Standards Terminology Paper Elizaveta Pavlenko Frostburg State University Preface In standards terminology paper one patient’s assessment will be presented along with Nursing Diagnosis, Nursing intervention Classification and the Nursing Outcome Classification. In conclusion part of the paper, the summary of these systems will be provided. Clinical Encounter Mary Smith, Female, 56 years old, presented to Emergency Department with abnormal Chest Xray, fever, chills and generalized weakness
tool in nursing because it is a universal language that aides in describing patient care and can be understood by all parties included. (Keenan, 1999).
Assignment Nursing is a field that requires all people involved in a patient’s care to be able to speak the same language, and to understand what is begin done to improve each patient’s outcome. There is no room for error or misinterpretation. This is the reason that it is critical to implement standards for nursing terminology. The Center for Nursing Classification and Effectiveness (CNC) is the organization responsible for ongoing research and development of the Nursing Interventions Classification
Breast Cancer Patient Throughout this paper the identification and application of standardized terminologies such as: The North American Nursing Diagnosis Association (NANDA) to identify the applicable diagnosis; Nursing Interventions Classification (NIC) to construct a care-plan with diagnosis specific interventions; and the Nursing Outcomes Classification (NOC) to evaluate the outcomes. This will be applied to a clinical patient scenario of newly diagnosed breast cancer; and present the conjunction
CFIM focuses on applying interventions that can either “promote, improve, or sustain family functioning in any or all of the three domains…” (Wright & Leahey, 2013, p. 152). Nevertheless, the CFIM chooses to focus on a family’s strengths and resilience instead of focusing on their shortcomings and dysfunction (Wright & Leahey, 2013). Primary Diagnosis. After careful consideration and evaluation, we have concluded on two nursing diagnoses for the above family. The primary diagnosis
standardized nursing language is a “common language, readily understood by all nurses, to describe care” (p. 1 2). The American Nurses Association (ANA) has 13 recognized standardized nursing terminologies that support nursing practice. The following are the terminologies and the year they were recognized. 1. NANDA-I: nursing diagnosis, definitions and classification : 1992 2. Nursing intervention classification system (NIC) : 1992 3. Clinical care classification system (CCC) formerly
College of Nursing NR 512: Nursing Informatics Fall 2014 Introduction As a result of the introduction of computer technology and the combination of evidence-based practice in nursing; standardization of terminologies has become imperative in the classification of nursing diagnosis, interventions and expected outcomes. The most popular and successful systems are the North American Nursing Diagnosis Association International (NANDA-I), Nursing Outcomes Classification (NOC), and Nursing Intervention Classification
Introduction This paper provides a discussion of the Electronic Health Record for healthcare, explains why it is important for nursing to have a standard nomenclature for nursing care, and compares and contrasts two of the nursing terminologies currently recognized by the American Nursing Association. Body "Organized information allows inferences to be made that answer questions greater than those answered by the information alone." (Moss, Damrongsak, & Gallichio, 2005, p. 545). Medical care is
The Need for Classification of Nursing Data in EHRs In the healthcare industry, nursing is underrepresented in the development of healthcare policies. Current nursing practice depends on the use of standardized nursing terminology and documentation to accurately communicate and identify nursing diagnoses, nursing care provided, and interventions that were performed within healthcare disciplines process (Mennella & Caple, 2016). The essential solution to making nursing more visible is having necessary
Applying Standardized Terminologies in Practice Chamberlain College of Nursing NR 512: Nursing Informatics Summer 2014 Introduction The health industry is in the process of adopting evidence based interventions. This has lead to the standardization on the mode of communication in the classification of diagnosis, applied interventions and the expected outcomes. In this standardization process, the NANDA, NIC, and NOC elements are the most commonly used and effective systems