Nursing Informatics & Terminology

Question

1. A standardized nursing terminology is going to be implemented in your practice setting (Family Nurse Practitioner). Based on your chosen specialty (FNP), which standardized terminology would most likely be adopted and why?

A standardized terminology is a tool that helps family practice nurses to describe all aspects of care such as assessing symptomology and patient responses with clarity and regularity, thus enhancing documentation, increasing visibility of nursing interventions, and ultimately improving patient care. The three terminologies: “NANDA, NIC, and NOC are recognized as official nursing languages by the American Nurses Association” (National Association of School Nurses, 2006).

“Once standardized, a term can be measured and coded” (Rutherford, 2008). Codes are quantifiable measures of patient state and nursing care activities, thus a standardized terminology provides greater objectivity and empowers administrators and case managers. The North American Nursing Diagnosis Association (NANDA) classification includes “172 nursing diagnoses and…13 domains” (NASN, 2006). This standardized taxonomy is essential to effective electronic charting which is being rapidly implemented nationally due to federal mandates. The Nursing Interventions Classification (NIC) aims to categorize any and all interventions that nurses perform; this “classification has 514 interventions and…seven domains” (NASN, 2006). Finally, the Nursing Outcomes Classification (NOC) describes states and behaviors as measured on a continuum. This vocabulary defines “330 outcomes…with seven domains” (NASN, 2006). These highly accurate and detailed terminologies would suit a family practice nurse’s needs.

References

National Association of School Nurses. (2006, June) Position Statement: Standardized Nursing Languages. Accessed 3/14/2014 at: http://orschoolnurse.org/flyers/Student%20Nurse%20Resources/Standardized%20Nursing%20Languages.pdf

Rutherford, M. (2008, January 31). Standardized Nursing Language: What Does It Mean for Nursing Practice? OJIN: The Online Journal of Issues in Nursing, Vol. 13 No. 1.

Question 

2. How would a standardized terminology (of your choice) directly impact your nursing practice? Provide a rationale and one example.

A standardized terminology for nursing diagnoses such as the NANDA would directly impact a family nursing practice because “measurement of the nursing care through a standardized vocabulary” has tremendous potential for data mining to lower costs and improve outcomes in such settings (Rutherford, 2008). A chronic or contagious disease might be spotted using trends derived from such databases, and most importantly, “evidence-based standards can be developed to validate the contribution of nurses to patient outcomes.” (Rutherford, 2008). Nursing care decisions can be evaluated quantitatively on a greater scale if a standardized terminology is adopted in a family practice. Without standardized terminology, “nursing is invisible and cannot be adequately monitored for safety, evaluated for quality, and improved” (Keenan, 2008, pp. 103-106).

References

Keenan, G. M., Tschannen, D., & Wesley, M. L. (2008). Standardized nursing terminologies can transform practice. JONA: The Journal of Nursing Administration, 38(3), 103-106.

Rutherford, M. (2008, January 31). Standardized nursing language: What does it mean for nursing practice? OJIN: The Online Journal of Issues in Nursing, Vol. 13 No. 1.

Question 

3. Describe the various elements necessary for effective leadership within a coalition.

There are different elements necessary for effective coalition leadership. In one “qualitative, longitudinal case study” of interdisciplinary integration of medical services, the authors stressed “the importance of the distributed change leadership model in contexts where legitimacy, authority, resources, and ability to influence complex change are dispersed across loci” (Chreim, 2010, pp. 187-199). Essentially, power should be distributed among members of the coalition, while the “change leaders” seek out team members and stakeholders and work to find “common ground” and inspire “credibility and trust” (Chreim, 2010, pp. 187-199). According to Mason, Leavitt & Chaffee, a coalition’s “structure serves the members, not the other way around.” Effective coalitions are “dynamic,” ranging from “highly structured, with formal” groups or “loosely structured, with shared leadership” (2013). A coalition’s power to change is built from its members upward, and a healthcare coalition’s structure should reflect that.

References

Chreim, S., Williams, B., Janz, L., & Dastmalchian, A. (2010). Change agency in a primary health care context. Health Care Management Review, 35(2), 187-199.

Mason, D. J., Leavitt, J. K., & Chaffee, M. W. (2013). Policy & politics in nursing and health care (6th ed.). St. Louis, MO: Saunders/Elsevier.

Question 

4. Consider your chosen policy priority: childhood obesity. How can you use evidence-based research to demonstrate the relationship of nursing practice to outcomes in your policy priority?

Evidence-based research clearly demonstrates the relationship of nursing practice to patient outcomes with regard to childhood obesity. In a school-based study in Beijing, researchers utilized “provision of educational materials to parents, classroom lessons on childhood obesity for students, a physical activity component,” family lectures on health consequences, a “traffic light food item list,” the “food pyramid,” and healthy activities (Jiang, 2007). Overweight and obese children and their parents were “singled out” for additional education to improve their fitness outcomes. (Jiang, 2007)

These types of interventions can be supervised by a school nurse who will assess the weight and health of the students. In the Beijing study, the intervention group had a “significantly lower” of overweight and obese students than the control group: “(overweight 9.8% compared with 14.4%; obese 7.9% compared with 13.3%). (Jiang, 2007) Interventions mirroring these such as child and family education concerning diet, activities, and healthy living can be evaluated with similar types of data, such as time of intervention and overall weight outcome. An evidenced-based literature analysis of a variety of school-based interventions has found that interventions which “combined diet and physical activity …may help prevent children becoming overweight in the long term,” based on measurements of weight and BMI (Brown & Summerbell, 2009). By tracing the quantitative outcomes of nursing practice through these different measures, nurses can set policies that emphasize evidence-based effective interventions over those that lack evidence or have been proven ineffective.

References

Jiang J. (2007) The effects of a 3-year obesity intervention in schoolchildren in Beijing. Childcare, health and development, 33(5), 641–6.

Brown, T., & Summerbell, C. (2009). Systematic review of school-based interventions that focus on changing dietary intake and physical activity levels to prevent childhood obesity: An Update to the obesity guidance produced by the National Institute for Health and Clinical Excellence. Obesity Reviews, 10(1), 110-141.