Validation of an instrument to assess fluid control in outpatient hemodialysis patients

Abstract

Purpose: To validate an instrument to assess fluid control in outpatient hemodialysis patients, using the NANDA International (NANDA-I), Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC) terminologies.

Methods: A methodological study was carried out in two steps: (1) construction of an instrument composed of operational definitions of the defining characteristics of the nursing diagnosis Excess fluid volume, indicators of the NOC outcome Fluid balance, and activities of the NIC intervention Fluid management, from a narrative literature review, and (2) content validation of the instrument by five experts through a focus group.

Results: The instrument was composed of operational definitions of 27 defining characteristics of Excess fluid volume, 23 Fluid balance indicators, and 13 Fluid management activities. Twenty-five out of the 27 defining characteristics were considered valid. Two defining characteristics were excluded from the instrument, as they were considered unsuitable for assessing outpatients on hemodialysis. Thirteen out of the 23 indicators of Fluid balance were reformulated, and two were removed. Thirteen activities of Fluid management were reformulated.

Conclusions: An instrument was built incorporating components of the nursing diagnosis Excess fluid volume, the nursing outcome Fluid balance, and the nursing intervention Fluid management. The instrument was considered valid in terms of content and can be used to assess outpatients on hemodialysis. Implications for nursing practice: The instrument created may contribute to the standardization, qualification, and improvement of nursing practice in outpatient hemodialysis facilities.