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Biomedical subjects

N R Hardiker

Publications and source records attributed to N R Hardiker.

8 recordsLinked to original sources

Logical ontology for mediating between nursing intervention terminology systems.

OBJECTIVES: Several researchers have proposed the use of logical ontologies as 'reference terminologies'. However, there are a number of unresolved issues. This article describes the development of a logical ontology for nursing interventions and presents the results of evaluation. METHODS: Initially this study involved the development in GRAIL of two separate experimental ontologies: an ontology based on the textual content of informal definitions for nursing interventions drawn from the Nursing Interventions Classification; and an ontology based on labels for the same nursing interventions. Following initial bench-testing, the ontology based on labels was selected for extension (to accommodate also nursing intervention components of the Home Health Care Classification System and the Omaha System), for further testing and for external evaluation. RESULTS: A hierarchy of nursing interventions generated automatically from the experimental ontology based on informal definitions contained only 3 hierarchical relationships, compared to 214 for the initial ontology based on labels. For the final extended ontology based on labels, the generated hierarchy contained the three source terminology systems in entirety - there were a total of 2861 hierarchical relationships. While the results of comparative bench testing of the final ontology were favourable, the results of external evaluation were mixed and showed little agreement between reviewers. CONCLUSION: This study suggests that while a logical ontology based on labels might be a useful tool for mediating between nursing intervention terminology systems, a formative consensus type development methodology might improve the approach by helping to harmonise ideological differences that may exist across the nursing profession.

Humans↗

Mediating between nursing intervention terminology systems.

The purpose of this study is to explore the use of formal systems as a way of mediating between diverse nursing intervention terminology systems. Existing approaches to mediation, such as the UMLS Metathesaurus, make heavy use of surface language. This compromises their capacity for managing similarities and differences between terminology systems. Within this study an initial ontology, derived from three existing terminology systems, was built using the GALEN approach. The ontology overcomes many of the barriers to effective mediation; it represents a rich integrated hierarchy that may be used to identify both direct and indirect mappings between concepts from diverse terminology systems. The approach used forms part of a formative, evolutionary development methodology in which potential mappings are validated and the results fed back into the next round of development.

Nursing↗

Process modelling and simulation for managing clinical care in the community.

'Care in the Community' is an easy catch phrase but a difficult goal. It is a phrase that addresses a current growth area within health care, and one that comes complete with an impressive array of political, economic and social factors that would seem to support the notion of a continuing trend. Technology, specifically information systems, however, has not been successfully cast in a supporting role. There are many reasons for this lack of success but a major one is the mismatch between the understanding of what is required to support the clinical care processes and the specifications of the current systems supplied. Specifically the interest here is in the use and assessment of two computer science techniques, i.e. process modelling and simulation, as suitable means of capturing and communicating requirements so as to bridge the divided and power differential between users and developers of information systems.

Community Health Nursing↗

Using the PEN&PAD information model to support hospital-based clinical care.

The PEN&PAD model for clinical record systems has been successfully used for medical records in both General Practice and hospital-based care. This paper describes experiences of using the model for developing computer-based nursing records. Results from this work show that there are some problems with directly applying the model to the nursing domain. Whilst the main purpose of the nursing record is to document and communicate a patient's care, it has several other, possibly incompatible, roles. Furthermore, the structure and content of the information contained within the nursing record is heavily influenced by the need for the nursing profession to visibly demonstrate the philosophical frameworks underlying their work. By providing new insights into the professional background of nursing records, this work has highlighted the need for nurses to clarify and make explicit, their uses of information, and also provided them with some tools to assist in this task.

Computer Systems↗

Data entry in computer-based care planning.

If computer-based care planning is to be acceptable to nurses, they must be able to enter care plans in a flexible and intuitive manner that does not distort their observations about the patient. The limitations of existing computer-based data entry techniques are discussed. A novel method of data entry called Predictive Data Entry is presented, and the underlying model of nursing terminology which supports it is described. The results of user evaluations are discussed.

