Risk for impaired emancipated decisionmaking

Domain 10. Life principles
Class 3. Value-belief-action congruence
Diagnostic Code: 00244
Nanda label: Risk for impaired emancipated decisionmaking
Diagnostic focus: Emancipated decisionmaking

Introduction to Nursing Diagnosis: Risk for Impaired Emancipated Decision-Making

Emancipated decision-making is an important life skill that is oftentimes overlooked. This can become a risk factor for those who do not possess the necessary skills, who may be more likely to make poor choices or have limited ability to make decisions due to their lack of experience. In this article, we will discuss nursing diagnosis, its definition, risk factors, at risk populations, and other important considerations such as suggested alternative NANDA nursing diagnoses, usage tips, list of nursing outcomes, evaluation objectives and criteria, list of nursing interventions, and nursing activities. We will also include five FAQs that are commonly asked about this particular nursing diagnosis.

NANDA Nursing Diagnosis Definition: Risk for Impaired Emancipated Decision-making

NANDA (North American Nursing Diagnosis Association) is a professional association and global authority of nursing diagnosis. According to their definition, Risk for Impaired Emancipated Decision-making is a nursing diagnosis which is defined as “a pattern of potential concerns related to limited ability to make informed decisions and chooes actions toward desired health outcomes”. It focuses primarily on the risk factors associated with limited decision-making skills that often lead to poorer health outcomes.

Risk Factors

There are numerous risk factors associated with Risk for Impaired Emancipated Decision-Making, the most prominent of which are the following:

• Lack of access to education or knowledge of the decision-making process.
• Lack of support from family and friends.
• Presence of mental health issues such as depression or anxiety.
• Lack of knowledge or resources needed to make informed decisions.
• Lack of self-confidence or self-esteem.
• History of poor decision-making in past situations.

At Risk Population

Anyone who has limited decision-making skills is considered to be at risk; however, there are certain populations who are particularly more vulnerable. These include:

• Adolescents who are transitioning into adulthood.
• Patients who have had a traumatic experience that affects their decision-making.
• Older adults who may no longer be able to make informed decisions due to age-related changes.
• People living in poverty who may lack access to resources or education.
• People with a history of substance abuse.

Suggestions of Use

When diagnosis Risk for Impaired Emancipated Decision-Making, nurses should use evidence-based practice to determine the individual's level of risk. Additionally, the nurse should assess the patient's knowledge and decision-making skills and provide appropriate aid and support whenever needed. When individualized care is important for independent decision-making, the nurse should work with the patient to develop a plan to foster self-governance and autonomy.

Suggested Alternative NANDA Nursing Diagnoses

• Knowledge Deficit: Decision-Making – The patient lacks understanding in the decision-making process, and will require additional guidance to make informed decisions.
• Risk for Noncompliance – The patient is at risk for not following medical treatment plans and prescription directions due to an inability to make appropriate decisions and/or lacking motivation or understanding of the need to follow directions.
• Deficient Diversional Activity – The patient is unable to engage in recreational activities due to lack of decision-making skills and the ability to choose appropriate activities and resources.

Usage Tips

To effectively care for patients with compromised decision-making skills, here are some useful tactics that nurses can implement in their practice:

• Educate the patient as needed to improve their understanding of the decision-making process, so they are better equipped to make independent decisions.
• Provide a supportive environment that encourages independent decision-making.
• Allow the patient the freedom to think and explore options before forcing a decision.
• Encourage the patient to take responsibility for their decisions and decisions-making skills.
• This process can be facilitated by providing access to resources and information, or even attending educational classes with the patient.

NOC Outcomes

In order to measure patient progress in terms of their decision-making, the following NOC (Nursing Outcomes Classification) outcomes can be used:

• Independent Decision Making – The patient is capable of formulating and understanding the decision-making process and making informed decisions.
• Ability to Make Decisions – The patient’s ability to make decisions is evaluated on a scale of 0 to 4, with 4 being the highest score.
• Health Practice-Decision Making Ability – Patient’s understanding of available health practices and the ability to make decisions regarding his/her own health care.

Evaluation Objectives and Criteria

In order to evaluate the patient’s level of risk for impaired emancipated decision-making, the following assessment criteria should be included:

• A baseline risk assessment based on the patient’s past decision-making experiences.
• Assessment of the patient’s current level of knowledge and decision-making skills.
• Identifying any environmental factors that may affect decision-making.
• Evaluating the patient’s level of confidence and ability to make confident decisions.
• An assessment of the patient’s ability to follow through with decisions in a consistent manner.

NIC Interventions

In providing care to those whom have impaired emancipated decision-making, here are several interventions that should be considered:

• Counseling – Providing emotional and mental health counseling to help the patient better understand decision-making and their options for making decisions.
• Education – Offering formal educational courses or classes to teach the patient how to navigate the decision-making process.
• Supportive Care – Ensuring that patient has adequate support from family, friends, and healthcare providers that can help guide the patient in their decision-making.
• Planning – Working with the patient to design and implement an individualized care plan that will help them become more independent and make more informed decisions.
• Monitoring – Keeping track of the patient’s progress in terms of his/her decision-making skills and intervening if necessary.

Nursing Activities

Nursing activities relevant to Risk for Impaired Emancipated Decision-Making are divided into two categories:

• Problem-focused: Listening to the patient’s concerns, evaluating the patient’s risk for impaired emancipated decision-making, planning and implementing individualized care interventions, and advising the patient on how to best manage decisions and their outcomes.
• Emphasis-focused: Monitoring the patient’s progress, providing education and resources, helping the patient build self-confidence, and promoting independent decision-making.

Conclusion

Emancipated decision-making is an important life skill that is oftentimes overlooked. Risk for Impaired Emancipated Decision-Making is a nursing diagnosis which is defined as “a pattern of potential concerns related to limited ability to make informed decisions and chooes actions toward desired health outcomes”. Nurses must take into consideration the numerous risk factors in order to accurately assess the patient’s level of risk, as well as the population of individuals who are more vulnerable to risk for impaired emancipated decision-making. Nurses should be aware of alternative NANDA nursing diagnoses, and provide a supportive environment that encourages independent decision-making. Furthermore, it is essential that nurses employ NOC outcomes, evaluation objectives, and NIC interventions to measure the success of care interventions while providing education, resources, and guidance to help the patient make better decisions.

5 FAQs

• What is Risk for Impaired Emancipated Decision-Making? – Risk for Impaired Emancipated Decision-Making is a nursing diagnosis which is defined as a pattern of potential concerns related to limited ability to make informed decisions and chooes actions toward desired health outcomes.
• What are some risk factors for impaired emancipation decision-making? – Common risk factors for impaired emancipation decision-making include lack of access to education, mental health issues, lack of resources, and lack of self-confidence.
• Which populations are most at risk for impaired emancipation decision-making? – Adolescents, older adults, those living in poverty, and people with a history of substance abuse are especially at risk for impaired emancipation decision-making.
• What types of activities can nurses employ for those with impaired emancipation decision-making? – Nurses can educate the patient as needed, provide a supportive environment, offer resources and information, and encourage responsibility when making decisions.
• What types of assessments should be included when making a diagnosis? – Baseline risk assessments based on patient history, assessments of the patient’s level of knowledge and decision-making skills, evaluations of environmental factors, and assessments of the patient’s level of confidence should all be included when assessing for risk for impaired emancipation decision-making.

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