Viewpoint

The Second NANDA/NIC/NOC Conference: Impressions from a Group of First-Timers

Melanie Meyer, BS, RN, CNIII; Janet Burton, MSN, BSN, RN; Margie Campbell, BS, RNC; Suzanne Connell, RN, CNIII; Jennifer Faulconer, BSN, RN; Susan Piirto, BSN, RN; Donna Stover, RNC, CNIII Column Editor: Judith Wilkinson, PhD, ARNP, RN, C

In this /wii', n groirp of iiirrses who prncticc nf Colirinhirs Regiomil Hospifnl, in Colirmbus, IN s h e s their impriwioizs if tlw N" confumce on "Documenting Niirsing €fecfizIiiii% by Using Nirrsiizs lnfonnatics," held in Nrzu Orlenns in April 1999. We ziek o/w bri4, iiifonnnl respmws to pirhlishi'11 zkziviiifs.

w e 'ire a group of clinical nurses who attended the NNN c-onference for the first time. Some of us had used the standardized languages in developing and/or imple- menting teaching plans or pathways; others had no expo- sure to NNN prior to the conference. We attended differ- ent ses\ions, so, as you might expect, our impressions were mixed. We attended tlie conference to (1) learn more about nursing informatics, (2) learn more about the NANDA/NIC/NOC languages, (3) find examples of tools other institutions have developed for documentation and hex results of research supporting their effectiveness, and (4) improve our ability to assist in future planning of NNN development in our specialties and workplace.

Highlights and Positive Impressions

Of all the good experiences, the opportunity to network with other nurses probably was the most rewarding. We enjoyed talking and sharing dormation informally with many ot the presenters. The preconference sessions with NIC and NOC leaders were the most exciting. The leaders seemed genuinely interested in our struggles and refresh- ingly open to input and feedback. It also was great to be able to talk with vendors of information systems. We obtained URL and e-mail addresses for dormation links (e.g., to SNOMED), as well as personal e-mad addresses of nurses and vendors we can contact with ongoing questions. The following are other comments by group members:

The posters, overall, were informative and well- done, although more handouts would have been ht.lpfu1. The excitement of the Iowa research teams was contagious. I t was good to hear what they've accomplished and about their future plans.

It was helpful to hear the history of how NANDA/ NIC/NOC was developed. I was impressed by the amount of education repre- sented by the presenters . . . and their efforts in developing tools to measure nursing effectiveness.

We want on-line documentation in our hospital, so we were excited about information system development. One of our nurses said, "This conference gave me hope that we really are, at last, going to bring nursing into the computer age."

Frustrations and Surprises

Conference organizers apparently assumed those in attendance would have a basic knowledge of research, informatics, and standardized languages. For those lack- ing any of these, many of the presentations were difficult to understand. We heard several participants comment that they were confused by all the acronyms being used.

Many of the speakers were academics and far removed from the experience of staff nurses. We perceived the ses- sions with concrete hidings and examples as ''better." For example, Connie Delaney described specific examples of patient information her staff was able to retrieve using a data mining tool, and Colleen Prophet discussed operational issues, such as how to track and document care orders.

We reacted in various ways to the research presentations. Some felt it was "over our heads" and not applicable to their practice. Others truly enjoyed tlie research and appreciated its importance. One member reflected both perspechves: "I was disappointed that the sessions were geared more to research than to the work of staff nurses. However, after a few sessions I was able to see how some of the research could be applied in my institution. After hearing Mar@iret England talk about the development of her instrunlent for the diagnosis of caregiver mle strain, I am now looking for- ward to helping her validate her questioimaire."

In general, we felt there was a lack of representation for clinical practice. We learned the "what" and "why," but not the "how to." We failed to gain Understanding of how other institutions have implemented tools using

Nursing Diagnosis Volume 10, No. 3, July-September, 1999 125

Viewpoint

NIC and NOC, spccif indly how to bring back tlie lan- guages to implement into our practice. Time and again we heard other participants say they wanted to know ”how to use this stuff in real life.” We had hoped for more examples of documentation tools for use in the clinical setting.

We all will be meeting with our hospital admini~tr,i- tors to discuss the conference and make recommenclcv tions for staff education and for the rollout of NIC/N<X in our organization. As a result of the conference, we’ tcel better prepared to do that.

Summary How Our Perspectives Were Changed

The excitement of the research teams was contagious and empowering. We are now more hopeful for the future of nursing. This comment is an example: “I was amazed at the precise data that can be gleaned from data banks that incorporate standardized nursing languages. As a case manager, I am hopeful now that we will be able to L I S ~ this to prove nursing effectiveness both to insurers and our administration.”

We came away with a greater appreciation for the importance of nursing informatics and for NANDA/ NIC/NOC as standardized nursing lanpages, as well as a gre;\ tcr appreciation for the research involved in their dcwAy~nient. One of us even said, ”I am excited about the possibility of being a part of the research in this area.”

Wc gained a feeling of pride in the language/informat- ics work that our own nurses have done. We have devel- o p d multiple teaching plans, and Jennifer Pappas’ presen- tation of our CHF clinical pathway demonstrated that our ivork is progressing as well as most. We also have a better understanding of the work we st i l l need to do. The follow- ing are some other comments from group members:

.* I was able to share with my work team the good news that it is possible to link NNN with Gordon’s Functional Health Patterns. This conference confirmed that I want to become more involved in implementing standardized lan- guage throughout our institution, even if it means changing to a different position. I hope to continue communicating with nurses trom my specialty (maternal-child) and help in some small way to provide input for this part of the langucige work.

We gradually came to understand that tlie con tercnclh had met our goals. However, we would have fo~111d thin following to be helpful:

Basic instruction workshops (perhaps preconfc’r- ence). Hands-on sessioiis, with case studies, Lvould be helpful for nurses who did not learn nursing diagnosis in school, who know little about nursing informatics and computerized patient records, who do not know about NIC and NOC, or who netd to know more about research methods. Ranking all sessions for difficulty (beginner, mod- erate, advanced knowledge) would enable pxtici- pants to attend presentations g e m d to their levcll ( 1 1 understanding, making better LISC of their time. More handouts. We would have liked handout5 h r n all presenters to help us rruall the wealth of intor- mation presented. The t a p wen’ a g t ~ x l idea, but lis- tening to tapes is more time consuming than reading ‘1 handout, and they are an additional expeiiw. More sessions with clinical applications and out- come measurements from implementation of doc- umentation tools/systems. It would also be useful to hear how the outcome me‘isures were acted on.

We would highly recommend ths conference to others, and we hope to attend again in the future. Wci hope thit conference will continue to be a forum for communicating the progress of the empirical and theoretical worh. We) also hope it will be a place for nurses in clinic,il prxtic.ca to come and share ways to advance nursing prc>lcticc, with practical applications.

126 Nursing Diagnosis Volume 10, No. 3, July-September, IWY