I've spent a semester studying this and used some really great quotes to summarize what they are and why nursing must use terminologies to describe our work and bill appropriately for it. However, I believe Thede and Sewell state it most simply: "standardized terminology is a list of terms with agreed upon definitions so that when a term is used it means the same thing to everyone." This is even more important as electronic health records become the norm for patients.
Nursing care, contrary to popular belief, is not billed separately, as many specialties are, in your typical hospital bill. We fit right in there with the room rate and paper towels. While we work 24/7 to be the "eyes and ears" of your physician, who pops in and out, and actually do work ordered by them (which incidentally, is about 33-40% of your bill) and other folks, our work has yet to be specifically defined. Implementation of standardized terminologies and data sets aims to do this.
If after reading this little bit, you are still horribly confused, I highly recommend Thede and Sewell's book, Informatics and Nursing: Competencies and Applications. It's a great overall book to start with for any nursing and computers topic about which you might have questions.
Once you've read a few chapters and want to delve into the intricacies of what exactly those terminologies are, see the links below for the ANA(American Nurses Association) recognized terminologies.
NANDA-I (North American Nursing Diagnosis Association International)
http://www.nanda.org/
Omaha System
http://www.omahasystem.org/overview.html/
CCC (Clinical Care Classification)
http://www.sabacare.com/
ICNP (International Classification of Nursing Practice)
http://www.icn.ch/pillarsprograms/about-icnpr/
NIC (Nursing Intervention Classification)
http://www.nursing.uiowa.edu/excellence/nursing_knowledge/clinical_effectiveness/nic.htm
NOC (Nursing Outcome Classification)
http://www.nursing.uiowa.edu/excellence/nursing_knowledge/clinical
_effectiveness/noc.htm
PDNS (Perioperative Nursing Data Set)
http://www.aorn.org/PracticeResources/PNDSAndStandardizedPeriopera
tiveRecord/PNDSHistoryAndMission/
SNOMED-CT (Systemized NOmenclature of MEDicine)
http://www.ihtsdo.org/snomed-ct/
LOINC (Logical Observation Identifiers Names and Codes)
http://loinc.org/
ABC codes (ABC Coding Solutions -formerly Alternative Link)
http://www.alternativelink.com/ali/abc_codes/
Enjoy your explorations of nursing terminology!
Sunday, May 16, 2010
Tuesday, April 13, 2010
Interesting WSJ article
Can Technology Cure Health Care? (from www.wsj.com)
Some say yes, some say no, but it will always be a debate, and an interesting one at that.
I found this article is interesting to read from a nursing perspective. No nurses appear to have been interviewed for this article.
Some say yes, some say no, but it will always be a debate, and an interesting one at that.
I found this article is interesting to read from a nursing perspective. No nurses appear to have been interviewed for this article.
Friday, April 2, 2010
Tuesday, March 2, 2010
My virtual tour --HIMSS
I mentioned the coverage of HIMSS10 earlier today, but I have to tell you, I thoroughly enjoyed attending via Better Health's coverage at UStream.
If you can't be there, you can interact with the folks at the booth via chat, and trust me, it's very interactive.
Many thanks to Dr. Val, Dr. Anonymous and the whole crew.
If you can't be there, you can interact with the folks at the booth via chat, and trust me, it's very interactive.
Many thanks to Dr. Val, Dr. Anonymous and the whole crew.
HIMSS10 live from Atlanta
Check out the happenings at HIMSS10 live from Atlanta for the latest and greatest in IT for healthcare.
Tuesday, January 19, 2010
Happy New Year
And 2010 is starting with a bang, literally and figuratively.
The Haiti earthquake is creating a ripple effect on how people donate to charities as noted in this article on texting for a cause (from www.usatoday.com). Also in Haiti, Partners in Health is proving IT can make healthcare delivery possible, even in remote areas of the country without landlines (from www.healthcareitnews.com)
iPods and iPhones have become commonplace in everyday living, but in hospitals? Huntington Hospital in Pasadena, CA is bringing them to their hospital to end the clutter of multiple pagers and other devices nurses are required to carry. At the University of North Carolina, interpreters are using them as well to get rid of pagers.
Finally, since grad school will be starting again soon, I've been checking out a few things on SNOMED. Want to know more? Check out this page at the National Library of Medicine.
The Haiti earthquake is creating a ripple effect on how people donate to charities as noted in this article on texting for a cause (from www.usatoday.com). Also in Haiti, Partners in Health is proving IT can make healthcare delivery possible, even in remote areas of the country without landlines (from www.healthcareitnews.com)
iPods and iPhones have become commonplace in everyday living, but in hospitals? Huntington Hospital in Pasadena, CA is bringing them to their hospital to end the clutter of multiple pagers and other devices nurses are required to carry. At the University of North Carolina, interpreters are using them as well to get rid of pagers.
Finally, since grad school will be starting again soon, I've been checking out a few things on SNOMED. Want to know more? Check out this page at the National Library of Medicine.
Subscribe to:
Posts (Atom)
