Education, Practice, and Research in Nursing Terminology: Gaps, Challenges, and Opportunities

Summary

Objectives To provide an overview of nursing terminology education, research, and clinical use, to identify and analyze any gaps therein, and to propose ways to close those gaps.

Methods We conducted an extensive Internet and literature search to establish the current status of nursing terminology education, research, and clinical use. We also surveyed 40 experts in nursing terminology from 15 countries to obtain more detailed information on nursing terminology education and clinical use.

Results We found that there are gaps in nursing terminology education, research, and use, with the area of research being the most advanced. Nursing terminology is not taught widely in either informatics or nursing programs. Where it is taught, it constitutes only up to several hours of an informatics or nursing course. Research into nursing terminology has been very active, focusing mainly on the development and evaluation/validation of nursing terminology, using reference terminology models, and mapping between these and nursing terminologies. However, little research has been carried out on the use of nursing terminologies in clinical information systems. In addition, there are very few systems in which a standardized nursing terminology has been implemented.

Conclusion In order to close the gaps in nursing terminology education, research, and clinical use, qualified personnel are required to educate potential users as to the importance of terminology-based information systems for semantic interoperability. In addition, more research is required into the implementation of nursing terminologies in information systems, and we must demonstrate the usefulness and effectiveness of nursing terminology-based information systems.

Keywords

Nursing terminology - nursing informatics - gap analysis - education - research - clinical practice

• References

• 1 Shortliffe EH, Perreault LE, Wiederhold G, Fagan LM. Medical Informatics: Computer Applications in Health Care and Biomedicine. New York: Springer; 1999
• 2 Bakken S, Cimino JJ, Hripcsak G. Promoting patient safety through enabling evidence-based practice through informatics. Medical Care. 2004. 42 II49.
• 3 American NursingAssociation. Nursing Informatics: Scope and Standards of Practice. Silver Spring: American Nurses Publishing; 2008
• 4 Nursing Informatics Working Groups. Education in Nursing Informatics. AMIA NI-WG. Available from: http://www2.amia.org/mbrcenter/wg/ni/ education.asp..
• 5 Saba VK, Taylor SL. Moving past theory: use of a standardized, coded nursing terminology to enhance nursing visibility. Computers, Informatics, Nursing: CIN 2007; 25: 324.
• 6 Cho I, Park HA. Development and evaluation of a terminology-based electronic nursing record system. J of Biomed Inform 2003; 36: 304.
• 7 Bakken S, Holzemer WL, Portillo CJ, Grimes R, Welch J, Wantland D. Utility of a standardized nursing terminology to evaluate dosage and tailoring of an HIV/AIDS adherence intervention. Journal of Nursing Scholarship: an Official Publication of Sigma Theta Tau International Honor Society of Nursing/Sigma Theta Tau 2005; 37: 251.
• 8 Junttila K, Salanterä S, Hupli M. Developing terminology for documenting perioperative nursing interventions. Int J Med Inform 2005; 74: 461.
• 9 Kennedy MA, Hannah K. Representing nursing practice: evaluating the effectiveness of a nursing classification system. Can J Nurs Res 2007; 39: 58.
• 10 Hardiker NR, Bakken S, Casey A, Hoy D. Formal nursing terminology systems: a means to an end. J Biomed Inform 2002; 35: 298.
• 11 Hardiker NR. Determining sources for formal nursing terminology systems. J Biomed Inform 2003; 36: 279.
• 12 Matney S, Dent C, Rocha RA. Development of a compositional terminology model for nursing orders. Int J Med Inform 2004; 73: 625.
• 13 Bakken S, Warren JJ, Lundberg C, Casey A, Correia C, Konicek D. et al. An evaluation of the usefulness of two terminology models for integrating nursing diagnosis concepts into SNOMED Clinical Terms. Int J Med Inform 2002; 68: 71.
• 14 Moss J, Coenen A, Mills ME. Evaluation of the draft international standard for a reference terminology model for nursing actions. J Biomed Inform 2003; 36: 271.
• 15 Ehnfors M, Angermo LM, Berring L, Ehrenberg A, Lindhardt T, Rotegard AK. et al. Mapping VIPS concepts for nursing interventions to the ISO reference terminology model for nursing actions: A collaborative Scandinavian analysis. Stud Health Technol Inform 2006; 122: 401.
• 16 Hwang J, Cimino JJ, Bakken S. Integrating nursing diagnostic concepts into the medical entities dictionary using the ISO Reference Terminology Model for Nursing Diagnostics. J Am Med Inform Assoc 2003; 10: 382.
• 17 Goossen W. Cross-mapping between three terminologies with the international standard nursing reference terminology model. Int J Nurs Terminol Classif 2006; 17: 153.
• 18 Park HA, Kim JH, Lee JH, Lee HY, Kim JW, Kim JH. et al. Standardization of Korean nursing terminology. Stud Health Technol Inform 2006; 122: 992.
• 19 Sagara K, Abe A, Ozaku HI, Kuwahara N, Kogure K. Features of standardized nursing terminology sets in Japan. Stud Health Technol Inform 2006; 122: 471.
• 20 Jokinen T, Ensio A, Saranto K. Using standardized terminology for nursing documentation. Stud Health Technol Inform 2006; 122: 995.
• 21 Ensio A, Saranto K, Ikonen H, Iivari A. The national evaluation of standardized terminology. Stud Health Technol Inform 2006; 122: 749.
• 22 Hyun S, Park HA. Cross-mapping the ICNP with NANDA, HHCC, Omaha system and NIC for unified nursing language system development. Int Nurs Rev 2002; 49: 99.
• 23 Cho I, Park H. Evaluation of the expressiveness of an ICNP-based nursing data dictionary in a computerized nursing record system. J Am Med Inform Assoc 2006; 13: 456.
• 24 Park H, Cho I, Jung E. Exploring use of a clinical data repository containing ICNP-based nursing practice data. Comput Inform Nurs. In press. 2009
• 25 CIC Home page. Committee on Institutional Cooperation. Available at: http://www.cic.net/.Accessed September 28, 2008..