the omaha system-final

8/14/2019 The Omaha System-final

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The Omaha System


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a research-based,comprehensive classification

system that promotesdocumentation of client care

It is a framework forintegrating and sharing clinicaldata that has existed in thepublic domain since 1965


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began in the 1970s when Visiting NurseAssociation (VNA) of Omaha (Nebraska) staffbegan revising their home health and public

health client records and adopting a problem-oriented approach.

DeLanne Simmons, VNA of Omaha ChiefExecutive Officer, envisioned a computerizedmanagement information system thatincorporated an integrated, valid and reliableclinical information system organized aroundclients who received services, not themultidisciplinary practitioners who providedservices.


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PURPOSE Developed to guide community health

nursing practice and serve as a methodfor documentation of care and datamanagement

It provides a structure to document

client needs and strengths, describemultidisciplinary practitionerinterventions and measure clientoutcomes in a simple and user-friendly

yet comprehensive manner


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Capabilities and Characteristics Advances the scientific practice of

nursing

Offers capabilities to quantifycommunity health nursing

Is practical for general communityhealth application

Is congruent with the nursing process

Minimizes redundancies in the clientrecord

Limits documentation time.


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MAJOR CONCEPTS Problem Classification Scheme

Intervention Scheme Problem Rating Scale for Outcomes


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PROBLEM-CLASSIFICATION

SCHEME Designed to identify diverse

clients health-related concerns Consists of four levels


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I. Four domains

Represent priority areasof practitioner and clienthealth-related concerns


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Environmental Domain Material resources and physical

surroundings both inside and outsidethe living area, neighborhood, andbroader community.

Income Sanitation Residence

Neighborhood/workplace safety


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Physiological Domain Functions and processes that

maintain life Hearing Vision Speech and language

Respiration Circulation Digestion-hydration


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Health Related Behaviors Domain Patterns of activity that maintain or promote

wellness, promote recovery, and decreasethe risk of disease.

Nutrition Sleep and rest patterns Physical activity Personal care Substance use Family planning


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II. Concepts, referred to as clientproblems or areas of clients

needs and strengths

III. Two sets of problem modifiers

Health promotion, potential andactual

Individual, family and community


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IV. Clusters of signs andsymptoms that describeactual problems


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INTERVENTION SCHEME Designed to address specific

problems for diverse clients.

the basis for planning and intervening, itenables practitioners to describe andcommunicate their practice includingimproving or restoring health, decreasing

deterioration, or preventing illness.

Three levels of professional actionsor activities


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I. Four broad categories ofinterventions

Teaching, Guidance, andCounseling

Treatments and Procedures Case Management Surveillance


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II. Alphabetical lists of 75 targetsor objects of action

anatomy/physiolog anger managementbehavior modification bladder care dressing change/wound care durable medical

equipment education Employment end-of-life care environment medication set-up

mobility/transfers nursing carenutritionist care sickness/injury caresigns/symptoms-mental/emotional

signs/symptoms-physicalskin care social work/counseling care


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III. Client-specific informationgenerated by practitioners


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Problem Rating Scale forOutcomes

Consists of three five-point,Likert-type scales for measuringthe entire range of severity forthe concepts of knowledge,behavior and status

Provides an evaluationframework for examiningproblem specific client ratings atregular or predictable times


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Consisten

tlyappropriatebehavior

Usually

appropriatebehavior

Inconsist

entlyappropriatebehavior

Rarely

appropriatebehavior

Not

appropriatebehavior

Behavior:Observable

responses,actions, oractivities ofthe clientfitting theoccasion or

purpose

Superior

knowledge

Adequate

knowledge

Basic

knowledge

Minimal

knowledge

No

knowledge

Knowledge:Ability of theclient torememberandinterpretinformation

54321Concepts


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Nosigns/sympto

ms

Minimalsigns/sympto

ms

Moderate signs/sympto

ms

Severesigns/sympto

ms

Extremesigns/sympto

ms

Status:Conditionof theclient inrelationtoobjectiveandsubjective definingcharacteristics

the omaha system-final

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