Viewpoint: Use of King's Conceptual System,Nursing Informatics,and Nursing Classification Systems for Global Communication

PURPOSE. To propose a common nursing language for communication among members of the nursing community worldwide. DATA SOURCES. The Taxonomy of Nursing Practice, nursing informatics literature, King's Theory of Goal Attainment applied to the nursing process. DATA SYNTHESIS. Several milestones in nursing in the 20th century indicated the need for a universal language for nursing. The nursing process provides a method for synthesis of nursing data, information, and knowledge and is congruent with Imogene King's Theory of Goal Attainment. CONCLUSIONS. The authors advocate for a common nursing language (nursing classification and terminology systems) that would unify nurses worldwide. Supported by nursing theory and technology, global communication would be enhanced for nurses and the interdisciplinary teams of which they are a part. IMPLICATIONS FOR PRACTICE. Use of Imogene King's Conceptual System and Theory of Goal Attainment and the nursing specialty of Nursing Informatics are examples of nursing theory and technology to frame global communication.     

Economic Evaluations and Usefulness of Standardized Nursing Terminologies

PURPOSE: To review different types of economic analyses commonly found in healthcare literature, discuss methodologic considerations in framing economic analyses, identify useful resources for economic evaluations, and describe the current and potential roles of standardized nursing terminologies in providing cost and outcome data for economic analysis. DATA SOURCES: The Advanced Billing Concepts Code Resource-based Relative Value Scale and Nursing Outcomes Classification. DATA SYNTHESIS: Using case studies, the applicability of standardized nursing terminologies in cost-effectiveness analysis is demonstrated. While there is potential to inform specific questions, comparisons across analyses are limited because of the many outcome measures. CONCLUSIONS: Including a standardized quality-of-life measure in nursing terminologies would allow for the calculation of accepted outcome measures and dollars per quality adjusted life years gained. IMPLICATIONS FOR PRACTICE: The nurse's ability to assess and contribute to all aspects of rigorous economic evidence is an essential competency for responsible practice.     

护理信息能力量表的编制及信度效度检验

目的 :旨在研制出一套适合我国国情并体现护理专业学科特征,同时具有较高信度、效度的护理信息能力量表。方法 :综合利用定性与定量相结合的方法,构建护理信息能力评价指标体系,形成护理信息能力量表的雏形;利用多种统计方法对量表进行信度、效度检验。结果 :构建了包含5个维度32个条目的护理信息能力量表,总量表的Cronbach’sα系数为0.947;探索性因子分析结果显示编制的量表具有较好的结构效度;内容效度CVI指数为0.957,验证性因子分析结果证明模型拟合较好(χ2/df=0.293、AGFI=0.82、RMSEA=0.06、RMR=0.04、CFI=0.91)。结论 :研制的护理信息能力量表具有较好的信度及效度,为临床护理人员护理信息能力的测评提供了客观、科学的评价工具。     

A Sense of Urgency: Integrating Technology and Informatics in Advance Practice Nursing Education

Health care is embracing technology and informatics systems that support documenting assessment findings, evaluating diagnostic labs and procedures, ordering medical tests, and coding for billing. Although advanced practice nurses possess these essential skills, are they adequately prepared to utilize this technology? In this article, we explore the external forces and current trends driving the use of informatics in health care and the need to integrate this content into the advanced practice nursing education curriculum. Kotter’s sense-of-urgency framework demonstrates the integration of technology into an existing advanced practice nursing curriculum. A hypothetical advanced practice nursing program incorporating technology into specific courses is presented.     

Measuring Elderly Care Through the Use of a Nursing Conceptual Model and the International Classification for Nursing Practice®

