This study examined the effectiveness of a training program on the ability of registered nurse students to write complete nursing diagnoses. A comparison group was used as a control. There were 47 participants in the training group and 51 participants in the comparison group who received no training. Five hypotheses were used to examine the (1) complete nursing diagnoses, (2) labels, (3) clarifiers, (4) etiologies, and (5) mislabeled medical diagnoses or clinical problems as nursing diagnoses. As a pretest and posttest, participants in both groups viewed a video tape of a nursing situation and were asked to write nursing diagnoses. The training group received nine clock hours of classroom instruction on the nursing process of which three hours were on nursing diagnosis with a focus on the inclusion of label, clarifier, and etiology necessary for a complete nursing diagnosis. In the clinical component of the educational program the training group wrote nursing diagnoses as part of the nursing process. It was assumed that the comparison group did not receive comparable education. The mean difference of proportions between the pretest and posttest was computed for each group on the item tested by the hypotheses and for the difference between the two groups. Three of the five hypotheses tested in the study were accepted. The training group did have a significant increase in the average (mean) difference of proportions in the number of complete nursing diagnoses and etiologies and a significant decrease in the number of mislabeled nursing diagnoses. There was no significant difference in the number of labels and clarifiers. The training group did show a percentage increase in the number of labels and clarifiers written. There was little or no change in the comparison group over the time period of the study.

Although a great deal is known about the etiology of falls in elderly individuals, fall accidents continue to represent a significant burden to elders residing in long-term care facilities. It has been stated that 75% of deaths due to falls in the United States occur in the 13% of the population age 65 and over. The first objective of the study was to identify which fall-predictor variables acknowledged in the research literature are associated with increased fall frequency with the older population. Identifying specific predictor variables related to a high occurrence of falls in long-term care setting can assist in the redesign of tools and programs aimed to recognize fall risk, and prevent fall-related accidents and fatalities in the geriatric population. The second objective of the study was to identify which combination of predictor variables could better predict the frequency of falls. A history of falls variable was the only predictive variable that differed significantly between groups of residents who had sustained subsequent falls and those who had not. Other variables including age, mental status, day number of stay, elimination, visual impairment, confinement, blood pressure drop, gait and balance, and medication were found to not be statistically significant between groups of fallers and non-fallers. In this setting, the current design of the tool had limited accuracy and exhibited an inability to effectively discriminate between resident populations at risk of falling and those not at risk of falling. Consequently, the current fall risk assessment tool is not adequate for assessing fall risk in this clinical setting. / Master of Science

Akutsjukvård är tidskänsliga vårdinsatser som ges till patienter som drabbas av akut sjukdom. Akut sjukdom kan innebära försämring av kronisk sjukdom eller nytillkommen plötslig ohälsa i behov av snabb handläggning. När en patient drabbas av akut sjukdom ökar risken för vätskebalansrubbningar, exempelvis dehydrering och hyperhydrering. Vätskebalansrubbningar kan leda till ökad ohälsa samt ökade samhällskostnader. Sjuksköterskan ansvarar för bedömning och dokumentation av vätskebalans. Detta ska göras med en helhetssyn och består till stor del av tre komponenter; bedömning av kliniskt status, klinisk kemi och dokumentation i vätskebalanslistor. Hantering av den akut sjuka patientens vätskebalans utgör en avgörande del av patientens vård. Då bedömning och dokumentation av vätskebalans syftar till att tidigt upptäcka inadekvat vätskebalans innebär suboptimal hantering en ökad risk för vårdskada hos patienten. Syftet var att belysa sjuksköterskans genomförande av bedömning och dokumentation av vätskebalans hos patienter som vårdas inom akutsjukvård. Metoden litteraturöversikt valdes för att besvara studiens syfte. Endast studier publicerade mellan åren 2007-2017 samt genomförda inom en