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Nursing Diagnosis & Midwifery 2018
S e p t e m b e r 1 0 - 1 1 , 2 0 1 8
P r a g u e , C z e c h R e p u b l i c
Page 63
Journal of Nursing and Health Studies
ISSN: 2574-2825
E u r o S c i C o n E v e n t o n
Nursing Diagnosis &
Midwifery
Background:
Standardized Nursing Terminologies apprise the nursing care provided and facilitate clinical research and education.
Aim:
To identify strengths and weaknesses of standardized nursing terminologies used in electronic health records.
Methods:
A literature review was conducted. Studies were retrieved from: PubMed, Cochrane Library, CINAHL, Cuiden, Scopus, and ISI
Web of Knowledge. The search strategy included articles in English, French, Portuguese and Spanish published between 2002 and 2016
focusing on standardized nursing terminologies most frequently used in electronic nursing records.
Findings:
NANDA/NIC/NOC and ICNP were the Standardized Nursing Terminology most frequently used. The use of Standardized Nursing
Terminology allows to make comparisons between nursing records sharing the same terminologies. Sometimes the standard terminology
was not sufficiently understood by nurses and therefore it could not be efficiently used, at some extent, hindering nursing continuity care.
Discussion:
Standardized nursing terminologies had a strong impact on information quality, process quality and efficiency, but not on
patients or professionals.
Conclusion:
nurses must know why they are using a particular standardized terminology is beneficial or detrimental for patients, nursing
knowledge or for themselves.
Strengths and weaknesses of standardized nursing terminologies
used in electronic health records: a literature review
Vigo Oller, O
1
; Leyva Moral, J.M
2
, Feijoo Cid, M
3
; Bernabeu Tamayo, M
D
4
; Martin Royo, J
5
; Galbany Estragues, P
6
; Fernandez Vandellos P
7
1
Vigo Oller, O - Institut Català de la Salut. Generalitat de Catalunya.
2
Leyva-Moral, JM - Universidad Autonoma de Barcelona, Department of Nursing. Faculty of Medicine
3
Feijoo Cid, M - Universidad Autónoma de Barcelona, Department of Nursing. Faculty of Medicine
4
Bernabeu Tamayo, M D - Universidad Autónoma de Barcelona, Department of Nursing. Faculty of Medicine
5
Martin Royo, J - Institut Català de la Salut. Generalitat de Catalunya
6
Galbany Estragues, P - Universidad Autónoma de Barcelona, Department of Nursing. Faculty of Medicine
7
Fernández Vandellòs, P – IDIBAPS, CIBERES. Barcelona, Spain
Vigo Oller et al., J Nurs Health Stud 2018 Volume: 3
DOI: 10.21767/2574-2825-C4-012
Biography
Mrs Olga Vigo Oller is presently working at Catalan Health Institute. Government of Catalonia, Spain.
ovigo@gencat.cat