Transcript A critical review of Omaha System use at the community level

A critical review of
Omaha System use at the
community level
Karen A. Monsen, MS, RN
Madeleine J. Kerr, PhD, RN
Karen S. Martin, MS, RN
Linda Olson Keller, MS, RN
MNRS 4/3/2006
Purpose
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To determine the state of the science of using
a standardized nursing classification, the
Omaha System, to describe community level
problems, interventions, and outcomes
Background
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In 2005, the second edition of the Omaha
System was published that contained a
“community” modifier
Several exemplars using the community level
modifier have since been developed and
published related to diverse topics
Data Points in the Omaha System
Omaha System
Environmental (4)
Income
Sanitation
Psychosocial (12)
Residence
Physiological (18)
Safety
Modifiers
Identity
Severity
Individual
Actual
Family
Potential
Community
Promotion
Signs & Symptoms
Category (4)
Target (75)
Client Specific Information
Knowledge
Behavior
Status
Health Related Behaviors (8)
Methods
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integrative descriptive review
Criteria for assessment of these studies
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populations served
problems addressed by domain
interventions used by category
reliability of data collection
concurrent validity measures used
outcomes measured
internal and external controls implemented
Outcomes and Interventions in a Communitybased Senior Health Clinic
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Populations served: Seniors in a high rise
Problems addressed: Nutrition (HRB)
Interventions used: Teaching, guidance, &
counseling (1); Surveillance (4)
Vance, E. A.; Fish, C. A. (2005).
Poster presented at the Omaha
System International Conference,
Minneapolis, MN
Outcomes and Interventions in Health
Promotion/Employee Health
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Populations served: Employees in a public
health department
Problems addressed: Circulation (Phys)
Interventions used: Teaching, guidance, &
counseling (1); Surveillance (4)
Fish, C. A.; Vance, E. A. (2005).
Poster presented at the Omaha
System International Conference,
Minneapolis, MN.
Using the Omaha System to Describe Community Level
Depression and Suicide Interventions
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Populations served: Adolescents
Problems addressed: Mental health (Psych)
Interventions used: Case Management (3);
Surveillance (4)
Galligher, P. S., & Monsen, K. A.
(2005). Poster presented at the
Omaha System International
Conference, Minneapolis, MN.
Maine’s Approach Modifier Community
Problem Communicable/ Infectious Condition
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Populations served: TB Clinics
Problems addressed:
Communicable/Infectious Condition (Phys)
Interventions used: Teaching, guidance, &
counseling (1); Surveillance (4)
Correll, P. (2005). Paper presented at
the Omaha System International
Conference, Minneapolis, MN.
West Nile Virus Outbreak: Reduce Disease
Transmission in a Community
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Populations served: A Minnesota County
Problems addressed:
Communicable/Infectious Condition (Phys);
Neighborhood/Workplace Safety (Env)
Interventions used: Teaching, guidance, &
counseling (1); Case management (3);
Surveillance (4)
Keller, L. O., MN Omaha System
User Group (2005). Case study in
Martin, K. S., Omaha System (2nd
ed). Elsevier: St. Louis.
Compliance checks: Strategies to decrease
tobacco sales to teens in the community
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Populations served: Adolescents
Problems addressed: Substance use (HRB)
Interventions used: Teaching, guidance, &
counseling (1); Surveillance (4)
Galligher, P., Minnesota Omaha
System Users Group (2005). Case
study in Martin, K. S., Omaha System
(2nd ed). Elsevier: St. Louis.
Garbage odors: Resolving a problem at a senior
apartment building in the community
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Populations served: Seniors in a high rise
Problems addressed: Sanitation (Env);
Communication with community resources
(Psych)
Interventions used: Teaching, guidance, &
counseling (1); Case management (3);
Surveillance (4)
Ottinger, B. (2005). Case study in
Martin, K. S., Omaha System
(2nd ed). Elsevier: St. Louis.
Influenza Outbreak: Reduce Disease
Transmission in a Community
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Populations served: A Minnesota County
Problems addressed:
Communicable/Infectious Condition (Phys)
Interventions used: Teaching, guidance, &
counseling (1); Treatments & Procedures (2);
Case Management (3); Surveillance (4)
Keller, L. O., Minnesota Omaha
System User Group (2005). Case
study in www.omahasystem.org
Results
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Eight community case studies and reports
described diverse problems from all domains
of the Omaha System Problem Classification
Scheme; all intervention Categories, and
reported Knowledge, Behavior, and Status
outcomes.
Results, continued
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Data reliability was addressed in one practice
setting for two of the case studies.
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KBS rating guides were created for inter-rater
agreement purposes
Concurrent validity was addressed in two
studies.
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Blood pressure measurement
Evaluation scores
Limitations
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difficulty reporting novel Omaha System
outcome data to the uninitiated
the usual limitations of observational
descriptive studies
Implications
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The Omaha System has the capacity to
describe community level problems,
interventions, and outcomes (face validity).
These case studies provide a beginning
platform for research agendas related to use of
standardized classifications for community
level intervention and outcome research.