All users of NIC encouraged to submit new interventions, suggest revisions. Iowa Intervention Project Research Team.
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Biomedical subjects
Publications and source records attributed to G M Bulechek.
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A survey of 111 critical care nurses was carried out to determine the frequency with which they perform each of the 336 interventions in the NIC. Forty-nine interventions were used at least daily, indicating a set of core interventions unique to critical care practice. These findings have implications for critical care practice, education, and research.
The mandate for establishing guidelines for assessing effectiveness has been given to the Agency for Health Care Policy and Research (AHCPR). This agency has published 10 practice guidelines for practitioners to use. The present task for practitioners is to establish how effectively use these guidelines. Nurse researchers at the University of Iowa have provided a practical standardized language of nursing interventions that will help nurses demonstrate and communicate current nursing practice. This Nursing Interventions Classification (NIC) will allow nurses to implement the guidelines, demonstrate nursing input for patient care, and make nursing visible to consumers and other health care providers.
As the nursing profession evolves, it is becoming increasingly evident that standardized languages are needed for nursing diagnoses, nursing interventions, and nursing sensitive patient outcomes. Such classifications will make explicit what is now largely implicit about the nature of nursing practice. These classifications are needed so nursing can enter both the computer world of health information systems and national databases used for health policy planning. A large and diverse research team at the University of Iowa has been working since 1987 on the construction and validation of a classification of nursing interventions. In 1990, the National Center for Nursing Research (NCNR) funded the Iowa Intervention Project team with a three-year (R01NR02079) grant and in 1993 awarded a four-year continuation grant. In June 1992, Nursing Interventions Classification (NIC) (Iowa Intervention Project, 1992) was published, representing the work of the Iowa group to date. The purpose of this paper is to describe NIC and the on-going efforts at Iowa to develop a standardized language to describe nursing treatments.
The Nursing Interventions Classification (NIC) is the first comprehensive classification of treatments that nurses perform. It is a standardized language of both nurse-initiated and physician-initiated nursing treatments. An alphabetical listing of 336 interventions was published in a book in May 1992 [Iowa Intervention Project, McCloskey, J. C., & Bulechek, G. M. (eds). Nursing Interventions Classification (NIC). St. Louis: Mosby-Year Book]. Each NIC intervention is composed of a label, a definition, a set of activities that a nurse does to carry out the intervention, and a short list of background readings. NIC interventions include: the physiological (e.g., Acid-Base Management, Airway Suctioning, Pressure Ulcer Care) and the psychosocial (e.g., Anxiety Reduction, Preparatory Sensory Information, Home Maintenance Assistance); illness treatment (e.g., Hyperglycemia Management, Ostomy Care, Shock Management), illness prevention (e.g., Fall Prevention, Infection Protection, Immunization/Vaccination Administration), and health promotion (e.g., Exercise Promotion, Nutrition Management, Smoking Cessation Assistance); and those used for individuals and those for families (e.g., Family Integrity Promotion, Family Support). Most recently, indirect care interventions (e.g., Emergency Cart Checking, Supply Management) have been developed. Research methods used to develop the classification include content analysis, expert survey, focus group review, similarity analysis, and hierarchical cluster analysis. The research, conducted by a large team of investigators at the University of Iowa and supported by the National Institute of Nursing Research, is ongoing. Since the 1992 publication, approximately 50 additional interventions have been developed, a taxonomic structure has been constructed and validated, a feedback and review system has been established and implemented, NIC interventions have been linked to nursing diagnoses, and five clinical agencies are serving as field sites to study the implementation process of NIC in nursing information systems. A numerical coding system for the interventions will be available in 1995. A second edition of the NIC book is in early preparation and will be available from Mosby-Year Book in early 1996. NIC facilitates the implementation of a Nursing Minimum Data Set. The use of NIC to plan and document care will facilitate the collection of large databases that will allow us to study the effectiveness and cost of nursing treatments. The use of standardized language provides for the continuity of care and enhances communication between nurses and other providers. NIC provides nursing with the treatment language that is essential for the computerized health care record. The domains and classes provide a description of the essence of nursing. NIC is helpful in representing nursing to the public and in socializing students to the profession. The coded interventions can be used in documentation and in reimbursement. For the first time in the history of nursing, nurses have a language which can be used to describe their treatments. The language is comprehensive and can be used by nurses in all settings and in all specialties. poster, giving an overview of the development of NIC, will be accompanied by a display of books and publications about NIC and its use.
The Nursing Interventions Classification (NIC) is a standardized language that identifies all interventions performed by nurses. Each nursing intervention has a label name, a conceptual definition, and a set of defining activities. The NIC provides a standardized nomenclature for automated databases, describes and measures nursing's contribution to health care, facilitates nursing education, supports clinical decision making, plans resource allocation, and facilitates nursing research. Perioperative nurses can use the NIC to describe and document their contributions to surgical patients' outcomes.
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Standardized languages for nursing practice are required to meet the needs of the profession and the patients we serve. The authors review and compare three classifications of nursing interventions: Nursing Interventions Classification (NIC), the Omaha System, and the Home Healthcare Classification (HHC). The information will help users make the best selection for their agency and client population.
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A research team at the University of Iowa has been working for 5 years to develop a classification of nursing interventions. Conceptual work to clarify the nature of a nursing intervention was needed. An inductive approach was taken to group discrete nursing activities and attach a conceptual label. Fehring's methodology was adapted for soliciting input from nurse experts for the 134 labels described in this issue. These labels are a part of the standardized language in the Iowa classification.
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This article describes the formation of a nursing diagnosis interest group through the State Nurses' Association. Activities for the first 2 years are described. An annotated bibliography and resource list to help others learn about nursing diagnosis was prepared by the committee and appears here.
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The development and use of standardized language in nursing marks the development of a new era of nursing science. It will assist the professional nurse to communicate with colleagues in her or his own facility and across the world. Being able to clearly articulate what it is we do makes visible what previously has been invisible about nursing. When we use standardized language to document the care we give, then we can build large databases, which will articulate with those of other health providers, that can be used to demonstrate the effectiveness of nursing care. As we move into the 21st century, the use of standardized nursing language will become one of the hallmarks of the profession.
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