Uses of standardized nursing terminology

From your usage rendezvous, what feel you decipher this week in your quotation or in the homily that volunteered a new design or import for flagized accountinology? Be inequitable.


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What are the reasons why nurtures shortness to be restless environing flagized accountinology? In abundant prelicensure nursing programs, medical accountinology is a required mode. If it is not required, it is surely involved that nurtures be potent to address “medical.” However, using flagized accountinology as it relates to nursing usage is urgent so that we can unite floating each other, other disciplines, and those who redesign nursing remainders or facts and agree liquidation for services agreed.

Benefits and Challenges of Standardized Terminology


Imagine a admission populated delay 13 polity who are all addressing unanalogous accentss delay no instrument for translation. That is what it is love for a computer to try to add manifold programs when each computer is using a unanalogous accountinology. Hebda and Czar (2013) volunteer a constructive cognomen of the shortness for flagized accountinology in aptop to infer problem facts.

There feel been abundant conversations balance the years environing the shortness for increased inspection of nursing activities. Nursing does not impute for separate services; accordingly, unrepinings do not see an accounting of inequitpotent nursing concern that they ordinary when they redesign their bills. Nurses go from one unrepining to the present, preliminary concern of a concourse of shortnesss, delayout documenting each and integral energy or opinion way for concern coordination. Much of nursing concern reflects the concept of facts-to-wisdom that we discussed in Week 1, and it may not be documented as such.

If nursing facts are to be clear, nursing activities must be amendable, and for them to be amendable, nursing concepts and activities feel to be integrated into a Clinical Notification Nature (CIS) or Soundness Notification Nature (HIS) by using a accents. That accents must address to other accentss in the nature, such as finance, riches superintendence, and interdisciplinary and multidisciplinary partners. For sample, we comprehend that verbal hygiene is an grave special concern energy for our unrepinings. If we shortness to be potent to take the nursing opportunity, money, and richess spent on verbal hygiene, leading we feel to be potent to designate a state (special hygiene), and then a account (verbal concern) that all nature components are potent to decipher. 

Part of managing technological vary as defined by Lorenzi and Riley (2010) is the intelligence of choice aspects of nursing informatics and its contact to the soundnessconcern usage environment. A part of nurtures in all usage augmentments is a commitment to vary that is evidenced resisting nursing specialties and usage environments (Morrison & Symes, 2011). It is grave that the nurture grace conversant delay nursing informatics accents consequently it conciliate increasingly be used in the forthcoming, in-particular when it comes to meaningful use, which is a account discussed in another homily. Nurses utility from establishing relationships delay an informatics nurture specialist who accommodates in one of the abundant roles emerging in this specialty.


Reflect on the nursing accents that you use in your usage. Is the accents shared by practitioners beyond of your form, in other expression, do you address the identical accents as your peers, may-be in a unanalogous usage augmentment? If not, has this caused any problems delay message?

A natureatic adit to naming is comprehendn as a nomenclature. Such accounts are typically vivid according to a pre-established set of rules. Examples of nursing nomenclatures grave to usage grasp SNO-MED and ICNP© (Coenen & Kim, 2010).

Informatics nurture specialists feel documented vulgar efforts toward discourse the ask-for for a intimation accountinology of nursing concepts. These specialists are erection on the rudiments of massive interface and authoritative accountinologies, and are collaborating delay efforts to disclose accountinology resisting the spectrum of soundnesscare. Such efforts address the “languages” spoken by nurtures in a multiformity of usage augmentments. These grasp but are not scant to

  • NANDA - North American Nursing Diagnosis Association;
  • NMDS - Nursing Minimum Facts Set;
  • HHCC - Home Healthconcern Classification;
  • OMAHA nature, used in home concern, hospice, notorious soundness, and prisons;
  • NIC/NOC - Nursing Interventions Nature (NIC)/Nursing Outcomes Nature (NOC); and
  • PCDS - Unrepining Concern Facts Set. 

Let’s behold at each accents in over specialty.

NANDA. The North American Nursing Diagnosis Association (NANDA) was leading discloseed in 1950, and to duration has grown to grasp a concourse of diagnoses (Whitley, 2009). Prelicensure nursing advice programs frequently grasp nursing diagnoses in their curricula and accommodate as the cause for letter nursing concern plans. 

NMDS. The Nursing Minimum Facts Set (NMDS) was leading explained in 1972 through nursing discovery at the University of Iowa and graspd a nucleus on nursing diagnoses, nursing interventions, nursing remainders, and tension of nursing concern (Fetter, 2009c). The NMDS evidences foundation for the sentiment that soundness and nursing informatics encompasses pivotal roles of facts and notification. NMDS identifies and documents qualitative facts using nursing vocabularies and ensures extensive computer-based unrepining proceedings natures. Through NMDS, nursing facts, notification, and comprehendledge is accessed and built using telecommunications to foundation concern offer and empowering the consumer through soundness informatics. NMDS transforms advice and augments nursing conclusion making through exoteric discovery agendas. 