akutsjukvårdskontext på vuxna patienter inkluderades. Datainsamlingen skedde genom sökning i de elektroniska databaserna PubMed, CINAHL complete, MEDLINE samt SveMed+ med indexeringsord och fritextord baserade på litteraturöversiktens syfte. Därtill genomfördes en manuell sökning. Datainsamlingen resulterade i att 17 originalartiklar inkluderades i litteraturöversikten. Artiklarnas kvalitet granskades mha Sophiahemmet Högskolas bedömningsunderlag för vetenskaplig klassificering samt kvalitet. Artiklarnas resultat analyserades med integrerad analys och presenterades därefter i en integrerad text. Resultatet visade att det fanns brister i sjuksköterskans bedömning och dokumentation av vätskebalans. Det fanns en fördröjning i agerande vid upptäckt av vätskebalansrubbningar och onormala värden i den kliniska kemin. Sjuksköterskan dokumenterade inte patientens vätskebalans i vätskebalanslista eller kroppsvikt på ett tillfredsställande vis. Faktorer som kunde påverka sjuksköterskans bedömning och dokumentation av vätskebalans var kommunikation, kunskap och patientens sjukdomstillstånd. Därtill indikerade resultatet att de mätmetoder som används för att bedöma vätskebalans inte verkar helt ändamålsenliga för äldre patienter, vilket gällande riktlinjer inte tillsynes tar hänsyn till. Vidare forskning behövs för att kartlägga detta vidare. Slutsatsen av litteraturöversiktens resultat indikerar att sjuksköterskans bedömning och dokumentation av vätskebalans idag är bristfällig. Insatser f  f ör att öka sjuksköterskans kunskap kring vätskebalans torde vara av värde för att förbättra detta. Vidare forskning behövs för att utvärdera huruvida de mätmetoder som används för bedömning och dokumentation av vätskebalans är väl lämpade för akutsjukvård. / Acute care is time sensitive care interventions given to patients who are acutely ill. Acute illness may imply deterioration of chronic disease or newly sudden illness that needs urgent treatment. In this state the risk of fluid balance disorders, such as dehydration and hyperhydration, increases. Fluid balance disorders may lead to increased morbidity and social costs. The nurse has a responsibility to assess and document fluid balance. This should be done with a holistic view and largely consists of three components; assessment of clinical status, clinical chemistry and documentation in fluid balance charts. Fluid balance management in the care of the acutely ill is a fundamental part of patient care. The aim of the assessment and documentation of fluid balance is to discover deviations early, and a suboptimal management of fluid balance implies an increases risk of care related injury. The aim was to illuminate the nurse’s implementation of fluid balance assessment and documentation in patients within acute care. The study was executed through a literature review. Only articles published between 2007 and 2017, conducted in acute care settings and of adult patients were included. The data collection was carried out using the electronic databases PubMed, CINAHL complete, MEDLINE and SveMed+ using keywords based on the purpose of the literature review. Both thesaurus and free text words were used as keywords. Thereafter a manual search was performed. The data collection process resulted in 17 original articles that were included in the literature review. The quality of the articles was assessed using the review template compiled by Sophiahemmet University. The results of the articles were analyzed using integrated analysis and presented within an integrated text. The findings revealed shortcomings in the nurse’s assessment and documentation of fluid balance. There was a delay in action after the detection of fluid imbalances and abnormal values ​​in the clinical chemistry. The nurse did not adequately document the patient's bodyweight or fluid balance in the fluid balance chart. Factors such as communication, knowledge, and the patient’s medical condition could affect the nurse’s assessment and documentation of fluid balance. In addition, the findings indicated that the measurement methods used to assess fluid balance do not appear to be entirely suitable for elderly patients. Applicable guidelines do not seem to recognize the diverse needs of these patients. Additional research is needed to explore this further. The conclusions of this literature review indicates that the nursing assessment and documentation of fluid balance is inadequate. Efforts to increase the nurse’s knowledge of fluid balance might be of value to improve this. Further research is needed to evaluate whether the measurement methods used for the assessment and documentation of the fluid balance are well suited for acute care settings.

