The Nursing Outcomes Classification (NOC) is a comprehensive, standardized classification of patient, family and community outcomes developed to evaluate the impact of interventions provided by nurses or other health care professionals.  Standardized outcomes are essential for documentation in electronic records, for use in clinical information systems, for the development of nursing knowledge and the education of professional nurses and students. An outcome is defined as a measurable individual, family, or community state, behavior or perception that is measured along a continuum in response to nursing interventions.  The outcomes are developed for use in all clinical settings and with all patient populations. NOC outcomes can be used across the care continuum to follow patient outcomes throughout an illness episode or over an extended time period.  Nurses in tertiary care hospitals, community hospitals, community agencies, nursing centers, and nursing homes evaluated the use of NOC outcomes in their practice as part of a federally funded NIH grant. Since the outcomes describe patient, family or community status, other disciplines may find them useful for the evaluation of the interventions they provide to patients.

The 612 outcomes in Nursing Outcomes Classification (NOC) (7th ed.) are listed in alphabetical order in the classification.  Each outcome has a definition, a list of indicators that can be used to evaluate patient status in relation to the outcome, a target outcome rating, a measurement scale(s) to measure patient status, and a list of references used in the development and refinement of the outcome. A five-point Likert scale is used with all outcomes and indicators.  A rating of a '5' is always the best possible score and '1' is always the worst possible score.  Examples of measurement scales used with the outcomes are 1= Extremely compromised to 5= Not compromised or 1= Never demonstrated to 5= Consistently demonstrated.  The NOC outcomes are grouped in a coded taxonomy that organizes the outcomes to facilitate nurses identifying an outcome for use with a patient, family, or community. The outcomes are grouped into thirty-six classes and seven domains for ease of use.  The seven domains are: Functional Health, Physiologic Health, Psychosocial Health, Health Knowledge & Behavior, Health & Life Quality, Family Health, and Community Health. Each outcome has a unique code number that facilitates its use in computerized clinical information systems and allows manipulation of data to answer questions about nursing care quality and effectiveness.  This edition has eighty-two new outcomes and over 400 outcomes were revised or reviewed. Each outcome has an expanded list of references supporting the content of the outcome including current research. A new section of the book focuses on resources to support research, implementation, and educational strategies.

The outcomes have been linked to NANDA International diagnoses, to Gordon's functional patterns, to the Taxonomy of Nursing Practice, to Omaha System problems, to resident admission protocols (RAPs) used in nursing homes, to the OASIS System used in home care and to NIC interventions.  In addition, NOC has been linked with the International Classification of Functioning, Disability and Health (ICF), the Model of Reflective Clinical Reasoning, the Global Model of Nursing, the Multi-Dimensional Model of Successful Aging, and the Self- and Family Management Framework. A more in-depth look at the linkage between NOC, NIC, and NANDA-I is available in a separate book, NOC and NIC Linkages to NANDA-I and Clinical Conditions: Supporting Critical Reasoning and Quality Care. Current linkage work has been published in a variety of nursing journals.

NOC is one of the standardized languages recognized by the American Nurses' Association (ANA).  NOC is included in the Unified Medical Language System (UMLS) in the National Library of Medicine (NLM) and in the Cumulative Index to Nursing and Allied Health Literature (CINAHL). The use of NOC in practice, nursing education, and research is the most accurate indicator of the classification’s usefulness. NOC has been adopted in clinical sites for the evaluation of nursing practice and in educational settings to structure curricula and teach students clinical evaluation. Interest in NOC has been demonstrated in other countries in Europe, Asia, Africa, and Central and South America. NOC has been translated into Chinese (simplified and traditional), Dutch, Estonian, French, German, Indonesian, Italian, Japanese, Korean, Norwegian, Portuguese, and Spanish and several other translations are in progress.

Source: Moorhead, S., Swanson, E., & Johnson, M. (Eds.). (2024). Nursing outcomes classification (NOC): Measurement of Health Outcomes (7th ed.). Elsevier.

For further information contact:

Center for Nursing Classification & Clinical Effectiveness
The University of Iowa, College of Nursing, 407 CNB
Iowa City IA 52242-1121
319-335-7051
email: classification-center@uiowa.edu