Research Article
Volume 2 Issue 2 - 2020
Validating Standardized Integrative Nursing Guidelines for Symptom Management
Penny D Kessler1*, Karen A Monsen2, Sheng-Chieh Lu3 and Mary Jo Kreitzer4
1Clinical Assistant Professor, University of Minnesota School of Nursing, Adjunct Faculty, University of Minnesota Center for Spirituality and Healing, Minneapolis, MN, USA
2Professor, University of Minnesota School of Nursing, Faculty, University of Minnesota Center for Spirituality and Healing, Minneapolis, MN, USA
3PhD Student, University of Minnesota School of Nursing, Minneapolis, MN, USA
4Professor of Nursing and Director, University of Minnesota Center for Spirituality and Healing, Minneapolis, MN, USA
*Corresponding Author: Penny D Kessler, Clinical Assistant Professor, University of Minnesota School of Nursing, Adjunct Faculty, University of Minnesota Center for Spirituality and Healing, Minneapolis, MN, USA.
Received: December 17, 2019; Published: January 11, 2020


Introduction: Evidence-based guidelines improve client health by identifying best practices, optimizing clinical interventions, and standardizing documentation. Kreitzer and Koithan [1] describe integrative nursing interventions to manage symptoms including stress, anxiety, sleep disturbance, nausea, depressed mood, fatigue, pain, cognitive impairment, human spirit, and palliative care. In the era of electronic health records, there is a need for structured documentation of evidence-based integrative nursing practice to disseminate and guide integrative nursing interventions and standardize data collection for outcomes. The purpose of this study was to validate a guideline based on the Omaha System and developed for integrative nursing interventions.

Methods: Two Omaha System experts identified and encoded problems and interventions in symptom management chapters of Integrative Nursing [1]. Ten content experts evaluated the accuracy of encoding using a content expert approach. Differences were resolved by consensus.

Results: Initial agreement was 66.8% across all interventions; after revisions, agreement reached 97.6%.

Conclusion: Validated integrative nursing guidelines provide support for clinical decision making and person-centered care. Documentation using the guideline will enable data comparison and interoperability across settings, populations, disciplines, and jurisdictions. Next steps include evaluating patient outcomes using Omaha System measures.

Keywords: Integrative Nursing; Integrative Therapies; Integrative Nursing Guideline; Omaha System


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  4. Gok Metin Z., et al. “Perspectives of oncology nurses on complementary and alternative medicine in Turkey: A cross-sectional survey”. Holistic Nursing Practice 32.2 (2018): 107-113. 
  5. Kamizato M., et al. “Nurses’ use of complementary alternative medicine for cancer patients in Japan”. Journal of Nursing and Care 5 (2013). 
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  7. Austin R. “Integrative nursing and informatics”. In Integrative nursing 2nd edition (2018): 128-135.
  8. Monsen KA., et al. “Toward population health literacy, wellbeing, consumer engagement, and information exchange: Developing Omaha System icons for digital platforms”. International Journal of Healthcare 2.1 (2016): 71-81.
  9. Martin KS. “The Omaha System: A key to practice, documentation, and information management (reprinted 2nd edition)”. Omaha, NE: Health Connections Press (2005): XX.
  10. The Omaha System Community of Practice (2015).
  11. Omaha System Web site. The Omaha System (2015).
  12. Martin KS and Kessler PD. “The Omaha System: Improving the quality of practice and decision support (The Omaha System: Improving the quality of practice and decision support)”. In MD Harris (Ed.) Handbook of home health care administration (6th edition). Sudbury, MA: Jones and Bartlett (2017): 1-496.
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  16. The Office of the National Coordinator for Health Information Technology. Standard nursing terminologies: A landscape analysis (2017): 235-248.
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  18. Omaha System Guidelines Web site (2015).
  19. Monsen KA., et al. “Seeing the whole person: Feasibility of using the Omaha System to describe strengths of older adults with chronic illness”. Research and Theory for Nursing Practice 28.4 (2014): 299-315.
  20. Center for Spirituality and Healing, University of Minnesota. Integrative Nursing (2015).
  21. Kreitzer MJ and Koithan M. “Integrative Nursing (2nd edition)”. New York, NY: Oxford University Press. (2018): XX.
  22. Barnes PM., et al. “Complementary and alternative medicine use among adults and children: United States, 2007”. CDC National Health Statistics Reports (2008): 12. 
  23. Kessler PD and Monsen KA. “Omaha System Intervention Library: Integrative Nursing Appendix and Metadata”. 
  24. Kreitzer MJ. “Whole-Systems Healing: A New Leadership Path”. In Integrative Nursing, eds. M.J. Kreitzer and M Koithan. New York, NY: Oxford University Press (2014): 47-55.
  25. Westra BL., et al. “Big data in nursing research”. In Routledge International Handbook of Advanced Quantitative. Methods in Nursing Research (2015): 280-293.
Citation: Penny D Kessler., et al. “Validating Standardized Integrative Nursing Guidelines for Symptom Management”. EC Nursing and Healthcare 2.2 (2020): 01-10.

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