Bedömning av patientens vitalparametrar (andningsfrekvens, blodtryck, puls, kroppstemperatur, saturation och medvetandegrad) är sjuksköterskans ansvar inom den akuta vårdkedjan. Tidigare forskning visar att en tidig identifiering av försämrade patienter minskar både mortalitet och morbiditet. För patientens välmående och säkerhet är det av högsta vikt att sjuksköterskor utför evidensbaserade och säkra bedömningar för att upprätthålla patientsäkerheten. Syftet var att utforska faktorer som påverkar sjuksköterskans bedömning av vitalparametrar för att tidigt upptäcka en försämrad patient inom den intrahospitala akuta vårdkedjan.  En litteraturöversikt med systematisk artikelsökning användes som metod. Databassökningar utfördes i PubMed och CINAHL. Sexton originalartiklar som undersökte sjuksköterskors bedömning av patientens vitalparametrar i den akuta vårdkedjan valdes ut från databassökningen samt manuell sökning. Studierna kvalitetsgranskades för att sedan analyseras med hjälp av integrerad analys.  Resultatet visade att sjuksköterskors bedömning av vitalparametrar påverkades av sjuksköterskefaktorer, patientfaktorer samt organisatoriska faktorer. Sjuksköterskefaktorer som sågs påverka var sjuksköterskans förhållningssätt till vitalparametrar, bedömning av frekvens, kunskap och erfarenhet, intuition, helhetsbild samt avsteg från rutiner. Gällande patientfaktorer sågs specifika patientgrupper svårare att bedöma på grund av exempelvis underliggande grundsjukdomar eller ålder. Organisatoriska faktorer som sågs påverka bedömningen var arbetsmiljö, samarbete/kommunikation, kontinuitet i vården samt bedömningsinstrument.   Slutsats som dras är att sjuksköterskans bedömning av vitalparametrar för att tidigt upptäcka en försämrad patient inom den akuta vårdkedjan är ett komplext ämne som påverkas av både sjuksköterske-, patient-, och organisatoriska faktorer. Även då vitalparametrar är ett viktigt redskap för att upptäcka förändring i patientens tillstånd och således främja patientens välmående och säkerhet, använder inte sjuksköterskans alltid dessa verktyg. Denna studie gav inte några säkra förklaringar till varför detta fenomen förekom utan behöver studeras vidare. / Assessing the patient's vital signs (respiratory rate, blood pressure, pulse, body temperature, saturation, and level of consciousness) is a responsibility assigned to the registered nurse within the emergency care chain. Previous research has shown that early identification of deteriorating patients reduces both mortality and morbidity. To enhance patient safety and well-being, it is vital that the registered nurse performs evidence-based and secure assessments of the patient.  The aim of this study was to explore the factors that influence the nurse’s assessments of vital signs to early detect patient deterioration within emergency care.   The research method used was a literature review with a systematic approach, using database searches in PubMed and CINAHL. Sixteen original articles with the main focus of examining registered nurses’ assessments of vital signs within emergency care was chosen from the database searches and manual searches. The quality of the studies was then examined, and an integrated analysis was performed.  The result of the analysis show that assessment of vital signs performed by registered nurses was affected by factors contributed to the nurse, the patient, and the organization as a whole.  When it comes to the factors found contributed to affect the registered nurses, these factors were found to be, approach to vital signs, assessment of frequency, knowledge and experience, intuition, comprehensive picture, and deviations from the established routine. For the factors contributed by the patient, specific patient groups were regarded as more difficult to assess due to underlying diseases or age.  The organisational factors seen affecting the nursing assessment were the work environment, teamwork/communication, continuity in the care and the evaluation tools at hand.  In conclusion, the results show that this is a complex subject that is affected by several factors contributed to the registered nurse, patient, and the organization. Even though vital signs are an important tool to identify changes in a patient’s well-being and safety, the registered nurse does not always utilize this as a tool. This study could not conclude any clear explanation as to why assessing vital signs was not used more often and will require further studies and analysis to determine an answer.

