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#AuthorTitle of ArticleJournal NameYear PubPurpose of the StudyEvidence Based GuidelineAvailable Online? no=0/yes=1Role(s) Specified?Number of InterventionsMethodsResults CommentsFull Reference
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1Monsen, K. A., Foster, D. J., Gomez, T., Poulsen, J. K., Mast, J., Westra, B. L., & Fishman, E.Evidence-based standardized care plans for use internationally to improve home care practice and population healthApplied Clinical Informatics2011to produce and disseminate a home care EB-SCP for assessment, documentation, and evaluation; to contribute to the evidence based practice, practice based evidence cycle to improve home care practice and population health expert consensus on targeted health problems; graduate student lit review for interventions, evidence; proposed interventions selected by consensus with two revisions incorporating public comment1No, because it is a standardized assessment?12Seven step process: convene expert team; identify problem and population; review lit to identify best practices and interventions; synthesize evidence, develop consensus on inclusion / exclusion of interventions; public comment #1; incorporate public comment, 2nd public comment, revised and finalize; disseminate 12 item evidence based standardized care plan based on evidence and grounded in practicesets the stage for "Methods" moving forward, great context for purpose / value of OS standardized care plansMonsen, K. A., Foster, D. J., Gomez, T., Poulsen, J. K., Mast, J., Westra, B. L., & Fishman, E. (2011). Evidence-based standardized care plans for use internationally to improve home care practice and population health. Applied Clinical Informatics, 02(03), 373–384. https://doi.org/10.4338/ACI-2011-03-RA-0023
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2Monsen, K. A., & Oftedahl, G.Cardiac rehabilitation and informatics: Strategies for increasing the global impact of cardiac rehabilitation on population healthTurkiye Klinikleri J Cardiol-Special Topics2012highlight advantages of encoding clinical guidelines to enhance care coordination, delivery, and communication; propose advantage of easily accessible guidelines, efficient documentation, and quality data captureAHA cardiac rehabexplanation of uniform data structure created by using the OS to encode clinical guidelinesMonsen, K. A., & Oftedahl, G. (2012). Cardiac rehabilitation and informatics: Strategies for increasing the global impact of cardiac rehabilitation on population health. Turkiye Klinikleri J Cardiol-Special Topics, 5(2), 14–20.
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3Monsen, K. A., Neely, C., Oftedahl, G., Kerr, M. J., Pietruszewski, P., & Farri, O.Feasibility of encoding the Institute for Clinical Systems Improvement Depression Guideline using the Omaha SystemJournal of Biomedical Informatics2012demonstrate feasibility of encoding ICSI's depression guideline using the OSICSI Health Care Guideline Major Depression in Adults in Primary Care13 level 1 assessment and diagnosis guideline; 6 level 2 steps for collaborative care; 9 level 3 steps for pt. education and engagementresearch team established; guideline encoded initially by KM; all team members reviewed and revised until consensus was reached; best fit consensus was used for confusing/ ambiguous itemsThe guideline was successfully encoded using the OS. All but one of the interventions were coded under the mental health problem (outlier under substance abuse). Three levels were used to address granularity (1 depression guideline assessment and diagnoses; 2 collaborative care; 3 educate and engage patient)feasibility criteria: content validity, linguistic validity, granularity. Need to further examine effectiveness / implementation of tiered guidelines in EHRMonsen, K. A., Neely, C., Oftedahl, G., Kerr, M. J., Pietruszewski, P., & Farri, O. (2012). Feasibility of encoding the Institute for Clinical Systems Improvement Depression Guideline using the Omaha System. Journal of Biomedical Informatics, 45(4), 719–725. https://doi.org/10.1016/j.jbi.2012.06.004
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4Kvarme, L. G., Monsen, K. A., & Eboh, W. O.Evidence-based solution-focused care for school-age children experiencing cyberbullying: Using the Omaha System to guide and document psychiatric nursing interventionsJournal of Psychosocial Nursing and Mental Health Services2014presentation of how the OS can be used to document evidence-based interventions (cyberbullying)Solution-Focused Approach interventionnurse and community level guidelines7 at individual level; 6 at community leveldevelopment: consensus between OS and cyberbullying experts based on literature. Individual level study DeJong & Berg, 2002; community level Kowalski, Limber, & Agatston, 2008)guidelines at community and individual level allow for a comprehensive approach to cyberbullying that includes the individual, family, and community contexts. Presented case study shows psychiatric nurse implementing the SFA care plandescription of psychiatric nurse interventions and assessmentsKvarme, L. G., Monsen, K. A., & Eboh, W. O. (2014). Evidence-based solution-focused care for school-age children experiencing cyberbullying: Using the Omaha System to guide and document psychiatric nursing interventions. Journal of Psychosocial Nursing and Mental Health Services, 52(3), 34–41. https://doi.org/10.3928/02793695-20131029-02
