Doody's Book Review

This handbook contains a system-organized selection of specific medical or surgical diagnosis-related assessment and care plan illustrations. Assessment is based on the authors' organization of nursing diagnoses as diagnostic divisions. Assessment focuses on nursing diagnosis as problems or needs of the patient, analysis aims for priorities, interventions are independent and collaborative with rationale from multiple disciplines, and desired outcomes/evaluation criteria are stated for each nursing diagnosis in broad terms. "Clinical Pathways" are illustrated for some nursing diagnoses and some medical diagnoses. The aim is to give definition and direction to development and use of individualized nursing care plans in multidisciplinary settings of medical/surgical hospital or community care. They express concern for the nurse in a changing healthcare system but propose help in reacting to change not leading as professional nurses with a knowledge base. The authors report designing t he book for use in acute medical/surgical settings and community settings of posthospital care. The authors illustrate assessment, care plans, and some clinical pathways for selected medical diagnoses with possible associated nursing diagnoses. They deliberately avoid detail in interventions for the stated purpose of avoiding a procedure book format to allow individualization. They include a disk for electronic care plan making. This book will not meet the needs of the student or practicing nurse for guidance in developing individualized care plans. Efforts to provide rationales from multiple disciplines results in generalized, overly basic content. Inaccuracies regarding pathophysiology to projected outcome seem to derive from combining a nursing diagnosis with a medical diagnosis, as exemplified in the use of impaired skin integrity, a nursing diagnosis, for a diabetic with a foot wound. Content also becomes confusing here because some interventions address medical treatment of diabetes. Lack of nursing focus with research-based specific interventions is surprising given information currently available. No nursing research or classic nursing diagnosis references are listed. Jean O'Neil, EdD, RN, C(Boston College School of Nursing). Copyright 2001, Doody Publishing