Journal of Korean Academy of Nursing Administration (간호행정학회지)

Korean Academy of Nursing Administration (한국간호행정학회)
권호 표지

Analysis on Military Hospital Nursing Records by NANDA, NIC, NOC System

간호과정 용어체계를 이용한 간호기록 분석 - 군병원 정형외과 재원환자 기록 대상으로 -

  • Published : 2010.03.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study was to construct a useful nursing language system on military nursing field. Method: Military hospital nursing records were analyzed using NANDA(North American Nursing Diagnosis Association), NIC(Nursing Interventions Classification), and NOC(Nursing Outcomes Classification) systems. All kinds of nursing statements from 80 sets of orthopedics inpatient's records were deduced. All nursing statements were mapped to 167 NANDA diagnoses, 433 NIC interventions, and 260 NOC outcomes. Result: 14,744 nursing statements were extracted. Among the extracted nursing statements, 11.75% were linked with NANDA diagnosis, 83.62% were connected with NIC intervention, and 0.96% was tied to NOC outcome. 3.66% of nursing statements were not linked with NANDA-NIC-NOC system. In the nursing statements, 18 diagnoses of NANDA, 63 interventions of NIC, 8 outcomes of NOC were used. Conclusions: The majority of those nursing statements focused on nursing intervention of the nursing process; few nursing plans or goals were found in nursing records. Therefore, it's difficult to make the nursing process network with the nursing statements. Documenting nursing records using a nursing process will contribute to strengthen nursing practice in patient care and to develop nursing as science. Continuous further researches related to nursing records are needed to provide basic data for developing nursing language system and nursing record system.