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5Pruinelli, L., Fu, H., Monsen, K. A., & Westra, B. L.Comparison of consumer derived evidence with an Omaha System evidence-based practice guideline for community dwelling older adultsNursing Informatics 20142014compare the OS EBP for community dwelling adults with consumer-derived evidence for ongoing needs, resources, adn strategies (p. 19)existing OS community dwelling adult EBP guideline1yes (self, family/informal caregivers, paid service)21Convenience sample of 30 chronically ill adults discharged from home care (one homecare agency, midwest; inclusion criteria p. 19); semi-structured interviews to understand needs, strategies, resources for managing health. First three interviews coded by all investigators independently with group consensus following. This process established rules on inclusions and codes for consistency (p. 20). Actual problems identified by S&S; potential absence of S&S - preventative intervention. OS-EBP guideline development (previous study article citations 8 & 9): synthesis of research, validation: international panel of experts)Majority consistent: 18 of 21 guideline problems relevant to sample with Neuro-musculo-skeletal and communication with community resources occurring in more than 90% of interviews (p. 20). 8 new problems were identified - urinary foundation (20%) most common, followed by bowel (13%) and vision (13%).Care plan vs. actual needs supports need for expert AND community validation. reinforces need for comprehensive assessment in addition to problem focused (p. 20). Necessary to update care plans with new interventions based on validated problems. Further research needed to determine if care plans can be a communication link between consumers and HCP.Pruinelli, L., Fu, H., Monsen, K. A., & Westra, B. L. (2014). Comparison of consumer derived evidence with an Omaha System evidence-based practice guideline for community dwelling older adults. Nursing Informatics, 18–24. https://doi.org/10.3233/978-1-61499-415-2-18
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6Monsen, K. A., Attleson, I. S., Erickson, K. J., Neely, C., Oftedahl, G., & Thorson, D. R.Translation of obesity practice guidelines: Interprofessional perspectives regarding the impact of public health nurse system-level interventionPublic Health Nursing2015investigate perceptions of administrators and clinicians use of the ICSI obesity guidelineICSI Health Care Guideline Obesityqualitative approach, university-community partnership. IRB approval. 10 health care orgs (5 primary care [3 private, 1 FQHC, 1 MHS}, 4 PH departments, 1 independent OT). 70,138 pts seen served (p. 3). Range of provider roles interviewed. Semi-structured interviews by RA at convenience of participants over 6 months, 2 years into project participation. Content analysis of transcripts by research team experts (rigor: triangulation, interrater reliability, member checking, reflexivity)(p. 4). 4 primary themes emerged (p. 4): "(1) a shift from powerlessness to positive motivation, (2) heightened awareness coupled with improved capacity to respond, (3) personal ownership and use of creativity, and (4) a sense of the importance of increased interprofessional collaboration. Concepts embedded across themes were personal self-respect and self-efficacy. Resources, which increased response capacity (p. 5). public access (website) facilitates dissemination. Charting prompts, reminders, follow up and referral information with in EHR supported adherence (p. 5). TRAINING in motivational interviewing was key.Administrator and clinician perceptions of EBP use vs. development. Guideline inspired a sense of interprofessional collaboration (p. 6). Challenges (typical ones): buy-in, lack of communication, absence of systemic information sharing (p. 6). Self-respect/efficacy finding. Wider awareness of community resources (expanded by wider implementation/ public access import). Helped address stigma / blame gave providers who share in obesity classification tools to comfortable address patients, some implemented resources in own lives. Guideline instrumental in providing skills and resources for assessment BASED on EBP.Monsen, K. A., Attleson, I. S., Erickson, K. J., Neely, C., Oftedahl, G., & Thorson, D. R. (2015). Translation of obesity practice guidelines: Interprofessional perspectives regarding the impact of public health nurse system-level intervention. Public Health Nursing, 32(1), 34–42. https://doi.org/10.1111/phn.12139
