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Nursing Interventions
Classification (NIC)
THE NIC LOGO
The NIC logo of a leaf and tree appears below and on the cover of this book. The leaf is an exact replica
of one from a tree in the Linnaeus Botanical Garden in Uppsala, Sweden. The leaf was picked by an artist
who lived next door to the garden for an imprint on a vase she was making. The vase was a present to a
team member in 1990 just when the NIC Research team was looking for a logo. Because the leaf came
from Linnaeus’ garden, the team thought this was a meaningful logo. Carl Linnaeus (1701-1778) was the
great classifier who brought order to the plant and animal kingdoms. In the logo, the leaf is joined with
the tree, the universal symbol of taxonomy.
Nursing Interventions
Classification (NIC)
S i x t h E d i t i o n
Editors
Gloria M. Bulechek, PhD, RN, FAAN Joanne M. Dochterman, PhD
Professor Emerita Professor Emerita
The University of Iowa The University of Iowa
College of Nursing College of Nursing
Iowa City, Iowa Iowa City, Iowa
Howard K. Butcher, PhD, RN Cheryl M. Wagner, PhD, MBA/MSN, RN
Associate Professor Associate Dean
The University of Iowa American Sentinel University
College of Nursing MSN Programs
Iowa City, Iowa Aurora, Colorado
3251 Riverport Lane
St. Louis, Missouri 63043
NURSING INTERVENTIONS CLASSIFICATION (NIC), SIXTH EDITION ISBN: 978-0-323-10011-3
Copyright © 2013 by Mosby, an imprint of Elsevier Inc.
Copyright © 2008, 2004, 2000, 1997 by Mosby, Inc., an affiliate of Elsevier Inc.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or
mechanical, including photocopying, recording, or any information storage and retrieval system, without
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This book and the individual contributions contained in it are protected under copyright by the Publisher
(other than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our
understanding, changes in research methods, professional practices, or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and
using any information, methods, compounds, or experiments described herein. In using such information
or methods they should be mindful of their own safety and the safety of others, including parties for whom
they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most
current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be
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contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of
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and to take all appropriate safety precautions.
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Library of Congress Cataloging-in-Publication Data
Nursing interventions classification (NIC) / editors, Gloria M. Bulechek . . . [et al.].—6th ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-323-10011-3 (pbk. : alk. paper)
I. Bulechek, Gloria M.
[DNLM: 1. Nursing Process—classification. WY 15]
610.7301’2—dc23
2012036567
Vice President and Publisher: Loren Wilson
Senior Content Strategist: Sandra Clark
Associate Content Development Specialist: Jennifer Palada
Publishing Service Manager: Julie Eddy
Project Manager: Jan Waters
Senior Book Designer: Amy Buxton
Printed in the United States of America
Last digit is the print number: 9 8 7 6 5 4 3 2
Preface
The NIC team was founded in 1987, so with this sixth edition, clinical guidelines when available and textbooks that
we are approaching 30 years of experience with standardized are research based. They represent a few of the sources
nursing language. Previous editions were published in 1992, that were used in the development of the intervention’s
1996, 2000, 2004, and 2008. Joanne McCloskey Dochterman definition and activity list and provide support that this
and Gloria M. Bulechek have served as editors on all six edi- intervention is used by nurses. Each of the interven-
tions. Howard K. Butcher joined on the fifth edition and we tions has a unique code number to assist in computer-
welcome Cheryl M. Wagner as an editor with this edition. ization of NIC and facilitate reimbursement to nurses.
NIC is a comprehensive standardized language that de- The Front Matter contains a page with tips on ap-
scribes the treatments that nurses perform. We have expanded proaches to finding an intervention.
and revised the Classification with continued research efforts • The NIC taxonomy, which was included for the first time
and input from the professional community. The features of in the second edition, has been updated to include all of
this edition are as follows: the new interventions. The taxonomy in this edition, as
• Two updated chapters introduce the classification: in the previous three editions, includes 7 domains and
Chapter One gives an overview of NIC and addresses 30 classes. The taxonomy, which appears in Part Two,
21 questions sometimes asked about NIC. Chapter Two helps nurses locate and choose an intervention and pro-
focuses on implementation and use of NIC in practice, vides structure that can assist with curriculum design
education, and research. Each of these chapters will be (See the overview of the NIC taxonomy on page 38 for
of interest to both the novice and experienced user of more detail.)
