A1258149769bYufs

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WHAT IS HET 4 LAGEN MODEL?
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Layer 1 Facts
- Demographical data
- Observations signs symptoms
- Aetiology facts causal relations / data
other disciplines etc.
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Layer 2 registration of
Nursing diagnoses
Nursing interventies
Results of nursing care
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Layer 3
Use of Nursing
Minimal Data Set
on Institutional level
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layer 4
Nursing Minimum Data Set for national and
international purposes
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Different views on nursing data set the NMDS
Policy
Education
Mirror information
Research
Management information
Quality assurance
Multi-disciplinairy co-ordination
Costing
Registration of Nursing Data in clinical practice
according to the Nursing Process.
Goossen Epping, 1995
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Structure
layer 4 VMDSN national and international purpose
s
characteristics
service items etc
Policy decisions
Management
decisions
Clinical decisions
Figuur data layers in nursing de Nursing
(Verpleegkundige) Minimale Data Set Nederland
(VMDSN).
Epping Goossen 1996.
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Taalgebruik in verpleegkunde en in de
gezondheidszorg
JÉCÉ
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Enkele initiatieven in verpleegkundige taal en
classificatie systemen
Clinical assessment tools
NANDA
Read-codes
Omaha System
ACENDIO
NILT
NOC
Eenduidig Begrippenkader Verpleegkunde
ICNP
PES GORDON
Nursing Sensitive Outcomes.
Diagnostic Reasoning
M.V.G.
UNLS
NIC
Nursing, Midwifery and Health Visiting Terms
Project
Goossen, Epping Abraham, 1995
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International Classification of Nursing Practice
consist of

• Nursing minumum data set
• Classification of nursing
• diagnoses, interventions and
  outcomes
• Unified nursing language.
• Standardised vocabulary for
• phenomena in nursing practice
• Nursing practice.

Clark Lang, 1992
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Dataset
Taxonomy
Classification
Nomenclature
Nursing Practice
Clark Lang, 1992
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Dataset
Taxonomy
Scientific rules that are followed by naming
phenomena and A list of names (Unified nursing
language)
Classification
Nomenclature
Nursing Practice
Clark Lang, 1992
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Dataset
Oldest known classification of animals from
China Class
Distinguishing
mark Animals
of the emperor by
owner Trained animals
by skills animals that atract flys
by quality animals from fairy
tales by origin animals in
this classification by domain
Taxonomy
Classification
Nomenclature
Nursing Practice
Clark Lang, 1992
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Dictionary
Systematic order in plants, animals and
phenomena
Dataset
Taxonomy
Liquorice
Classification

plain
salt
sweet
Nomenclature
white black grey
white black grey
white black grey
Nursing Practice
Clark Lang, 1992
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EXAMPLE OF THE READ CLINICAL CODE HIERARCHY
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A B C D E F
G H I
CIRCULATORY SYSTEM DESEASES
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• G0 G1
  G2 G3
• ISCHAEMIC
  HEART DESEASE
• G30 G31
  G32 G33
• ACUTE MYOCARDIAL INFARCTION
• G301 G302
  G303 G304
• ACUTE ANTERIOR MYOCARDIAL INFARCTION
• G3011 G3012
  G3013 G3014
• ACUTE ANTEROSEPTAL MYOCARDIAL INFARCTION

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4
5
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Dataset
All data (NMDS) that can be used in healthcare
and compared local, national and international
in order to broaden the perspective of the
profession of nursing.
Taxonomy
Classification
Nomenclature
Nursing Practice
Clark Lang, 1992
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Dataset
Taxonomy
Classification
Information systems for Patient
records Costing Manpower planning Research Nationa
l databanks International databanks
Nomenclature
Nursing Practice
Clark Lang, 1992
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The use of Patient data
Physicians use
Nurses use
Commonalities
Nurses and physicians use of patient data
A Venn diagram representing a view on the use of
patient data. Goossen, 1993
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The use of Patient data in a electronic patient
record
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Medical diagnosis protocols and classifications
Treatment protocols
Medical diagnostics
Reporting
Admission data of the patient for
all disciplines. Nursing data are part of this.
Evaluation of careproces and careproduct (Outcom
es)
Delivery of care
information
knowledge
Data
Decision
Action
Evaluation
Reporting
Protocols and quality standards
Nursing diagnosis and decision making process
Nursing terms, e.g. for diagnosis, Standard /
Core careplans and nursing classifications
Goossen, 1994
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Medical diagnosis protocols and classifications
Treatment protocols
Medical diagnostics
Reporting
Problem list, including Medical diagnoses Nursin
g diagnoses and in multidisciplinairy determined
careproblems.
Admission data of the patient for
all disciplines. Nursing data are part of this.
Evaluation of careproces and careproduct (Outcom
es)
Workplan for all disciplines
consulting togheter and recording
Delivery of care
Reporting
Protocols and quality standards
Nursing diagnosis and decision making process
Nursing terms, e.g. for diagnosis, Standard /
Core careplans and nursing classifications
MORE ARROWS ..........
Goossen, 1994
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WHAT ELSE IS GOING ON AT THE MOMENT?

• Chipcards
• Integrated patient records (accross settings)
• Clinical decision support systems
• Knowledge based systems (expert systems)
• Datacommunication, video conferencing , open and
  distance learning projects
• Using the World Wide Web in Nursing and Nursing
  education.