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• PNDS History and Mission

How the PNDS Began
Starting in the late 1980s, AORN's Board of Directors recognized the need for a national computerized database related to perioperative nursing. Building on Norma Lang's pronouncement of, "If you cannot name it, you cannot control it, finance it, teach it, or put it into public policy," AORN committed resources to the development of the Perioperative Nursing Data Set (PNDS).

Appointing the Task Force on Perioperative Data Elements Coordinating Committee was the first step. Next, the Board of Directors brought together a group of expert perioperative clinicians, educators, manager, researchers, and consultants to participate in a seven year language development effort.

The committee members believed that a standardized nursing language would provide a structured vocabulary, and thus a common means of communication. Identifying terms that were clear, precise, consistent and described nursing care in the perioperative setting formally defined the professional roles and contributions of perioperative registered nurses.
 
How the PNDS was Developed
The guiding premise of the language development effort was to assist perioperative nurses in documenting the care they gave, while providing a foundation for examining and evaluating the quality and effectiveness of that care.

Committee members utilized a systematic process to explore and develop each data element to ensure the content validity and reliability of the perioperative language.

To develop nursing diagnostic, nursing intervention, and patient outcomes statements, each sub-committee:

• Conducted a review of the published and non-published nursing and related literature, as well as AORN documents related to each component
• Examined and considered the current status and predicted future of perioperative nursing practice
• Established a process for determining inter-rater reliability for accepted terms and definitions
• Conducted a series of validation studies with experienced perioperative nurses as respondent.
• Ensured that each component contributed to an integrated product that reflected the entire perioperative patient care experience

These efforts resulted in the PNDS, a standardized nursing data set that describes perioperative nursing practice. It consists of:

• 74 nursing diagnoses
• 133 nursing interventions
• 28 nurse-sensitive patient outcomes

The language is clinically relevant and empirically validated. The data elements are clearly defined, common to all cases, and consistent across time. The PNDS is appropriate for use in any surgical setting and any time during the perioperative experience.

The data set is useful for: 

• Consistent clinical documentation
• Communication between clinicians in various practice settings
• Benchmarking activities
• Evaluating patient outcomes
• Orientation programs and competency evaluation
• Effectiveness research
• Activity-based costing

In 1999, AORN received written notification from the ANA that the PNDS had been officially recognized as a data set useful for the practice of nursing. This highly respected recognition and designation indicates that the PNDS has met the stringent criteria set forth by the ANA.

These criteria were established to ensure that vocabularies and classification schemes for nursing practice are clinically useful, reliable, and valid; have a coherent taxonomic structure; have a unique coding system; and are clear and precise.

The Value of the PNDS
In order to fully appreciate the value of the PNDS, it is important to consider the strengths of the PNDS itself and the opportunities related to its use:

• The PNDS is the only ANA-recognized standardized vocabulary of its kind that meets the specific needs of the perioperative nurse clinician.
• The PNDS is the only recognized standardized vocabulary that limits its focus to the specialty practice of perioperative nursing. 
• The PNDS addresses a sub-set of terms that specifically describe perioperative nursing diagnoses, nursing interventions, and patient outcomes in surgical settings. 
• The PNDS provides perioperative registered nurse with clear precise terms of documentation purposes. 
• The PNDS offers clinicians and software vendors a limited number of terms that are pertinent and specific to the perioperative experience. 
• As a professional organization, AORN members hold a unique position to support perioperative language development, validation, and testing.