Kontakt 2016, 18(3):e164-e169 | DOI: 10.1016/j.kontakt.2016.08.002

Problems, interventions and outcomes of the Omaha system in nursing clinical practiceNursing - Original article

Eva Beňová^a,b, Mária Boledovičová^b,*, Kathryn H. Bowles^c

^a Vyšší odborná škola zdravotnická a Střední škola zdravotnická, Ústí nad Labem, Česká republika

^b Jihočeská univerzita v Českých Budějovicích, Zdravotně sociální fakulta, Ústav ošetřovatelství, porodní asistence a neodkladné péče, České Budějovice, Česká republika

^c University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania, USA

Hepatic pancreatic biliary diseases are very common in gastroenterology. The issue of implementing the standardized terminology of the Omaha system in the Czech Republic has not been studied so far.
The goal of the study was to identify the problems, interventions and the results of clients with a chosen gastroenterology problem according to the Omaha system in clinical nursing practice. The study used the quantitative method of documentation forms of the Omaha system with the author's permission. The studied sample group was composed of 23 clients who had a hepatic pancreatic biliary disease.
The number of documented difficulties according to the Problem Classification Scheme was from 3 to 10, where 10% covered the environmental domain, 20% covered the psychological domain, 40% covered the physiological domain and 30% covered the domain of health-related behaviour. In total, there were 274 interventions. The average number of interventions was 11.9 per client. While mapping the interconnections of problems and interventions, most interventions occurred in the category of treatments and procedures (35.4%) and surveillance (31.8%). A very low number of interventions occurred in the category of teaching, guidance, and counseling (18.2%), and case management (14.6%). The intervention in treatments and procedures category dominated in pain problem (35.5%), digestion - hydration (45.3%), skin (93.8%) and circulation (62.9%). Case management was used in substance use (50%) and nutrition (31.7%). After comparing the initial results to the final results, there was significant improvement in the knowledge and status regarding individual problems.
The results of the study present the pilot experience with the implementation of the Omaha system in a selected group of clients. The most common problems of clients with hepatic pancreatic biliary disease were in the physiological domain and the health-related behaviour domain according to the Problem Classification Scheme of the Omaha system. More frequently, the problems were associated with the interventions in the treatments and procedures and surveillance categories. The interventions were less frequent in teaching, guidance, and counseling and case management. Using a Problem Rating Scale for Outcomes, an improvement in knowledge and status in individual problems was found. For future studies, we recommend verifying the components of the Omaha system using a larger number of respondents.

Keywords: The Omaha system; Problem Classification Scheme; Intervention Scheme; Problem Rating Scale for Outcomes; Gastroenterology; Hepatic pancreatic biliary disease

Received: May 25, 2016; Revised: June 15, 2016; Accepted: August 19, 2016; Published: September 30, 2016  Show citation