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.     

Application of Orem's Self‐Care Deficit Theory and Standardized Nursing Languages in a Case Study of a Woman with Diabetes

PURPOSE. This paper aims to illustrate the process of theory‐based nursing practice by presenting a case study of a clinical nurse specialist's assessment and care of a woman with type 2 diabetes. DESIGN. Orem's self‐care deficit theory and standardized nursing language, NANDA, NIC (Nursing Interventions Classification), and NOC (Nursing Outcomes Classification), guided assessment and the identification of outcomes and interventions related to the client's management of diabetes. FINDINGS. Theory‐based nursing care and standardized nursing language enhanced the client's ability to self‐manage the chronic illness: diabetes. CONCLUSION. Nursing theory and standardized nursing language enhance communication among nurses and support a client's ability to self‐manage a chronic illness.     

Application of Orem''s Self-Care Deficit Theory and Standardized Nursing Languages in a Case Study of a Woman with Diabetes

PURPOSE: This paper aims to illustrate the process of theory-based nursing practice by presenting a case study of a clinical nurse specialist's assessment and care of a woman with type 2 diabetes. DESIGN: Orem's self-care deficit theory and standardized nursing language, NANDA, NIC (Nursing Interventions Classification), and NOC (Nursing Outcomes Classification), guided assessment and the identification of outcomes and interventions related to the client's management of diabetes. FINDINGS: Theory-based nursing care and standardized nursing language enhanced the client's ability to self-manage the chronic illness: diabetes. CONCLUSION: Nursing theory and standardized nursing language enhance communication among nurses and support a client's ability to self-manage a chronic illness.     

Using King's Goal Attainment Theory to facilitate drug compliance in a psychiatric patient

This paper describes a schizophrenic patient who failed to comply with his drug regimen and was repeatedly admitted to hospital. Using King's Goal Attainment Theory as guidance, it was found that the patient's main problem was medication noncompliance. We developed an individual nursing care plan that met the patient's needs, including helping him to understand the importance of medication compliance, the relationship between disease and medication-control, and the symptoms of disease recurrence. The result showed that King's Goal Attainment Theory benefited both patients and families when it was applied to drug therapy and medication compliance. From this experience, we are able to demonstrate that using King's Goal Attainment Theory to design nursing care plans and interventions for schizophrenic patients who are repeatedly admitted to hospital because of medication noncompliance is very effective. In addition, it can also assist patients to control their conditions, decrease frequency of the disease recurrence and hospital readmission, and maintain their socialized functions.     

Perspective: Implementation of Nursing Language in Long-Term Care and Nursing Education

PURPOSE.  This article describes one nurse's experiences of returning to school after a 10-year absence, her introduction to nursing theory and terminology, and her subsequent implementation of nursing language in a long-term care setting and later experiences in teaching nursing language to students.
DATA SOURCES.  A 21-year career as a long-term care nurse coincided with the evolution of the new organization North American Nursing Diagnosis Association International, and she found herself in a position to implement nursing diagnosis in the long-term care setting. Practice experiences and pertinent nursing references and resources were used in clinical implementation and in teaching nursing students.
DATA SYNTHESIS.  The author reviewed the implementation and teaching of nursing language from a personal historical perspective.
CONCLUSIONS AND IMPLICATIONS FOR PRACTICE.  The author's experiences and perspectives on implementation of nursing language in clinical practice and in teaching provide information and a perspective for nurses and students involved in these processes.     

Perspective: Implementation of Nursing Language in Long‐Term Care and Nursing Education

PURPOSE. This article describes one nurse's experiences of returning to school after a 10‐year absence, her introduction to nursing theory and terminology, and her subsequent implementation of nursing language in a long‐term care setting and later experiences in teaching nursing language to students. DATA SOURCES. A 21‐year career as a long‐term care nurse coincided with the evolution of the new organization North American Nursing Diagnosis Association International, and she found herself in a position to implement nursing diagnosis in the long‐term care setting. Practice experiences and pertinent nursing references and resources were used in clinical implementation and in teaching nursing students. DATA SYNTHESIS. The author reviewed the implementation and teaching of nursing language from a personal historical perspective. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE. The author's experiences and perspectives on implementation of nursing language in clinical practice and in teaching provide information and a perspective for nurses and students involved in these processes.     

A systems approach in nursing administration: structure, process, and outcome

This article presents a systems approach for administrators to consider as they review structure, process, and outcome in their healthcare organization. Systems provide a way to access data, information, and knowledge. Systems organize and unify the complex world of nursing practice in healthcare systems. Use of King's conceptual system, Theory of Goal Attainment, and transaction process is presented as an example that helps the multiple individuals and groups use information and knowledge to structure nursing practice. The transaction process helps individuals and groups identify goals and outcomes that lead to effective nursing care, evidence-based practice, and cost-effectiveness.     

