Invisibility of Nursing - Essay Example

? “Invisibility of Nursing” For a long time, nurses rely on word of mouth for passing of information and knowledge. Nurses tend to use informal notes when reporting to other nurses verbally, instead of using care plans and patient records. Nursing data is, therefore, not seen to be valuable; leading to discernment that nursing is a handmaiden to medicine. This results into their work being invisible. Using computerized nursing documentation systems will reduce the invisibility, by providing a more patient centred and dependable documentation. However, data used by nurses in providing care is time and again unmanageable and extensive, due to the fast explosion of nursing knowledge globally. Nursing Minimum Data Set(NMDS), solves this issue; it can be defined as “… a minimum set of items of information with uniform definitions and categories concerning the specific dimension of nursing which meets the information needs of multiple data users in the healthcare system…” ( Werley et al., 1991, p. 422) . It is a tool modelled for collection of nursing data, which is standard, uniform and comparable that is used across different settings and different groups of patients. NMDS creates a minimum set of important core data used by nurses; in other words, NMDS standardizes the process of collecting essential nursing data. Public health nurses use NMDS in their practises in addition to comparing resource consumption and nursing care across other settings (Dick, & Steen, 1991). In development and promotion of standardized terminologies, patient and nursing care data is collected at first either electronically or manual through paper based systems. This is done from different selected samples. Thereafter, the collected data is analysed using different methods of data analysis. The analysis enables outcomes on nursing diagnosis and patients outcomes. After the analysis, feedback on nursing care is presented. Various findings are then reported in publications and at conferences. Further, national map is incorporated into the feedback which allows easy comparison of wards, institution and patient categories. Standard clinical terminologies were developed as a mechanism to resolve problems that arise from using diverse terminologies in the nursing field. Focus of development and adoption of standard clinical terminology is to enhance quality in the field of nursing through terminologies that are established using tried and tested methods; reducing effort through avoidance of wheel reinvention; compatibility by integration of data gathered from different source systems, and great coherence and convergent mechanism between terminologies. The American Nurses Association (ANA) is responsible for standardizing nursing terminologies and coordinating various minimum data sets in the United States of America. Nursing Practice Information Infrastructure (CNPII), a committee for ANA, evaluates the data sets in addition to standardized terminologies that are submitted to them, to check whether they are in accordance to certain criteria (ANA, 2012). This criterion includes, terminology development is clinically useful and that the terms are not ambiguous in addition to being clear. The International Health Terminology Standards Development Organization (IHTSDO) is an international organization, which in non-profit and it is based in Denmark. The organization owns, acquires, and administers rights to SNOMED CT in addition to other related standards and health terminologies. IHTSDO purpose is to develop, promote, maintain and enable the correct uptake and use of its terminology products around the world. The organization improves health of human kind through nurturing development and use of standardized clinical terminologies. This enables accurate, safe and effective exchange of health related and clinical information. Several advantages of using standardized terminologies arise for direct care nurses. There is better communication among nurses and other health care providers. Using standardized nursing language helps in improving communication within the institution among nurses, administrators and health care professionals. This is because there is a common standard language or code that is used. Another benefit is an increase in visibility of nursing interventions. It is important for nurses to express themselves exactly, what it is that they are doing for patients. This is because nurses rely greatly on word of mouth for information and knowledge passing. The work of nurses remains invisible since they use informal reports rather than, care plans and patient records, to one another. Visibility on nursing interventions in increased by computerized nursing documentation systems which results into highlighting nurses’ contribution to patient outcomes. Data collection for effective nursing care outcome is also enhanced through use of standardized language. This is because; recording of nursing care is done by a standardized language that provides consistency. A vital quality in assessing or comparing different interventions is consistence data (Werley, 1991). Standardized terminologies also help in adherence to standards of care. The level of adherence to standards