INTRODUCTION: Nursing models and terminologies can contribute to research the nature of nursing care. AIM: The aim of this study was to describe nursing diagnoses in acute‐ and long‐term elderly care. METHODS: A point prevalence survey was conducted on 240 patients. The International Classification for Nursing Practice was used to describe nursing diagnoses, and a conceptual model was used to categorize them in nursing needs. RESULTS: A total of 2,673 diagnoses were detected. Mean was higher in nursing home than in hospital (t test =?3.688; p = .0003). Prevalent diagnoses were significantly different. DISCUSSION: High complexity, with different issues for nurses, was observed both in acute‐ and in long‐term settings. CONCLUSION: The results could help to comprehend the nature of older persons needs and could contribute to the development of an International Classification for Nursing Practice catalogue for elderly care. INTRODUZIONE: Le terminologie infermieristiche possono contribuire a studiare la natura dell'assistenza infermieristica. SCOPO: Lo scopo dello studio è quello di descrivere le necessità assistenziali infermieristiche dell'anziano nell'ospedale per acuti e in lungodegenza. METODI: Uno studio di prevalenza di punto è stato condotto coinvolgendo 240 pazienti. L'ICNP è stato impiegato per identificare le necessità assistenziali infermieristiche (nursing diagnoses) ed un modello concettuale per raggrupparle in bisogni di assistenza infermieristica. RISULTATI: Sono state identificate 2,673 necessità assistenziali. La media è stata maggiore in casa di riposo che in ospedale (t test =?3.688; p = .0003). Le necessità prevalenti sono state significativamente differenti. DISCUSSIONE: È stata osservata una elevata complessità dell'assistenza infermieristica, con differenti problematiche per gli infermieri, sia nel contesto acuto che di lungodegenza. CONCLUSIONI: I risultati possono aiutare a comprendere i bisogni delle persone anziane e possono contribuire allo sviluppo di un ICNP Catalogue per l'assistenza in ambito geriatrico.     

Conceptual Basis for the Organization and Advancement of Nursing Knowledge: Nursing Diagnosis/Taxonomy

An analysis of the conceptualization embedded within the development of nursing diagnoses, including the historical perspective on this process, is presented. Although there are conceptual issues still to be resolved, nursing diagnosis can be considered as a conceptual approach to developing disciplinary knowledge.     

A Retrospective Study of Nursing Diagnoses,Outcomes, and Interventions for Patients Admitted to a Cardiology Rehabilitation Unit

PURPOSE. The aim of this study was to describe the use of nursing terminologies in the care plans made for patients in a cardiology rehabilitation unit. METHODS. We retrospectively examined the clinical documentation for all patients admitted to a cardiology program in a small hospital in the northeast of Italy in 2008. FINDINGS. The sample included 76 patients (87% male) with an average age of 60 years. Care plans included 21 NANDA‐I nursing diagnoses and three collaborative problems, 45 Nursing Outcomes Classifications (NOC) and 46 Nursing Intervention Classifications (NIC). The most frequent diagnoses were the following: decreased cardiac output, activity intolerance, and risk for or presence of imbalanced nutrition (more than body requirements). The prevalent outcomes were related to cardiopulmonary physiological health and knowledge about cardiac disease management and diet. The most frequent nursing interventions were the following: exercise promotion, energy management, weight management, medication management, cardiac precautions, cardiac care (rehabilitative), teaching (prescribed activity/exercise and diet), and vital signs monitoring. CONCLUSIONS AND IMPLICATIONS FOR NURSING PRACTICE. Nurses in rehabilitative cardiology care are aware of patients' problems, but projects can improve the coherence between concepts, the attention to psychological problems, and self‐care. SCOPO. Lo scopo di questo studio era descrivere l'uso di terminologie infermieristiche nei piani di assistenza prodotti per i pazienti assistiti un un'unità operativa di cardiologia riabilitativa. METODI. Sono state esaminate in modo retrospettivo le cartelle cliniche di tutti i pazienti trattati in un programma di cardiologia, in un piccolo ospedale del Nord‐Est dell'Italia nel 2008. RISULTATI. Il campione includeva 76 pazienti (87% maschi) con età media di 60 anni. I piani di assistenza includevano 21 diagnosi infermieristiche NANDA e tre problemi collaborativi, 45 esiti NOC e 46 interventi NIC. Le diagnosi più frequenti erano le seguenti: riduzione della gittata cardiaca, intolleranza all'attività e rischio di/nutrizione superiore al fabbisogno. Gli esiti prevalenti erano correlate alla salute fisiologica cardiopolmonare e alle conoscenze sulla gestione della malattia cardiaca e della dieta. I più frequenti interventi infermieristici erano i seguenti: promozione dell'attività fisica, gestione dell'energia, gestione del peso, gestione dei farmaci, precauzioni cardiache, assistenza cardiaca: riabilitazione, insegnamento: attività/esercizi prescritti e dieta e monitoraggio dei parametri vitali. CONCLUSION E IMPLICAZIONI PER LA PRATICA INFERMIERISTICA. Gli infermieri che operano in cardiologia riabilitativa sono consapevoli dei problemi dei pazienti, ma i piani di assistenza possono essere migliorati in termini di coerenza tra i concetti, e garantendo una maggiore attenzione ai problemi psicologici e alla cura di sé.     

