Creating NANDA, NOC and NIC Linkages for Elder Abuse

Creating NANDA, NOC, and NIC Linkages for Elder Abuse Care Delivery Abstract Specific Objective: This paper describes evidence-based linkages using concepts from NANDA-International (NANDA-I), Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC) (referred to as NNN) for care delivery for individuals impacted by elder abuse (EA), aligning them with the five types of physical, financial, sexual, psychological, and neglect. Methods: Each EA type contains distinct characteristics and risk factors that profoundly impact EA. Applying the literature, a table was created with signs and symptoms for each EA type, and used to create linkages categorized by EA type. These linkages were further refined and validated by experts. Findings: Twenty-four NANDA-I actual and risk nursing diagnoses were identified, organized by EA type, with NOC and NIC added to create the linkages. A total of 530 NOC and 438 NIC were selected for the linkages, with 200 unique NOC outcomes and 133 unique NIC interventions, with some NOC and NIC labels used repetitively. An interesting finding was that there were no NANDA-I that focused on financial abuse of elders and only one NANDA-I for sexual abuse of elders. Conclusions: Since the structure of NNN allows nurses to move beyond symptom management to identify and address the complex needs of elders experiencing or at risk of abuse, creating NANDA-I diagnoses specific to the five types of EA will aid in problem identification, goal setting, and intervention selection, while facilitating communication among healthcare team members. This work identified that although current NANDA-I are useful for addressing secondary issues from signs and symptoms of EA, work is needed to provide actual, risk, and health-promotion diagnoses addressing each of the five types of EA as areas of nursing concern.