Nursing Rounds Link Nursing Diagnoses to Clinical Practice

Abstract

BACKGROUND A pediatric burn nursing internship program was developed to train new graduate nurses to become competent and confident in their practice. The goals were to teach critical thinking, develop individualized plans of care for patients with burns, and guide the development of sound nursing practice. The strategy was to build the curriculum around nursing diagnoses. Theoretical content of the program included pediatrics, burns, and critical care nursing. MAIN CONTENT POINTS The format for linking the patient, the problem, and nursing practice was nursing rounds. Each class day began with a nursing round focused on an assigned topic for the day: growth and development, pulmonary, cardiovascular, gastrointestinal, fluid and electrolytes, integumentary, resuscitation of a burn patient, or nutritional/metabolic and psychosocial needs. A student assessed the assigned patient, reviewed existing patient data, identified the appropriate nursing diagnoses, and recommended changes to the existing plan of care. A concept map (a schematic representation of the relationship of defining characteristics, related factors, and nursing interventions) was developed as an adjunct tool to diagram the desired components. The presentations were made to senior nursing staff and preceptors who critiqued the work and provided other feedback. CONCLUSIONS This educational process was a guided learning activity with multiple benefits, including incorporation of critical thinking into practice by individualizing the plans of care and recognizing relationships between nursing theory and practice. The unexpected benefits were the increased presence of the nurturing role by senior staff, increased familiarity of students with other staff members, and increased awareness of the plan of care by all staff. A future study of this process includes outcome evaluation as it is incorporated into daily practice for senior as well as novice nurses.