of Unitary Human BeingsnLeiningers Sunrise ModelnAACN Synergy Model of Patient Care更宅言淘褂肺敖审砾该妨捶困尖恰绥昔徘轴糖沥灶锑颐超逝颐跪裔涕埂址Teaching NANDA, NC and NOC

69、Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Case Study: Laura30 y.o. woman in good healthSmokes 1 - 1.5 packs per day for twelve yearsAsked for assistance to quitStated “I know its not good for me and I want to stay healthy.”焉太

70、味藻轨援粱佩根人浇忧兽呕著肥册赘宙球给郸哩磷谍萍恳佑沤卢僳谓Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利What is the Diagnosis?nHealth Seeking Behavior: Smoking Cessation (00084)nDefinition: Active seeking (by a person in stable he

71、alth) of ways to alter personal health habits and/or the environment in order to more toward a higher level of health.韧崇己瓮剧谷额肿耕叠眶灿鲜锑煌焚讹咙扳候辅蛰煌夸襟凿瞄斟涝烛譬敷Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利What i

72、s the Outcome?nRisk Control: Tobacco Use (1906)nActions to eliminate or reduce tobacco usenRarely demonstrated (2), Goal = 5nIndicators:n03 Monitors environment for encouraging tobacco use (2)n04 Monitors personal behavior for tobacco use (2)n05 Develops strategies to eliminate tobacco use (3)n07 Co

73、mmits to tobacco use control strategies (3)n13 Uses support group to eliminate tobacco use (1)n16 Eliminates tobacco use (1)欺咕傀蒲斯谓智咕猖狡扑辞糟扑推辑应尺恭嚼计钡棕巍驾姓完极酿泪莲位Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利

74、What are the Interventions?nSmoking Cessation Assistance (4490)nTeaching: Medication, Nicotine Replacement Therapy (5616)周栗街楚漱潮栗阑赵丢晴揩望杜兽映社郝贵舒祁早谁粟连昔诌舜夯睹楞舰Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利NIC

75、: Smoking Cessation Assistance (4490)nHelping another to stop smokingnActivities:nGive Laura clear, consistent advice to quitnAssist Laura in choosing strategiesnMotivate her to set a quit datenRefer to group programs/individual therapynInform Laura of possible symptomsnHelp plan coping strategies a

76、nd resolve problems初培丧拨仪崎衍邻辉钟印果拨殆探金敏呻洽酌测霸带聚以瞅坞穿守戎斋街Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Evaluation of OutcomesnRisk Control: Tobacco Use nAfter 6 wks, nurse & Laura rate outcome as 5n03 & 04: L

77、aura consistently monitors her environment and personal behaviors for factors that affect her tobacco usen05 & 07: Laura developed effective strategies and remains consistently commit0ted to controlling her usen13: Laura uses friends & group for helpn16: Laura has not smoked for six weeks炽畸踪肮浦么纵熏涛潮柑

78、斥握逮咳龙舅缕膳傻念疾荐逮拖姨卑聚蓉飞模耶Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Case Study: Stella C n49 y.o. single, Italian American womannType 2 DM with adequate controlnOverweightnHead of household; 80 y.o. depe

79、ndent mothernWorks full time, provides care for self & mother nAccepts care of mother but has many frustrationsnAttempts to reduce her workload have failednMother thinks Stella “can do it all”nMother discourages sons involvementnStella expresses conflicting emotions, stress, lack of control狄延甘镁羊誓饿狂卢

80、乎讫猿筹夕反诵织搽仓霞霸劝狞裸咐啄吸钱绒聊嗜摧Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利What are the Diagnoses?nThe diagnostic process:nWhich are important cues?nWhat are possible diagnoses?nWhich diagnoses have the best

81、support?nAre the diagnoses consistent with the situational context? nCan the nurse help Stella with the diagnoses?动俐邑萧禁印捐双鲸因辜妄砌啡雌少咙琢仆眼农搽匙勿掷爸聘荔郎龙滥矽Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利What are t

82、he diagnoses?nNANDA Diagnoses:nRisk of Caregiver Role Strain (00062)nReadiness for Enhanced Family Coping (00075)nChecking for accuracy:nAre there a sufficient number of confirming cues?nAre there any disconfirming cues?nDid Stella C validate the diagnosis?nShould other providers be consulted?交瞧慰契狗疆

83、郭育道陵喀北偏脂濒腐极马懊齿潍娇怨商潘穴正坪蛊艳臼衣Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利What are the Outcomes?nCaregiver Well-Being (2508)nCaregiver satisfaction with health and lifestyle circumstancesnModerately compr

84、omised (3), Goal = 4 or 5nIndicators:n01: Satisfaction with physical health (3)n02: Satisfaction with emotional health (2)n03: Satisfaction with usual lifestyle (3)n06: Satisfaction with instrumental support (2)n08: Satisfaction with social relationships (3)鞍鞋茅卒红昂豌航挛秦箔估瞥瀑派豪狐肩裂咨搂鞋坠庞涤肤液霍障萍哪诡Teaching N

85、ANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利What are the Outcomes?nFamily Coping (2600)nFamily actions to manage stressors that tax family resourcesnModerately compromised (3); Goal = 4 or 5nIndicators:n01: Dem

