Abstract
BACKGROUND: Standardized nursing frameworks are widely used to unify nursing practices and enhance patient outcomes, but their application in liver transplantation is still limited. This study evaluates the use of NANDA-I, NOC, and NIC linkages in the perioperative care of liver transplant recipients, aiming to inform future nursing practice improvements. METHODS: This prospective observational cohort study (December 2022-August 2023) included 44 liver transplant recipients using consecutive sampling. The Delphi method refined the NANDA-I, NOC, and NIC (NNN) linkage framework to 15 nursing diagnoses, 42 outcomes, and 106 interventions. Postoperative NOC indicators were assessed on surgery day and postoperative days 3, 7, 14, and at discharge. One-way repeated measures ANOVA, with Greenhouse-Geisser correction for sphericity violations, analyzed the indicators. RESULTS: Twelve nursing diagnoses had a 100% usage rate, with an average intervention usage rate of 96.59%. Nine diagnoses showed consistent improvement in NOC scores across four time points, with significant differences (P < 0.008). In contrast, five diagnoses displayed fluctuating scores, highlighting the need for targeted interventions. CONCLUSIONS: The NNN linkages effectively tracked postoperative changes and guided care for liver transplant patients. The findings support refining nursing care protocols to address fluctuating outcomes and improve patient recovery.