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7Monsen, K. A., Peters, J., Schlesner, S., Vanderboom, C. E., & Holland, D. E.The gap in big data: Getting to wellbeing, strengths, and a whole-person perspectiveGlobal Advances in Health and Medicine2015examine potential alignment of Wellbeing Model wit the OS to document wellbeing assessments (p. 31) - operationalizeWellbeing Model (Kreitzer citation 15)37 OS problem concepts represented in WbMSampling: upper Midwest senior living; 59 total residents; 5 wellbeing assessments randomly selected and de-identified. Instrument, the OS. 1) Wellbeing Model mapped to OS (two independent mappings, combied, reviewed by experts, consensus). 2) Adapted for use in study population, incorporated into existing EHR. 3) assessments collected at admission, periodically, by RNs w/ BSN or >. 4) strengths and S&S of 5 were aggregated an analyzed to assess overall wellbeing and relations between strengths and needs. (p. 36)Sampling: upper Midwest senior living; 59 total residents; 5 wellbeing assessments randomly selected and de-identified. Instrument, the OS. 1) Wellbeing Model mapped to OS (two independent mappings, combied, reviewed by experts, consensus). 2) Adapted for use in study population, incorporated into existing EHR. 3) assessments collected at admission, periodically, by RNs w/ BSN or >. 4) strengths and S&S of 5 were aggregated an analyzed to assess overall wellbeing and relations between strengths and needs. (p. 36)First study looking at clinical assessment data from well being perspective (p. 37). Feasible to use OS WbM as strengths based, whole-person perspective, assessment. Potential to generate large clinical data sets for studying wellbeing via a clinical standardized terminology. OS operationalized WbM theory - allows for theory specific research and refinement and large datasets (pending broad implementation)Monsen, K. A., Peters, J., Schlesner, S., Vanderboom, C. E., & Holland, D. E. (2015). The gap in big data: Getting to wellbeing, strengths, and a whole-person perspective. Global Advances in Health and Medicine, 4(3), 31–39. https://doi.org/10.7453/gahmj.2015.040
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8Monsen, K. A., Swenson, S. M., & Kerr, M. J.The perceptions of public health nurses on using standardized care plans to translate evidence-based guidelines into family home visiting practiceKontakt2016evaluate PHN experience and awareness of cognitive process while using the EB-FHV care plan (p. 90)EB- Family Home Visiting Guideline28Sampling: volunteer sample of leaders and PHNs from MN gov. PH agency who had been using the guideline embedded in EHR for ~1 year. Five participants (of 6) who had used both care plans participated. Participants were provided copies of the original care plan and interviewed regarding their experiences with both plans. Thematic analysis approach. Inter-rater reliability, member checking, reflexivity. Themes developed and revised over three waves. Final themes agreed upon by consensusFour themes: "1. PHN thinking is separate from the care plan, 2. PHN thinking is supported by the care plan, 3. PHN thinking is stimulated by the care plan, and 4. PHN documentation distress is minimized when the care plan matches PHN thinking" (p. 90). Ability to tailor care plan to clients was appreciated. PHNs used their knowledge to work both within and outside of the care plan. The structure of the OS based care plan allowed for identifying the problems and client status; gave a tangible way for PHNs to assess their impact and see how they fit in to advocate for the patient and promote their health. OS-EBP guideline development (previous study-article citation 11): **"content-expert appraoch" THIS is the term for many of the guidline devel methods.**synthesis of research, validation: practicing PHNs, scholars, consumers(!) - consumers calls back to article #5, Purinelli). PHNs feedback indicates need for provider input/consensus. Results not generalizable (small sample. Customizing care plan or needing to find additional information impedes workflow (p. 92). Persisting challenges: revising care plan so it is relevant in practice and not burdensom to workflow/ contributiong. documentation distress. Always additional reserach - is tehre ONE area, ONE care plan where there could be longituidnal research? This one has been used for awhile, mayve the home care one, which has some consumer validation?Monsen, K. A., Swenson, S. M., & Kerr, M. J. (2016). The perceptions of public health nurses on using standardized care plans to translate evidence-based guidelines into family home visiting practice. Kontakt, 18(2), e75–e83. https://doi.org/10.1016/j.kontakt.2016.04.001
