Creating an ICNP subset: children with HIV/AIDS in developing countries.

Since 1993, the International Classification of Nursing Practice has evolved as a unified language for global nursing diagnoses/outcomes and interventions. It contains 5148 terms. Population- or condition-specific subsets of terms facilitate easier and consistent use of the International Classification of Nursing Practice. One condition, care of children in developing countries with HIV/AIDS, is listed by the World Health Organization as a world health priority. In this study, the investigators identified nursing diagnoses/outcomes and intervention terms used by nurses for this population and mapped the terms to the International Classification of Nursing Practice. Terms represent healthcare at different phases along a continuum: health promotion, health maintenance, acute conditions, chronic conditions, and end-of-life care with the child as the focus surrounded by family, community, and culture. In the analysis, the investigators' process is compared with the one outlined in the Guidelines for International Classification of Nursing Practice Catalogue Development, and the match of each local and International Classification of Nursing Practice term is categorized as perfect fit, conceptual fit, partial fit, or unable to fit. A total of 53 nursing diagnosis/outcome terms and 85 intervention terms make up the subset. Eighty-two percent of local terms mapped at least partially to International Classification of Nursing Practice.

Updating and normalization of the Nursing Management Minimum Data Set element 6: patient/client accessibility.

Patient/client accessibility is one of 18 Nursing Management Minimum Data Set data elements developed to evaluate contextual factors at the nursing unit or service level of care. The Nursing Management Minimum Data Set 06 patient/client accessibility was developed to capture variability in time and distance required to access patients. Variability in access to patients, needed supplies, equipment, and information for patient care has an impact on the amount of time available for direct patient care. Limitations in time available to provide safe and quality care may negatively affect patient outcomes, nurse retention, and, as a result, a healthcare organization's accreditation and finances. Since 2005, the first five Nursing Management Minimum Data Set data elements have been incorporated into the publicly accessible healthcare data set Logical Observation Identifier Names and Codes, thereby making results derived from these nursing management data elements available for empirical use. A critical review of the literature and other healthcare resources was conducted to update patient/client accessibility. A consensus approach was used by an interdisciplinary panel of experts to finalize recommendations for revisions. The name, conceptual and operational definitions, and measures were updated. The revised data element is titled "client accessibility." The conceptual and operational definitions were expanded and measures changed to increase validity and reliability of data collection. The updated conceptual definition is "the time, distance, and method to connect the nurse/provider and client for an encounter and includes the information, supplies, equipment, and personnel required for the encounter." The Nursing Management Minimum Data Set can provide individuals responsible for managing and financing nursing resources with quantifiable data regarding the context of nursing care. At present, healthcare costs are rising at an unsustainable rate, and many national healthcare outcomes are worsening. More information is needed to identify potential areas of improvement in the management and funding of nursing care. The update and use of Nursing Management Minimum Data Set 06 data element client accessibility may help to identify problem areas associated with nursing time, distance traveled, and methods used to provide patient care. Such empirical evidence may support better informed decisions on caseloads in diverse settings, hospital designs, methods used to provide care, and fiscal requirements.

Achieving "meaningful use" of electronic health records through the integration of the Nursing Management Minimum Data Set.

OBJECTIVE: To update the definitions and measures for the Nursing Management Minimum Data Set (NMMDS). BACKGROUND: Meaningful use of electronic health records includes reuse of the data for quality improvement. Nursing management data are essential to explain variances in outcomes. The NMMDS is a research-based minimum set of essential standardized management data useful to support nursing management and administrative decisions for quality improvement. METHODS: The NMMDS data elements, definitions, and measures were updated and normalized to current national standards and mapped to LOINC (Logical Observation Identifier Names and Codes), a federally recognized standardized data set for public dissemination. RESULTS: The first 3 NMMDS data elements were updated, mapped to LOINC, and publicly disseminated. CONCLUSIONS: Widespread use of the NMMDS could reduce administrative burden and enhance the meaningful use of healthcare data by ensuring that nursing relevant contextual data are available to improve outcomes and safety measurement for research and quality improvement in and across healthcare organizations.