NURSING OUTCOMES CLASSIFICATION NOC Presented by Esther K

NURSING OUTCOMES CLASSIFICATION (NOC) Presented by Esther K. AFOLABI RN, MSc. FWACN.

Introduction It is a laid down fact that nursing process is a cyclical process consisting of six steps. Nursing outcome classification occupies 2 key positions along the process; Outcome Identification and Evaluation Having discussed the Nursing diagnosis, the next on the SNLs is the nursing outcome classification. The NOC was developed in the 1990’s.

Learning Objectives At the end of this session, we will be able to : Define the NOC Identify the format for writing the NOC List out some examples of NOC Link the NOC with other segments of the Nursing process

Nursing Outcomes Classification (NOC) Fifth Edition v 490 outcomes 107 new 123 revised 2 retired

WHAT IS NOC?

NURSING OUTCOME CLASSIFICATION( NOC) An individual, caregiver, family, or community state, behavior or perception that is measured along a continuum in response to a nursing intervention(s). • Each outcome represents a concept that can be used to measure the state of a patient, caregiver, family, or community before and after intervention.

NOC Format v Label name v Definition v Measurement scale(s) v Indicators v References

LEVELS OF NOC TAXONOMY The taxonomy has five levels: Domains – 7 Classes - 32 Outcomes – 490 Indicators Measurement scales

NOC Measurement Scales A five-point Likert type scale that quantifies a patient outcome or indicator status on a continuum from least to most desirable and provides a rating at a point in time It is a standardized scale, a rating of 5 is always the best possible score and a rating of 1 is the worst score.

NOC Measurement scale contd. Measurement of the outcome prior intervention helps the nurse establish a baseline score and can then rate the outcome after the intervention is provided, and to follow changes in patient’s status. Measurement will reflect a continuum such as 1 =severely compromised, 2= substantially compromised, 3 = moderately compromised, 4=mildly compromised, 5 =not compromised

Change score This is the difference between a baseline rating and post-intervention rating of the outcome. The change score can be positive (increased outcome) The change score can be negative There may be no change (zero) The change score represents the outcome achieved following an intervention

Change score cont’d If a patient is rated 2 prior intervention, and 4 after intervention, the change score is +2 A change score can be zero where zero is the goal. That is when the patient needs to be maintained at the present status.

Times To Measure Outcomes Measure the outcome when: v Outcome is selected v Patient is transferred to another unit v Patient’s status changes v Patient is discharged from care episode v Other times as determined by policy * Always consider the outcome characteristics

NOC NANDA Juxtaposed Outcomes vs. Problems v Bowel continence v Parent-infant attachment v Self-Care Status v Community health status v Self esteem v Risk Control v Knowledge: Treatment Regimen v Diarrhea v Ineffective childbearing process v Self-Care Deficit v Ineffective community coping v Situational low self esteem v Risk for: Infection, Injury v Knowledge Deficit

BOWEL CONTINENCE- 0500 Definition: Control of passage of stool from the bowel Outcome Target Rating Maintain at…. . Increase to…… Outcome overall rating Never demonstrated 1 Rarely Demonstrated 2 Sometimes Demonstrated 3 Often Demonstrated 4 Consistently Demonstrated 5

Indicators 050002 050013 050015 050018 050019 Maintains control of stool passage Gets to toilet between urge and evacuation of stool Ingest adequate amount of fluid Describes relationship of food intakes to stool consistency Monitors the amount and consistency of stool Toilets independently

PARENT-INFANT ATTACHMENT - 1500 Definition: Parent and infant behaviors that demonstrate an enduring affectionate bond Outcome Target Rating Maintain at………. Increase to…………. Outcome overall rating Never demonstrated Rarely Demonstrated Sometimes Demonstrated Often Demonstrated Consistently Demonstrated 5 1 2 3 4 5

• Indicators 150001 Practices healthy behaviors during pregnancy 150003 Prepares for infant prior birth 150004 Verbalizes positive feelings towards infant 1500015 Responds to infant cues 1500024 Holds infants for feeding 1500020 Infant responds to parent’s cues 1500021 Infant seeks proximity with parent

COMMUNITY HEALTH STATUS- 2701 Definition: General state of wellbeing of a community or population Outcome Target Rating Maintain at………. Increase to…………. Outcome overall rating Poor Fair Good Very good Excellent 1 2 3 4 5

• Indicators 270101 participation rate in preventive health care services 270107 Participation rate in community health programs 270108 Participation rate in school health programs 270109 Evidence of health protection measures 270117 Compliance with environmental health standards 2701 27 Health surveillance data system in place

SELF ESTEEM - 1205 Definition: Personal judgment of self worth Outcome Target Rating Maintain at………. Increase to…………. Outcome overall rating Never positive Rarely positive Sometimes positive Often positive Consistently positive 1 2 3 4 5

• Indicators 120501 Verbalization of self acceptance 120502 Acceptance of self limitation 120505 Description of self 120509 Maintenance of grooming and hygiene 120510 Balance of participation and listening in group 120511 Confidence level 120512 Acceptance of compliment from others 120519 Feeling about self-worth

NOC Outcomes NOC -Outcome for individuals. Activity Tolerance e. g. Self care deficit NOC -Outcomes for Families e. g. Family Integrity NOC -Outcomes for Communities e. g. Community Risk Control: Chronic Disease

Conclusion As nurses the NOC with its likert scale measure helps in measuring the achievement / progress made in the care of our clients. And it aids evaluation of the clients’ care.

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