Timely management in pre-hospital emergency care enhances the chances of patients' survival or clinical outcomes of an Acute Coronary Syndrome (ACS). In Botswana nurses serve in the frontline of pre-hospital emergency services as the initial recipients of the emergency reports and situations. Knowledge of the patient's characteristics will assist the nurses as well as the family/others to understand the patient's responses during an ACS situation and therefore enable prompt patient assessment and facilitation of early access to appropriate care. Patient and family involvement in care during cardiac emergencies also influences the patient outcomes. This is a non-experimental, quantitative, exploratory and descriptive study, designed to explore and describe the characteristics of patients with the experience of an ACS, and the available resources during the pre-hospital phase of emergency care, with the aim of improving patients' clinical outcomes. The results indicated that optimal care by nurses is essential in the chain of care influencing patients' chances of surviving ACS. / Health Studies / M.A. (Health Studies)

Timely management in pre-hospital emergency care enhances the chances of patients' survival or clinical outcomes of an Acute Coronary Syndrome (ACS). In Botswana nurses serve in the frontline of pre-hospital emergency services as the initial recipients of the emergency reports and situations. Knowledge of the patient's characteristics will assist the nurses as well as the family/others to understand the patient's responses during an ACS situation and therefore enable prompt patient assessment and facilitation of early access to appropriate care. Patient and family involvement in care during cardiac emergencies also influences the patient outcomes. This is a non-experimental, quantitative, exploratory and descriptive study, designed to explore and describe the characteristics of patients with the experience of an ACS, and the available resources during the pre-hospital phase of emergency care, with the aim of improving patients' clinical outcomes. The results indicated that optimal care by nurses is essential in the chain of care influencing patients' chances of surviving ACS. / Health Studies / M.A. (Health Studies)

Thesis (MCur)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Differences were observed in clinical demonstration and assessment techniques of clinical supervisors involved with the supervision of undergraduate nursing students at an institution of higher education. These differing techniques displayed by the clinical supervisors may have implications for the standard of nursing care provided by the students and the throughput of these students. A qualitative approach with a descriptive design was applied to explore the perceptions and experiences of the undergraduate nursing students’ on clinical supervision. Nine (n=9) students were deliberately selected by means of purposive sampling from each year to participate in focus group interviews. Nine 1st year students, nine 2nd year students, nine 3rd year students and nine 4th year students respectively constituted the groups that were interviewed. Thus the total sample consisted of n=36 nursing students. Consent to conduct the study was obtained from the Health Research Ethical Committee at Stellenbosch University, as well the institution under study. Informed consent was obtained from all the participants. Data collection was completed by two trained fieldworkers who were not affiliated with the institution under study. The interviews were analysed through content analysis. Six themes emerged from the data. These included support, professionalism, realities of supervision, student preferences regarding supervisors, experiences that relate to abusive behaviour and the clinical supervision process. The findings indicated negative and positive experiences on clinical supervision. Recommendations were proposed to enhance clinical supervision and the learning experiences of student nurses. Key words: Clinical supervision, undergraduate nursing, clinical supervisor, clinical practice, differing techniques. / AFRIKAANSE OPSOMMING: Verskille was waargeneem in kliniese demonstrasie- en assesseringstegnieke van kliniese toesighouers wat betrokke is met die supervisie van voorgraadse verpleegstudente by 'n institusie van hoër onderwys. Die verskille in tegnieke gedemonstreer deur die kliniese toesighouers mag implikasies hê vir die standaard van verpleegsorg gelewer deur die studente en die slaagsyfer van hierdie studente. 'n Kwalitatiewe benadering met 'n beskrywende ontwerp was toegepas om die persepsies en ervaringe van die voorgraadse verpleegstudente oor kliniese supervisie te verken. Nege (n = 9) studente vanuit elke jaargroep was bewustelik gekies by wyse van doelgerigte steekproefneming om deel te neem in fokusgroep onderhoude. Nege 1ste jaar studente, nege 2de jaar studente, nege 3de jaar studente en nege 4de jaar studente het onderskeidelik die groepe gevorm waarmee onderhoude gevoer was. Die totale steekproef het uit n=36 verpleegstudente bestaan. Toestemming om die studie te doen was vanaf die Etiese Komitee vir Gesondheidsnavorsing by Stellenbosch Universiteit, asook die instelling ter ondersoek verkry. Ingeligte toestemming is van al die deelnemers verkry. Data insameling was deur twee opgeleide veldwerkers gedoen wat nie geaffilieer is met die instelling ter ondersoek nie. Die onderhoude was deur inhoudsontleding geanaliseer. Ses temas het uit die data ontstaan. Dit sluit in ondersteuning, professionaliteit, realiteite van supervisie, student voorkeure ten opsigte van toesighouers, ervaringe wat verband hou met mishandelende gedrag en die kliniese supervisie-proses. Die bevindinge het negatiewe en positiewe ervaringe oor kliniese supervisie getoon. Aanbevelings is voorgestel om kliniese supervisie en die leerervaring van die studentverpleegsters te verbeter. Sleutelwoorde: Kliniese supervisie, voorgraadse verpleging, kliniese toesighouer, kliniese praktyk, teenstrydige tegnieke.

