Nursing Outcomes Measures and Interventions
Whats are Nursing Interventions Classification (NIC)
Researchers at the University of Iowa developed the Nursing
Interventions Classifications (NIC) with a grant from the National Center for
Nursing Research. The authors used a national Delphi survey of masters-prepared
nurses to generate the original list of 336 specific interventions (Moorehead,
McCloskey, & Bulechek, 1993).
Categories of Interventions
Currently, the NIC contains more than 514
research-based, standardized clinical interventions grouped into seven
categories:
(1) basic physiological
(2) complex physiological
(3) behavioral
(4) safety
(5) family
(6) health system
(7) community (Dochterman &
Bulechek 2004; McCloskey & Bulechek, 2000)
The NIC has been validated by a
sample of 121 nurses from the Midwest Nursing Research Society. NIC’s creators
used input from this survey to revise the original taxonomy. NIC is
continuously updated and has an ongoing process for feedback and review
(McCloskey & Bulechek, 2000).
NIC is designed to be used by all nursing
specialties in any setting. It can also be used by other providers to document
their interventions (Dochterman & Bulechek, 2004). NIC is included as one
data set that will meet the uniform guidelines for information system vendors
in the American Nurses Association’s Nursing Information and Data Set
Evaluation Center (NIDSEC).
The NIDSEC was established by the American Nurses
Association (ANA) to review, evaluate against defined criteria, and recognize
information systems from developers and manufacturers that support
documentation of nursing care within automated Nursing Information Systems
(NIS) or within Computer-based Patient Record systems (CPR). The
What are Nursing Outcomes Classification (NOC)
In order to complete the requirements for documentation of a
nursing clinical encounter, researchers from the NIC team realized the need of
a system to classify patient outcomes. Johnson and Maas published the Nursing
Outcomes Classification (NOC) in 1997. The 330 outcomes can be used across
episodes of care and in various settings.
Outcomes Measures and NANDA
The outcomes have been linked to
NANDA International diagnoses, Gordon’s functional patterns, the Taxonomy of
Nursing Practice, the Omaha Classification System, resident admission protocols
used in nursing homes, the OASIS System used in home care, and NIC
interventions.
Although the classification system is mostly individually
focused (311 of the 330 outcomes are at the individual level), the outcomes can
be aggregated to provide some measure of community and family outcomes and an
additional 10 family and nine community level outcomes have been developed
(Iowa Outcomes Project, Johnson, Maas, & Moorhead, 2000).
Before the
development of the classification taxonomies, there was no systematic way to
document nursing actions in a common language that novice nurses could use as a
guide to the wide array of possible diagnoses, interventions, and outcomes.
Although nursing diagnoses have been a part of the organization of most major care
planning textbooks since NANDA’s inception, there has been no easy way to link
nursing diagnosis and intervention with the patient’s signs and symptoms,
demographic characteristics, medical diagnoses, and therapies.
Outcome Measures and Benefits In Nursing Education
The NIC/NOC
system can be used by the nursing instructor to facilitate teaching beginning
nurses how to assess a patient and then link that assessment to a list of
potential interventions and hoped-for outcomes (McCloskey & Bulechek,
2000). Because the lists are not proscriptive, the student nurse, along with
the instructor, must exercise clinical judgment when selecting the
intervention.
The classifications cannot replace nursing judgment, nor are they
absolutely necessary for nursing decision making to take place, they simply
provide one possible systematic way to document and communicate about nursing
actions. Each of the databases has different advantages for different users.
The NANDA diagnosis classification scheme is probably the most widely
recognized method for categorizing nursing diagnoses.
This scheme, however,
does not offer a taxonomy for interventions and outcomes. The OCS is a more
complete classification system because it does include taxonomies for
diagnoses, interventions, and outcomes, but it has not changed substantially since
the original work. The NIC/NOC, unlike the systems derived in community health
settings, was designed to be universally applicable in any care environment.
The NIC/NOC employed panels of nurse experts to develop its taxonomy. The
NIC/NOC have evolved after several stages of development and validation. Only
NANDA, NIC, and NOC have ongoing research efforts to keep them current
(Dochterman & Bulechek, 2004). The three systems have now been integrated
since the formation of the NIC/NOC/NANDA (NNN) Taxonomy of Nursing Practice.