NANDA, NOC and NIC: Nursing Classification Systems Explained

NOC Domain Level Abstraction

Level 1 of the NOC classification: Domains — Level 1: 7 domains, included in the NOC classification and corresponding to the domains. The domains are defined and named, and are identified by a number from 1 to 7.

Level 2: 29 classes in total, whose corresponding definitions are assigned according to the domain definition. Classes are identified by 26 letters (excluding N) plus 3 signs (+, -, ±).

Level 3: Outcomes, formed by 260 results. Each class defines the results corresponding to the domain. Outcomes are susceptible to nursing intervention and are identified by a code number equivalent to a 4-digit code. The outcomes, along with indicators, serve as specific objectives marked in concrete situations in social life.

Level 4: Concrete indicators: an index of results susceptible to nursing intervention. Scales of values are used to evaluate outcomes and allow specifying changes. Codes are 6 digits, with a 4-digit result and a 2-digit scale from 1 to 99.

NOC Operational Elements

Outcomes susceptible to nursing intervention form the third level of classification. These outcomes, conducts or perceptions of persons, families or social groups are sensitive to nursing interventions.

The NOC is a conceptual level 1 of abstraction. These outcomes vary and can be measured and compared with previous assessments, with 10 points of April, at 2 determinations (at the beginning of care and at the end of care). The results are not equivalent to objectives; rather, they are the goals that nurses aim to achieve. The NOC is used with indicators to mark specific objectives in concrete situations.

• Indicators of results susceptible to nursing intervention. These outcomes, conducts or perceptions of the person, family or social group are sensitive to nursing interventions.
• Conceptual level 1 of abstraction (fourth level).

Classification elements are useful for nursing-oriented developments with the person, the goal and the objectives in every specific situation.

NOC Process Stages

The process stages relate to the results contained in the NOC classification. These stages relate to assessment, planning and evaluation, which can be used to evaluate the way in which the objectives have been achieved.

NIC Classification: Interventions

Chapter 16 covers nursing interventions: NIC (Nursing Interventions Classification) or CIE.

1. The NIC classification elements are structured in levels, from greater to lesser abstraction.

• Level 1: Domains, 7 in total, ordered numerically.
• Level 2: Classes, 29 in total. Their definition corresponds to the domain they belong to. Letters are identified by 26 capital letters (except N) plus 3 sensitive signs.
• Level 3: Interventions, 400 in total, ordered alphabetically. This is a concrete level and corresponds to the operations associated with the class assigned. When an intervention is attached to 2 different classes, its code and name are shown in both, and the intervention is also included in the other class. Interventions are identified with a 4-digit code.
• Level 4: Nursing activities, indeterminate number (more than 12,000). This is a concrete level of taxonomy and is not encrypted. These are behaviors or specific actions to carry out and achieve the outcomes of the NOC. The code is recorded by placing the intervention code number first, followed by 2 digits (01 to 99), in the order of the activity within the intervention.

Operational Application of the NIC

The operational elements of the NIC classification are interventions and nursing activities.

• Interventions: refer to any nursing treatment based on clinical trial knowledge, which the nurse carries out to favor the client achieving the NOC outcomes.
• Nursing activities: are any specific action or conduct nurses use to carry out the intervention, helping clients move forward toward achieving the NOC outcomes.

The process stages related to the NIC interventions contained in the qualifying process are planning and execution. The NIC asks what outcomes are wanted and how they will be achieved, through actions.

NANDA, NOC and NIC Integration

NANDA, NOC and NIC are three independent taxonomies. However, once established, they are linked to clinical practice. The elements are related as follows:

• NANDA: nursing diagnosis label with defining characteristics and related factors.
• NOC: nursing outcome with indicators.
• NIC: nursing intervention with nursing activities.

Multiple associations between NANDA labels, NOC outcomes and NIC interventions are established. However, these interrelations are not determinants and do not replace clinical judgment; the outcomes may require other interventions. The joint use of the three classifications provides a framework to describe their combined application.

Advantages

• Facilitates the client care plan
• Makes statement of objectives easier
• Facilitates the organization of nursing activities
• Offers clear assessment criteria for client outcomes and nursing activities
• Easy-to-use nursing diagnosis
• Enables documentation homogeneity for research
• Unifies performance criteria
• Improves professional quality

Disadvantages

• Difficulties in joint use
• Different structures
• Independent objectives
• Different language
• Uneven development