of care for a certain population of patient, relates to quality of nursing care. This is because expert input of nurses and care standards from different professional organizations make the basis of standardized languages. Lastly, standardized language can be used to assess nursing competency. Staff competence for the Joint Commission, is required to be demonstrated by health care facilities (Harmer, 1926). Nurse competency can be assessed by nursing interventions outlined in the standardized nursing languages. Various challenges arise in using standardized terminologies. Constraints arise on what is achievable and desirable. A lot of communication is health care will be informal. This includes written comments and conversations that are meant for short term purposes. The challenge here is to draw a line where to justify feasibility and desirability of formalization (Thede, & Sewell, 2010). Granularity is another issue. The level of details to be used in standardized language is a challenge. Relevance of details in the language is arguable on matters of functionality, for current or future use of the standardized terminologies (McCloskey, & Bulechek, 1992). Different world views must be taken into consideration in standards that are applied internationally. Risk monitoring, quality assurance and communication between nurses are issues to be considered upon standardization in addition to allowing comparison and exchange of information. Achieving a consensus on the ultimate goal for standardization of nursing language is also a challenge. A greater task lies on agreement of content on the standardized language. This is brought about by the notion or implication that, despite the shortcomings, if something works it should be welcome. Furthermore, scares expertise and resources, are additional challenges to standardization. There are a number of values that arise from adoption of standard clinical terminology to informatics nurses, through implementation of NMDS. The first implication is on clinical practice and administration. Accurate data together with professional judgment has a great influence on decision making, since practice data and management are complementary (Werley, 1991). This helps greatly in administrative work. Nurse clinicians and public health nurses should make sure that documentation of nursing care is done in a complete and accurate manner. Nurse administrators use this information to recognize the trend which the core data reflect in nursing practices and service provision for their administrative work. The second value is research. Through NMDS, nursing information is compiled across different settings, populations, geographical locations. This information is compiled using the same definitions, elements, categorisations and nursing process labels. This enables the element of comparability which makes research possible that can enhance nursing practices (Werley, 1991). Various areas where research can be done through NMDS include; description of nursing care of clients, assessment of patterns in diagnosis done by nurses, evaluation of resolution status of referrals for further nursing, appraisal of cost effectiveness in nurse staffing, evaluation of resource requirements in care delivery settings, and evaluation of nursing care patterns among others (Abdella, Beland, & Martin, 1959). Lastly, development and adoption of standard clinical terminology, also adds value in healthy policy decision making. NMDS is essential when it comes to Medical Treatment Effectiveness Program. This is a program that is funded by the federal government and its sole purpose is to demonstrate the procedures that are most effective in production of quality client outcomes. This is enabled through a standardized nursing language through NMDS. The federal government is able to make decisions on healthy policy issues such as, effective nursing care, based on nursing data on NMDS. Another area on decision making on healthy issues is, the prospective payment for home healthcare. Through NMDS, data can be retrieved and used for prospective payment systems that can account for variances in the cost of care providence to clients in home stings. References: Abdella, F.G., Beland, I.L., & Martin, A. (1959). Patient Centred Approaches to Nursing. New York: Macmillan. American Nurses Association(ANA).  (2012). ANA recognized terminologies that support nursing practice.  Retrieved from http://nursingworld.org/npii/terminologies.htm  Dick, R., &Steen , E. (1991). The Computer-Based Patient Record: An Essential Technology for Health Care. Washington, DC: National Academy Press. Harmer, B. (1926). Methods and Principles of Teaching the Principles and Practice of Nursing. New York: Macmillan. McCloskey, J.C., & Bulechek, G..M. (1992). Nursing Interventions Classification (1st Ed). St Louis. Mosley Year Book Inc. Thede, L. Q., & Sewell, J. P. (2010). Informatics and Nursing: Opportunities and Challenges (3rd ed.). Philadelphia: Lippincott, Williams & Wilkins. Werley, H. H., Devine, E. C , Zorn, C. R., Ryan P., & Westra, B. L. (1991), The Nursing Minimum Data Set: Abstraction Tool for Standardized, Comparable, Essential Data. The American Journal of Public Health, 81(4), 421-426. Read More