Learning Objective #1: describe the use of Standardized Nursing Language (NNN) in the development of evidence-based practice guidelines.

Learning Objective #2: describe the level of evidence for the Nursing Interventions Classification “Family Integrity Promotion.”

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The adoption of standardized nursing language (referred to as NNN language) and the adoption of evidenced-based practice (EBP) are two independently occurring trends in nursing schools and clinical institutions. The authors will examine the implications of combining NNN language and EBP when working with the families of adult patients in acute care settings. NNN language includes Nursing Diagnosis (NANDA), Nursing Interventions Classifications (NIC) and Nursing Outcomes Classifications (NOC). EBP includes determining the level of evidence for specific nursing interventions and the development of guidelines for practice. Many of these guidelines are available through the AHRQ website, www.guideline.gov.

The authors examined published nursing studies from 2001 to present to determine the level of evidence for the specific activities (nursing interventions) of the NIC “Family Integrity Promotion.” Using an adapted version of Melnyk and Fineout-Overholt’s (2004) scale, the authors determined there are Level I and II evidence for some activities, other activities are “standards of practice,” and other activities were determined priority areas for future research.

Level I and II evidence, comprising one or more randomized controlled trials, exists for interventions related to promoting family communication and coping skills, supporting family relationships, facilitating families to participate in patient care, and referral to family support groups and therapy. Additional interventions classified as “standards of practice,” include strategies that are strongly recommended based on expert opinion, descriptive findings, and standards of care. Examples included establishing trust, providing privacy, and listening to families. However, these interventions cannot be tested in randomized controlled trials because of ethical and practical considerations. Implications for this limitation when adopting EBP will be discussed. The authors will also outline strategies for testing the NICs “Guilt Work Facilitation,” “Anger Control Assistance,” and “Hope Instillation” when working with families. Finally, the impact of NNN language on guideline development will be explored.