Page 226 - Encyclopedia of Nursing Research

FOrMAL NurSING LANGuAGES n 193

whether or not standardized terminologies across heterogeneous information systems,
not designed specifically for nursing were research transitioned from a focus on con-
useful for encoding nursing-relevant con- tent coverage toward computable rep- F
tent such as diagnoses, interventions, goals, resentations and the goal of semantic
and outcomes. Henry, Holzemer, reilly, interoperability, that is, data collected in one
and Campbell (1994) demonstrated that the information system using one terminology
Systematized Nomenclature of Human and can be understood in another information
Veterinary Medicine (SNOMEd) was more system that uses a different terminology.
comprehensive than NANdA to describe the This involved the development and testing
problems of persons living with HIV/AIdS. of reference terminology models (Bakken
Studies by Griffith and robinson (1992, et al., 2002; Hardiker, Casey, Coenen, &
1993) provided evidence that nurses per- Konicek, 2006; Moss, Coenen, & Mills, 2003),
form many Current Procedural Terminology a core component of a concept-oriented
(CPT)–coded functions and that some func- terminology, and integration of nursing-
tions are performed multiple times in a sin- specific terminologies into large concept-
gle day. In another study, Henry, Holzemer, oriented terminologies such as SNOMEd
randell, Hsieh, and Miller (1997) compared CT (International Health Terminology
the frequencies with which 21,366 nursing Standards development Organization,
activity terms from multiple data sources 2010) and LOINC (Matney, Bakken, & Huff,
(patient interviews, nurse interviews, inter- 2003).
shift reports, and patient records) could be Since the early 2000s, researchers have
categorized using NIC and CPT codes and focused increased attention on formal lan-
provided evidence for the superiority of NIC guages in the context of other standardized
in representing nursing activity data. and formal structures such as domain mod-
Complementary to the research that els, templates, documents, and electronic
was being conducted, the American Nurses health records to decrease the ambiguity of
Association played a significant policy role meaning and increase the usefulness of the
in “recognizing” language systems (Table 2) data recorded. Goossen et al. (2004) developed
that met specific criteria related not only to a provisional domain model for the nurs-
utility for nursing but also to scientific rigor ing process for use within the Health Level
(McCormick et al., 1994). This process facili- 7 reference information model. Hyun et al.
tated the inclusion of selected nursing termi- (2009) tested the utility of the Health Level
nologies into the unified Medical Language 7—LOINC Clinical document Ontology for
System (Humphreys, Lindberg, Schoolman, & representing nursing document names. Hoy,
Barnett, 1998). The 2010 version of the unified Hardiker, McNicoll, Westwell, and Bryans
Medical Language System Metathesaurus (2009) described the process of develop-
(http://umlsks.nlm.nih.gov) includes the ing clinical nursing templates as a national
following terminologies recognized by the resource and highlighted the need for inter-
American Nurses Association: NANdA, NIC, national collaboration. Within the context of
Nursing Outcomes Classification, Clinical electronic health records, additional research
Care Classification, Omaha System, Perio- focused on the development of a preliminary
perative Nursing data Set, SNOMEd Clinical set of requirements centered on how struc-
Terms (CT), ICNP, and Logical Observation tured data is presented to users for selection;
Identifiers, Names, and Codes (LOINC™). how to mediate between a variety of con-
In the third generation, with the ceptual structures including terminologies,
increasing sophistication in terminolog- information models, user interface models,
ical science and the need for data sharing and models of the clinical process; and how