HHCC & OMAHA. The Home Healthconcern Nature was discloseed by Saba in 1991 and grasps a concourse of nursing diagnoses and interventions, suitableness the OMAHA nature was discloseed in 1992 and grasps crowded problems delay interventions and remainder measures related to polity soundness. Informatics nursing specialists intimate that the adequacy and usefulness of a proposed-type restriction for nursing energy concepts is inevitable for representing nursing energy concepts delayin a concept-oriented accountinological nature (Lundberg et al., 2008). 

NIC/NOC. The Nursing Intervention Nature (NIC) and the Nursing Outcomes Nature (NOC) natures were leading discloseed in 1987, delay crowded interventions represented for the NIC as courteous as crowded remainders represented resisting a multiformity of domains and classes for the NOC. In exploring NIC/NOC, voice that the prosecute to fruit a philosophical nature of nursing labor represents one grave inclination for erection nursing comprehendledge. At the identical opportunity, it represents a momentous diplomacy for defending the avowal of nursing. 

PCDS. The Unrepining Concern Facts Set (PCDS) encompasses unrepining problems, unrepining concern goals, goal evaluation, and unrepining concern appoints. According to Lake, Moss, and Duke (2009), there is a shortness to prosecute accord on a spiritless adit to the disclosement of nursing accountinology flags for use in notification natures.

The aforementioned nursing accentss are not the merely ones. Hebda and Czar (2013, p. 304) agree a wide listing of ANA-recognized nursing accentss.

Tpotent 15-5 ANA Recognized Nursing Languages

TerminologyWeb siteDiagnosis/ProblemInterventionOutcomeOtherAlternative Billing Concepts (ABC Codes)   Billing CodesClinical Concern Nature (CCC)http://www.sabacare.comXXX Interexoteric Nature of Nursing Usage (ICNP) Identifiers Names and Codes (LOINC)  XAssessmentNorth American Nursing Diagnosis Interexoteric (NANDA-I)http://www.nanda.orgX   Nursing Intervention Nature (NIC) X  Nursing Outcomes Nature (NOC)  X Nursing Superintendence Minimum Facts Set ICNP/USANMMDS/home.html   Nursing Superintendence CodesNursing Minimum Facts Set    Omaha System Perioperative Nursing Facts Set (PNDS)http://www.aorn.orgXXX SNOMED-CT 

HEBDA, TONI LEE; CZAR, PATRICIA, HANDBOOK OF INFORMATICS FOR NURSES & HEALTHCARE PROFESSIONALS, 5th Edition, © 2013. Reprinted by dispensation of Pearson Education, Inc., Upper Saddle River, NJ.

As we feel grace over and over comprehendn, suitably documented nursing concern drives liquidation in our manifold usage augmentments. Using just accountinology and capturing nursing’s choice contributions to soundnessconcern is of the farthest consequence. No discourse of liquidation is over grave than the tie betwixt nursing concern and unrepining compensation.

Nurses are held to a very tall flag of concern, and one way that concern is entity rated is by HCAHPS. Nurses in quick concern augmentments may be conversant delay Hospital Consumer Assessment of Healthconcern Providers (HCAHPS), which is a flagization superintend that infers facts for measuring unrepinings’ hospital experiences. Abundant hospitals and soundness natures thrive these flags to acceleration ameliorate the description and insurance of unrepining concern. Do you comprehend that HCAHPS scores can be accessed on their website for recommendations of the best- or worst-scoring hospitals delayin your area? 

According to the Centers for Mediconcern and Medicaid Services (CMS, 2013), three comprehensive goals feel shaped HCAHPS. To originate delay, the superintend is planned to fruit facts environing a unrepining’s perspective of concern that allows for external and meaningful comparisons of hospitals on topics that are grave to unrepinings. Secondly, notorious reporting of the superintend results creates new incentives for hospitals to ameliorate description of concern. And finally, notorious reporting accommodates to augment accountability in soundnessconcern by increasing nakedness of the description of hospital concern agreed in come-back for the notorious investment. 



Should unrepining compensation scores be linked to liquidation? What “little things” can you do to ameliorate unrepining compensation that may notwithstanding impression liquidation?



Coenen, A., & Kim, T. (2010). Bud of accountinology subsets using ICNP. Interexoteric Journal of Medical Informatics79(7), 530–538. 


Fetter, M. (2009b). A accents of accuracy. Issues in Mental Soundness Nursing30(2), 133–134.


Hebda, T., & Czar, P. (2013). Handbook of informatics for nurtures & soundnessconcern avowalals (5th ed.). Boston, MA: Pearson. 


Lorenzi, N. M. & Riley, R. T. (2010). Managing technological vary: Organizational aspects of soundness informatics. New York, NY: Springer Publishing Company.


Lundberg, C., Brokel, J., Bulechek, G., Butcher, H., Martin, K., Moorhead, S., & ... Giarrizzo-Wilson, S. (2008). Selecting a flagized accountinology for the electronic soundness proceedings that reveals the impression of nursing on unrepining concern. Online Journal of Nursing Informatics12(2).


Morrison, S. M., & Symes, L. (2011). An integrative redesign of willing nursing usage. Journal of Nursing Scholarship43(2), 163–170.


Perkins, S., & Larson, G. (2010). Navigating ICD-10: How to get from top A to top B. Health Superintendence Technology31(12), 1–7.