Using the Nursing Interventions Classification (Nic) to Codify the Nursing Activities of Advanced Beginner, Competent/Proficient, and Expert Nurses

Abstract

There is an increasing awareness of the need to achieve interoperability, the capability of different clinical documentation systems to communicate with each other. This sharing of data can only be achieved by the implementation of structured terminologies, such as the Nursing Interventions Classification (NIC). The classification of nursing data will enable nursing practice to be measured consistently. A nursing research study on the complexity of nursing provided a unique opportunity for the secondary analysis of actual observed nursing activities. An evaluation of these activities was conducted to determine if the NIC could be used to code the data. Observational data from two advanced beginner nurses, two competent/proficient nurses, and two expert nurses were coded with the NIC by two health informatics graduate students. The agreement between coders in the identification of a nursing intervention, unitizing inter-rater reliability, was calculated as 91.55%. The consistency of coding between coders, interpretive inter-rater reliability, was calculated as 75.60%. The results of this study show that the flexibility inherent in the design of the NIC can pose issues in the consistent assignment of interventions to the observed nursing activities. The challenges of implementing the NIC in a complex nursing environment can also be seen.