NIC. Material describing the beginning of NIC from • A feature continued since the third edition is specialty
1987, and the research to develop the classification, ap- area core interventions that help to define the nature of
pears in previous editions and has not been included in the specialty. These lists of core interventions appear in
this edition. Appendix C contains a timeline with high- Part Four and have been updated and expanded for
lights of the evolution of NIC. this edition. The addition of 5 specialties, including
• There are a total of 554 interventions in this edition. Diabetes Nursing, HIV/AIDS Nursing, Home Health
Twenty-three of the interventions are new, and 128 of Nursing, Plastic Surgery Nursing, and Transplant
the previously included interventions have been revised Nursing, makes a total of 49 specialties with core inter-
for this edition. (See Appendix A for the list of new, ventions. (See the introduction to the core interven-
revised, and deleted interventions.) The format for each tions on page 422 for more information.)
of the interventions is the same as in previous editions. • Part Five of this edition contains the estimate of time to
Each intervention has a label name, a definition, a list of perform and minimum level of education that a provider
activities that a nurse might do to carry out the inter- needs to safely and competently administer the interven-
vention in the logical order that she or he might do tion. The time and education level are included for all
these, a publication fact line, and a short list of back- 554 interventions in this edition. (See the introduction to
ground readings. The standardized language is the label the estimated time and education on page 448 for more
name and the accompanying definition. The activities information.)
can be selected or modified as necessary to meet the • The linkages between NIC interventions and NANDA-I
specific needs of the population or individual. Thus diagnoses have been updated for this edition and appear
NIC can be used to communicate a common meaning in Part Six. In the fifth edition, these linkages were
across settings but still provide a way for nurses to indi- moved to an electronic site, but due to user requests are
vidualize care. The background readings for many of being brought back into the book for this sixth edition.
the interventions have been updated for this edition, • More than 60 nurses participated in reviewing and updat-
with changes in activities made as indicated. The read- ing interventions to be sure current practice is reflected in
ings do not include, by any means, a complete reference this edition. The Recognition List in the Front Matter of
list for any intervention. Effort was made to include the book lists these individuals. Interventions were sent
v
vi Preface
electronically for review, which included an update of • Facilitates communication of nursing treatments to
background readings and additions to the list of activities other nurses and other providers
and, in some cases, revision of definitions. We were • Enables researchers to examine the effectiveness and
pleased to receive suggestions for new interventions from cost of nursing care
several countries. Appendix B contains the guidelines for • Assists educators to develop curricula that better
submission of a new or revised intervention. articulate with clinical practice
• This edition contains a listing of all previous editions • Facilitates the teaching of clinical decision making to
and translations of NIC. (See Appendix E.) Previous novice nurses
editions included a bibliography of publications about • Assists administrators in planning more effectively
NIC; however, the growing number of publications for staff and equipment needs
from multiple countries has made the task of compiling • Promotes the development of a reimbursement sys-
a comprehensive bibliography difficult. Information tem for nursing services
about publications is being moved to the website for the • Facilitates the development and use of nursing infor-
Center for Nursing Classification and Clinical Effec- mation systems
tiveness (www.nursing.uiowa.edu/cnc). • Communicates the nature of nursing to the public
In summary, NIC captures the interventions performed When standardized language is used to document prac-
by all nurses. As in the past, all of the interventions included tice, we can compare and evaluate the effectiveness of care
in NIC are meant to be clinically useful, although some are delivered in multiple settings by different providers. The use
more general than others. Because the interventions en- of standardized language does not inhibit our practice; rather,
compass a broad range of nursing practice, no nurse could it communicates the essence of nursing care to others and
be expected to perform all interventions listed here, or even helps us improve our practice through research. The develop-
a major portion. Many of the interventions require special- ment and use of this Classification helps to advance nursing
ized training and some cannot be performed without ap- knowledge by facilitating the clinical testing of nursing inter-
propriate certification. Other interventions describe basic ventions. We believe the continued development and use of
hygiene and comfort measures that, in some instances, may this Classification helps in the advancement of nursing
be delegated to assistants, but still need to be planned and knowledge and in the efforts of nursing to gain greater voice
evaluated by nurses. The uses of NIC include the following: in the health policy arena. We continue to welcome your
• Helps demonstrate the impact that nurses have on feedback and look forward to your continued input.
