Risk for bleeding nursing diagnosis components: an integrative review

Abstract Objective To identify the best evidence to describe risk factors, at risk populations and conditions associated with the “Risk for bleeding” Nursing Diagnosis (00206; NANDA International classification). Methods This integrative literature review (period: 2017-2023) was carried out in six stages: research question; literature search; study categorization; critical assessment of findings; data interpretation; and synthesis of knowledge. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations were followed. The studies were classified by level of evidence according to the Oxford Centre for Evidence-based Medicine, which proposes their organization by methodological design. Results A total of 386 articles were found, and 37 of them were included in this study. New risk factors for diagnosis (intraoperative hypothermia, lack of family planning, smoking and alcoholism (4)), new associated conditions (hypertension, complications during childbirth, inadequate conditions for care (regarding human resources and infrastructure), shock, history of peptic ulcer, congestive heart failure, acute myocardial infarction, hereditary bleeding disorders, chronic kidney disease, esophageal varices and prolonged time since abdominal surgery (11)) and new at risk populations (older, pregnant, postpartum and multiparous women (3)) were identified. Conclusion The study highlighted new components for “Risk for bleeding” (00206), reinforcing the need for its update in NANDA International. The findings confirm the importance of this diagnosis in planning safe nursing interventions for patients at risk. It is necessary to develop clinical validity studies capable of confirming the findings of this review.