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9Austin, R. R., Monsen, K. A., & Schulz, C.An informatics approach to interprofessional management of low back pain: A feasibility study using the Omaha SystemJournal of Innovation in Health Informatics2017demonstrate feasibility of encoding EBP low back pain guidelines using the OSICSI Clinical practice guidelines for the non-invasive management of low back pain1yes, 613review of literature; selection of well-constructed recent SRs of LBP clinical practice guidelines. comprehensive SR of non-invasive Tx for LBP to select guideline. research team each encoded the guideline using medical coding method; content selected for feasibility; finally review, differences resolved via consensus. Three factors for feasibility: content validity, linguistic validity, granularity (cosisthen methodological theme)13 interventions, 6 problems, 3 domains; case management and T&P were most frequent intervention categories; S&S-phys was most frequent target (p. 272)transition to including ROLES for multidisciplinary nature of client problems to address comprehensive holistic approach to care- no single team member completes all interventions. Precise coding critical to convey meaning and produce quality data (p. 273). GREAT methods section. Austin, R. R., Monsen, K. A., & Schulz, C. (2017). An informatics approach to interprofessional management of low back pain: A feasibility study using the Omaha System. Journal of Innovation in Health Informatics, 24(3), 268. https://doi.org/10.14236/jhi.v24i3.929
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10Monsen, K. A., Vanderboom, C. E., Olson, K. S., Larson, M. E., & Holland, D. E.Care coordination from a strengths perspective: A practice-based evidence evaluation of evidence-based practiceResearch and Theory for Nursing Practice2017practice-improvement project: evaluate fit of interventions from 2 EBP guidelines with PBE (intervention phrases from nurse generated practice narratives (p. 44)CDE and Strengths Interventions (p. 42)CDE: 236; SI: 10reuse of 66 phrases from de-identified descriptions of strengths-based nursing practice. narrative encoded by researchers with previously established inter-rater validity; differences resolved by research team; final mapping, consensus. descriptive stats to establish relative fit; visualizations to show overlap between guidelines and documentation10 standardized SI guideline care descriptions mapped to 100% of the 66 practitioner phrases (p. 47). OS allows the quantification, visualization, comparison of relationships between guidelines and practice phrases (narrative notes?) (p. 47). Finding that phrases described guideline interventions supports feasibility of embedding guidelines in EHR (p. 48). // to PHN perception article: Finding that phrases described guideline interventions supports feasibility of embedding guidelines in EHR (p. 48). // to PHN perception article: need to understand how practitioner expertise for tailoring interventions interacts w/ use of existing guidelines (p. 48). Sampling: volunteer sample of leaders and PHNs from MN gov. PH agency who had been using the guideline embedded in EHR for ~1 year. Five participants (of 6) who had used both care plans participated. Participants were provided copies of the original care plan and interviewed regarding their experiences with both plans. Thematic analysis approach. Inter-rater reliability, member checking, reflexivity. Themes developed and revised over three waves. Final themes agreed upon by consensusMonsen, K. A., Vanderboom, C. E., Olson, K. S., Larson, M. E., & Holland, D. E. (2017). Care coordination from a strengths perspective: A practice-based evidence evaluation of evidence-based practice. Research and Theory for Nursing Practice, 31(1), 39–55. https://doi.org/10.1891/1541-6577.31.1.39
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11Gao, G., Kerr, M. J., Lindquist, R. A., Chi, C.-L., Mathiason, M. A., Austin, R. R., & Monsen, K. A.A strengths-based data capture model: Mining data-driven and person-centered health assetsJAMIA Open2018explore and illustrate incorporation of strengths-based data capture modeling risk assessment and management (data-drive, person-centered health assets, use of OS)leveraging use of existing OS data capture thought piecerole of strengths-based approach in countering biased problem-based risk prediction models (p. 12). Better to leverage strengths to promote behavioral change (intervene prior to problem development using strengths vs. risk management. focus on deficits) (p. 13). proposes strengths-based approach to move beyond problem based data framework. Need for context / consistent interoperable documentation of strengths / SBDH for data aggregation, comparability, interoperability. Goal to develop value-based risk prediction models (p. 13). Advocates of use of OS to produce this type of data. Gao, G., Kerr, M. J., Lindquist, R. A., Chi, C.-L., Mathiason, M. A., Austin, R. R., & Monsen, K. A. (2018). A strengths-based data capture model: Mining data-driven and person-centered health assets. JAMIA Open, 1(1), 11–14. https://doi.org/10.1093/jamiaopen/ooy015
