The Omaha System-Final

The Omaha System
 a research-based,
comprehensive classification
system that promotes
documentation of client care
 It is a framework for
integrating and sharing clinical
data that has existed in the
public domain since 1965
 began in the 1970s when Visiting Nurse
Association (VNA) of Omaha (Nebraska) staff
began revising their home health and public
health client records and adopting a problem-
oriented approach.
 DeLanne Simmons, VNA of Omaha Chief
Executive Officer, envisioned a computerized
management information system that
incorporated an integrated, valid and reliable
clinical information system organized around
clients who received services, not the
multidisciplinary practitioners who provided
services.
PURPOSE
 Developed to guide community health
nursing practice and serve as a method

for documentation of care and data
management
 It provides a structure to document
client needs and strengths, describe

multidisciplinary practitioner
interventions and measure client
outcomes in a simple and user-friendly
yet comprehensive manner
Capabilities and Characteristics
 Advances the scientific practice of
nursing
 Offers capabilities to quantify
community health nursing
 Is practical for general community
health application
 Is congruent with the nursing process
 Minimizes redundancies in the client
record
 Limits documentation time.
MAJOR CONCEPTS
 Problem Classification Scheme

 Intervention Scheme
 Problem Rating Scale for Outcomes
PROBLEM-CLASSIFICATION
SCHEME
 Designed to identify diverse
clients’ health-related concerns
 Consists of four levels
I. Four domains
Represent priority areas
of practitioner and client
health-related concerns
 Environmental Domain
 Material resources and physical
surroundings both inside and outside
the living area, neighborhood, and
broader community.
 Income
 Sanitation
 Residence
 Neighborhood/workplace safety
 Psychosocial Domain
 Patterns of behavior, emotion,
communication, relationships, and
development.
 Communication with community resources
 Spirituality
 Grief
 Mental health
 Sexuality
 Caretaking/parenting
 Physiological Domain
 Functions and processes that
maintain life
 Hearing
 Vision
 Speech and language
 Respiration
 Circulation

Digestion-hydration
 Health Related Behaviors Domain
 Patterns of activity that maintain or promote
wellness, promote recovery, and decrease
the risk of disease.
 Nutrition
 Sleep and rest patterns
 Physical activity
 Personal care
 Substance use
 Family planning
II. Concepts, referred to as client
problems or areas of clients
needs and strengths
III. Two sets of problem modifiers

 Health promotion, potential and
actual
 Individual, family and community

IV. Clusters of signs and
symptoms that describe
actual problems
INTERVENTION SCHEME
 Designed to address specific
problems for diverse clients.
 the basis for planning and intervening, it

enables practitioners to describe and
communicate their practice including
improving or restoring health, decreasing
deterioration, or preventing illness.
 Three levels of professional actions

or activities
I. Four broad categories of
interventions
 Teaching, Guidance, and
Counseling
 Treatments and Procedures
 Case Management
 Surveillance
II. Alphabetical lists of 75 targets
or objects of action
 anatomy/physiolog anger management
behavior modification bladder care
 dressing change/wound care durable medical
equipment
 education Employment
 end-of-life care environment medication set-up
mobility/transfers nursing care
nutritionist care sickness/injury care
signs/symptoms-mental/emotional
 signs/symptoms-physical
skin care social work/counseling care
III. Client-specific information
generated by practitioners
Problem Rating Scale for
Outcomes
 Consists of three five-point,
Likert-type scales for measuring
the entire range of severity for
the concepts of knowledge,
behavior and status
 Provides an evaluation
framework for examining
problem specific client ratings at
regular or predictable times
Concept 1 2 3 4 5
s
Knowledge No Minimal Basic Adequate Superior
:
knowledg knowledg knowledg knowledg knowledg
Ability of the
client to e e e e e
remember
and
interpret
Behavior:
information Not Rarely Inconsist Usually Consisten
Observable
appropria appropria ently appropria tly
responses,
actions, or te te appropria te appropria
activities of behavior behavior te behavior te
the client behavior behavior
fitting the
occasion or
purpose
Status: Extreme Severe Moderat Minimal No
Condition signs/ signs/ e signs/ signs/ signs/
of the sympto sympto sympto sympto sympto
client in
ms ms ms ms ms
relation
to
objective
and
subjectiv
e defining
characteri
stics

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What is the Omaha System and what is its purpose?

What are the major components of the Problem Classification Scheme?

The Omaha System

nursing practice and serve as a method

client needs and strengths, describe

 Problem Classification Scheme

III. Two sets of problem modifiers

 Individual, family and community

 the basis for planning and intervening, it

 Three levels of professional actions

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