Implementing Nursing Diagnoses Within the Context of King's Conceptual Framework

The use of nursing conceptual frameworks and nursing diagnoses is generally acknowledged to hold immense promise for the further development of nursing's scientific base. The nursing profession to date has failed to link the two, thus diminishing their impact. A large community hospital in Canada adopted King's Conceptual Framework for Nursing Practice and advocated the use of NANDA's nursing diagnostic statements as the manner by which patient needs or problems would be identified. Nurses, however, required assistance in identifying more clearly the connection between the theoretical base and nursing diagnoses. During stage one of this project a tool was designed that categorized NANDA's nursing diagnoses according to the concepts and systems of King's conceptual framework. The difficulties encountered in categorizing the nursing diagnoses are discussed and the categorization system is outlined. The utility of the tool was tested during stage two. A total of 25 nurses were asked to describe how they arrived at a particular nursing diagnosis before and after using the categorization tool. Criteria were used to indicate whether a connection had been made between the formulation of the nursing diagnosis and King's conceptual framework throughout the nurse's thought processes. The results indicated that nurses could make a connection between NANDA's nursing diagnoses and King's framework with the assistance of the categorization tool.     

A Conceptual Model for Nursing Information.

PURPOSE: This Conceptual Model for Nursing Information describes the core activities of nursing, the collection of information about these activities, and argues that these activities must be described using standardized nursing languages. DATA SOURCES: Relevant literature, both national and international, was reviewed and summarized. DATA SYNTHESIS: A maximum data set for nursing was developed. CONCLUSIONS: In the United Kingdom, a new and radical approach to the process of nursing is required; one that demonstrates that nursing is the decision-making that takes place in all core activities of nursing. IMPLICATIONS FOR NURSING PRACTICE: Unless nurses have a clear view of what the profession requires from technological solutions for the recording of nursing activities, less than optimal solutions will be forced upon the profession.     

Integrating Nursing Diagnoses, Interventions, and Outcomes in Public Health Nursing Practice

TOPIC. Applying standardized nursing language in public health nursing practice.
PURPOSE. To develop a charting format to document public health nursing practice based on standardized nursing language.
SOURCES. Literature review of documentation systems for public health nursing practice.
CONCLUSIONS. A task force of public health nurses developed a charting format based on Taxonomy I of Nursing Diagnosis (NANDA), Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC).     

Imogene King''s theory: A nursing case study of a psychotic client with human immunodeficiency virus infection

The nursing theory of Imogene King provided an effective framework for viewing the complex interactions that occurred when a psychotic client with newly diagnosed human immunodeficiency virus infection (acquired immunodeficiency syndrome-related complex) was admitted to a general psychiatric unit. The interacting systems identified in King's theory assisted in the evaluation of the relationship that formed between the client and the nurses and provided a plan for action that led to the successful achievement of nursing care goals.     

Nurse shift report: who says you can't talk in front of the patient?

Bedside nurse shift report is a process where nurses provide shift-to-shift report at the patient's bedside so the patient can be more involved in his or her care. There are many benefits of bedside report, including relationship building between staff members and increased patient satisfaction, to both the patient and to the healthcare team. Concerns about the traditional methods of communication between the various shifts helped drive a nursing unit's decision to move to a more patient-involved model of shift-to-shift report. The change from the traditional taped report between healthcare providers to bedside reporting focused on patients wanting more involvement in their care, activities, and current status. Patients also wanted updates about their health status, their medical plan as well as information about their progress toward their goals. This, coupled with Banner Desert Medical Center's Care Model, embraces patient-centered care, King's Theory of Goal Attainment, and keeps the patient informed. The current nursing shift report did not meet the medical center's model of care on any of these aspects. This article will include information on the benefits of bedside nurse shift-to-shift report, how one unit implemented bedside reporting, and some of the outcomes achieved after implementing this change at a 600-bed urban medical center.     

A Conceptual Model for Nursing Information

PURPOSE. This Conceptual Model for Nursing Information describes the core activities of nursing, the collection of information about these activities, and argues that these activities must be described using standardized nursing languages. DATA SOURCES. Relevant literature, both national and international, was reviewed and summarized. DATA SYNTHESIS. A maximum data set for nursing was developed. CONCLUSIONS. In the United Kingdom, a new and radical approach to the process of nursing is required; one that demonstrates that nursing is the decision‐making that takes place in all core activities of nursing. IMPLICATIONS FOR NURSING PRACTICE. Unless nurses have a clear view of what the profession requires from technological solutions for the recording of nursing activities, less than optimal solutions will be forced upon the profession.     