the system of health care delivery
• Standardizes and defines the knowledge base for Gloria M. Bulechek
nursing curricula and practice Howard K. Butcher
• Facilitates the appropriate selection of a nursing Joanne M. Dochterman
intervention Cheryl M. Wagner
Strengths of the Nursing Intervention Classification
• Comprehensive—NIC includes the full range of nurs- • Has established process and structure for continued
ing interventions for general practice as well as spe- refinement—Suggestions for refinement are accepted
cialty areas. Interventions include physiological and from users around the world. The continued refinement
psychosocial; illness treatment and prevention; health of NIC is facilitated by the Center for Nursing Classifi-
promotion; those for individuals, families, and com- cation and Clinical Effectiveness, established in the
munities; and indirect care. Both independent and College of Nursing at The University of Iowa in 1995 by
collaborative interventions are included; they can be the Iowa Board of Regents.
used in any practice setting regardless of philosophical • Has been field tested—The process of implementation
orientation. was initially studied in five field sites representing the
• Research based—The research to develop NIC used a various settings where nursing care takes place; hun-
multimethod approach; methods included content anal- dreds of other clinical and educational agencies are also
ysis, questionnaire survey to experts, focus group re- implementing the Classification. Steps for implementa-
view, similarity analysis, hierarchical clustering, multidi- tion have been developed to assist in the change process.
mensional scaling, and clinical field testing. The early • Accessible through numerous publications and media—
research was partially funded by the National Institutes In addition to the classification itself, numerous arti-
of Health, National Institute of Nursing Research. Ongo- cles and chapters have been published since 1990. Book
ing work to update the classification builds on expert and article reviews and publications about use and
opinion and research based publications. value of NIC attest to the significance of the work. A
• Developed inductively based on existing practice—Original video was been made about the early development of
sources include current textbooks, care planning guides, NIC. Elsevier publishes a newsletter quarterly and
and nursing information systems from clinical practice, maintains a Facebook page to keep people abreast of
augmented by clinical practice expertise of team mem- recent developments.
bers and experts in specialty areas of practice. The new • Linked to other nursing classifications—Linkages of NIC to
additions and refinements are the result of suggestions NANDA-I diagnoses are provided in Part 6 of this book
from users and peer reviewers. to assist with clinical decision making. A third edition of
• Reflects current clinical practice and research—All a book linking the Nursing Outcomes Classification
interventions are accompanied by a list of back- (NOC) outcomes and NIC interventions to NANDA-I
ground readings that support the development of the diagnoses and other clinical conditions is available from
intervention. All interventions have been reviewed Elsevier. Earlier editions of NIC were linked to Omaha
by experts in clinical practice and many by relevant system problems, NOC outcomes, RAP in long-term
clinical practice specialty organizations. A feedback care, and OASIS for home health.
process is used to incorporate suggestions from users • Recipient of national recognition—NIC is recognized by
in practice. the American Nurses Association, is included in the Na-
• Has easy-to-use organizing structure (domains, classes, tional Library of Medicine’s Metathesaurus for a Unified
interventions, and activities)—All domains, classes and Medical Language, is included in indexes of CINAHL, is
interventions have definitions. Principles have been mapped into SNOMED (Systemized Nomenclature of
developed to maintain consistency and cohesion within Medicine), and is registered in HL (Health Level Seven
7
the Classification; interventions are numerically coded. International).
• Uses language that is clear and clinically meaningful— • Developed at same site as outcomes classification—The
Throughout the work, the language most useful in clini- NOC of patient outcomes sensitive to nursing practice
cal practice has been selected. The language reflects has also been developed at Iowa; both NIC and NOC are
clarity in conceptual issues, such as including only inter- housed in the Center for Nursing Classification and
ventions and not diagnoses or outcomes. Clinical Effectiveness (www.nursing.uiowa.edu/cnc).
vii
viii Strengths of the Nursing Intervention Classification
• Included in a growing number of vendor software clinical • Global use—NIC is an established classification of nursing
information systems—The SNOMED has included NIC interventions with 20 years of use in multiple countries.
in its multidisciplinary record system. Several vendors Translations are complete or in process for the following
have licensed NIC for inclusion in their software, tar- languages: Chinese, Dutch, French, German, Icelandic,
geted at both hospital and community settings, as well as Italian, Japanese, Korean, Norwegian, Portuguese, and
practitioners in either general or specialty practice. Spanish.
