NIC Interventions in Cardiac Home Healthcare

Stocker Schneider, Julia

Purpose:

The purpose of this research was to describe home health nursing care provided to cardiac patients using the Nursing Interventions Classification (NIC).

Methods:

NIC intervention data were collected on convenience sample of 106 patients admitted to home healthcare for treatment of a cardiac condition. At each home visit, home healthcare nurses identified the NIC interventions they performed for seven Nursing Outcome Classification (NOC) outcomes deemed important for cardiac patients receiving home healthcare. Top NIC interventions were identified for each NOC outcome. NIC intervention frequency was contrasted among patients with coronary artery disease (CAD) and those with congestive heart failure (CHF).

Findings:

Top NIC interventions performed to improve cardiac pump effectiveness included vital signs monitoring, medication management, and cardiac care. The NIC interventions medication management, teaching: individual, and teaching disease process were important across several NOC outcomes for the cardiac patients, including treatment behavior: illness or injury, knowledge: illness care, and medication response. The most NIC interventions were provided to improve NOC outcomes including cardiac pump effectiveness, treatment behavior: illness or injury, medication response, and knowledge: illness care.

Discussion:

The home healthcare nurses’ interventions were most frequently focused on improving cardiac status, self-care management abilities, medication response, and knowledge of illness care. These outcomes are in stark contrast to those contained in the Outcome and Assessment Information Set (OASIS) that home healthcare nurses are routinely required to gather, which predominantly address ADLs and IADLs. Conclusions: Some of the most frequent interventions provided to cardiac patients by home healthcare include patient education and monitoring interventions. Yet the outcomes resulting from these interventions are not a focus of the OASIS. The inclusion of NANDA diagnoses, NIC interventions, and NOC outcomes in information systems is an important step towards more accurately identifying the care provided by home healthcare nurses and the resultant changes in patient outcomes.