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Aim: To test a middle-range theory (MRT) for the nursing diagnosis of ineffective breathing pattern in children with congenital heart disease (CHD) based on analysis of two general propositions., Methods: This cross-sectional study is guided by STROBE. The propositions represent hypotheses about the relationships between the concepts of this MRT to be tested empirically, and thus, log-linear models were used to verify the structure of the proposition related to the stimuli. Diagnostic accuracy measures, univariate logistic regressions and the Mann-Whitney test were used to analyse the structure of the propositions related to behaviours., Results: The analysis of the propositions related to the stimuli (eight concepts, four of which were classified as focal stimuli and four as contextual stimuli) suggested a reclassification of the stimulus "deformities in the thoracic wall" which became too focal. In the analysis of the propositions related to behaviours (17 concepts, five of which were classified as acute confirmatory, nine as acute clinical deterioration and three classified as chronic), guided changes in the operationalisation of concepts were suggested after comparing clinical findings; thus, acute confirmatory behaviours now have 10 concepts, while acute clinical deterioration behaviours and chronic behaviours continued with nine and three concepts, respectively, but with reclassifications between them., Conclusion: Changes in the operationalisation of the classification of the elements of the two propositions occurred after comparing the clinical findings with the theoretical model., Relevance to Clinical Practice: By establishing precise causal relationships and describing how IBP manifests itself over time in children with CHD, empirical testing of this MRT helps nurses understand clinical reasoning based on temporal logic and spectral interaction between diagnostic components, which in turn will improve the use and accuracy of nursing diagnoses., Patient Contribution: Children and adolescents with CHD were recruited for this study sharing their clinical history and physical lung examination., (© 2024 John Wiley & Sons Ltd.)

This study aimed to analyze the accuracy of the clinical indicators of the nursing diagnosis of dysfunctional gastrointestinal motility in infants from neonatal units and identify their association with clinical variables. This is a study of the diagnostic accuracy of clinical indicators of the diagnosis of dysfunctional gastrointestinal motility, with a cross-sectional design, performed on 228 hospitalized infants in neonatal units. A high prevalence of dysfunctional gastrointestinal motility was identified in the studied population. Regarding accuracy measures, clinical indicators such as increased gastric residual, changes in bowel sounds, bile-colored gastric residual, regurgitation, absence of flatus, and hard and formed stool were useful to discriminate between infants with and without dysfunctional gastrointestinal motility. The findings can help nurses during the diagnostic process, as they identify which defining characteristics can be used to confirm or rule out the probability of occurrence of the diagnosis.

Aims and Objectives: To compare polyurethane and silicone peripherally inserted central catheters (PICCs) in newborns regarding the success rates of insertion and duration and the reasons for nonelective removal., Background: Previous studies have attempted to identify predictors of PICC complications in newborns, such as lower extremity insertion or femoral catheter insertion, procedures that require 60 minutes or more, duration longer than 30 days and non-central position of the catheter tip. However, there is little evidence on which type of PICC material causes less complications, especially in newborns., Design: Retrospective cohort, guided by the STROBE tool., Methods: We divided the newborns into two groups according to the type of PICC material: polyurethane and silicone. Our sample was composed of 449 PICCs, of which 246 polyurethane PICCs and 203 silicone PICCs, inserted in 294 newborns. Bivariate analysis was performed for data comparison. All statistically significant variables in the bivariate analysis were included in the logistic regression (p ≤ .05)., Results: Of the 449 PICCs that we analysed, the central position of the catheter tip predominated for both types of materials, with a higher prevalence of false passage for the polyurethane group. There was no difference between the average duration. The incidence of nonelective PICC removal was 49.27% for the silicone group, and infiltration/extravasation and rupture were among the reasons for nonelective removal., Conclusion: The overall success rates in the insertion and duration of the PICC were almost identical for both types of material, despite the high incidence of false passage for polyurethane PICCs. Nonelective removals were higher for silicone PICCs, which also had a higher incidence for infiltration/extravasation and rupture., Relevance to Clinical Practice: Can contribute to the knowledge of the strengths and weaknesses of polyurethane and silicone PICCs, with a view to reduce the incidence of nonelective removals., (© 2021 John Wiley & Sons Ltd.)