The Use of Omaha System in the Nursing Care of Children with Acute Care Needs

Aim: To identify the problems of children hospitalized in a pediatric clinic for acute problems using a Nursing Informatics Program based on the Omaha System, to assess the nursing interventions applied regarding these problems and the contributions of the interventions to care outcomes, and to test the usability of the system in the fi eld.

Method: The sample was comprised of 30 children hospitalized in the pediatric clinic of a state-run hospital for acute problems between April and May 2012. The nursing problems, nursing interventions and care outcomes were collected through the three forms of the Omaha System, namely the Problem Classifi cation Scheme, Intervention Scheme and Problem Rating Scale for Outcomes The data were processed via web-based Nightingale Notes by Champ Software (NN) based on the Omaha System, and the fi ndings were evaluated with descriptive and explanatory analyses.

Results: The most commonly observed diagnoses of the children who applied to the emergency were “high temperature”, “breathing diffi culty”, and “nausea-vomiting”. Nursing problems related to Communicable / Infectious Condition (n=25-48%), Digestion-Hydration (n=12-23%), Respiration (n=9-17%), Urinary Function (n=4-8%), and Bowel Function (n=2-4%) were selected from the Nightingale Notes program in the order of frequency. Fifty-two nursing diagnoses were used with regard to problems which were all related to physiology (mean=1.73±0.52). Four hundred nursing activity entries were made in line with nursing diagnoses. For the nursing enterprises selected from Treatments and Procedures (n=130-32.5%), Surveillance (n=106-26.5%), Teaching, Guidance, and Counseling (n=102- 25.5%) and Case Management categories (n=62-15.5%), 20 of the 75 system targets were used. The progress in the nursing care results of care applied within the scope of Infection Status, Digestion-Hydration and Respiratory problems was found to be signifi cant (p<0.05).

Conclusion: It was found out that the most frequently applied intervention was Treatments and Procedures and the least frequently applied intervention was Case Management; nearly one fourth of the system targets was used for all interventions and an improvement was observed in the care results of the most frequently diagnosed problems. These results revealed that Nightingale Notes program which is based on the Omaha System can be used by children’s nurses working in acute care.