Concept Analysis of Similarity Applied to Nursing Diagnoses: Implications for Educators

PURPOSE. This philosophical inquiry examined similarity using the concept analysis methodology by Walker and Avant (2005 ). DATA SOURCES. Data were obtained from Google, CINAHL, PsychINFO, and PubMed using keywords “similarity,”“concept analysis,” and “similarity concept analysis.” DATA SYNTHESIS. Various definitions, uses, and defining attributes of similarity were identified; model cases were presented along with antecedents, consequences, and empirical referents. CONCLUSIONS. The concept analysis of similarity identified five defining attributes, antecedents, consequences, and different ways to measure the concept. IMPLICATIONS FOR NURSING PRACTICE. Representing nursing care involves similarity and when applied can promote or enhance shared understanding.     

医疗补助护理———繁异性、分类和基本矛盾

将传统的医疗补助护理模式下的全部护理活动看作统一的认识对象而进行整体性研究，提出并讨论了医疗补助护理的繁异性和基本矛盾，指出矛盾的解决策略是建立相应的护理理论。同时，根据不同标准对医疗补助护理活动进行了分类，并提出一些需要思考的问题。     

基于护理措施分类的儿童肿瘤护理核心护理措施的确立与比较

目的建立我国儿童肿瘤核心护理措施,并比较中美两国儿童肿瘤护理实践范畴上的异同。方法基于护理措施分类第5版中文版的基础,对第6版的更新部分进行汉化,并形成调查问卷。通过2轮专家咨询确认儿童肿瘤核心护理措施。结果 2轮专家咨询得出82条儿童肿瘤核心护理措施,其中,有24条是与美国确定的42条儿童肿瘤核心护理措施重叠,敏感度为57.1%,特异度为65.5%。从核心护理措施所属的领域来看,两国的儿童肿瘤护士均偏重于复杂性生理、行为和家庭领域方面的护理措施;而从类别上来看,我国儿童肿瘤核心护理措施主要集中在从事患者教育、危险管和育儿护理,美国则偏重于药物管理、协助应对以及生命周期护理。结论中美两国儿童肿瘤护理实践范畴在领域上是相近的,而在具体类别上存在差异;儿童肿瘤护理核心条目有待进一步临床验证。     

Applicability of the Nursing Interventions Classification to describe nursing

The aim of this survey was to test the applicability of the Nursing Interventions Classification (NIC) system for use in a future nursing information system for documenting nursing in an electronic patient record in Iceland. Also, the aim was to test the translation of NIC into Icelandic. In order to be applicable to nursing NIC needs to be sensitive enough to describe the work nurses do, differentiate between specialities in nursing, and be understandable to nurses. A sample of 198 nurses was asked to identify how often they used each of 433 NIC nursing interventions. Of the 36 most frequently used interventions half are within the physiological domain. Core nursing interventions were different between specialities, e.g. Analgesic Administration had a high mean score in surgical nursing, and Health Education in primary health care. anova for the 27 classes in NIC showed significant differences (p < 0.01) by all nursing specialities except one, Crisis Management. A Tukey post hoc test showed how nursing specialities were reflected differently in the NIC domains, e.g. medical/surgical nursing in the Physiological: Basic Domain, but psychiatric nursing in the Behavioural Domain. Factor analysis of classes in NIC show good resemblance with the domains in NIC and the structure of the classification is strongly supported, except the Safety Domain. The results from this study indicate that nurses in the sample consider NIC to be applicable to describe nursing. The language is a powerful tool and is central in reflecting nursing practice as well as supporting the construct of knowledge. The translation of NIC to Icelandic is one step in many in preparing nurses to use a standardized language which can also be used in an electronic patient record.     

基于奥马哈问题分类系统对肠造口患者出院后护理问题的评估

目的探索基于奥马哈问题分类系统对肠造口患者出院后1个月存在的护理问题评估。方法便利抽样选取2013年7-12月哈尔滨医科大学第二附属医院结乙直肠外科造口患者40例,以奥马哈问题分类系统为依据,对出院后1个月的40例肠造口患者进行电话随访,对患者存在的护理问题进行分析、归类,为临床护理提供依据。结果出院后1个月肠造口患者的护理问题主要是精神健康、身体活动、个人照顾、排便功能、造口黏膜水肿、社交、营养、睡眠和休息型态、皮肤,其发生率均超过70%。结论在对肠造口患者的评估中应用奥马哈系统,能够从生理、心理和社会等方面全面评估患者,从而制定相应的护理干预方案,有利于整体护理和医院-社区-家庭一体化的全程护理干预模式的形成。