How did you make the decision to use that terminology?
Does your system allow the use of more than one of the
SNTs?
Identifying Challenges and Opportunities within Standard Nursing Terminologies 36
Appendix D: List of Abbreviations
ABC Codes Alternative Billing Concepts Codes
ANA American Nurses Association
AORN Association of Perioperative Registered Nurses
CAP College of American Pathologists
CCC System Clinical Care Classification System
CMS Centers for Medicare and Medicaid Services
CNC Center for Nursing Classification and Clinical Effectiveness
CORE Clinical Observations Recordings and Encoding
CPT Current Procedural Terminology
DDC Diagnosis Development Committee
EHR Electronic Health Record
HCPCS Healthcare Common Procedure Coding System
HIT Health Information Technology
HL7 Health Level Seven
ICD-10 International Classification of Diseases – 10TH version
ICN International Council of Nurses
ICNP International Classification for Nursing Practice
LOINC Logical Observation Identifiers Names and Codes
MDH Minnesota Department of Health
NANDA North American Nursing Diagnosis Association
NANDA-I NANDA International
NCVHS National Committee on Vital and Health Statistics
NEC Not elsewhere classified
Identifying Challenges and Opportunities within Standard Nursing Terminologies 37
NIC Nursing Interventions Classification System
NLM National Library of Medicine
NMDS Nursing Minimum Data Set
NMMDS Nursing Management Minimum Data Set
NNN NANDA/NIC/NOC
NOC Nursing Outcomes Classification
NOS Not otherwise specified
NRC National Release Centers
OJIN Online Journal of Issues in Nursing
ONC Office of the National Coordinator for Health Information Technology
OSCOP Omaha System Community of Practice
PNDS PeriOperative Nursing Data Set
PoC Plan of Care
RELMA Regenstrief LOINC Mapping Assistant
SDO Standards Development Organization
SMEs Subject Matter Experts
SNOMED CT Systematized Nomenclature of Medicine – Clinical Terms
SNTs Standard Nursing Terminologies
ULMS Uniform Medical Language System
UMHDS Uniform Minimum Health Data Set
v. Version
VNS Visiting Nurse Association
Identifying Challenges and Opportunities within Standard Nursing Terminologies 38
References
(ICN), I.C. (n.d.). International Classification for Nursing Practice (ICNP) Information Sheet. Retrieved from http://www.icn.ch/images/stories/documents/pillars/Practice/icnp/ICNP_FAQs.pdf
2015AB UMLS ICNP Source Information. (2016, January 14). Retrieved from U.S. National Library of Medicine: https://www.nlm.nih.gov/research/umls/sourcereleasedocs/current/ICNP/
ABC Coding Solutions. (n.d.). Retrieved from KarenAllenHomeopathy: http://karenallenhomeopathy.com/wp-content/uploads/2013/06/c_abc-coding-structure1.pdf
ANA. (2012, June 4). “ANA Recognized Terminologies that Support Nursing Practice.” Retrieved 2017, from Nursing World: http://www.nursingworld.org/MainMenuCategories/Tools/Recognized- Nursing-Practice-Terminologies.pdf
ANA. (2015, March 19). ANA. Retrieved from “Inclusion of Recognized Terminologies within EHRs and other Health Information Technology Solutions”: http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and- Resolutions/ANAPositionStatements/Position-Statements-Alphabetically/Inclusion-of- Recognized-Terminologies-within-EHRs.html
ANA. (2015). “Inclusion of Recognized Terminologies within EHRs and other Health Information Technology Solutions.” Retrieved from http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and- Resolutions/ANAPositionStatements/Position-Statements-Alphabetically/Inclusion-of- Recognized-Terminologies-within-EHRs.html
Association, A.M. (n.d.). “Coding with CPT for Proper Reimbursement.” Retrieved July 27, 2016, from Coding & Billing: https://www.ama-assn.org/practice-management/cpt
Association, A.N. (2008). “2009 Biennial Review of Recognized Terminologies.” Retrieved from http://studylib.net/doc/7874394/recognition-criteria
Beseth, K. (n.d.). “Doctors Say Obamacare’s Electronic Health Record Mandate Is.” Retrieved May 20, 2016, from http://watchdog.org/201170/obamacare-doctors-electronic-health-record/
Button, P., Androwich, I., Hibben, L., Kern, V., Madden, G., Marek, K., . . . Mead, C. (1998). “Challenges and Issues Related to Implementation of Nursing Vocabularies in Computer-Based Systems.” Journal of the American Medical Informatics Association, 5, 332-4.
