Readiness for enhanced organized infant behavior

Domain 9. Coping-stress tolerance
Class 3. Neurobehavioral stress
Diagnostic Code: 00117
Nanda label: Readiness for enhanced organized infant behavior
Diagnostic focus: Organized behavior

Nursing diagnosis is part of the nursing process, wherein a health care provider assists in identifying a patient's health care needs. In particular, nursing diagnosis readiness for enhanced organized infant behavior involves taking into consideration the patient's physical and mental status, their lifestyle, facilities available, and other factors affecting the patient. The aim is to develop a comprehensive plan which will maximize the patient's quality of life, while providing efficient medical care. Nurses must be able to use assessment, medical information, and sound clinical judgment to arrive at an appropriate diagnosis.

NANDA Nursing Diagnosis Definition

NANDA-International (Nursing Assessment and Diagnostic Association) defines readiness for enhanced organized infant behavior as "the state in which the patient has the potential for decreased behavior disorganization and increased ability for the display of organized behavior." This diagnosis is applicable regardless of the cause of disorganization and provides nurses with guidance on meeting the needs of the client in question.

Defining Characteristics

Subjectives

Subjectives are signs that may suggest readiness for enhanced organized infant behavior. They include:

• Expressions of concern regarding the infant’s behavior
• Expressions of need for more direction
• Surface level relaxation response when provided with mother’s/caretaker’s concentrated attention
• Demonstration of parental behavior in response for infant’s cues
• Expressions of acceptance regarding the need to provide more organized structure to the infant’s environment

Objectives

Objectives are measurable changes indicating readiness for enhanced organized infant behavior. These include:

• Demonstrating self-regulation when provided with maternal/caretaker’s protection and guidance
• Increased lengths of sleep at night or naps during the day
• Improved communication, comprehension, and competency skills
• Enhanced ability to build relationships with age and developmentally appropriate activities
• Enhanced abilities to regulate and respond to stressful situations

Suggestions for Use

It is essential for nurses to discuss the benefits and potential disruptive effects of an organized approach to parenting with parents and caregivers before implementing it. Suggestions for use include:

• Provide education regarding strategies to promote organized behaviors
• Assess the risk of child abuse and prevention strategies
• Develop an organized lifestyle for the infant with the parent/caregiver’s cooperation
• Ensure that the parent/caregiver and infant have adequate resources to support the changes
• Provide emotional support as needed to reinforce new behavior patterns
• Monitor carefully for signs of improvement, including lengthening periods of sleep, improved communication and comprehension, increased self-regulation, and relationships with age appropriate activities.

Suggested Alternative NANDA Nursing Diagnoses

The following list of alternative NANDA nursing diagnoses may be considered based on the symptoms and signs associated with Readiness for Enhanced Organized Infant Behavior:

1. Risk for Injury related to infant’s behavior
2. Impaired Parenting related to lack of knowledge
3. Confused Self-Identity related to lack of organized behavior
4. Chronic Sorrow related to structured infant care
5. Ineffective Coping related to event-based infant behavior

Each alternative diagnosis requires further assessment to determine if readiness for enhanced organized infant behavior is the best diagnosis based on the signs, symptoms, and patient history.

Heredity Usage Tips

When diagnosing readiness for enhanced organized infant behavior, nurses should consider the following:

• Involve the parent/caregiver as much as possible in the process so they may understand their role.
• Encourage collaboration between the parent/caregiver and the infant so the infant understands their right to choice.
• Plan structured activities that can be supervised and enforced.
• Reinforce positives when promoting changes in behavior.
• Be reasonable and realistic about the expectations for change. Excessive changes that are not achievable may lead to resentments and foster negative reactions.

NOC Outcomes

The NOC outcomes that indicate readiness for enhanced organized infant behavior are as follows:

• Self-Regulate Affect - The infant demonstrates control over their own emotional responses and impulses.
• Social Interaction - The infant exhibits competence in relationships with others and adapts to social situations.
• Parenting Competence - The parent/caregiver exhibits skills necessary to manage the infant's behavior.
• Adaptability - The infant adjusts and adapts to changes in their environment.
• Mood Regulation - The infant demonstrates regulated positive affect and does not show signs of distress in response to changes.