Health care systems consist of various individuals and organizations that aim to meet the health care needs of people and provide a complete and responsive health care solution. One of the important aspects of a health care delivery system is nursing. The use of technology is a vital aspect for delivering an optimum and complete nursing care to individuals; and also for improving the quality and delivery mechanism of nursing care. The model proposed in this thesis for Nursing Knowledge Management System is a novel knowledge-based decision support system for nurses to capture and manage nursing practice, and further, to monitor nursing care quality, as well as to test aspects of an electronic health record for recording and reporting nursing practice. As a part of a collaborative research of the Christine E. Lynn College of Nursing and the Department of Computer Science, a prototype toolset was developed to capture and manage nursing practice in order to improve the quality of care. This thesis focuses on implementing a web based SOA solution for Automated Classification of Nursing Care Categories, based on the knowledge gained from the prototype for nursing care practice. / by Sughomoy D. Dass. / Thesis (M.S.C.S.)--Florida Atlantic University, 2011. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2011. Mode of access: World Wide Web.

Estudo descritivo, metodológico que teve como objetivo construir e validar os Marcos de Competências e as Entrustable Professional Activities (EPAs) para formação e avaliação de enfermeiros na assistência de pacientes adultos na abordagem das vias aéreas, ventilação e circulação, e avaliar o uso das EPAs em ambientes clínicos simulados. Após aprovação do Comitê de Ética e Pesquisa da Escola de Enfermagem de Ribeirão Preto e da Comissão Ética da Unidade de Investigação em Ciências da Saúde: Enfermagem da Escola superior de Enfermagem de Coimbra. O estudo contou com a participação de experts que atenderam os critérios adaptados de Fehring e se desenvolveu em três sub-estudos: na primeiro realizou-se uma revisão de literatura para avaliar os ganhos percebidos dos enfermeiros com o uso da simulação clínica nas atividades de urgência e emergência. No segundo realizou-se uma oficina em uma Universidade pública localizada em uma cidade no interior do estado São Paulo, composta por sete experts para a construção dos marcos de competências; na segunda fase desse sub-estudo participaram 15 experts para a validação de aparência e conteúdo por meio da Snowball Technique e a Técnica Delphi, a terceira fase ocorreu após a análise de conteúdo das considerações e sugestões realizadas pelos experts ao material a ser validado. Após a organização dos dados e análise, uma nova versão dos marcos de competências foi emitida e, posteriormente, uma segunda rodada de opiniões foi solicitada. Os 15 experts participantes receberam um novo correio eletrônico com os marcos de competências reformulados, participaram dessa fase 13 experts, caracterizando a concordância do material apresentado. Após foi realizado uma análise de conteúdo das sugestões realizadas e calculado o Índice de Validação de Conteúdo (IVC) para aferir a concordância dos juízes quanto à representatividade de cada item. Com a análise de conteúdo das sugestões recebidas dos experts, chegou-se à conclusão que houve um consenso sobre o conteúdo apresentado, resultando nos quadros dos marcos de competências. A concordância dos juízes quanto à representatividade dos itens em relação ao conteúdo dos quadros resultou na análise final em todos os itens com um IVC >= 85%. No terceiro sub-estudo, construiu-se as EPAs para desenvolver e avaliar no ambiente clínico simulado os marcos de competências construídos e validados. Assim, diante dos marcos de competências e baseados no referencial teórico os autores construíram 21 EPAs. A validação das EPAs quanto ao conteúdo, aparência e aplicabilidade em cenários clínicos simulados em situações de urgência, ocorreu através da participação de nove experts. Para validação utilizou-se quatro cenários clínicos simulados no qual cinco EPAs foram validadas. Embora o número de experts participantes em todas as fases do estudo possa ser considerado em fator limitante, acredita-se que os resultados podem contribuir de maneira efetiva, sendo fonte de estímulo para discussões e mudanças positivas no ensino, na formação e capacitação em enfermagem / This is a descriptive methodological study with the aim to construct and validate milestones of competencies and entrustable professional activities (EPAs) for the education and evaluation of nurses in the delivery of care to adult patients in the approach to their airways, ventilation, and