CIMI. (2013, February 19). http://informatics.mayo.edu/CIMI/index.php/Category:Reference_Terminology. (C. I. Initiative, Editor) Retrieved from Category: Reference Terminology: http://informatics.mayo.edu/CIMI/index.php/Category:Reference_Terminology
Identifying Challenges and Opportunities within Standard Nursing Terminologies 39
Cimino, J. (1998). “Desiderata for Controlled Medical Vocabularies in the Twenty-First Century.” Methods of Information in Medicine, 37, 394-403.
Cimino, J., Hripcsak, G., Johnson, S., & Clayton, P. (1989). “Designing an Introspective, Multipurpose, Controlled Medical Vocabulary.” Proceedings of the Annual Symposium on Computer Application in Medical Care, (pp. 513-518).
Coenen, A. (2003). The International Classification for Nursing Practice (ICNP) Programme: Advancing a Unifying Framework for Nursing. The Online Journal of Issues in Nursing, 8(2). Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/Ta bleofContents/Volume82003/No2May2003/ArticlesPreviousTopics/TheInternationalClassificatio nforNursingPractice.aspx
Coenen, A., McNeil, B., Bakken, S., Bickford, C., & Warren, J. (2001). “Toward Comparable Nursing Data: American Nurses Association Criteria for Data Sets, Classification Systems and Nomenclatures.” Computers in Nursing, 19, 240-8.
Copyright Notice and License. (n.d.). Retrieved July 14, 2016, from LOINC from Regenstrief: https://loinc.org/terms-of-use
Delaney, C. (2006, October 10). “Data Element Set: Nursing Minimum Data Set (NMDS).” (A. Helper, Interviewer) Online Journal of Nursing Informatics. Retrieved from http://ojni.org/10_3/termint.htm
Delaney, C., Westra, B., & Pruinelli, L. (2015). Implementation Guide for the Nursing Management Minimum Data Set: NMMDS. School of Nursing – University of Minnesota, Centers for Nursing Informatics.
Dochterman, J., & Bulechek, G. (2004). CNC-NIC: Frequently Asked Questions. Retrieved from University of Iowa College of Nursing: https://nursing.uiowa.edu/cncce/nic-frequently-asked-questions
Effken, J., & Weaver, C. (2016). “Spring Cleaning – The Informatics Version.” Online Journal of Nursing Informatics, 20(Summer). Retrieved March 29, 2017, from http://www.himss.org/library/spring- cleaning-informatics-version
e-Health Standards. (n.d.). Retrieved from Minnesota Department of Health: http://www.health.state.mn.us/e-health/standards/index.html
Farlex, I. (n.d.). Nursing Dictionary by Farlex. Mobile Application. Google Apps.
Frequently Asked Questions. (2016, March 28). Retrieved from The Omaha System: http://www.omahasystem.org/faq.html
Gardner-Huber, D., Delaney, C., Crossley, J., Mehmert, M., & Ellerbe, S. (n.d.). “A Nursing Management Minimum Data Set: Significance and Development.” Journal of Nursing Administration, 22(7/8), 35-40.Identifying Challenges and Opportunities within Standard Nursing Terminologies 40
Garvin, J., Martin, K., Stassen, D., & Bowles, K. (2008, March). “Omaha System: Coded Data That Describes Patient Care.” Journal of the American Health Information Management Association, 44-49.
Hardiker, N., & Saba, V. (2016, March). Harmonising Nursing Terminologies Using ICNP. Retrieved from https://www.nurse.or.jp/nursing/international/icn/update/mail/pdf/2016/03_06.pdf
Harman, T., Seeley, R., Oliveira, I., Sheide, A., Kartchner, T., Woolstenhulme, R., & Matney, S. (2012). “Standardized Mapping of Nursing Assessments Across 59 U.S. Military Treatment Facilities.” AMIA Annual Symposium Proceedings, (pp. 331-339).
Harris, M., Langford, L., Miller, H., Hook, M., & Dykes, P. (2015). Harmonizing and Extending Standards from a Domain-Specific and Bottom-Up Approach: An Example from Development Through Use in Clinical Applications. American Medical Informatics Association, 22(3), 545-552.
HIMSS. (n.d.). CNO-CNIO Vendor Roundtable: Guiding Princples for Big Data in Nursing, 2. Retrieved July 12, 2016, from http://www.himss.org/sites/himssorg/files/FileDownloads/HIMSS_Nursing_Big_Data_Group_Pri nciples.pdf
Huber, D., Schumacher, L., & Delaney, C. (1997, April). Nursing Management Minimum Data Set. Journal of Nursing Administration, 27(4), 42-8.
