看護介入II：看護介入の選択と分類

Nurses should consider six essential factors: the nursing diagnosis characteristics, desired patient outcomes, evidence-based research or expert opinion, feasibility regarding time and cost, patient acceptability including values and beliefs, and the nurse's own competence and abilities. These factors ensure interventions are appropriate, achievable, and likely to succeed in improving patient outcomes.

Evidence-based research helps nurses implement and evaluate interventions specific to patient groups with proven effectiveness. When research is inadequate in a particular field, expert opinion or scientific principles can guide intervention selection. This approach ensures interventions are grounded in validated knowledge rather than arbitrary choices, improving care quality and patient outcomes.

The Nursing Interventions Classification (NIC) provides a comprehensive, research-based, standardized set of guidelines organized into three levels: seven domains, 30 classes, and 542 interventions. This taxonomy nursing interventions system facilitates communication of nursing care across healthcare settings, enables data integration, supports effectiveness research, and aids in comparing results globally.

Patient acceptability is a critical consideration when selecting interventions. Nurses should involve patients in planning and take their values, beliefs, and cultural preferences into account. Evaluating patient needs, priorities, and previous experiences helps nurses choose the most appropriate intervention with the highest chance of achieving desired results.

The NIC model has three hierarchical levels. Level one contains seven domains covering basic physiological, complex physiological, behavioral, safety, family, health system, and community care. Level two includes 30 clinically valuable classes for selecting interventions. Level three comprises 542 specific interventions nurses perform based on clinical judgment and knowledge.

Nurses should examine nursing literature, standard protocols or recommendations, critical pathways, policy or procedure manuals, and textbooks when developing care plans. Collaboration with other healthcare providers is also beneficial. These resources support informed intervention selection and ensure care aligns with current best practices and organizational standards.

Interventions should be selected based on nursing diagnosis characteristics to alter etiological factors, treat signs and symptoms, or eliminate risk factors. This targeted approach ensures interventions directly address the root causes and manifestations of the patient's condition, improving the likelihood of achieving desired outcomes and evaluating intervention effectiveness.