circulation, and to assess the EPAs in simulated clinical environments. The research project was approved by the Research Ethics Committee of the Ribeirão Preto College of Nursing at the University of São Paulo and by the Ethics Committee of the Health Sciences Research Unit of the Higher School of Nursing of Coimbra. The study had the participation of experts who complied with the criteria adapted by Fehring and was developed in three sub-studies. A literature review was conducted in the first study to assess the benefits perceived by nurses with the use of clinical simulation in urgency and emergency activities. In the second study a workshop was developed in a public university located in a city in the state of São Paulo, with the participation of seven experts for the construction of milestones of competencies; in the second stage of this sub-study 15 experts participated in the face and content validation through the snowball and the Delphi techniques; and the third stage took place after analysis of content of the considerations and suggestions made by the experts to the material to be validated. After data organization and analysis, a new version of the milestones of competencies was designed and, later, a second round of reviews was requested. The 15 participating experts received a new e-mail with the reformulated milestones of competencies, and 13 of them participated in this stage, characterizing agreement with the material presented. Analysis of content of the suggestions was conducted and the content validity index (CVI) was calculated to measure the agreement of the experts as regards the representativeness of each item. This content analysis showed that there was a consensus among the experts on the content presented, resulting in charts with the milestones of competencies. Experts\' agreement as regards the items\' representativeness in relation to the content in the charts resulted in the final analysis of all items with a CVI >= 85%. In the third sub-study, the EPAs were constructed to develop and assess the validated milestones of competencies in the simulated clinical environment. Thus, the authors constructed 21 EPAs in face of the milestones of competencies and based on the theoretical framework. The validation of the EPAs regarding content, face, and applicability in simulated clinical environments in emergency situations took place with the participation of nine experts. Four simulated clinical settings were used in the validation of five EPAs.. Although the number of experts participating in each study stage may be considered a limitation, the authors believe that the results of this study can contribute effectively to encourage discussions and positive changes in nursing teaching, education, and qualification

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico / O uso de bons indicadores clÃnicos possibilita uma atribuiÃÃo mais adequada dos diagnÃsticos de enfermagem, contribuindo com a eficÃcia do plano de cuidados. A acurÃcia determina a relaÃÃo direta entre as caracterÃsticas definidoras e a presenÃa ou ausÃncia de um determinado diagnÃstico de enfermagem. A necessidade de pesquisas voltadas para a determinaÃÃo da acurÃcia diagnÃstica motivou o desenvolvimento do estudo, com o objetivo principal de analisar a acurÃcia de indicadores clÃnicos de âDesobstruÃÃo ineficaz de vias aÃreasâ (DIVA) em pacientes no pÃs-operatÃrio cardÃaco. Estudo transversal desenvolvido na unidade pÃs-operatÃria de um hospital especializado em cardiologia do municÃpio de Fortaleza-CE. Uma amostra de 98 pacientes foi selecionada consecutivamente e constituiu-se de indivÃduos de ambos os sexos, com idade acima de 18 anos e que se encontravam em pÃs-operatÃrio imediato (atà 48 horas). A coleta de dados foi realizada no perÃodo de janeiro a abril/2010, mediante a utilizaÃÃo de um formulÃrio, submetido a um teste piloto e aplicado por participantes de um projeto de pesquisa voltado para terminologias de enfermagem, apÃs treinamento e avaliaÃÃes. Foram contemplados os elementos que compÃem o diagnÃstico DIVA de acordo com a Taxonomia II da NANDA-I. ApÃs a coleta, os dados foram sintetizados no formato de casos clÃnicos e encaminhados para cinco peritas que executaram as inferÃncias diagnÃsticas. Foram utilizados os softwares Excel e PASW para organizaÃÃo e anÃlise estatÃstica dos dados. O nÃvel de significÃncia adotado foi de 5%. Verificou-se uma proporÃÃo equilibrada de homens e mulheres, predominÃncia de pessoas com baixa renda e baixa escolaridade, mÃdia de 55,89 anos de idade e vÃnculo de uniÃo estÃvel na amostra. Os diagnÃsticos mÃdicos mais prevalentes foram angina e coronariopatias, levando a uma maior incidÃncia de cirurgias