Evaluation Objectives and Criteria

Monitor the patient's progress by measuring the specified objectives outlined above. The criteria that must be met to identify readiness for enhanced organized infant behavior include:

• The infant successfully completes age-appropriate tasks with minimal guidance.
• The infant accurately recognizes and expresses emotions.
• The infant's ability to fall asleep, get up, and go to sleep again is improved.
• The infant spends longer periods of time with peers and adults.
• The infant displays improved self-control and reduced anxiety.
• The infant behaves in an age appropriate manner and is able to fit into their environment.

NIC Interventions

Interventions implemented to improve readiness for enhanced organized infant behavior should follow the NANDA-I nursing interventions classification system (NIC). This includes the following interventions:

• Maternal/Infant Enhancement - Encouraging the parent/caregiver to have regular interactions with their infant that enable the infant to grow and develop in a healthy and safe environment.
• Parenting Assistance - Assisting the parent/caregiver by providing instruction in parenting skills and techniques that enable them to effectively manage their infant's behavior.
• Crisis Intervention - Providing timely intervention in the event of a crisis, such as an infant's sudden aggression or severe distress, by quickly calming the infant and discussing appropriate strategies with the parent/caregiver.
• Neonatal Teaching - Instructing the parent/caregiver on how to instruct the infant in age-appropriate activities in order to increase their level of self-regulation.
• Therapeutic Care Instillation (TCI) - Using the TCI model to teach the parent/caregiver how to create an environment of consistency and predictability in order to manage the infant's behavior.

Nursing Activities

Nurses may take a variety of actions to ensure successful implementation of interventions aimed at improving readiness for enhanced organized infant behavior. These activities may include:

• Providing education regarding strategies to promote organized behaviors
• Assessing the risk of child abuse and prevention strategies
• Developing an organized lifestyle for the infant with the parent/caregiver’s cooperation
• Ensuring that the parent/caregiver and infant have adequate resources to support the changes
• Providing emotional support as needed to reinforce new behavior patterns
• Monitoring carefully for signs of improvement, including lengthening periods of sleep, improved communication and comprehension, increased self-regulation, and relationships with age appropriate activities.

Conclusion

In conclusion, Readiness for Enhanced Organized Infant Behavior is a diagnostic category used to help identify infants whose behavior requires more organization and discipline. Early detection and intervention can ensure that the infant learns appropriate behavior and develops healthy relationships with those around them. Nursing assessment and interventions focused on this area of care can play a key role in enabling the infant to reach their full potential.

FAQs

• Q: What is Readiness for Enhanced Organized Infant Behavior?
  A: Readiness for Enhanced Organized Infant Behavior is a diagnostics category used to describe infants and their parents/caregivers who require additional organization and discipline to increase the infant’s quality of life.
• Q: What are the defining characteristics of Readiness for Enhanced Organized Infant Behavior?
  A: The defining characteristics of Readiness for Enhanced Organized Infant Behavior may include expressions of concern regarding the infant’s behavior, expressions of need for more direction, surface level relaxation response when provided with mother’s/caretaker’s concentrated attention, demonstration of parental behavior in response for infant’s cues, and expressions of acceptance regarding the need to provide more organized structure to the infant’s environment.
• Q: How can nurses diagnose Readiness for Enhanced Organized Infant Behavior?
  A: Nurses should use assessment, medical information, and sound clinical judgment when diagnosing Readiness for Enhanced Organized Infant Behavior. Involvement of the parent/caregiver is essential in formulating a plan to meet the infant’s needs.
• Q: What are the NOC outcomes for Readiness for Enhanced Organized Infant Behavior?
  A: Nurses should monitor the patient's progress by measuring the NOC outcomes which indicate readiness for enhanced organized infant behavior. These include self-regulate affect, social interaction, parenting competence, adaptability, and mood regulation.
• Q: What interventions can be used to improve Readiness for Enhanced Organized Infant Behavior?
  A: Interventions that can be used to improve Readiness for Enhanced Organized Infant Behavior involve Maternal/Infant Enhancement, Parenting Assistance, Crisis Intervention, Neonatal Teaching, and Therapeutic Care Instillation (TCI) model.