Decision Making, Computer-Assisted↗

Modeling nursing terminology using the GRAIL representation language.

OBJECTIVE: The purpose of the study is to explore the use of formal systems to model nursing terminology. DESIGN: GRAIL is a formal, compositional terminologic language, closely related to frame-based systems and conceptual graphs, which allows concepts to be formed from atomic-level primitives and automatically classified in a multiple hierarchy. A formal model of the alpha version of the International Classification for Nursing Practice (ICNP) classification of nursing interventions was constructed in GRAIL. MEASUREMENTS: The model was analyzed for completeness, coherence, clarity, expressiveness, usefulness, and maintainability. RESULTS: GRAIL is capable of representing the complete set of atomic-level concepts within the ICNP as well as certain cross-mappings to other vocabularies. It also has the potential to represent many more concepts, to an arbitrary level of detail. CONCLUSIONS: Formal systems such as GRAIL can overcome many of the difficulties associated with traditional nursing vocabularies without restricting the level of detail needed to describe nursing care.

Models, Theoretical↗

Standards for nursing terminology.

Terminology work in nursing has given rise to an increasing number of nursing terminologies. These generally take the form of controlled vocabularies. Because of the limitations of the controlled vocabulary approach, individual terminologies tend to be tuned to meet the specific needs of their intended users. Differences between terminologies are now a significant barrier to the comparison and interchange of health information. To agree on a single, multipurpose terminology would be problematic. However, several options for resolving unnecessary differences between nursing terminologies are currently being explored by international standards bodies and other groups, such as the U.S. Nursing Vocabulary Summit. One such option is the use of a terminology model to facilitate evolution toward a more coherent range of terminologies. The authors describe the motivation behind the development of a standard for nursing terminologies. They explain how a terminology model might form the basis for such a standard through a description of the approach taken by CEN TC251 (the Health Informatics Technical Committee of the European Committee for Standardization). They also discuss possible limitations of standardization.

Nursing↗

Structural validation of nursing terminologies.

OBJECTIVE: The purpose of the study is twofold: 1) to explore the applicability of combinatorial terminologies as the basis for building enumerated classifications, and 2) to investigate the usefulness of formal terminological systems for performing such classification and for assisting in the refinement of both combinatorial terminologies and enumerated classifications. DESIGN: A formal model of the beta version of the International Classification for Nursing Practice (ICNP) was constructed in the compositional terminological language GRAIL (GALEN Representation and Integration Language). Terms drawn from the North American Nursing Diagnosis Association Taxonomy I (NANDA taxonomy) were mapped into the model and classified automatically using GALEN technology. MEASUREMENTS: The resulting generated hierarchy was compared with the NANDA taxonomy to assess coverage and accuracy of classification. RESULTS: In terms of coverage, in this study ICNP was able to capture 77 percent of NANDA terms using concepts drawn from five of its eight axes. Three axes-Body Site, Topology, and Frequency-were not needed. In terms of accuracy, where hierarchic relationships existed in the generated hierarchy or the NANDA taxonomy, or both, 6 were identical, 19 existed in the generated hierarchy alone (2 of these were considered suitable for incorporation into the NANDA taxonomy and 17 were considered inaccurate), and 23 appeared in the NANDA taxonomy alone (8 of these were considered suitable for incorporation into ICNP, 9 were considered inaccurate, and 6 reflected different, equally valid perspectives). Sixty terms appeared at the top level, with no indenting, in both the generated hierarchy and the NANDA taxonomy. CONCLUSIONS: With appropriate refinement, combinatorial terminologies such as ICNP have the potential to provide a useful foundation for representing enumerated classifications such as NANDA. Technologies such as GALEN make possible the process of building automatically enumerated classifications while providing a useful means of validating and refining both combinatorial terminologies and enumerated classifications.

Nursing↗