Keywords

References

  1. Cheon, H. S., Moon, S. N., & Kim, E. J. (2005, September). Development and evaluation of nursing process program in DEMIS. Presented at 17th Military Nurse Conference.
  2. Chi, S. A., Choi, K. S., Park, K. S., & Jung, Y. K. (1999). A basic study on improvement and computerization of nursing record. J Korean Acad of Nurs, 29(1), 21-33. https://doi.org/10.4040/jkan.1999.29.1.21
  3. Choi, J. Y. Kim, H. S., & Park, M. S. (2003). A correlation study of perceived importance of nursing interventions with performance frequency in psychiatric nursing units using the 3th NIC. J Korean Acad of Nurs, 33(1), 95-103. https://doi.org/10.4040/jkan.2003.33.1.95
  4. Choi, J. Y., Park, M. S., & Kim, H. S. (2002). A survey on nursing interventions of psychiatric nursing unit using the 3th NIC. J Korean Acad Psychiatr Ment Health Nurs, 11(2), 125-136.
  5. Choi, S. H., Cho, B. H., Ji, H. R., Lee, E. J., Kim, H. S., & Park, M. J. (2004). Standardized linkage between nursing diagnosis and intervention. Hyunmoon publlishung co.: Seoul.
  6. Kang, H. S. (2003). Nursing interventions for the patient with liver cirrhosis under the patient classification. Unpublished master's thesis, Seoul National University, Seoul.
  7. Kim, H. S. (2005). Development and application of a computerized nursing process program for orthopedic surgery inpatients - NANDA, NOC, and NIC Linkages. J Korean Acad of Nurs, 35(6), 979-990. https://doi.org/10.4040/jkan.2005.35.6.979
  8. Kim, K. M. J., Kim, K. J., Cha, Y. N., Jang, J. S., Yoon, J., Gong, E. S., Jung, Y, S., Hwang, S. J., & Yang, B. S. (2006). NANDA nursing diagnosis and intervention guide. Hyunmoon publlishung co.: Seoul.
  9. Kim, M. S. (1997). Use of the nursing intervention classification by the coronary care nurses in Korea. Unpublished master's thesis, Seoul National University, Seoul.
  10. Kim, S. Y., Chin, Y. R., Oh, V. Ch., Park, E. J., Yun, S. N., & Lee, I. S. (2006). Analysis of the nursing interventions performed by public health nurses in health centers using the NIC. J Korean Acad of Nurs, 36(2), 217-226. https://doi.org/10.4040/jkan.2006.36.2.217
  11. Kim, Y. J. (2004). Analysis of nursing records of cardiac surgery patients based on nursing process focusing on nursing outcome. Unpublished master's thesis, Seoul National University, Seoul.
  12. Kwon, M. S. (2002). Analysis of nursing intervention using NIC. Unpublished master's thesis, Chung-Ang University, Seoul.
  13. Lee, E. J. (2001). International comparison of neurology and orthopedics nursing intervention. J Korean Adult Nurs Acad, 13(4), 517-528.
  14. Lee, E. J., & Choi, I. H. (2003). Comparison on nursing importance and performance of nursing interventions linked to nursing diagnoses-focused on 5 NANDA nursing diagnoses. J Korean Acad of Nurs, 33(2), 210-219. https://doi.org/10.4040/jkan.2003.33.2.210
  15. Lee, M. S. (2003). Analysis of nursing records of cancer patients using standardized nursing language. Unpublished master's thesis, Keimyung Universty, Daegu.
  16. Lee, M. S., & Lee, B. S. (2004). Analysis of nursing records of cancer patients with standardized nursing language systems. J Korean Acad Nurs Admin, 10(2), 243-254.
  17. Lee, Y. Y., & Chi, S. A. (2001). Analysis of core intervention using NIC. Chung Ang Nursing, 5(2), 33-44.
  18. McCloskey, J. C., & Buleckek, G. M. (1998). NIC (Yom, Y. H., Kim, M. S., Park, S. A., Park, J. H., Trans.). Hyunmoon publlishung co.: Seoul. (Original work published 1996)
  19. Oh, W. O., Suk, M. H., & Yoon, Y. M. (2001). A survey of the nursing interventions performed by neonatal nursing unit nurses using the NIC. J Korean Acad Child Health Nurs, 7(2), 161-178.
  20. Park, H. A., Kim, J. E., & Cho, E. S. (2000). Taxonomy of nursing diagnosis, intervention, and outcome. Seoul National University publishing department: Seoul.
  21. Park, O. Y. (2006). Analysis of the nursing intervention performed in the medical & surgical units and the health insurance cost items based on the NIC. Unpublished master's thesis, Kyungsang National University, Jinju.
  22. Park, S. A. (2005). Nursing management. Parkmoongak: Seoul.
  23. Park, S. H. (2006). Linkages of nursing diagnoses and nursing interventions for nursing clinical decision support system. Unpublished doctoral dissertation, Seoul National University, Seoul.
  24. Ryu, D. H. (2001). Analysis of nursing records of cardiac internal medicine unit using ICNP classification. Unpublished master's thesis, Seoul National University, Seoul.
  25. Ryu, E. J., Choi, K. S., Kwon, Y. M., Joo, S. N., Yun, S. R., Choi, H. S., Kwon, S. B., Lee, J. H., Kim, B. J., Kim, H. Y., Ahn, O H., Rho, E. S., & Park, K. S. (1998). Analysis of the nursing interventions done by MICU and SICU nurses using NIC. J Korean Acad of Nurs, 28(2), 457-467. https://doi.org/10.4040/jkan.1998.28.2.457
  26. Yom, Y. H. (1999). Analysis of the nursing interventions performed by hospital nurses using NIC. J Korean Acad of Nurs, 29(2), 346-360. https://doi.org/10.4040/jkan.1999.29.2.346
  27. Yom, Y. H., Kim, S. S., Kim, I. S., Park, W. S., & Kim, E. J. (1999). Nursing Interventions Classification (NIC) use in Korea: Oriental medicine hospitals and general hospitals. J Korean Acad of Nurs, 29(4), 802-816. https://doi.org/10.4040/jkan.1999.29.4.802
  28. Yom, Y. H, Lee, K. E., Chang, H. K., Kim, E., J., Li, C. Y., Kim, K. Y., Huang, Z. Y., & Yuk, M. A. (2001). Analysis of nursing interventions performed by Chosunjok nurses in Yanbian using NIC. J Korean Acad of Nurs, 31(5), 793-807. https://doi.org/10.4040/jkan.2001.31.5.793
  29. Yu, H. S. (2001). Database construct of nursing diagnosis, intervention and outcome for laparotomy patient. Unpublished doctoral dissertation, Chung-Ang University, Seoul.