Embedded structures and representation of nursing knowledge.
Nursing Vocabulary Summit participants were challenged to consider whether reference terminology and information models might be a way to move toward better capture of data in electronic medical records. A requirement of such reference models is fidelity to representations of domain knowledge. This article discusses embedded structures in three different approaches to organizing domain knowledge: scientific reasoning, expertise, and standardized nursing languages. The concept of pressure ulcer is presented as an example of the various ways lexical elements used in relation to a specific concept are organized across systems. Different approaches to structuring information-the clinical information system, minimum data sets, and standardized messaging formats-are similarly discussed. Recommendations include identification of the polyhierarchies and categorical structures required within a reference terminology, systematic evaluations of the extent to which structured information accurately and completely represents domain knowledge, and modifications or extensions to existing multidisciplinary efforts.
Harris
M R
MR
University of Minnesota, Rochester, Minnesota, USA. harris.marcelline@yahoo.com
Graves
J R
JR
Solbrig
H R
HR
Elkin
P L
PL
Chute
C G
CG
D020000:Decision Support Systems, Clinical / Q000458:organization & administration / Q000592:standards; D019451:Information Management / Q000379:methods*; D007256:Information Systems / Q000458:organization & administration* / Q000592:standards; D016347:Medical Records Systems, Computerized / Q000458:organization & administration / Q000592:standards; D009729:Nursing / Q000592:standards*; D009626:Terminology as Topic; D018875:Vocabulary, Controlled