Standardized nursing terminologies in primary care: a qualitative approach to the experience of nursing professionals.

Abstract

Standardized Nursing Terminologies are used to describe diagnoses, interventions, and care outcomes. This study explores the use of Standardized Nursing Terminologies among Primary Care nurses, particularly in the context of frailty syndrome, and identifies barriers to and facilitators of their integration into clinical practice. Descriptive-interpretive qualitative study with a phenomenological approach. Purposive and snowball sampling techniques were used to select 33 Primary Care nurses involved in healthcare, teaching, management, and research in Spain. Three focus groups and fourteen semi-structured interviews were conducted in 2024. The qualitative data were transcribed, aggregated, analysed, and interpreted using reflexive thematic analysis. Three 3 main themes related to the use of Standardized Nursing Terminologies were identified: (1) The value of a common language: professional autonomy; (2) From standardization to action: integration into clinical practice; and (3) Skills-building: towards Nursology. Participants described language standardization as a driving force for professional development and the use of real-world data in research. The NANDA-I, NIC, and NOC terminologies were the most widely used; however, they generated certain ambivalence due to their complexity, cost, and need for regular updates, and were seldom used in clinical practice. Study participants identified several facilitators of their use, such as their usefulness in structuring clinical reasoning, improving continuity of care, planning resources, and addressing complex care. They also identified barriers, primarily insufficient training, poor usability, scant enforcement, bureaucratic approach, and the absence of a clearly defined organizational strategy. In the context of frailty syndrome, Standardized Nursing Terminologies were reported to promote comprehensive care, although their use was limited, training scarce, and evidence of their impact lacking. Participants also referred to the role of Nursology in fostering research in person-centred, outcome-oriented care, and highlighted leadership as key to strengthening a professional identity based on a reflective and thoughtful-critical approach to nursing. Standardized Nursing Terminologies hold significant potential to transform nursing care; however, their integration into Primary Care remains limited. Frailty syndrome illustrates the gap between this potential and its practical implementation. Bridging this gap requires targeted training strategies, strong institutional support, and leadership committed to fostering person-centred, evidence-based practice.