Nursing Outcomes Classification

The Nursing Outcomes Classification (NOC, dt care classification result ) is a classification used to describe patient-related outcomes resulting from maintenance actions. The NOC describes in their classification status, abilities, behaviors, opinions and experience descriptions of the patient / resident (van der Bruggen 2002). The NOC describes neutrally formulated indicators to be evaluated with respect to the observed expression on a Likert scale. Care -related indicators of patient outcome be understood as a variable state, behavior or perception of a patient or the care involved in the process. Based on a literature review of the research team, the definitions of " nursing -related patient outcome " and " nursing sensitive indicator of patient outcome " were developed. These are defined as follows:

Nursing -related patient outcome:

" A (s) evaluable ( R / S) state, behavior or performance of a patient or a family conceptualized as a variable that can be attributed to and is substantially affected by maintenance interventions. A nursing -related patient outcome is on a conceptual level. Order to be evaluated, requires a result, the identification of a number of specific indicators. Nursing -related patient outcomes define the general patient's condition, behavior or perception, of / resulting from nursing interventions. "

Care -related indicator of a patient's outcome:

" A specifically related to a nursing -related patient outcome variable that is attributable to a nursing intervention. An indicator is an observable patient's condition, behavior, or self-reported perception or evaluation. Care -related indicators of patient outcome characterize a patient's condition at a concrete level ... "

NOC is one of the standardized languages ​​from the American Nurses' Association ( ANA) recognized. As a recognized language it meets the language guideline standards ANA Nursing Information and Data Set Evaluation Center ( NIDSEC ) set system vendors for information. NOC is included in the National Library of Medicine Unified Medical Language metathesaurus for and in the cumulative Index to Nursing Literature ( CINAHL ) and has been approved for use by Health Level 7 Terminology ( HL7).

Stories

It has evolved in five phases:

  • Phase I: Pilot study to test a method (1992-1993)
  • Phase II: Construction of nursing outcomes (1993-1996)
  • Phase III: Construction of the taxonomy and field test (1996-1997)
  • Phase V: optimization and application (1997 to present)

For the taxonomy development strategies of the cluster method were used as these have been applied in the development of NIC. There exist in the German publication 7 areas ( functional health, physiological health, psychosocial health, health knowledge and behavior, perceived health, family health situation of health care in a community), 29 classes (A -X), 260 results per result are formulated about 15-30 indicators. A total of 17 different scales for the assessment of the indicators have been developed, all of which are 5- scaled. The assessment of indicators will take place on Likert scales. When NOC - formulation "Status of the swallowing process ", for example, the evaluation of the indicators on a scale of evaluation criteria is extremely endangered, largely at risk, moderately vulnerable, at some risk and is not intended endangered. A rating of '5 ' is always the best possible result and '1' is always the worst possible outcome. The classification is continuously revised to complement or verify old nursing outcomes based on new research new skin care results. The changes will be published in a four - year cycle.

In addition, we currently working hard on the integration of the NOC into an overall system of care classifications, which in turn describe the various aspects of the nursing process. In particular, the NANDA Taxonomy II are and the Nursing Interventions Classification ( NIC, dt care measures classification) to call. The latter has also been launched by the University of Iowa.

Size and structure

At present, the taxonomy of the Nursing Outcomes Classification is in the fifth release.

It is basically divided into three levels of abstraction:

  • The top level with seven domains,
  • The middle level with 33 classes,
  • The lowest level of 490 nursing outcomes ( NOC outcomes).

Each nursing result was also assigned a unique code number to use the NOC in computerized hospital information systems (HIS) can. Especially for this purpose, the NOC was registered with HL7.

Every care result consists of this:

  • A definition,
  • A list of indicators in order to match the current patient state with the described maintenance can result,
  • A comprehensive five-point Likert scale, to assess the current patient's condition.
  • And the literature in order to make the research process transparent.

A total of 26 different scales were developed. Both the indicators and scales are assigned to the care and results are outside the classification.

The computerized application simplifies statistical analyzes for the care effectiveness and quality of care actions, and is therefore of interest to nursing research and quality management.

The encryption structure of NOC will be explained below with an example: IC0204013 means

Example of a NOC

The outcome illustrated below is a proper translation of the current version NOC

Self Care: body wash / Baden 0301 (Self - Care: Bathing )

Definition: Personal measures for self- cleansing of the body with or without aids. (Personnel actions to cleanse own body with or without Independently assistive device. )

Quality of the NOC

The research team expects a certain quality of the NOC, as the sources on which the NOC relies in the development had to meet quality requirements. There were substantive validations instead of nursing experts. The care experts were asked to examine the results and indicators to see if they can meet the requirements of your facilities. The experts rated each care results in terms of importance and relatedness to nursing interventions. This evaluation has been on a five - scaling instead with weights, as Fehring has suggested this ( 5 = 1, 4 = 0.75, 3 = 0.5, 2 = 0.25, 1 = 0). All care results that were weighted with a weight of at least 0.6 by the experts who have been included in the NOC. In the previously conducted validation efforts of the NOC ultimately remains unclear whether these results are specific care outcome indicators of care, or are subject to other influences. Reliability studies were not found. Similarly, no Kriteriumsvaliditätsstudien could be found or validity studies in a particular setting. It can be found in the literature indications that NOC is used in software, eg

1991
611254
de