reconstrutoras. A incidÃncia elevada de tabagismo mostrou-se como um elemento desfavorÃvel, repercutindo em prejuÃzos no processo de limpeza das vias aÃreas. A prevalÃncia de DIVA foi de 33,7%. Do total de 13 caracterÃsticas definidoras, somente 4 apresentaram associaÃÃes significativas com o diagnÃstico: âdispnÃiaâ, âtosse ausenteâ, âruÃdos adventÃcios respiratÃriosâ e âtosse ineficazâ, sendo as duas Ãltimas as mais acuradas. Os fatores relacionados tambÃm se mostram mais especÃficos do que sensÃveis, destacando-se: âasmaâ, âhiperplasiaâ, âalergia respiratÃriaâ e âinfecÃÃoâ, sendo os dois Ãltimos os mais acurados. Os fatores relacionados âtabagismoâ, âsecreÃÃes retidasâ e âmuco excessivoâ mostraram relaÃÃo de risco. As peculiaridades do perÃodo pÃs-operatÃrio e a alta incidÃncia de tabagismo foram apontadas como elementos que se relacionaram à incidÃncia dos indicadores clÃnicos. SugestÃes a respeito da modificaÃÃo da nomenclatura dos indicadores e da inclusÃo de um fator relacionado referente ao pÃs-operatÃrio foram contribuiÃÃes deixadas pelas peritas. Foi demonstrada a existÃncia de diferenÃas de especificidades e sensibilidades, as quais sÃo influenciadas pelas caracterÃsticas populacionais estudadas. Ressalta-se a necessidade de desenvolver estudos neste tema contemplando outras populaÃÃes. As variaÃÃes de concordÃncia entre as peritas foram atribuÃdas Ãs diferenÃas de interpretaÃÃo destas frente aos dados levantados. O estudo forneceu direÃÃo para a eficiÃncia do uso dos indicadores clÃnicos avaliados, contribuindo com o aprimoramento da acurÃcia diagnÃstica. / The use of good clinical indicators contributes to the assignment of nursing diagnoses making the care plan more effective. Accuracy determines the direct relationship between defining characteristics and the presence or absence of a specific nursing diagnose. The need for research focused on diagnosesâ accuracy motivated the development of this study, whose purpose is to examine the accuracy of clinical indicators of "Ineffective airway clearance" (IAC) in patients in post-operative period of cardiac surgeries. Cross-sectional study developed in the post-operative unit of a specialized hospital of Fortaleza-CE. A sample of 98 patients was selected consecutively and it was composed by individuals of both sexes, age above 18 years old and evaluated in the immediate post-operative (up to 48 hours). The data collection occurred within the period of January to April/2010 from a form, which had been subjected to a pilot test and applied by research project participants, focused on nursing terminologies, after training and evaluations. The components of the nursing diagnose IAC were evaluated according to the NANDA-I Taxonomy. Clinical cases were formulated after the data collection and five specialists performed the diagnostic inference. For the organization and statistical analysis of data collected, the software Excel and PASW were used. The level of significance adopted in the study was 5%. The proportion of men and women was equal in the sample, with predominance of people with low income and low scholarship, with average of 55.89 years old and living with a partner. The clinical diagnosis angina and coronary diseases were more prevalent, increasing the incidence of reconstructive surgeries in the sample. The high incidence of smoking was showed as a favorable factor for dysfunction in the process of airway clearance. The prevalence of ICA was 33.7%. Four of thirteen defining characteristics have significant associations with the studied diagnosis: "dyspnea", "absence of cough", "adventitious breath sounds" and "ineffective cough", and the last two were accurate. Some of related factors were more specific that sensitive: "asthma", "hyperplasia", "allergic airways" and "infection", and the last two were the most accurate. The related factors: "smoking", "retained secretions" and "excessive mucus" increased the risk for IAC. Peculiarities of post-operative period and the high incidence of smoking were identified as elements linked to the incidence of clinical indicators. Contributions left by specialists were suggestions concerning the modification of the nomenclature and the inclusion of a related factor for post-operative period. The study demonstrated the existence of difference in the specificities and sensitivities, which are influenced by population characteristics. The need of further studies development in other contexts was emphasized. Changes in the trial of the specialists were attributed to differences in their interpretations. The study gave us a direction towards the diagnostic efficiency for some clinical indicators contributing to improve the accuracy of these elements.