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12Slipka, A. F., & Monsen, K. A.Toward improving quality of end-of-life care: Encoding clinical guidelines and standing orders using the Omaha SystemWorldviews on Evidence-Based Nursing2018investigate feasibility of using OS for encoding interoperable EB EOL interventions - specified temporality, multiple roles4: hasting Center...Care Near EOL, CPG for Quality Palliative Care, Guidelines for EOL Care in Nursing Homes, ICSI Palliative Care WITH standing orders from licensed hospice facility1yes, 10- verify153interventions synthesized from guidelines, standing orders encoded by research team; interventions encoded and synthesized to eliminate overlap; revision with incorporation of hospice RN case manager, expert feedback; revised and validated until consensus.153 interventions: 22 problems, 4 categories, 20 targets. most interventions within scope of nursing practice (NOTE: including roles allows one to see scope of practice - another article mentions this, the LBP one, I think). 12 of 22 problems addressable by more than one discipline - interprofessional guideline (p. 3) - care coordination - EBP across disciplines (p. 10). Actionable data! - "who receive what, how many, whe, by whom" (p. 3 - also see that citation, Lee, Kim, & Monsen, 2015). Inclusion of temporality ma improve prompt intervention (p. 10). largest exploration of roles; introduce temporality to OS guidelines (first). "Clinical documentation based on encoded guidelines gener- ates individualized, meaningful data suitable for program evaluation and health care quality research" (p. 10). continually update - EBP PBE cycleSlipka, A. F., & Monsen, K. A. (2018). Toward improving quality of end-of-life care: Encoding clinical guidelines and standing orders using the Omaha System. Worldviews on Evidence-Based Nursing, 15(1), 26–37. https://doi.org/10.1111/wvn.12248
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13Kessler, P. D., Monsen, K. A., Lu, S.-C., & Kreitzer, M. J.Validating standardized integrative nursing guidelines for symptom managementEC Nursing and Healthcare2020validate an integrative nursing intervention OS guidelineEB information extracted from Integrative Nursing textbook 1211clinical expert approach, established terminology mapping methods. 1st mapping-grad student; 2nd-OS and integrative experts; all authors review and resolve differences by consensus. Duplicate interventions deleted. Validation phase: 10 content experts review interventions for each book chapter for clarity, utility, accuracy of mapping. Expert comments were reviewed and addressed to revise final guideline.211 interventions: 10 problems.141 deemed accurately coded by experts. OS deemed broadly applicable to integrative nursing. Identified need for additional terms to be added in next OS revision. p. 08: heuristics for describing integrative interventions using OS. potential to support visibilty of integrative practice (extends to nursing at large), CDS, data comparision, interoperability, outcome evaluation. Ongoing challange of using standardized terms to nuances put in free text documentationKessler, P. D., Monsen, K. A., Lu, S.-C., & Kreitzer, M. J. (2020). Validating standardized integrative nursing guidelines for symptom management. EC Nursing and Healthcare, 2(2), 1–10.
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14Monsen, K. A. Rapid development and deployment of an international Omaha System evidence-based guideline to support the COVID-19 responseCIN: Computers, Informatics, Nursing2020describe rapid development of covid guideline / process of guideline developmentcovid response guideline sources (ACA, NCCHC, FBP, CDC (p. 4)1yesCROWDsourcing techniques for covid response guideline via webinars with content experts. (1st use of "crowdsourcing" descriptor, I think). illustrate application of guideline with practice stories; OSCOP developed initial guideline, content expert crowdsource, revision, consensus. cross referenced clinical terminology codes. Rapid - guideline published and the guideline online 1 day after WHO pandemic declaration. rapid development extending to real-time practicedescribe rapid development of covid guideline / process of guideline developmentMonsen, K. A. (2020). Rapid development and deployment of an international Omaha System evidence-based guideline to support the COVID-19 response. CIN: Computers, Informatics, Nursing, 38(5), 224–226. https://doi.org/10.1097/CIN.0000000000000648
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15Novacek, L., Shelton, D., Luethy, R., Medley-Lane, B. S., McLane, T. M., & Monsen, K. A.Correctional nurses on the front lines of the COVID-19 pandemic: Omaha System guidelines documentation case studyJournal of Correctional Health Care2021describe role of correctional nurse within OS covid response guideline; illustrate application of guideline via CN storiescovid response guideline1yes74 within CN copeOSCOP developed initial guideline, content expert crowdsource, revision, consensus. cross referenced clinical terminology codes. CN role had interventions in all four categories - most frequent targets: infection precautions, sickness/injury care, medication coordination, signs/symptoms-phys, coping, safety. CN nurses have broad scope of practice in response to covid per guideline. Novacek, L., Shelton, D., Luethy, R., Medley-Lane, B. S., McLane, T. M., & Monsen, K. A. (2021). Correctional nurses on the front lines of the COVID-19 pandemic: Omaha System guidelines documentation case study. Journal of Correctional Health Care, 27(2), 89–102. https://doi.org/10.1089/jchc.20.07.0062