Nursing Intervention Classification Systems

Purpose: To analyze the features, development, and research of the Omaha System, the Iowa Nursing Intervention Classification, and the Home Health Care Classification and provide a critical review of the unique components of each.
Organizing Framework: Five elements: achievement of original purpose, language used, ease of computerizing format, clinical utility, and linkage of the Nursing Minimum Data Set (NMDS) nursing care elements.
Conclusions: Further testing and development of nursing classification systems should be done to determine the general value of nursing classification, the extent to which the original goals and purposes of classification are met, and to identify the unique features and contributions of each system. Further testing is important to determine the strengths, weaknesses, and applicability of the various systems for capturing the elements of the NMDS for different care settings, care givers, and patient populations.
Implications: Nursing classification may eventually lead to naming and describing the work of nurses. Research findings will continue to provide information leading to a unified nursing language system that describes the practice of nursing in local, regional, national, and international health-care data sets used for research, clinical, education, policy, and administrative purposes.     

King达标理论在构建和谐护患关系中的应用

目的:探讨King达标理论在构建和谐护患关系中的作用.方法:对第二次住院的100例患者,在入院时和出院时填写调查表,住院期间接受经过培训并应用King达标理论的护理人员护理.结果:患者出院时对护士的满意度明显高于入院时满意度,差异有显著性(P＜0.01).结论:采用King达标理论指导护理实践,可提高患者对护士的满意度,从而构建和谐的护患关系.     

Viewpoint

PURPOSE: To propose the addition of a fifth domain, Administrative, to the Taxonomy of Nursing Practice, and to introduce the related concept of organization nursing diagnoses. DATA SOURCES: The Taxonomy of Nursing Practice, organizational and nursing management/leadership literature, experience of the authors. DATA SYNTHESIS: Analyzing the concept of a taxonomy to capture nursing practice revealed an omission of the management/leadership roles assumed by nurses in organizational, nurse manager, and staff nurse practice levels. To incorporate this administrative practice, an additional domain, Administrative, was developed. Nursing diagnoses were oriented to the organization as client, hence the addition of organization nursing diagnoses. CONCLUSIONS: Including an Administrative Domain in the Taxonomy of Nursing Practice will cover the scope of nursing practice and will provide a basis for developing the diagnoses for which nurses are accountable within organizations. IMPLICATIONS FOR PRACTICE: Nurses' contributions to healthcare organizational function and their effect on patient care outcomes will be made more explicit and can more readily be measured with terminology that captures the nursing administrative roles at three levels of practice.     

Contexts for the Study of the Economic Influence of Nursing Diagnoses on Patient Outcomes

PURPOSE: To examine the historical, legal/ organizational, informatics, clinical, economic, and policy contexts underlying economic consequences of nursing diagnoses on patient outcomes. DATA SOURCES: Published literature, online material. DATA SYNTHESIS: Nursing diagnoses influence diagnostic-specific patient outcomes and other outcome variables such as length of hospital stay, morbidity, and mortality. CONCLUSIONS: Examination of the economic ramifications of nursing diagnosis on patient outcomes can be facilitated using standardized language and databases containing nursing-sensitive measures.     

Nursing diagnosis and classification systems: a position paper*

There has been little professional debate in the UK literature about nursing diagnosis and this paper explores some of the reasons why nursing diagnosis has failed to gain momentum among nurses in the United Kingdom. The nursing diagnosis movement has now reached some European countries and in the light of the International Classification of Nursing Project (ICNP) and the Strategic Advisory Group for Nursing Information Systems (SAGNIS) project commissioned by the NHS Executive (NHSE), requires a close examination by British nurses. The unsuccessful attempt by the North American Nursing Diagnosis Association (NANDA) to have its taxonomy accepted for inclusion in the World Health Organization's 10th revision of the International Classification of Diseases, an innovation which would have made the NANDA taxonomy the definitive classification of nursing, should alert British nurses to the importance of nursing diagnosis. Although nurses effectively diagnose as part of the nursing process, adoption of the concept of nursing diagnosis as a driving force for practice evades many of them. This paper reflects upon some of the logistical and conceptual difficulties including issues of culture and terminology. It is suggested that nursing diagnosis has a great deal to offer British nurses in their efforts to improve the quality of care and to provide data in this area for both practice and research.     

Nursing doctoral education in Turkey

Quality health care is an issue of concern worldwide, and nursing can and must play a major and global role in transforming the healthcare environment. Doctorally prepared nurses are very much needed in the discipline to further develop and expand the science, as well as to prepare its future educators, scholars, leaders, and policy makers. In 1968, the Master of Science in Nursing Program was initiated in Turkey, followed by the Nursing Doctoral Education Program in 1972. Six University Schools of Nursing provide nursing doctoral education. By the graduating year of 2001, 154 students had graduated with the Doctor of Philosophy in Nursing (Ph.D.), and 206 students were enrolled in related courses. Many countries in the world are systematically building various collaborative models in their nursing doctoral education programs. Turkey would like to play an active role in creating collaborative nursing doctoral education programs with other countries. This paper centres on the structure and model of doctoral education for nurses in Turkey. It touches on doctoral programs around the world; describes in detail nursing doctoral education in Turkey, including its program structure, admission process, course units, assessment strategies and dissertation procedure; and discusses efforts to promote Turkey as a potential partner in international initiatives to improve nursing doctoral education.