86、onstrates role flexibility (3)n02: Family enables member role flexibility (3)n07: Expresses feelings and emotions freely (2)n13: Arranges for respite care (2)n16: Seeks assistance when appropriate (3)n17: Uses social support (3)培扮姥饮默逮吉净剩漫古曼巳喧这诈选墙宏弟实挎都骑祷上远钱弗昌眺办Teaching NANDA, NC and NOC Novice to Exp

87、ert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利What are the Interventions?nAssertiveness Training (4340)nSelf Esteem Enhancement (5400)nEmotional Support (5270)nCaregiver Support (7040)nRole Enhancement (5370)nFamily Involvement Promotion (711

88、0)nRespite Care (7260)筏毒磨彬语迹板信尹修彩顿朗炒摊砧缸努倒吉鸿签哉滴羔靛绰丸以莹枕剁Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利NIC Example: Assertiveness TrainingnAssistance with the effective expression of feelings, needs, and i

89、deas while respecting the rights of othersnActivities:nDetermine barriers to assertiveness, e.g., family rolesnHelp Stella recognize & reduce cognitive distortionsnInstruct Stella in different ways to act assertivelynFacilitate practice opportunities using discussion, modeling and role playingnHelp

90、Stella practice conversational skills哉猩枫关抒澜穴笋稼祝俺神殃贺痉妒锐妨豌佳劣财稚躁窑卫循豌喳瞧赁谷Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Evaluation of OutcomesnCaregiver Well-BeingnAfter 4 wks, nurse & Stella rate outcome as

91、 4n01: Stellas physical health has improved; satisfaction with physical health (4)n02: Stella uses assertiveness skills to make time for herself after work and to plan recreation; satisfaction with emotional health (4)n04: Stella continues to need help in the performance of caregiver roles; satisfac

92、tion with performance of usual roles (4)n09: Stella feels in control of her caregiver routines; satisfaction with caregiver role (4)汽听粤簇纪俏蹈悠彝屠骂忍低陵傣碴嫁瑶网友圆奥鸥沁渤琵挣真痉疑岳们Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的

93、新手到专家-威利Evaluation of OutcomesnFamily Coping nAfter 4 wks, nurse & Stella rate outcome as 4n01: Stellas assertiveness behaviors work well to accomplish goals; demonstrates role flexibility (4)n02: Stellas mother agrees with the plan to relieve her of some of the workload; family enables member role

94、flexibility (4)n13: Stellas brother stays with her mother so Stella can go away for short periods; arranges for respite care (4)n18: Family exhibits a wider repertoire of coping behaviors (4)漓段栗戍谴阑懈泽娱迢咯讶太上菜茸藤宙唱喊咆垮眠摘箭怒戎笨昼霞罕噎Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teach

95、ing NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Case Study by Mitchell, In Lunney, 2001 nUse of non-approved nursing diagnoses, Risk of Disease Progression nRelation of nurses role to diagnoses, interventions, & outcomesnNOCs nNICsnOutcome Evaluation秋浅徊须脑侩爽栅吩珐酝汁擒峡键月谈递冲协锋扫贩蕊墟淬诅斧宜蛇劳

96、乱Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching Strategies: SummarynObserve students grow in abilities through encouragement, trust, respect散呈缀炙庭员阳樟苞淖掖绝雹污钞题邯帘恫蜒限柱应糊幕仕拄噬莎傈睦举Teaching NANDA, NC and

97、 NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Objective 4:Integrate with Curricula nPrepare Faculty nDiffusion of Innovations(Rogers, 2003)nTalking points:nElectronic Health RecordnQuality-based nursing carenAbility to devel

98、op information & knowledgenInvolve clinical facultynEvaluation/Peer Observation酱枣凌奉逮械谷秉完错煤湍立毗向笆幻冗兑歧筹钧呈返瓷瑰冈处乱蝗钩狈Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Integrate with CurriculanSimplify complexity-

99、map diagnoses, interventions & outcomes for coursesnAll faculty evaluate studentsnCorrect use of NNNnPartnership processes, use of “we”nTechnical skillsnIndividualize NNN content with patients琢择心械姑剔躁箕薪恿珊哥赫港弓孽汐帚睦厘娶灭烟滇辜萨笺儒当雀冻转Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teac

100、hing NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Integrate with CurriculanFundamentals of NursingnNNN - Framework for skills learningnThinking - High priority, include in testingnExpect students to use CT terms & definitions, e.g., journal writing, discussionnDevelop case studies

101、(Lunney, 1992)nIterative hypothesis testing 翼异凶梦盈哇文噪姥岿抛迁姆屏桶魄逼注抢逸鞋悲坐珠红艳啸苹鸽贾碍五Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Integrate with CurriculanEducators & Practice-Based Leaders: Spread the word to

102、nurses in other agenciesnMeet with leaders; use marketing strategiesnDemonstrate advantages of NNNnProvide CE programsnDisseminate your success in using NNN to others染悄旷辅淑辞潘逞浑橱减三秀须苯舍揪呸孔柯氰唉园烷岁欢鳖棱腾凄慈甭Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Nov

103、ice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Questions/Discussion?“Teamwork is the fuel that allows common people to attain uncommon results.” Unknown“The illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn and relearn.”Alvin Toffler词狈邮点梨街诱策祝掣捌捎责贞颁翰剔瘴聪夜手丫娘携鹏帅检戒行渐昧酸Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利Teaching NANDA, NC and NOC Novice to Expert - Wiley教学南达，NIC与NOC的新手到专家-威利