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. 2016 Jul;34(7):312-20.
doi: 10.1097/CIN.0000000000000243.

Mapping Perinatal Nursing Process Measurement Concepts to Standard Terminologies

Catherine H Ivory  1
Affiliations

Mapping Perinatal Nursing Process Measurement Concepts to Standard Terminologies

Catherine H Ivory. Comput Inform Nurs. 2016 Jul.

Abstract

The use of standard terminologies is an essential component for using data to inform practice and conduct research; perinatal nursing data standardization is needed. This study explored whether 76 distinct process elements important for perinatal nursing were present in four American Nurses Association-recognized standard terminologies. The 76 process elements were taken from a valid paper-based perinatal nursing process measurement tool. Using terminology-supported browsers, the elements were manually mapped to the selected terminologies by the researcher. A five-member expert panel validated 100% of the mapping findings. The majority of the process elements (n = 63, 83%) were present in SNOMED-CT, 28% (n = 21) in LOINC, 34% (n = 26) in ICNP, and 15% (n = 11) in CCC. SNOMED-CT and LOINC are terminologies currently recommended for use to facilitate interoperability in the capture of assessment and problem data in certified electronic medical records. Study results suggest that SNOMED-CT and LOINC contain perinatal nursing process elements and are useful standard terminologies to support perinatal nursing practice in electronic health records. Terminology mapping is the first step toward incorporating traditional paper-based tools into electronic systems.

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Figures

Figure 1
Figure 1
Perinatal Failure to Rescue (P-FTR) Process Measurement Adapted by the author from Simpson KR. Failure to rescue: Implications for evaluating quality of care during labor and birth. J Perinat Neonatal Nurs. Jan–Mar 2005;19(1):24–34; quiz 35–26.
See this image and copyright information in PMC

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