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16Bennett, V., Southard, M. E., & Monsen, K. A.Evaluation of evidence-based interventions for the nurse coach scope of practice within the Omaha System Guidelines corpusJournal of Holistic Nursing2021nurse coach scope of practice examination of existing OS guidelinesall guidelines in the Omaha System Guidelines corpus at the time of analysis1yes; systematic evaluation of guidelines in relation to nurse coaching1,377 from 20 guidelines in corpusclinical expert consensus approach. Two experts independently reviewed all interventions to determine if they were in the nurse coach scope of practice. Differences were resolved through consensus and a input from a third reviewer A majority of interventions in the corpus were considered to be in the nurse coach scope of practice: 929, 67.5% (p. 3). Most interventions were within the Psychosocial domain; followed by Environmental, HRB, and Physiological. Health care supervision interventions were the most frequently addressed Problem. 93.2% of interventions in the TCG category were determined to be within the NC scope of practice. Coping skills was the most frequent intervention Target. Findings support use of the OS to describe multidisciplinary practices in various guidelines.First study to examine corpus in relation to the scope of practice of a specific role using standardized terminologies. Expands the methods used to evaluate the correctional nurse role in Novacek et al., 2021. "support the use of Omaha System guideline interventions for NC knowledge representation, decision support, documentation support, and data reuse in NC evaluation and knowledge generation" (p. 4). Bennett, V., Southard, M. E., & Monsen, K. A. (2021). Evaluation of evidence-based interventions for the nurse coach scope of practice within the Omaha System Guidelines corpus. Journal of Holistic Nursing, 089801012110455. https://doi.org/10.1177/08980101211045550
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18O'Neill, A. M., Mossing, M. R., Newcome, M. D., Miller, K. B., & Monsen, K. A.Developing structured Omaha System goals for use in an electronic health record.CIN: Computers, Informatics, Nursing2019The purpose of this study was to create standardized language goals for a case management system that used the Omaha System. The specific
aims were to revise natural language goals into structured goals mapped to Omaha System problems and to incorporate taxonomic principles in the development and evaluation of the Omaha System goals for an HSO system (Case Management Service of the Health Service Organization (HSO), a large insurer with case management programs for members)		Omaha Systems Guidelines, 1Yes, case managers identifying patient-specific goalsThe team formated 987 unique SMART goals to over 130 of the 141 concepts in the Omaha SystemThe team consisted of eight nurses who had master's or doctoral degrees, including informatics nurse specialists. First, brief key concepts were abstracted from the natural language goals and then were mapped onto Omaha System problems using the Problem Classification Scheme definitions and classified as KBS goals. Goals were classified based onwords such as verbalizes, states, and reports Team members then reviewed all goals, key concepts, and Omaha System mappings, and differences were resolved by consensus of the entire team. The Omaha System goals were evaluated by 14 nurse informaticists who were recruited from a graduate nursing informatics class. They reviewed the adapted Cimino principles, 20 selected natural language goals, and corresponding Omaha System goals; they then responded to a brief survey regarding the alignment of the Omaha System goals with the adapted Cimino principles. Survey responses were aggregated and analyzed using descriptive and inferential statistics.The final standardized goals included 987 unique SMART goals for 141 concepts across 42 Omaha System problems. Each goal was specific to client Knowledge (42%), Behavior (29%), or Status (29%). Also provided a logical naming convention to create goal IDs and maintained the character limit requirement of the HSO case management software. This goal ID naming convention would allow the HSO to retrieve outcomes by KBS goal type, domain, problem, or
concept. The HSO informaticists affirmed that all HSO criteria were met.		Further research is needed to test the goals within the EHR environment and to evaluate client response to incorporating goal setting within the Omaha System assessment workflow. Further research is needed to examine key conceptsfrom additional natural language goals across populations and settings.O'Neill, A. M., Mossing, M. R., Newcome, M. D., Miller, K. B., & Monsen, K. A. (2019). Developing structured Omaha System goals for use in an electronic health record. CIN: Computers, Informatics, Nursing, 37(12), 655-661.
