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The Benefits of Standardized Nursing Languages in Complex Adaptive Systems Such as Hospitals

Clancy, Thomas R. MA, MBA, RN; Delaney, Connie White PhD, RN, FAAN; Morrison, Bernice MSN, RN; Gunn, Jody K. MSN, RN

JONA: The Journal of Nursing Administration: September 2006 - Volume 36 - Issue 9 - p 426-434

Paperwork is a major source of frustration for hospital nurses and takes valuable time away from patient care. Studies indicate that nurses spend an estimated 13% to 28% of total shift time documenting. The growth in documentation requirements for nurses can, in part, be attributed to an exponential rise in health system complexity. Authors explore the documentation of nursing care plans from a complex adaptive system perspective and then analyze the utility of adopting a standardized nursing language. An actual case history of a nursing unit's attempt to reduce complexity, improve completion time, and increase staff satisfaction in care planning by adopting a standardized nursing language is provided to emphasize a practical application.

Authors' affiliations: Vice President (Mr Clancy), Nurse Manager, Fifth Floor Telemetry (Ms Morrison), Nursing Informaticist (Ms Gunn), Mercy Hospital, Iowa City, Iowa; Dean, College of Nursing (Dr Delaney), University of Minneapolis School of Nursing, Minneapolis, Minn.

Corresponding author: Mr Thomas R. Clancy, Mercy Hospital, 500 E. Market St, Iowa City, IA 52245 (

© 2006 Lippincott Williams & Wilkins, Inc.