Nursing Informatics Project Discussion
Nursing Informatics Project Discussion
In a 4- to 5-page project proposal written to the leadership of your healthcare organization,
propose a SPECIFIC nursing informatics project for your organization that you advocate to improve patient outcomes or patient-care efficiency.
Your project proposal should include the following:
Describe the project you propose.
Identify the stakeholders impacted by this project.
Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving and
explain how this improvement would occur. Be specific and provide examples.
Identify the technologies required to implement this project and explain why.
Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.
I attached the resources for the week and the rubric…..please follow rubric and use the resources as you need them
Use of a standardized nursing language for documentation of nursing care is vital both to the nursing profession and to the bedside/direct care nurse. The purpose of this article is to provide examples of the usefulness of standardized languages to direct care/bedside nurses. Currently, the American Nurses Association has approved thirteen standardized languages that support nursing practice, only ten of which are considered languages specific to nursing care. The purpose of this article is to offer a definition of standardized language in nursing, to describe how standardized nursing languages are applied in the clinical setting, and to explain the benefits of standardizing nursing languages. These benefits include: better communication among nurses and other health care providers, increased visibility of nursing interventions, improved patient care, enhanced data collection to evaluate nursing care outcomes, greater adherence to standards of care, and facilitated assessment of nursing competency. Implications of standardized language for nursing education, research, and administration are also presented.
Keywords: North American Nursing Diagnosis Association (NANDA); Nursing Intervention Classification (NIC); Nursing Outcome Classification (NOC); nursing judgments; patient care; quality care; standardized nursing language; communication Nursing Informatics Project Discussion
Citation: Rutherford, M., (Jan. 31, 2008) “Standardized Nursing Language: What Does It Mean for Nursing Practice? “OJIN: The Online Journal of Issues in Nursing. Vol. 13 No. 1.
Recently a visit was made by the author to the labor and delivery unit of a local community hospital to observe the nurses’ recent implementation of the Nursing Intervention Classification (NIC) (McCloskey-Dochterman & Bulechek, 2004) and the Nursing Outcome Classification (NOC) (Moorehead, Johnson, & Maas, 2004) systems for nursing care documentation within their electronic health care records system. …it is impossible for medicine, nursing, or any health care-related discipline to implement the use of [electronic documentation] without having a standardized language or vocabulary to describe key components of the care process. During the conversation, one nurse made a statement that was somewhat alarming, saying, “We document our care using standardized nursing languages but we don’t fully understand why we do.” The statement led the author to wonder how many practicing nurses might benefit from an article explaining how standardized nursing languages will improve patient care and play an important role in building a body of evidence-based outcomes for nursing.
Most articles in the nursing literature that reference standardized nursing languages are related to research or are scholarly discussions addressing the fine points surrounding the development or evaluation of these languages. Although the value of a specific, standardized nursing language may be addressed, there often is limited, in-depth discussion about the application to nursing practice.
Practicing nurses need to know why it is important to document care using standardized nursing languages, especially as more and more organizations are moving to electronic documentation (ED) and the use of electronic health records. In fact, it is impossible for medicine, nursing, or any health care-related discipline to implement the use of ED without having a standardized language or vocabulary to describe key components of the care process. It is important to understand the many ways in which utilization of nursing languages will provide benefits to nursing practice and patient outcomes.
Norma Lang has stated, “If we cannot name it, we cannot control it, practice it, teach it, finance it, or put it into public policy” (Clark & Lang, 1992, p. 109). Although nursing care has historically been associated with medical diagnoses, …today nursing needs a unique language to express what it does so that nurses can be compensated for the care provided. nurses need an explicit language to better establish their standards and influence the regulations that guide their practice.
A standardized nursing language should be defined so that nursing care can be communicated accurately among nurses and other health care providers. Once standardized, a term can be measured and coded. Measurement of the nursing care through a standardized vocabulary by way of an ED will lead to the development of large databases. From these databases, evidence-based standards can be developed to validate the contribution of nurses to patient outcomes.
The purpose of this article is to offer a definition of standardized language in nursing, to describe how standardized nursing languages are applied in the clinical arena, and to explain the benefits of standardizing nursing languages. These benefits include: better communication among nurses and other health care providers, increased visibility of nursing interventions, improved patient care, enhanced data collection to evaluate nursing care outcomes, greater adherence to standards of care, and facilitated assessment of nursing competency. Implications of standardized language for nursing education, research, and administration are also presented. Nursing Informatics Project Discussion
Standardized Language Defined