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19Monsen, K. A., Schenk, E., Schleyer, R., & Schiavenato, M.Applicability of the Omaha System in acute care nursing for information interoperability in the era of accountable care. American Journal of Accountable Care2015Monsen, K. A., Schenk, E., Schleyer, R., & Schiavenato, M. (2015). Applicability of the Omaha System in acute care nursing for information interoperability in the era of accountable care. American Journal of Accountable Care, 3(3), 53-61.
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20Monsen, K. A., Finn, R. S., Fleming, T. E., Garner, E. J., LaValla, A. J., & Riemer, J. GRigor in electronic health record knowledge representation: lessons learned from a SNOMED CT clinical content encoding exercise.Informatics for Health and Social Care2016To educate clinicians and students about knowledge representation and to evaluate their success of applying the manual lookups method for assigning Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) concept identifiers using formally mapped concepts from the Omaha System interface terminology.Omaha System Guidelines, SNOWMED CT guidelines1Clinicians who were students in a doctoral nursing program conducted 21 lookups for Omaha System terms in publicly available SNOMED CT browsers. Lookups were deemed successful if results matched exactly with the corresponding code from the January 2013 SNOMED CT-Omaha System terminology cross-map.Of the 21 manual lookups attempted, 12 (57.1%) were successful. Errors were due to semantic gaps differences in granularity and synonymy or partial term matching.Cross-maps have potential to improve rigor in SNOMED CT encoding of clinical data. Further research is needed to evaluate outcomes of using of terminology cross-maps to encode clinical terms with SNOMED CT concept identifiers based on interface terminologies.Monsen, K. A., Finn, R. S., Fleming, T. E., Garner, E. J., LaValla, A. J., & Riemer, J. G. (2016). Rigor in electronic health record knowledge representation: lessons learned from a SNOMED CT clinical content encoding exercise. Informatics for Health and Social Care, 41(2), 97-111.
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21Schenk, E., Schleyer, R., Jones, C. R., Fincham, S., Daratha, K. B., & Monsen, K. A. Impact of adoption of a comprehensive EHR on nursing work and caring efficacy.CIN: Computers, Informatics, Nursing2018To measure differences in nursing work and caring efficacy on their units i one hospital pre implementation of a comprehensive EHR and 12 months after implementation. -Omaha System Guidelines that are guided by the facility clinical practice guidelines.1Yes; Nurses in acute care setting, 4 RN observers (pre), 7 RN observers (post), they observed randomly selected RN's1 - examination implementation of a comprehensive EHR system on acute care nurse efficacy30 item Caring Efficacy Scale (to measure nurses' perceptions of their ability to perform caring behaviors and develop caring relationships) & time and motion observations pre (2014) and 12 months post (2015) comprehensive EHR implementation. Selected observers observed randomly selected RN's for 30 hours per unit pre and post implementation between 0500-1700.Pre EHR implementation: 50.5% of time spent in team area. Post EHR implementation: 35% of time spent in team area & significantly more time was spent in patient rooms. The average number of location changes nurse made per hr also decreased. More time spent in the Omaha System Surveillance (teaching, guidance) & Counseling (treatments, procedures). Prior to the implementation, most nursing time was spent in the case management category (Coordination, advocacy, referral). Even with an increase in time spent in patient rooms thE pt room there was a decrease in caring efficacy post implemention of EHR. Provided an improved understanding of how implementation of a comprehensive EHR impacts nursing work and efficacy. This article indicates that future research can be aimed to determine whether or not the increased time spent documenting post implemention can be reduced & how this impacts the patient exprience, safety, outcomes.Schenk, E., Schleyer, R., Jones, C. R., Fincham, S., Daratha, K. B., & Monsen, K. A. (2018). Impact of adoption of a comprehensive EHR on nursing work and caring efficacy. CIN, Computers Informatics, Nursing, 36, 331-339. doi: 10.1097/CIN.0000000000000441