Hurst, K. (n.d.). “How Much Time Do Nurses Spend at the Bedside?” Nursing Standard, 24(52), 2010. Retrieved from http://journals.rcni.com/doi/pdfplus/10.7748/ns.24.52.14.s20
IEEE. (2016). Retrieved 2017, from https://www.ieee.org/education_careers/education/standards/standards_glossary.html
“International Council of Nurses (ICN) and IHTSDO Deliver Collaborative Product.” (2015, September 4). Geneva, Switzerland; Copenhagen, Denmark. Retrieved from http://www.snomed.org/news- articles/international-council-of-nursing-icn-and-ihtsdo-deliver-collaborative-product
International, N. (n.d.). What Are the Differences Among Standardized Nursing Languages? Retrieved from NANDA International: http://kb.nanda.org/article/AA-00277/53/English-/Frequently- Asked-Questions/Nursing-Diagnosis/Standardized-Nursing-Language/What-are-the-differences- among-standardized-nursing-languages-.html
Interview, C. (2016). ONC Nursing Terminology Interviews. (C. G. MBL Technologies, Interviewer)
Iowa, U. o. (n.d.). Center for Nursing Classification and Clinical Effectiveness (CNC). Retrieved July 2016, from https://nursing.uiowa.edu/center-for-nursing-classification-and-clinical-effectiveness
Identifying Challenges and Opportunities within Standard Nursing Terminologies 41
Jones, D., Lunney, M., Keenan, G., & Moorhead, S. (2010). “Standaradized Nursing Languages.” Annual Review of Nursing Research, 28, 253-294.
Kim, T., Hardiker, N., & Coenen, A. (2014, June). “Inter-Terminology Mapping of Nursing Problems.” Journal of Biomedical Informatics, 49, 213-220.
Learning about the Omaha System. (n.d.). Retrieved June 10, 2016, from The Omaha System Community of Practice: http://omahasystemmn.org/index.php
Links. (2005). Retrieved from The Omaha System: Solving the Clinical Data-Information Puzzle: http://www.omahasystem.org/links.html
Logical Observation Identifiers Names and Codes (LOINC). (2015, February 17). Retrieved from U.S. National Library of Medicine: https://www.nlm.nih.gov/research/umls/loinc_main.html
Lumpkin, J. (2003, November 3). Retrieved from National Committee on Vital and Health Statistics, DHHS: http://www.ncvhs.hhs.gov/wp-content/uploads/2014/05/031105lt3.pdf
Lundberg, C. W. (2008, June). “Selecting a Standardized Terminology for the Electronic Health Record that Reveals the Impact of Nursing on Patient Care.” Online Journal of Nursing Informatics, 12(2). Retrieved from http://ojni.org/12_2/lundberg.pdf
Matney, S. (2016). “Semantic Interoperability: The Good, the Bad, the Ugly.” Nursing, 46(10), 23-24.
Matney, S., Settergren, T., Carrington, J., Richesson, R., Sheide, A., & Westra, B. (2016). “Standardizing Physiologic Assessment Data to Enable Big Data Analytics.” Western Journal of Nursing Research, 5, 1-15.
Matney, S., Warren, J., Evans, J., Kim, T., Coenen, A., & Auld, V. (2012). “Development of the Nursing Problem List Subset of SNOMED CT(R).” Biomedical Informatics, 45(4).
McCormick, K., Lang, N., Zielstorff, R., Milholland, D., Saba, V., & Jacox, A. (1994). “Towards Standard Classification Schemes for Nursing Language: Recommendations of the American Nurses Association Steering Committee on Databases to Support Clinical Nursing Practice.” Journal of the American Medical Informatics Association, 1(6), 421.
McDonald, C., Huff, S., Suico, J., Hill, G., Leavelle, D., Aller, R., . . . Maloney, P. (2003, April). “LOINC, a Universal Standard for Identifying Laboratory Observations: A 5-Year Update.” Clinical Chemistry. doi:10.1373/49.4.624
Meaningful Use of the Omaha System for Program Evaluation in Public Health Nursing. (2010, June). Minnesota Technology Informatics Guidelines Education Reform (TIGER) Summit. Retrieved from http://slidegur.com/doc/1124243/powerpoint-slideshow—minnesota-omaha-system- users-group