Development and validation of a case study to aid in the diagnostic reasoning of nursing students and nurses

Purpose

The aim of this study is to develop and validate a case study to aid in the diagnostic reasoning of nursing students and nurses.

Methods

It is a validation study using a case study based on Lunney's method including (1) content validation of the case study by nurse experts through the Delphi technique, (2) identification of nursing diagnoses (NDs) in the case, (3) evaluation of diagnostic accuracy, and (4) establishment of a priority diagnosis by nurse experts.

Findings

The case study was developed from the findings of a narrative literature review on the cues of the NDs with a prevalence > 50% in patients with peripheral arterial occlusive disease. Two rounds of expert evaluation were required to validate the case study. The experts identified 18 NDs with different degrees of accuracy. The highly accurate diagnoses most frequently identified by the experts were: Ineffective peripheral tissue perfusion (100%), impaired walking (83%), impaired comfort (50%), and chronic pain (50%). The diagnosis considered a priority by all experts was ineffective peripheral tissue perfusion.

Conclusions

The case study was developed and had its content validated. High-accuracy diagnoses were identified, and a priority was determined.

Implications for Nursing Practice

The validated case study may be used by students and nurses to facilitate the development of diagnostic reasoning and critical thinking in practice, teaching or research.