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22Schenk, E., Schleyer, R., Jones, C. R., Fincham, S., Daratha, K. B., & Monsen, K. A. Time motion analysis of nursing work in ICU, telemetry and medical-surgical unitsJournal of nursing Management2017This study examined nurses' work, comparing nursing interventions and locations across three units in a United States hospital using Omaha System standardized terminology as the organizing framework.Omaha Systems Guidelines1Yes; nurses in acute care setting - 7 RN observers0 - observational studyNurse-observers recorded locations and interventions of nurses on three acute-care units using hand-held devices and web-based TimeCaT™ software. Nursing interventions were mapped to Omaha System terms. Unit-differences were analysed.Nurses changed locations approximately every 2 min, and averaged approximately one intervention/minute. Unit differences were found in both the interventions performed and the locations. Most interventions were case-management related, demonstrating the nurses' patient management/coordination role.Nursing work varies by unit, yet managers have not been armed with empirical data with which to make more informed decisions about nurses' work priorities, clinical outcomes, patient satisfaction, staff satisfaction and cost. The results from this study will help them to do so.Schenk, E., Schleyer, R., Jones, C. R., Fincham, S., Daratha, K. B., & Monsen, K. A. (2017). Time motion analysis of nursing work in ICU, telemetry and medical‐surgical units. Journal of Nursing Management, 25(8), 640-646.DOI: 10.1111/jonm.12502
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23Yas, M. A., Secginli, S., Mathiason, M. A., & Monsen, K. A.Method development for describing content of multitasked interventions using the omaha systemResearch and Theory for Nursing Practice2019develop and test a method for describing intervention content of nurse/midwife multitasked interventions using the OS
and TimeCaT data in a FHC in Turkey		Omaha System Guidelines used to track multitasked interventions in the FHC1yes; nurse and midwives perform same tasks in FHCs in TurkeyOnly and observational studyProspective observational study where 8 nurses (4)/midwives(4) volunteered using convenience sampling. TimeCaT (web-based time motion capture tool) customized to track interventions in a FHC using the OS. Nurses/midwives were also observed by author (MA) unobtrusively while completing task and simultaneously tracked on TimeCaT.Of 1066.8 total minutes observed, 34.0% were multitasking. Caretaking/parenting and postpartum problems, teaching, guidance, and counseling category, and caretaking/parenting skills target were
more often multitasked. Interventions that were multitasked were significantly shorter than interventions that were not multitasked (median = 1.4 minutes vs. 1.9 minutes, p = .001);
The hypothesis of shorter intervention duration being related to multitasking supported. Both postpartum and caretaking/parenting were more often multitasked than pregnancy,
health-care supervision, family planning, and growth and development.
teaching, guidance,
and counseling was more often multitasked and treatments and procedures was
less often multitasked.		First Omaha System time and motion study to analyze the content of multitasking interventions in a primary care setting. Further research needed to understand the awareness of multitasking among
nurses/midwives, and the impact of multitasking on error, patient satisfaction, and
safety in FHCs. Emphasis was on methods development for understanding the
content of multitasked interventions. Also, further research
needed with larger datasets to extend multitasking pattern detection, hypothesis
generation, and analysis; and to understand multitasking beyond
FHCs in CHCs and other settings.		Yas, M. A., Secginli, S., Mathiason, M. A., & Monsen, K. A. (2019). Method development for describing content of multitasked interventions using the omaha system. Research and Theory for Nursing Practice, 33(2), 147-168.
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24Kang, Y., Duan, Y., Mueller, C., McMorris, B., Gaugler, J., & Monsen, K. A. Interventions employed by licensed nurses in nursing homes: Refinement and validation of an existing Omaha System nursing intervention set.Research and Theory for Nursing Practice2022To develop guidelines that revealed partnership principles using the Omaha System guidelines'Omaha Systems Guidelines0Yes: Nurses in nursing homes0 - observational studyImplementation of nursing home specific care plans within the COVID-19 Response Guideline via crowdsourcing and expert feedback. Utilization of a two-phase qualitative process (mapping and expert consenses). Coding completed via the Problem Classification Scheme and Intervention Scheme of the Omaha System. Six nursing home staff roles and 112 interventions encoded by the Omaha System were added to the COVID-19 Response Guideline. 96% of the interventions were in scope for the selected roles. 90 nursing home COVID-19 response interventions were specific to the Nursing Services roles. This study showed that the Omaha System COVID-19 Response Guideline could be effectively deployed in nursing home setting. These guidelines could also be implemented in relevant health information technology for timely documentation, analysis, and care protocol templates. Kang, Y., Duan, Y., Mueller, C., McMorris, B., Gaugler, J., & Monsen, K. A. (In press). Interventions employed by licensed nurses in nursing homes: Refinement and validation of an existing Omaha System nursing intervention set. Research and Theory for Nursing Practice. https://doi.org/10.24926/ijps.v9i1.4644
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