Page 225 - Encyclopedia of Nursing Research

192 n FOrMAL NurSING LANGuAGES

This report also differentiated between clin- (ICNP) commenced (Clark & Lang, 1992)
ical terms, which represent the language of and has continued to mature (International
F practice, and definition terms, which repre- Council of Nurses, 2010).
sent the language of nursing knowledge Testing of nursing-specific and more
comprising theory and research. The distinc- general languages for multiple clinical and
tion between language that supports practice research purposes by persons other than the
versus language that supports theory and developers followed. For example, Carter,
research is blurring as the state of the science Moorhead, McCloskey, and Bulechek (1995)
in this area moves toward definitional, con- demonstrated the usefulness of NIC in
cept representations that can be processed by implementing clinical practice guidelines for
computer algorithms and shared among het- pain management and pressure ulcer man-
erogeneous information systems (Hardiker, agement. Parlocha and Henry (1998) reported
Bakken, Casey, & Hoy, 2002). the usefulness of the Home Health Care
research in standardized language Classification for categorizing nursing care
to represent nursing concepts reflects four activities for home care patients with a diag-
generations of inquiry: (a) development of nosis of major depressive disorder. Several
organized collections of terms, (b) testing studies demonstrated the capacity of the
of nursing-specific and general health care Omaha System to predict service utilization
terminologies to represent terms from nurs- (Marek, 1996) and outcomes of care (Martin,
ing practice, (c) integration of nursing con- Scheet, & Stegman, 1993). Moreover, instead
cepts into other health care terminologies of creating new terminologies from scratch,
using reference terminology models, and groups such as the Association of periOpera-
(d) context-specific organization of nursing tive registered Nurses (2008) adopted some
concepts. Initial research on formal nurs- terms from existing terminologies and aug-
ing language focused on the development mented as needed for their specialty prac-
of standardized coding and classification tice to create the Perioperative Nursing data
systems that represented the phenomena of Set. Other investigators provided evidence
clinical practice across care settings within that nursing terminologies were useful to
the framework of the nursing minimum data retrospectively abstract and codify patient
set, comprising five data elements specific problems and nursing interventions from
to nursing: (a) nursing diagnosis, (b) nurs- sources of research data such as care logs
ing interventions, (c) nursing outcomes, (d) (Naylor, Bowles, & Brooten, 2000) or patient
intensity of care, and (e) unique rN provider records (Holzemer et al., 1997). In another
number (Werley & Lang, 1988). This resulted investigation, Holzemer et al. (2006) based
in multiple nursing language systems the documentation of their nurse-delivered
including those that persist today: the North adherence intervention on the Home Health
American Nursing diagnosis Association Care Classification to determine the dose of
International (NANdA International, 2008), the nursing intervention in a randomized
the Nursing Interventions Classification controlled trial (Bakken et al., 2005).
(NIC; dochterman & Bulechek, 2004), the As confidence grew that the nursing-
Nursing Outcomes Classification (Moor- specific systems that had been developed
head, Johnson, & Maas, 2004), the Clinical reflected the domain of nursing and the
Care Classification (formerly known as the drivers for multidisciplinary care and care
Home Health Care Classification; Saba, systems grew, some investigators evaluated
2007), and the Omaha System (Martin, 2004). the extent to which terminologies not devel-
Internationally, the development of the Inter- oped for nursing had utility for nursing
national Classification of Nursing Practice practice. Several research studies examined