Description

Terminology that identifies the discrete data elements of nursing practice. Standardized framework and coding structure of diagnoses interventions, and outcomes for assessing, documenting, and classifying care in all healthcare settings. Used to track and measure patient/client care holistically over time, across settings, population groups, and geographic locations.

Contact Information For Nursing Content: Virginia K. Saba, EdD, RN, FAAN, FACMI Distinguished Scholar, Adjunct Georgetown University, SONHS 3700 Reservoir Road, NW Washington, DC CEO SabaCare, Inc. Arlington, VA Phone: 703-521-6132 E-mail: vasba@worldnet.att.net For Licenses: Version 2.0 is free and granted upon permission and available at www.sabacare.com.

Latest Version Version 2.0 Number of Nursing Terms 182 nursing diagnostic coded concepts. 792 nursing interventions and action coded concepts (198 interventions and 4 action qualifiers -- assess/monitor, direct care/perform, teach/instruct. manage/refer) 546 nursingoutcomes (182 diagnoses and 3 expected and actual outcome qualifiers - imporve, stabilie, or deteriorate) 21 Care Components classifies, codes and links terminologies.

Relationship of CCC to Other ANA Recognized Terminologies and Data Element Sets

• Integrated partially into Logical Observations, Identifiers, Names and Codes (LOINC).
• Integrated into Systematized Nomenclature of Medicine Clinical Terms (SNOMED-CT).
• Served as basis for original International Classification of Nursing Practice (ICNP).
• Selected Nursing Interventions adapted in ABC Codes for Complimentary and Alternative Medicine (CAM) and Conventional Nursing.
• Twenty (20) Care Components (Version 1.0) adapted by Ozbolt as a framework for the Patient Care Data Set (PCDS) (retired)
• Mapped to SNOMED-CT & ICNP.

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Relationship to Related National Initiatives

• Accepted by US DHHS as a "named standard" within the Healthcare Information Technology Standards Panel (HITSP) Interoperability Specification for Electronic Health Records (1/22/07)
• Conforms to the criteria for a Reference Terminology Model for Nurses (ISO 18104) Standard approved by the International Standards Organization (ISO) Technical Committee (TC) 215 Working Group 3 - concept Representation in October 2003 in Oslo, Norway.
• Listed in the American National Standards Institute (ANSI) Healthcare Informatics Standards Technical Panel (HITSP) Inventory of Standards Library.
• Registered as a Health Level 7 Language and complies with format standards of HL7 for electronic transmission of data promoting interperability.
• Integrated into Metathesaurus of the Unified Medical Language System (UMLS of the National Library of Medicine (NLM)
• Indexed in Cumulative Index of Nursing and Allied Health Literature (CINAHL)
• Approved by American National; Standards Institute - Healthcare Informatics Standards Board (ANSI-HISB)
• Translated into Portugese, Dutch, Chinese, Korean, Finnish, German, Spanish, Slovania, Norwegian, and several others are in progress